Journal of clinical and experimental neuropsychology最新文献

{"title":"Memory and metamemory performance in individuals with and without post-COVID-19 subjective cognitive symptoms.","authors":"Breanna K Nelson, Edwina Picon, Lia Sayers, Lea N Farah, Sidney A Saint, Johnson Chen, Vesna Sossi, Mypinder S Sekhon, A Jon Stoessl, Cheryl Wellington, William G Honer, Donna Lang, William J Panenka, Noah D Silverberg","doi":"10.1080/13803395.2025.2555610","DOIUrl":"https://doi.org/10.1080/13803395.2025.2555610","url":null,"abstract":"<p><strong>Background: </strong>Metamemory is the awareness of and ability to evaluate one's own cognitive abilities. This study examined impaired metamemory as a possible mechanism contributing to persistent cognitive symptoms after COVID-19.</p><p><strong>Methods: </strong>Individuals with previous COVID-19 illness were recruited. Participants completed questionnaires regarding physical health, mental health, and their COVID-19 illness. To assess memory and metamemory performance, participants were presented with 50 words and then completed a two-alternative forced choice recognition memory task with a confidence rating after each trial. This was repeated for 3 blocks of 50 trials each. A signal detection theory framework was applied to derive metrics of memory performance (d'), metamemory performance (meta-d'), and metamemory efficiency (M-ratio). We compared participants who self-reported persistent cognitive symptoms at the time of their metamemory assessment (<i>n</i> = 47) to participants who denied persistent cognitive symptoms (<i>n</i> = 87). We used a general linear model to compare groups, covarying for age and days between COVID-19 and metamemory assessment.</p><p><strong>Results: </strong>Participants with and without self-reported persistent cognitive symptoms did not differ on memory performance (d': <i>p</i> = .24, <math><mi>β</mi></math> = 0.22 95% CI [-0.1, 0.6]), metamemory performance (meta-d': <i>p</i> = .28, <math><mi>β</mi></math> = 0.20 95% CI [-0.2, 0.6]), or metamemory efficiency (M-ratio: <i>p</i> = .85, <math><mi>β</mi></math> = -0.04 95% CI [-0.4, 0.3]). Those with persistent cognitive symptoms reported a higher degree of depression (<i>p</i> < 0.001, <math><mi>β</mi></math> = 0.83 95% CI [0.5, 1.2]), anxiety (<i>p</i> = 0.016, <math><mi>β</mi></math> = 0.50 95% CI [0.2, 0.9]), and somatic symptom scores (<i>p</i> < 0.001, <math><mi>β</mi></math> = 0.92 95% CI [0.5, 1.3]).</p><p><strong>Conclusions: </strong>Patients with and without self-reported persistent cognitive symptoms had similar memory accuracy and both demonstrated good (synchronous) awareness of their memory test performance. While both cognitive and metacognitive impairment appear unlikely to drive cognitive symptoms after COVID-19, psychological distress (particularly anxiety) remains a compelling candidate perpetuating factor. Future mechanistic research is necessary to understand if and how psychological distress contributes to cognitive symptoms, and vice versa.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurocognitive correlates of end-stage organ dysfunction: the role of Transplant Neuropsychology.","authors":"Kyle Jennette, Sarah M Szymkowicz, Amanda Messerlie, Jenessa S Price","doi":"10.1080/13803395.2025.2556906","DOIUrl":"https://doi.org/10.1080/13803395.2025.2556906","url":null,"abstract":"<p><p>End-stage organ failure (e.g. kidney, liver, heart, lung) is a critical medical illness and can result in death without solid organ transplantation. However, many patients present with cognitive deficits and challenges with adherence, which can limit access to life-saving transplant. In this session, we provided an overview of the medical and biopsychosocial factors impacting cognition among patients with end-stage organ disease. Dr. Kyle Jennette discussed the pathophysiology of organ dysfunction and relationships with the central nervous system (CNS) among those with liver, kidney, heart, and lung failure. Dr. Sarah Szymkowicz described neuropsychological profiles associated with those conditions, focusing on biopsychosocial factors and comorbid medical disease states that may impact cognition. Mrs. Amanda Messerlie explained the risks and benefits of solid organ transplant as a potential treatment for organ failure and associated cognitive difficulties. Finally, Dr. Jenessa Price integrated this information in a discussion of the specialty practice of Transplant Neuropsychology, including interpreting cognition in the context of the full biopsychosocial picture, framing transplant readiness based on the comprehensive evaluation, and delivering meaningful feedback within the multidisciplinary treatment team setting. Attendees increased clinical understanding of this medically complex population and gained insight on the specialty practice of Transplant Neuropsychology, toward the goal of increasing comprehensive neuropsychological care and access to transplant among those at-risk for cognitive difficulty.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"1-5"},"PeriodicalIF":1.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the moderating role of adverse childhood experiences on the link between executive functioning and depressive/anger rumination among adolescents.","authors":"Chrystal Vergara-Lopez, Esteban Ortiz, Milagros Grados, Shira Dunsiger, Beth C Bock, Nicole R Nugent, Laura R Stroud, Michael Armey, Audrey R Tyrka, Stephanie H Parade","doi":"10.1080/13803395.2025.2547737","DOIUrl":"10.1080/13803395.2025.2547737","url":null,"abstract":"<p><strong>Introduction: </strong>Adverse childhood experiences (ACEs) are theorized to amplify the effects of poor executive functioning (EF) leading to rumination. Though, few studies test this hypothesis among adolescents. Rumination is a transdiagnostic risk factor linked to mental health problems. We tested the moderating effect of ACEs (across informants) on the association between EF (measured using neutral and negative stimuli) and depressive and anger rumination.</p><p><strong>Method: </strong>Youth were initially recruited at 3-5 years-old for a longitudinal project examining the biopsychosocial consequences of child maltreatment. These analyses are based on a follow-up study that included adolescents (<i>n</i> = 48; ages 14-16; <i>M</i> = 14.86, SD = .50) who completed self-reports of lifetime ACEs, depressive and anger rumination, and the affective interference resolution task (a measure of EF). Additionally, a caregiver provided lifetime report of youth ACEs, and early childhood ACEs (3-5 years of age) were assessed using child protective records and caregiver interviews.</p><p><strong>Results: </strong>Contrary to expectations, EF in the context of negative information was not associated with any form of rumination. Instead, poor EF in the context of neutral information was associated with more anger rumination for adolescents who experience two or more ACEs per adolescent report (b = .01, <i>p</i> = .011), or three or more ACEs per caregiver report (b = .01, <i>p</i> = .046) after controlling for gender and current mental health problems; however, these effects were no longer significant when mental health problems were removed as a covariate. Furthermore, the interaction utilizing early childhood ACEs was not significant. Lastly, the interactions between ACEs and EF assessed with neutral information on depressive rumination and brooding were null.</p><p><strong>Conclusions: </strong>There is some support for the interactive relationship between EF and ACEs on rumination. However, statistical significance varies based on model specification and assessment of constructs. It is important to utilize multi-informants to assess ACEs, EF measured across valenced stimuli, and broad conceptualizations of rumination.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"1-13"},"PeriodicalIF":1.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Another dualism: cognitive versus personality predictors of rumination in later life depression.","authors":"Allison P Gregg, Joseph Kim, Jack Kaufman, Jeremy Maciarz, Vincent Koppelmans, Scott A Langenecker, Regan Patrick, Sara L Weisenbach","doi":"10.1080/13803395.2025.2549999","DOIUrl":"https://doi.org/10.1080/13803395.2025.2549999","url":null,"abstract":"<p><strong>Introduction: </strong>Rumination, a predisposing and perpetuating feature of depression, has been linked to personality and cognition. However, little is known about their comparative influence on rumination. This study examined personality and cognitive variables as predictors of rumination in early-onset, later life depression (LLD) relative to healthy controls (HC).</p><p><strong>Methods: </strong>Participants were 98 adults aged 55-79 divided into an HC group and LLD group (including active and remitted depression). Secondary analysis considered the subset of LLD with a current depressive episode to investigate effects in state-level depression. Personality predictors included the five domains assessed by the NEO-PI-R. Cognitive domains were executive functioning, attention, and global cognitive ability. Hierarchical linear regressions included predictors of rumination, with variable blocks composed of 1) demographic characteristics, 2) group (LLD vs HC), 3) cognitive/personality variables, and 4) interaction terms for variables with significant main effects. Secondary state depression analysis considered MADRS score in the second block and select predictors in the third block.</p><p><strong>Results: </strong>Group (LLD vs HC) significantly predicted rumination in the primary analysis and remained significant following inclusion of all cognitive and personality variables. Neuroticism, and less significantly perseveration on the WCST, also predicted rumination; while there was some indication that cognitive variables were associated with increased rumination in LLD, results overall did not reach significance. MADRS score significantly predicted rumination in the secondary analysis, though predictor variables did not moderate this association.</p><p><strong>Conclusion: </strong>Results demonstrate that personality, namely neuroticism, is more predictive of rumination than cognition in older adults. Depression history, neuroticism, and to a lesser extent cognitive flexibility were associated with higher levels of rumination in LLD, while only depression symptom severity was predictive of rumination in state depression. Findings suggest personality is more related to rumination than cognition in LLD, though the relationship may be distinct for state and trait depression.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"1-10"},"PeriodicalIF":1.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial validation of SENIC: a cognitive test for assessing concussion in team sports.","authors":"Carolane Croteau, Cindy Chamberland, Helen M Hodgetts, Sébastien Tremblay","doi":"10.1080/13803395.2025.2547726","DOIUrl":"https://doi.org/10.1080/13803395.2025.2547726","url":null,"abstract":"<p><strong>Introduction: </strong>Concussions present a significant public health concern, with an estimated 1.6 to 3 million sport-related cases reported annually in the United States alone. Athletes are particularly vulnerable due to repeated exposure to high-risk situations. We wish to validate a novel assessment tool designed to evaluate cognitive functioning through a sport-specific, decision-based task.</p><p><strong>Method: </strong>This study introduces SENIC (ENgaging and Immersive Cognitive Simulation), a dynamic, context-sensitive cognition task developed collaboratively with athletes and stakeholders. SENIC integrates ecological validity by contextualizing cognitive tasks within the athlete's sport. This approach offers an integrated view of cognition, as opposed to traditional methods that assess cognitive functions independently. Reaction time, a behaviorally linked indicator, serves in this study as a measure of information processing efficiency. Ninety-six athletes without current or recent concussion completed SENIC and the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) battery. Construct validity was examined using a multitrait-multimethod matrix (MTMM) approach.</p><p><strong>Results: </strong>The MTMM revealed correlations between SENIC's detection time and ImPACT's reaction time, ImPACT's visuomotor speed, and ImPACT's visual memory, providing preliminary evidence for convergent validity.</p><p><strong>Conclusion: </strong>Our study proposes an innovative neurocognitive assessment approach that combines external validity with dynamic cognition. SENIC seems promising in providing a contextually relevant evaluation of cognitive functioning in athletes at risk of concussion.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"1-14"},"PeriodicalIF":1.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with lateralized cognitive dysfunction using the Cognitive Lateralization Rating Index in pediatric epilepsy.","authors":"Sydney E Park, Hope M Reecher, Heather Hennrick, Marsha Gabriel, Kristina E Patrick, Katrina Boyer, Crystal Cooper, Amanda Max Decrow, Priscilla Duong, Elise Hodges, Hayley Loblein, David Marshall, Kelly McNally, Jonathan Romain, Leigh Sepeta, Michael Zaccariello, Alyssa Ailion, Madison M Berl, Jennifer Koop","doi":"10.1080/13803395.2025.2542244","DOIUrl":"https://doi.org/10.1080/13803395.2025.2542244","url":null,"abstract":"<p><strong>Introduction: </strong>Optimizing cognitive outcomes of pediatric epilepsy surgery requires understanding of risk for change in function, typically based on hemispheric lateralization of language skills. Identification of cognitive lateralization in children is complicated by disease in the setting of ongoing functional development. A quantitative method for assessing lateralization, the Cognitive Lateralization Rating Index (CLRI), was used as a systematic way to assess lateralized cognitive dysfunction in a sample of pediatric epilepsy surgery candidates.</p><p><strong>Method: </strong>The current study examined demographic and clinical variables in relation to the CLRI in 179 patients evaluated prior to epilepsy surgery from a national multi-site cohort.</p><p><strong>Results: </strong>The sample was comprised of 179 patients (43.3% female; 76.3% White, 83.6% not Hispanic/Latino; age of seizure onset <i>M</i> 6.58 years; seizure type: 84.7% focal; side of seizure onset: 51.3% left hemisphere, 38.1% right hemisphere). Results demonstrated that lateralization of cognitive dysfunction in a pediatric sample, as well as characterization of presumed atypical functional organization, is possible with the CLRI. There was no significant association of demographic variables on lateralization. Age of seizure onset was not significantly related to the CLRI. Children with focal epilepsy were more likely to have lateralized cognitive profiles than children with generalized seizures, though this relationship was not significant. Additionally, analyses demonstrated those with left hemisphere seizures were significantly more likely to have dominant hemisphere dysfunction or presumed atypical organization on the CLRI.</p><p><strong>Conclusions: </strong>Results establish the CLRI as a potentially useful tool for both research and clinical care to quantitively stratify cognitive risk profiles for pediatric epilepsy surgery evaluations.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"1-13"},"PeriodicalIF":1.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbid symptoms in cancer patients and caring for the caregiver.","authors":"Sumita M Strander, Daniel Chiu, Jennifer S Temel, Jamie M Jacobs, Deborah A Forst","doi":"10.1080/13803395.2025.2542245","DOIUrl":"https://doi.org/10.1080/13803395.2025.2542245","url":null,"abstract":"<p><p>Patients living with cancer often experience significant neuropsychological symptoms throughout their illness trajectories, stemming either from the cancer itself or from antineoplastic therapies. In many cases, these neuropsychological effects, including impacts on cognition, are the result of various comorbid symptoms patients with cancer frequently face. These comorbid symptoms include: 1) fatigue and sleep disturbance, 2) mood symptoms, 3) peripheral neuropathy and neuropathic pain, and 4) symptoms related to endocrine and nutritional dysfunction. This review discusses the putative pathophysiological mechanisms connecting each of these comorbid symptoms to cognitive dysfunction in patients with cancer, along with a review of recommendations for evaluating and managing these symptoms. The review highlights the influence of concomitant medication use on cognition with a survey of the most common medication classes that could have cognitive implications. Finally, this review concludes with a discussion of caregiver distress, a frequently neglected component of cancer care that may be especially pertinent in cases in which patient cognition is impaired.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"1-24"},"PeriodicalIF":1.7,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurotoxicity of chemotherapy and brain-radiotherapy in cancer: overlapping mechanisms underlying cognitive impairment.","authors":"Laura E Kuil, Celeste Nicola, Jorg Dietrich, Hélène Castel","doi":"10.1080/13803395.2025.2539199","DOIUrl":"https://doi.org/10.1080/13803395.2025.2539199","url":null,"abstract":"<p><p>Cancer and its treatments often result in cognitive impairment (CRCI), impacting the well-being of survivors. Chemotherapy and brain-targeted radiation therapy contribute significantly to central nervous system toxicity, which underlies these cognitive issues. Preclinical animal studies serve as pivotal tools in elucidating the cellular and molecular changes triggered by cancer therapies. This review assesses both clinical and preclinical evidence, offering insights into optimal preclinical study designs to deepen our understanding of the underlying injury mechanisms. Such understanding is crucial and adapted to precision medicine for advancing preventive and restorative interventions. Early interventions show promising outcomes, underscoring the importance of identifying predictive biomarkers for patient stratification.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"1-41"},"PeriodicalIF":1.7,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advocacy and leadership in neuropsychology doctoral education: a developmental integration of perspectives on training.","authors":"Erin T Kaseda, Julia E Maietta, Nicole D Evangelista, Eleni A Kapoulea, Mary A Fernandes, Rachael L Ellison","doi":"10.1080/13803395.2025.2542243","DOIUrl":"https://doi.org/10.1080/13803395.2025.2542243","url":null,"abstract":"<p><strong>Objective: </strong>Advocacy has been identified as an important aspect of professional practice and identity in many subfields of health professions and science, including clinical neuropsychology. Despite this, opportunities for doctoral students to develop concrete skills related to advocacy and leadership more broadly within the specialty are sparse.</p><p><strong>Method: </strong>An exploratory pilot survey was conducted to better understand neuropsychologists' prior training experiences with advocacy and leadership and their perspectives on how and when training should be provided. Sixty-eight neuropsychologists across career stages who self-identified as having had leadership or governance positions in psychology completed the survey. Thematic analysis of open responses was undertaken to identify primary themes related to training and education in advocacy and leadership.</p><p><strong>Results: </strong>The majority of respondents (77.3%) were interested in receiving formal training or mentorship in advocacy/leadership. Even among neuropsychologists in formal leadership or governance positions, the majority had never participated in formal training opportunities in advocacy (76.5%) or leadership (60.3%), although most endorsed having received informal training and mentorship in leadership (76.5%). Most respondents believe that training should begin during doctoral training or earlier (68.7%). Perceived benefits of training include increased professional competency and relationships, while drawbacks included the time and cognitive cost of participation as well as limitations in the content and perspectives shared.</p><p><strong>Conclusions: </strong>These results highlight the importance of advocacy in neuropsychology training, as well as the current limited access to training opportunities. While engaging in this work may require some flexibility, creativity, and self-advocacy on the part of doctoral students, there are many ways for trainees and mentors to leverage existing skills and professional organizations to support trainees in developing advocacy competency. Specific recommendations for the integration of such training into doctoral training and case vignettes highlighting advocacy in action during doctoral training are provided.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"1-23"},"PeriodicalIF":1.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering minds: revolutionizing cognitive and emotional health assessment with stepped care and digital tools.","authors":"Sara L Weisenbach","doi":"10.1080/13803395.2025.2535584","DOIUrl":"https://doi.org/10.1080/13803395.2025.2535584","url":null,"abstract":"<p><p>The field of neuropsychology has been slow to adapt the use of new technologies, relative to other healthcare fields, accounted for by multiple factors, including a lack of sufficient normative data, reliability, and validity for novel measures; low motivation by testing companies to develop measures that utilize modern psychometrics; and comfort in continuing to use measures and processes that have been used for decades in clinical practice. While these are all reasonable rationales for continuing to practice what we know, we find ourselves in a zeitgeist with rapidly developing technologies that can change and improve the way that we practice. At the same time, there is a growing recognition of cognitive health as a critical vital sign that needs to be well-managed throughout the lifespan to contribute to general good health and well-being, requiring large-scale screening efforts at the population level. Neuropsychologists are specialty care practitioners with limited bandwidth to provide comprehensive evaluations. Stepped-care models in neuropsychology that deploy novel technological innovations provide a solution to both challenges heretofore described. This manuscript, an adaptation of this author's 2024 Society for Clinical Neuropsychology's Presidential Address, illustrates models of stepped-care in neuropsychology and describes how novel tools, currently employed primarily in research settings, can eventually be integrated into the clinical practice of stepped-care neuropsychology. It also describes steps that our field is taking now to enter the new age of digital healthcare provision.</p>","PeriodicalId":15382,"journal":{"name":"Journal of clinical and experimental neuropsychology","volume":" ","pages":"1-8"},"PeriodicalIF":1.8,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}