Neuropsychology最新文献

{"title":"Characterization of cognitive health among a community-based Vietnamese older adult cohort: Associations with demographic and social determinants and medical comorbidities.","authors":"Sarah Tomaszewski Farias, Brandon E Gavett, Danielle J Harvey, Van Ta Park, Quyen Q Tiet, Rachel Whitmer, Alka M Kanaya, Ladson Hinton, Quyen Vuong, Lauren Mai, Puneet S Kaler, Oanh L Meyer","doi":"10.1037/neu0001099","DOIUrl":"10.1037/neu0001099","url":null,"abstract":"<p><strong>Objective: </strong>This study examined cognitive health in Vietnamese American older adults in association with social determinants of health and a variety of health-related variables.</p><p><strong>Method: </strong>Participants were 548 volunteers in the Vietnamese Insights into Cognitive Aging Program, which enrolls community-dwelling Vietnamese-speaking older adults. Cognitive outcomes were measured using a global composite and domain-specific measures of memory, language, visuospatial abilities, and executive functions. Medical comorbidities included self-reported overall health, a history of hypertension, hyperlipidemia, and diabetes. Social determinants of health variables included self-reported economic status, neighborhood environment, and migration. Bayesian regression was used to model associations.</p><p><strong>Results: </strong>Participants had a mean age of 73 ± 5.3 years and resided in the United States for an average of 27 ± 13.1 years, and a majority (63.3%) had ≤12 years of education. In models including all predictors and covariates, lower cognitive performance was related to older age (<i>b</i> = -0.028 to -0.064), less education (<i>b</i> = 0.230-0.385), not speaking English (<i>b</i> = 0.190-0.331), and younger age at immigration (<i>b</i> = 0.010-0.014); lower scores were also seen in people with hypertension (executive, <i>b</i> = -0.156) and diabetes (executive, <i>b</i> = -0.188; visuospatial, <i>b</i> = -0.185; and global, <i>b</i> = -0.208). Cognitive associations with sex, neighborhood trust, income, and general health were more nuanced and, in some cases, varied by which covariates were included in the models.</p><p><strong>Conclusions: </strong>Findings largely align with those from other diverse older adult populations and emphasize the complex relationships between cognitive performance, demographic factors, medical comorbidities, and social determinants of health, including those specific to immigration history. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":19205,"journal":{"name":"Neuropsychology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive rehabilitation in a patient with posterior cortical atrophy.","authors":"S Cintoli, G Spadoni, M Del Chicca, R Ceravolo, G Tognoni","doi":"10.1037/neu0001115","DOIUrl":"10.1037/neu0001115","url":null,"abstract":"<p><strong>Objective: </strong>Posterior cortical atrophy (PCA) is a neurodegenerative syndrome primarily affecting visuospatial processing while sparing memory, language, and insight. The study aimed to evaluate the effects of a structured cognitive rehabilitation program on executive, attentional, and visuospatial functions in a patient with PCA.</p><p><strong>Method: </strong>A 64-year-old male diagnosed with PCA underwent a 16-week cognitive rehabilitation program focused on visuospatial scanning, attention, and executive functions. Neuropsychological assessments were conducted at baseline (T0), immediately postintervention (T1), and at a 1-year follow-up (T2). Standardized measures were used to evaluate visuospatial abilities, attention, fluency, and learning, with performance changes analyzed across the three time points.</p><p><strong>Results: </strong>At the end of rehabilitation, the patient demonstrated short-term improvements from baseline in visuospatial scanning, attention, verbal fluency, and learning. At the 1-year follow-up, cognitive gains were primarily maintained in auditory attention and learning/encoding tasks. Working memory and delayed recall remained stable over time, without significant gains. Notably, the patient reported subjective improvements in daily functioning and confidence in performing instrumental activities of daily living.</p><p><strong>Conclusions: </strong>Cognitive rehabilitation may provide short-term benefits for individuals with PCA, particularly in enhancing visuospatial and attentional skills. The results emphasize the importance of ongoing, multidisciplinary, and adaptive interventions to sustain cognitive functioning and quality of life in PCA patients. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":19205,"journal":{"name":"Neuropsychology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Saccadic paradigms in restless legs syndrome with and without augmentation: An eye-tracking study.","authors":"Philipp Ellmerer, Beatrice Heim, Ambra Stefani, Marina Peball, Marcel Ritter, Federico Carbone, Abubaker Ibrahim, Philipp Mahlknecht, Evi Holzknecht, Elisabeth Brandauer, Klaus Seppi, Atbin Djamshidian, Birgit Högl","doi":"10.1037/neu0001112","DOIUrl":"https://doi.org/10.1037/neu0001112","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether saccadic eye movement paradigms can be used to detect impulsivity and executive dysfunction in patients with restless legs syndrome (RLS), particularly in those experiencing augmentation due to long-term dopaminergic therapy.</p><p><strong>Method: </strong>Forty-seven nondemented RLS patients were included in this study. Nineteen patients without augmentation or symptoms of impulse control disorders (RLS controls) were compared with 28 patients with augmentation (RLS + AUG) and 20 matched healthy controls (HC). All participants underwent an eye-tracking battery including prosaccade, antisaccade, and stop signal paradigms. Error rates and reaction times were compared between groups. Correlation analyses were performed to evaluate associations between saccadic performances between the different paradigms.</p><p><strong>Results: </strong>RLS + AUG patients demonstrated significantly higher error rates in all saccadic tasks compared with HC (<i>p</i> < .05) indicating impaired inhibitory control, while error rates of RLS controls were similar to those of HC (<i>p</i> > .1). Overall reaction times did not differ significantly, but evaluating correct antisaccade trials only, RLS + AUG patients had longer reaction times than HC (<i>p</i> = .030). Correlation analyses revealed moderate to strong positive associations between error rates of prosaccade, antisaccade, and stop signal tasks.</p><p><strong>Conclusions: </strong>RLS + AUG exhibit deficits in oculomotor response inhibition, possibly indicating executive dysfunction and increased impulsivity likely related to long-term dopaminergic therapy. These preliminary results highlight the potential utility of eye tracking in clinical monitoring of dopaminergic therapy in RLS. Future longitudinal eye-tracking studies in a larger cohort are necessary to evaluate temporal dynamics of dopaminergic exposure, augmentation, and impulse control disorder symptoms. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":19205,"journal":{"name":"Neuropsychology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Executive function test norms in the Ecuadorian population: A generalized additive mixed model approach.","authors":"Alberto Rodríguez-Lorenzana, Lila Adana-Díaz, Mabel Torres-Tapia, Diana Álvarez-Mejía, Diego Rivera, Laiene Olabarrieta-Landa, Guido Mascialino, Juan Carlos Arango-Lasprilla, Aimé Holguín Espinoza","doi":"10.1037/neu0001107","DOIUrl":"10.1037/neu0001107","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop demographically adjusted normative data for executive function tests in the Ecuadorian population, aiming to capture variability across the main regions of Ecuador across the Coast, Highlands, and Amazon regions.</p><p><strong>Method: </strong>A total of 1,084 healthy participants aged 6-82 years were recruited through a stratified sampling procedure. Participants completed the Stroop Color-Word Test, Symbol Digit Modalities Test, Trail Making Tests A and B, and Modified Wisconsin Card Sorting Test. Generalized additive mixed models were applied to examine nonlinear effects of age, education, and sex, with region included as a random effect. Normative percentiles were derived using the estimated probability distributions, and an interactive calculator was developed to facilitate clinical use.</p><p><strong>Results: </strong>Age and education exerted significant nonlinear effects on performance across tests, with education moderating age-related decline especially in Trail Making Test B and Modified Wisconsin Card Sorting Test perseverative errors. Women with higher education outperformed men on tasks requiring cognitive flexibility. Negative binomial models effectively reduced overdispersion for count data, while gamma models provided optimal fits for time-based measures. Model fit indices (<i>D</i>² = 14.7%-62.6%) indicated robust predictive capacity and low overfitting rates (<10%).</p><p><strong>Conclusions: </strong>The study provides the first large-scale, demographically diverse normative data set for executive function in Ecuador, capturing complex demographic and regional effects through advanced modeling. These norms, integrated into an open-access calculator, enhance diagnostic accuracy and cross-cultural validity in neuropsychological assessment, supporting more equitable clinical practice in Latin America. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":19205,"journal":{"name":"Neuropsychology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive functioning in first episode and recurrent major depressive disorder: A systematic review and meta-analysis of comparative performance.","authors":"Sarah Kennedy, Elayne Ahern","doi":"10.1037/neu0001118","DOIUrl":"10.1037/neu0001118","url":null,"abstract":"<p><strong>Objective: </strong>Major depressive disorder is associated with cognitive deficits, yet the specific impact of recurrence remains unclear. This systematic review and meta-analysis compared cognitive performance between individuals with first-episode depression (FED) and recurrent major depressive disorder (rMDD).</p><p><strong>Method: </strong>Five databases were searched to identify eligible studies. A series of meta-analyses for each cognitive domain were conducted with inverse-variance, random-effects modeling. Demographic and clinical moderators were explored, with leave-one-out sensitivity analyses.</p><p><strong>Results: </strong>Twenty-four eligible studies were included in the review, of which data from 2,487 participants (<i>k</i> = 20; FED<i>_n</i> = 1,288, rMDD<i>_n</i> = 1,199) contributed to meta-analyses. Relative to FED, rMDD showed statistically significant small to moderate effects indicative of poorer performance across several cognitive domains: processing speed (<i>g</i> = -0.20), auditory attention (<i>g</i> = -0.33), working memory (<i>g</i> = -0.47), verbal learning (<i>g</i> = -0.41), and verbal memory (<i>g</i> = -0.54), albeit the size of effect was found to vary dependent on the neuropsychological test or outcome measure. Over half the analyses resulted in nonsignificant differences in cognitive performance in rMDD versus FED. Findings remained relatively robust to leave-one-out analyses. No demographic or clinical variables reliably moderated effects.</p><p><strong>Conclusions: </strong>Scarring effects of episode recurrence appear to impact a select few cognitive domains. To further advance understanding of cognitive heterogeneity across illness stages and to inform targeted interventions to mitigate possible worsening of cognitive function and relapse risk, longitudinal cognitive tracking is needed to elucidate when and under what circumstances recurrent episodes may exacerbate cognition. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":19205,"journal":{"name":"Neuropsychology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What lab-based and self-report executive function measures predict in real-world task performance.","authors":"Paulo Guirro Laurence, Matheus de Melo Rodrigues, Tatiana Abrão Jana, Elizeu Coutinho Macedo","doi":"10.1037/neu0001117","DOIUrl":"https://doi.org/10.1037/neu0001117","url":null,"abstract":"<p><strong>Objective: </strong>This study examined whether cognitive laboratory tests or self-report inventories more effectively predict performance in a real-world executive function (EF) task.</p><p><strong>Method: </strong>Data were collected from 71 healthy university students who completed a battery of cognitive tasks, self-report inventories, and an ecologically valid Library task incorporating behavioral and eye-tracking measures.</p><p><strong>Results: </strong>Regression analyses revealed a dissociation in predictive validity between assessment methods. Lab-based EF measures showed a nonlinear association with task accuracy and uniquely predicted fixation behavior during instruction reading, indicating their relevance for goal-related and task-level performance. In contrast, self-report EF measures were more consistently associated with global eye-movement metrics, particularly fixation count and fixation rate, reflecting differences in attentional engagement and behavioral regulation. Across models, effect sizes were modest and neither assessment approach broadly predicted all outcomes.</p><p><strong>Conclusions: </strong>Overall, the findings support a complementary view of EF assessment, demonstrating that laboratory tasks and self-report inventories capture distinct aspects of executive functioning in ecologically valid contexts and highlighting the importance of aligning assessment methods with theoretically motivated real-world outcomes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":19205,"journal":{"name":"Neuropsychology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Task-switching abilities in bilinguals: The importance of language dominance and acculturation.","authors":"Alexander M Eisenstein, David A S Kaufman, Xavier E Cagigas, Fred W Sabb, Robert M Bilder","doi":"10.1037/neu0001098","DOIUrl":"10.1037/neu0001098","url":null,"abstract":"<p><strong>Objective: </strong>The present study examined group differences between monolingual English and bilingual English/Spanish speakers in task switching. Additionally, relationships between English language dominance and time since immigration were explored within bilingual immigrants.</p><p><strong>Method: </strong>In this cross-sectional, correlational study, task switching was measured via a computerized paradigm in a large community sample of adults. In the bilingual sample, the degree of English language dominance (measured as a ratio of English to Spanish phonemic verbal fluency scores) was hypothesized to correlate with switch cost. Exploratory analyses were conducted to examine the relationship between immigration history, English language dominance, and switching cost within a subsample of bilingual immigrants.</p><p><strong>Results: </strong>There were no group differences between monolingual and bilingual participants in switch cost. Among all bilinguals, greater English dominance predicted less switch cost (<i>b</i> = -.20, <i>p</i> = .01). Among non-U.S. born bilinguals, greater time since immigrating to the United States and greater English dominance predicted less switch cost (that is, more efficient switching; <i>b</i> = -0.37, <i>p</i> = .025).</p><p><strong>Conclusions: </strong>These findings suggest that the effects of bilingualism on executive control, specifically task switching, may be impacted by factors related to acculturation rather than bilingualism alone, which may partially explain the variability seen in prior studies. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":19205,"journal":{"name":"Neuropsychology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive health on the fingertips: Fine motor deficiencies for assessing the risk of mild cognitive impairment in the aging adults.","authors":"Yejing Zhao, Jie Zhang, Yanyan Zhao, Ying Yuan, Ji Shen, Hongyu Peng, Jing Li","doi":"10.1037/neu0001074","DOIUrl":"10.1037/neu0001074","url":null,"abstract":"<p><strong>Objective: </strong>Mild cognitive impairment (MCI) represents a critical prodromal stage associated with Alzheimer's disease and other age-related neurocognitive conditions in middle-old aging adults, yet research exploring its association with fine motor skill deficits remains relatively limited. This study explores the specific characteristics of fine motor function in middle-old aging adults with MCI using the latest wearable inertial motion capture technology.</p><p><strong>Method: </strong>A computerized system with wearable inertial motion capture technology captured and assessed fine motions. The least absolute shrinkage and selection operator-based machine learning algorithm was utilized to construct a nomogram. The discriminatory ability of the model was determined by calculating the area under the curve. Decision curve analysis, clinical impact curve analysis, and bootstrap validation were used to evaluate and validate the stability of models.</p><p><strong>Results: </strong>A total of 289 participants aged ≥50 were recruited, of which 140 participants experienced MCI. Compared with the control group, patients with MCI showed significantly poorer fine motor performance in hand function assessment tasks. Spearman correlation analysis revealed a stronger correlation between fine motor function and visuospatial/executive function. A multivariable nomogram model based on fine motion parameters showed satisfactory discrimination, with an area under the curve of .773. Decision curve analysis, clinical impact curve analysis, and bootstrap validation demonstrated the good clinical utility and stability of the model.</p><p><strong>Conclusions: </strong>Poor motor functioning was associated with MCI status. The nomogram model, based on fine motion parameters, demonstrated moderate discriminative performance in assessing the risk of MCI, serving as a valuable clinical supplement. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":19205,"journal":{"name":"Neuropsychology","volume":" ","pages":"489-500"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive and electrophysiological biomarkers of endometriosis with versus without chronic pelvic pain.","authors":"Ashlee Berryman, Liana Machado","doi":"10.1037/neu0001069","DOIUrl":"10.1037/neu0001069","url":null,"abstract":"<p><strong>Objective: </strong>Despite endometriosis impacting at least 10% of women globally, with most self-reporting chronic pelvic pain (CPP) and cognitive difficulties, research reporting on objective cognitive disruptions remains extremely limited, although recent research has identified brain alterations in women with endometriosis that could cause cognitive difficulties. To address this gap, the current research profiled objective cognitive and neuroelectrophysiological distinctions in women with endometriosis, with consideration of CPP status.</p><p><strong>Method: </strong>We measured cognitive performance via a diverse battery and electroencephalography (P300) in three groups of women: endometriosis with CPP (<i>n</i> = 22), endometriosis without CPP (<i>n</i> = 13), and healthy controls (<i>n</i> = 42). Pain ratings and psychological measures were analyzed as potential moderators of group differences.</p><p><strong>Results: </strong>Relative to controls, women with endometriosis-associated CPP exhibited significant moderate-to-large difficulties across multiple cognitive domains. In contrast, women with endometriosis without CPP exhibited fairly large significant difficulties only for verbal short-term memory. Pain factors and affective symptomatology emerged as moderators of cognitive performance differences. Regarding electroencephalography, we identified in the parietal planes of women with endometriosis-associated CPP moderately smaller P300 amplitudes, particularly P3b component amplitudes, aligning with previous reports, and pain and affective factors emerged as moderators of group differences.</p><p><strong>Conclusions: </strong>The behavioral results provide seminal evidence of objective cognitive difficulties in women with endometriosis, particularly those experiencing CPP, who also exhibited reduced P300 amplitudes. The data implicated pain and affective factors as drivers of these differences. These findings warrant consideration in clinical contexts and future research focused on developing targeted interventions for cognitive rehabilitation in endometriosis. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":19205,"journal":{"name":"Neuropsychology","volume":" ","pages":"533-551"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146106585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential diagnosis in clinical neuropsychology: A case example of assessment without testing.","authors":"William Stiers","doi":"10.1037/neu0001063","DOIUrl":"10.1037/neu0001063","url":null,"abstract":"<p><strong>Objective: </strong>Neuropsychological testing is the standard of care in the United States for assessing functional deficits related to cognitive impairment. However, there are well-known limitations of neuropsychological testing, including issues of reliability and validity, appropriate norming, predictive and ecological validity, and cultural appropriateness. The goal of this case example is to differentiate assessment from testing and to describe how assessment of brain-behavior relationships can be conducted when testing data are not available.</p><p><strong>Method: </strong>This case example describes a neuropsychological differential diagnosis where the individual being examined was unable to participate in any standardized testing and had no available brain imaging. By necessity, the entirety of the differential diagnosis rests on the history and behavioral observations. This case is presented as a fact-finding exercise, as it would be in a board examination to assess neuropsychological competencies.</p><p><strong>Results: </strong>The diagnostic value of history and behavioral observations are discussed in the context of disease base rates to rule in/rule out differential diagnoses involving the peripheral and central nervous systems. Clearly, standardized neuropsychological testing would add important data to revise and refine diagnoses and to develop treatment interventions.</p><p><strong>Conclusions: </strong>Neuropsychological competency examinations usually observe clinicians in a controlled environment with comprehensive information, similar to demonstrating swimming skills in a swimming pool. However, neuropsychologists should also be able to swim in the ocean, where the setting is not well controlled, comprehensive information may not be available, and the waters are often murky, such as when assessing patients where standardized testing is not possible. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":19205,"journal":{"name":"Neuropsychology","volume":" ","pages":"451-457"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145708766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}