Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists最新文献

{"title":"Normative Data of an Argentinean Color Naming Test.","authors":"Leticia Y Vivas, Patricia Paolantonio, Daniela Andreotti, Mónica Garavaglia, Miguel Lamenza, Andrea Aragonés, Ana Fabiani, Laura Manoiloff","doi":"10.1093/arclin/acaf089","DOIUrl":"https://doi.org/10.1093/arclin/acaf089","url":null,"abstract":"<p><strong>Objective: </strong>To develop normative data for the Psycholinguistic Picture Naming Test in Color (PAPDIC) for Spanish-speaking Argentinians, in order to establish reliable cut-off scores and examine the impact of color on test performance.</p><p><strong>Method: </strong>A cross-sectional study was conducted with 158 healthy participants, 22 participants with mild cognitive impairment (MCI), 13 participants with post-stroke aphasia, and 14 participants with post-stroke without aphasia. Participants were assessed using the PAPDIC and sociodemographic data were collected.</p><p><strong>Results: </strong>The PAPDIC demonstrated strong internal consistency (Kuder-Richardson 20 = 0.925). Item varied difficulty, with some items proving more challenging than others. Significant differences in accuracy were found between the color and black-and-white versions, favoring the former. Receiver operating characteristic curve analysis revealed moderate accuracy in identifying cognitive decline (area under the curve [AUC] = 0.787; 95% confidence interval [CI] 0.663-0.910) and high accuracy in detecting anomia in patients who have had a stroke (AUC = 0.918; 95% CI 0.781-1.000). Age was found to be a significant predictor of PAPDIC scores, whereas education level and gender were not.</p><p><strong>Conclusions: </strong>The PAPDIC is a reliable and culturally appropriate tool for assessing language function in Argentinean Spanish speakers. Color images enhanced the participants' performance on the test compared to black-and-white images, probably due to improved perceptual clarity and greater alignment with real-world visual representations, improving the test specificity. Although promising for detecting anomia, further research is required to improve sensitivity in identifying MCI.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Guide to the Interpretation and Reliability of Annual Collegiate ImPACT Baselines by Sex.","authors":"Kristen G Quigley, Brian Szekely, Madison Fenner, Philip Pavilionis, Nicholas G Murray","doi":"10.1093/arclin/acaf092","DOIUrl":"https://doi.org/10.1093/arclin/acaf092","url":null,"abstract":"<p><strong>Objective: </strong>To create a sex-specific clinicians guide to evaluating significant immediate post-concussion assessment and cognitive testing (ImPACT) score changes using minimal detectable change (MDC) ranges, to evaluate the sex-specific test-retest reliability using intraclass correlation coefficients (ICCs), and to compare male and female performance across all composite and subtest scores.</p><p><strong>Method: </strong>Data from 390 National Collegiate Athletic Association Division I athletes (n = 390; male = 106, female = 284) across four athletic seasons (2020-2021 through 2024-2025) who had completed ImPACT remotely for two consecutive seasons were used to calculate the MDC and ICC at the 95% confidence intervals (CIs) by sex, as well as to compare sex-based performance for all ImPACT scores (subtest and composite).</p><p><strong>Results: </strong>The visual memory composite score, as well as the subtests of design memory correct distractors (immediate), design memory hits (delay), XO total correct memory, XO total correct (interference), XO average correct reaction time (RT; interference), symbol match total correct RT (visible), and color match total correct, exhibited significant differences between males and females at the first and/or second remote time point. ICCs for females demonstrated poor reliability on 14 of the 33 subtest scores (ICC = 0.06-0.49) and on the visual memory composite score (ICC = 0.49). For males, 11 of the 33 subtests had poor reliability (ICC = 0.21-0.48). Many of the subtests present poor reliability for both genders, particularly as it relates to the three letters task.</p><p><strong>Conclusions: </strong>This study found sex differences on ImPACT performance, suggesting that sex-specific MDC values are needed to evaluate significant changes in ImPACT scores. Additionally, this study found several ImPACT subtest scores to be unreliable, suggesting only moderate to good scores be used in clinical evaluation.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Associations Between Perceived Social Support and Cognition in Older Adults With and Without Multiple Sclerosis.","authors":"Hannah R Cohen, Roee Holtzer","doi":"10.1093/arclin/acaf088","DOIUrl":"https://doi.org/10.1093/arclin/acaf088","url":null,"abstract":"<p><strong>Objective: </strong>In persons with multiple sclerosis (MS), perceived social support (PSS) is linked with better mental health, physical well-being, and quality of life. As MS becomes more prevalent in older adults, research on the effects of MS on cognition remains limited. The present study examined the impact of PSS total and domain scores on processing speed and memory in older adults with MS (OAMS) and healthy controls.</p><p><strong>Method: </strong>Participants were OAMS (n = 94, mean age = 64.59 years; %female = 68.1) and controls (n = 114, mean age = 67.95 years; %female = 64). The Symbol Digit Modalities Test (SDMT) assessed processing speed, the Hopkins Verbal Learning Test-Revised (HVLT-R) assessed memory, and the Medical Outcomes Study Modified Social Support Study (MSSS) assessed PSS. Linear regression models examined associations of total and domain PSS scores with SDMT and HVLT-R performances in the entire sample and then stratified by group.</p><p><strong>Results: </strong>In the combined cohort, higher overall, emotional, and positive interaction MSSS scores were associated with better SDMT performance. In stratified analyses, however, except for social interaction, adjusting for depressive symptoms attenuated these associations in OAMS. Associations between MSSS and HVLT-R performance were limited.</p><p><strong>Conclusions: </strong>The current study demonstrated that total and specific facets of PSS were related to processing speed in both OAMS and control participants. Except for positive interaction, depressive symptoms attenuated these associations in OAMS. Hence, treating depression has implications for both cognition and PSS in OAMS.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural Adaptation and Validation of the CALMS Questionnaire in an Arabic-Speaking MS Population.","authors":"Walid Al-Qerem, Sawsan Khdair, Dunia Basem, Anan Jarab, Judith Eberhardt","doi":"10.1093/arclin/acaf085","DOIUrl":"https://doi.org/10.1093/arclin/acaf085","url":null,"abstract":"<p><p>Multiple sclerosis (MS) is a chronic neurological condition that often results in language and communication difficulties, significantly affecting patients' quality of life. While several tools have been developed internationally to assess these impairments, few are validated for Arabic-speaking populations. This study aimed to translate, culturally adapt, and validate the Arabic version of the Communication and Language Assessment for Multiple Sclerosis (CALMS) questionnaire, designed to evaluate communication difficulties in individuals with MS. A cross-sectional study was conducted with 307 MS patients recruited from Al-Bashir Hospital in Amman, Jordan. Participants completed the Arabic CALMS (A-CALMS) via an online survey. Psychometric evaluation included Rasch analysis and Confirmatory Factor Analysis (CFA). Model fit, internal consistency (Cronbach's alpha), person/item reliability, threshold ordering, and Differential Item Functioning (DIF) by sex were assessed. The partial credit model (sign) provided a better fit than the rating scale model. After reordering, all threshold parameters were properly ordered, and item/person fit statistics were acceptable. Internal consistency was excellent (α = 0.935); CFA supported a one-factor solution with good model fit (χ2/df = 1.82, RMSEA = 0.052, CFI = 0.987, TLI = 0.984). No significant DIF was found across sexes. A moderate positive correlation was observed between CALMS and MSIS-29 scores (r = 0.534, p < .001), supporting construct validity. The A-CALMS demonstrated strong psychometric properties and cultural relevance, making it a reliable, valid instrument for assessing communication and language difficulties in Arabic-speaking individuals with MS. Its use in clinical and research settings may enhance diagnostic precision and inform tailored interventions.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Limb Apraxia in Quebec: Normative Study of the Brief Battery for the Evaluation of Praxis in Healthy French-Speaking Adults.","authors":"Joël Macoir, Mariane Landry, Carol Hudon","doi":"10.1093/arclin/acaf086","DOIUrl":"https://doi.org/10.1093/arclin/acaf086","url":null,"abstract":"<p><strong>Objective: </strong>This study presents normative data for the Batterie Brève d'Évaluation des Praxies (BBEP), a brief screening tool developed to assess symbolic gestures, pantomimes, and imitation of meaningless gestures-three domains commonly impaired in limb apraxia. While the BBEP was originally validated in a French population, no normative data have been available for French-speaking adults in Quebec. Given that cultural, linguistic, and demographic factors may influence gesture production and interpretation, the current study aimed to generate region-specific reference values to support accurate clinical assessment.</p><p><strong>Method: </strong>A total of 240 neurologically and cognitively healthy French-speaking adults from Quebec were assessed using the BBEP. Norms were stratified by age and are presented in percentile format to facilitate clinical interpretation.</p><p><strong>Results: </strong>Results indicated significant effects of both age and education, with older as well as educated participants obtaining lower scores across all subtests. Compared to the original French sample, Quebec participants demonstrated slightly lower performance, particularly in the imitation of meaningless gestures, likely reflecting cultural and demographic differences. Spearman rank-order correlations-computed while controlling for age, sex, and education-revealed weak and non-significant associations among the three subtests, suggesting they assess distinct components of praxis.</p><p><strong>Conclusions: </strong>This study provides the first culturally-adapted normative data for the BBEP in a French-Quebec population. These findings underscore the need for region-specific norms in apraxia assessment and highlight the clinical relevance of evaluating each praxis domain independently. The BBEP may prove useful in the early detection of subtle praxis deficits associated with neurodegenerative conditions or cerebrovascular events.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric Properties of the Spanish Version of the Self-Report Teenage Executive Functioning Inventory (TEXI).","authors":"Borja Costa-López, Nicolás Ruiz-Robledillo, Elizabeth Cañas-Pardo, Rosario Ferrer-Cascales","doi":"10.1093/arclin/acaf080","DOIUrl":"https://doi.org/10.1093/arclin/acaf080","url":null,"abstract":"<p><p>The purpose of the present study was to validate the Spanish version of the Teen Executive Functioning Inventory (TEXI) and to investigate its psychometric properties. The TEXI was translated and back-translated into Spanish, and administered by high schools to adolescents aged 14-18 years (N = 902). The findings presented a bifactor structure (inhibition, working memory, and the general factor of Executive Functioning) with adequate fit indexes (Comparative Fit Index = 0.94, Root Mean Square Error of Approximation = 0.07, Standardized Residual Mean Squared Ratio = 0.03), which confirmed the original structure of the test. Also, it showed good reliability for the general factor and its subscales (α/ω > 0.90). The invariance analysis indicated differences for the interpretation of the instrument based on gender. Specifically, girls significantly pointed out a worse scoring in most of the items of the TEXI (p < .05). In conclusion, the Spanish version of the TEXI is a short, valid, reliable, and easy-to-fulfill screening for measuring working memory, inhibition, and executive functions in Spanish adolescents.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gerstmann's Syndrome and Limb Apraxia: A Single Case Study.","authors":"Sara Bertagnoli, Maddalena Beccherle, Riccardo Danese, Cristina Bulgarelli, Valeria Gobbetto, Greta Vianello, Elena Rossato, Valentina Moro","doi":"10.1093/arclin/acaf083","DOIUrl":"https://doi.org/10.1093/arclin/acaf083","url":null,"abstract":"<p><strong>Objective: </strong>Gerstmann's syndrome (GS) represents a still debated clinical condition, in terms of both symptoms' evolution and neural correlates. In depth, repeated neuropsychological assessments along with advanced methods of lesion analysis can contribute to a better understanding of the syndrome and clinical diagnosis.</p><p><strong>Method: </strong>The study reports a patient suffering from GS and limb apraxia following a left hemisphere lesion. Two in-depth assessments, at two and four months from the lesion onset, in addition to video material, document the symptoms over time. An in-depth analysis of the grey and white matter lesions was carried out with 3D reconstruction and a disconnection map.</p><p><strong>Results: </strong>The patient shows the characteristic tetrad of GS symptoms in both subacute and chronic phases, in the absence of other clinically relevant sensorimotor or cognitive deficits. Limb apraxia persists over time as well. The neuroanatomical investigation shows the involvement of cortical damage in the inferior parietal cortex that extends to the superior parietal cortex, anteriorly to the peri-rolandic area and medially to the precuneus. Furthermore, disconnections in the fronto-parietal networks and the corpus callosum were identified.</p><p><strong>Conclusions: </strong>This single case study supports previous neuropsychological evidence and neuroanatomical findings on healthy participants, suggesting a core neural network underlying the four GS symptoms, which involves the left superior parietal lobe, the intraparietal cortices and the white matter parietal and fronto-parietal tracts. Furthermore, the involvement of the three branches of the superior longitudinal fasciculus explains the co-occurrence of limb apraxia.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apolipoprotein E e4 Status Predicts Memory Performance and Daily Functioning in Aging Hispanic/Latino Adults.","authors":"Jennifer Lozano, Ezekiel Hernandez, Dora Beacham, Lisa V Graves","doi":"10.1093/arclin/acaf081","DOIUrl":"https://doi.org/10.1093/arclin/acaf081","url":null,"abstract":"<p><strong>Objective: </strong>The Hispanic/Latino population is projected to have the steepest increase in cases of Alzheimer's disease (AD) and related dementias (ADRD) by 2060. Although the apolipoprotein (APOE) e4 allele and family history of AD are potent risk factors for dementia, their predictive role in AD/ADRD-related cognitive and functional outcomes in this population remains unclear.</p><p><strong>Method: </strong>We examined potential main and interactive effects of APOE e4 status and family history of cognitive impairment on neuropsychological performance and daily functioning in aging Hispanic/Latino adults in the National Alzheimer's Coordinating Center cohort (n = 475).</p><p><strong>Results: </strong>Significant main effects of APOE e4 status were observed, such that e4-positive participants demonstrated worse verbal and visual recall and had worse subjective informant reports of daily functioning compared to e4-negative participants (ps < .01). An APOE e4 status × family history interaction effect on auditory attention was also observed (p < .01), with post hoc comparisons indicating that e4-positive individuals with family history performed significantly better than other subgroups.</p><p><strong>Conclusions: </strong>The present findings extend previous research examining the contributions of APOE e4 status and family history of AD on cognitive and functional outcomes in aging individuals at risk for ADRD, suggesting that in the Latino population, positive APOE e4 status may serve as a more reliable predictor of ADRD-related cognitive and functional outcomes than family history alone. Interventions aimed at reducing ADRD risk through maintenance of cognitive and daily functioning in aging Latinos will be imperative as this population is projected to have the highest increase in ADRD prevalence in the coming decades.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Cognitive Performance in Post-COVID Condition: a Multivariate Analysis.","authors":"Cristina Delgado-Alonso, María Díez-Cirarda, Carlos Pérez-Izquierdo, Silvia Oliver-Mas, María José Gil-Moreno, Esther Valiente-Gordillo, Juan Ignacio López-Carbonero, José Manuel Alcalá Ramírez Del Puerto, Constanza Cuevas, Yadhira Barroso, Lucía Fernández-Romero, Jorge Matias-Guiu, Jordi A Matias-Guiu","doi":"10.1093/arclin/acaf082","DOIUrl":"https://doi.org/10.1093/arclin/acaf082","url":null,"abstract":"<p><strong>Objective: </strong>Contributing factors on cognitive dysfunction in post-COVID condition (PCC) remain unclear. We aimed to examine the influence of clinical variables (such as disease severity, time since onset, waves, and reinfections), demographic factors (age, years of education, and sex), and comorbidities (fatigue and depression) on cognitive performance.</p><p><strong>Methods: </strong>Two hundred thirty-six patients were evaluated using a comprehensive clinical and neuropsychological protocol. A total of 18 tests from two batteries (standardized and computerized) were administered. One hundred forty-eight controls were also included. Linear models were used to evaluate the effect and interaction of the different variables on cognitive performance.</p><p><strong>Results: </strong>We found significant main effects of hospitalization, sex, and waves as factors, along with years of education, age, depression, and fatigue as covariates. Hospitalization during the acute stage was significantly associated with almost all attention, memory, and executive function tests. Older hospitalized patients performed better than younger. Sex was only associated with attentional tests. Reinfections and time since the onset showed no significant associations. The interaction between hospitalization and fatigue was different for attention (non-hospitalized showed worse cognitive performance with higher fatigue levels) and episodic memory (hospitalized patients displayed worse performance with higher fatigue levels). The effect of fatigue on cognitive function was different in the first wave compared to the following ones, in which the effect was greater.</p><p><strong>Conclusions: </strong>Several factors are linked to cognitive performance in PCC, interacting with one another and exhibiting different effects. Recognizing these factors is relevant for future studies evaluating the pathophysiology of cognitive dysfunction in PCC.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rumination, but Not Reflection, Predicts the Reporting of Post-concussive Symptoms in a Non-clinical Sample.","authors":"Michael J Deng, Nathan J Budd, Paul A Strutt, Travis A Wearne","doi":"10.1093/arclin/acaf078","DOIUrl":"https://doi.org/10.1093/arclin/acaf078","url":null,"abstract":"<p><strong>Objective: </strong>Although traditionally associated with mild head trauma, post-concussive symptoms are commonly reported across both healthy and other clinical populations. Existing research indicates that individuals with depression report high levels of post-concussive symptoms, though the underlying causes of this association remain unknown. The current study aimed to explore potential factors underlying this relationship: specifically, how maladaptive and adaptive self-focused cognitive coping styles, namely, rumination and reflection, respectively, differentially contribute to post-concussive symptoms.</p><p><strong>Method: </strong>489 undergraduate students and 136 community participants with no history of head trauma completed the Rivermead Post-Concussion Symptom Questionnaire, the Depression Anxiety and Stress Scales-21 Items, and the Rumination and Reflection Questionnaire.</p><p><strong>Results: </strong>Rumination significantly predicted post-concussive symptoms after controlling for the effects of depression, demographic variables, and confounding factors. However, reflection did not predict lowered symptom reporting as hypothesized. Overall, the final model explained 42.5% of the variance in reported symptoms. Rumination, female gender, prior history of headaches, pre-existing diagnosis of attention-deficit/hyperactivity disorder, and depression were significant predictors of elevated post-concussive symptoms.</p><p><strong>Conclusions: </strong>These findings suggest that rumination, a negative coping style linked to depression, plays a key role in influencing post-concussive symptom endorsement. Future research should examine combinations of rumination and reflection, as well as other cognitive coping styles, that affect symptom reporting. Clinically, assessment of an individual's ruminative tendency following head trauma and the potential incorporation of rumination-focused treatment is recommended to improve recovery outcomes.</p>","PeriodicalId":520564,"journal":{"name":"Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}