Clinical Neuropsychologist最新文献

{"title":"Distortion errors characterise visuo-constructive performance in Huntington's disease.","authors":"Angelica Di Cecca, Ciro Rosario Ilardi, Flavio Della Pia, Chiara Criscuolo, Sergio Della Sala, Elena Salvatore","doi":"10.1080/13854046.2024.2411740","DOIUrl":"10.1080/13854046.2024.2411740","url":null,"abstract":"<p><p><b>Objective:</b> Visuospatial deficits have been extensively studied in Huntington's disease (HD), particularly in relation to visuomotor integration, with less emphasis on visuo-constructive abilities. Quantitative analyses have demonstrated that individuals with HD perform worse than healthy controls (HC) but similarly to people with Alzheimer's disease (AD). The aim of the present study was to conduct a qualitative investigation of visuo-constructive abilities in both HD and AD. By employing both simple and complex tasks, we hypothesized that a qualitative analysis of performance would reveal a distinct pattern of errors specific to HD. <b>Methods:</b> Participants for this study were identified retrospectively. The sample included 41 individuals with HD, 25 with AD, and 35 HC. All participants underwent a neuropsychological battery, which included the Constructional Apraxia Test (CAT) and the Rey-Osterrieth Complex Figure (ROCF) test. <b>Results:</b> Our results showed no significant quantitative difference in visuo-constructive performance between the two patient groups. However, distinct qualitative patterns of drawing errors emerged. Simplifications were more frequent in the AD group, while distortions were distinctive errors in the HD group. These qualitative error patterns were consistent across both the CAT and ROCF. <b>Conclusion:</b> Our study emphasises the value of qualitative analysis in interpreting visuo-constructive performance, shifting the focus from \"how much\" a participant achieves to \"how\" they perform a neuropsychological task. This qualitative approach is useful to capture the complexity and variability of individual performance, providing deeper insight into the cognitive processes affected by different neurological conditions.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1615-1633"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481391","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":"Semantic memory navigation in HIV: Conceptual associations and word selection patterns.","authors":"Carolina A Gattei, Franco J Ferrante, Bárbara Sampedro, Lucas Sterpin, Valeria Abusamra, Lorena Abusamra, Paola Andrea Cañataro, Adolfo M García","doi":"10.1080/13854046.2024.2417844","DOIUrl":"10.1080/13854046.2024.2417844","url":null,"abstract":"<p><p><b>Objective:</b> This proof-of-concept study aimed to characterize semantic memory profiles in individuals with human immunodeficiency virus (HIV) and mild neurocognitive impairment. <b>Method:</b> Using a semantic relatedness task, we explored conceptual association and word selection patterns in people living with HIV (PLWH; <i>n</i> = 50) relative to people living without HIV (<i>n</i> = 46). We also studied whether word selection patterns in the PLWH group were associated with working memory capacity, cognitive flexibility and inhibitory control. <b>Results:</b> While accuracy did not differ between groups, PLWH produced significantly longer responses than controls (<i>r</i> = .32), with fewer hypernyms (<i>d</i> = .47), more troponyms (<i>r</i> = .37), and words that were more frequent (<i>r</i> = .39) and had more phonological neighbors (<i>r</i> = .22). These patterns survived covariation with participants' cognitive status. None of these patterns correlated with measures of working memory, cognitive flexibility, inhibitory control or viral load (all correlation coefficients <i><</i> .36). <b>Conclusions:</b> Together, these results suggest that PLWH might use alternative word finding strategies during semantic memory navigation, irrespective of the severity of other cognitive symptoms. Such findings contribute to the characterization of cognitive deficits in HIV and to the search for novel markers of the condition.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1598-1614"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513290","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 reserve in the recovery and rehabilitation of stroke and traumatic brain injury: A systematic review.","authors":"Giulia Oliva, Fabio Masina, Nazanin Hosseinkhani, Sonia Montemurro, Giorgio Arcara","doi":"10.1080/13854046.2024.2405226","DOIUrl":"10.1080/13854046.2024.2405226","url":null,"abstract":"<p><p><b>Objective:</b> Cognitive reserve (CR) is the brain's ability to cope with changes related to aging and/or disease. Originally introduced to explain individual differences in the clinical manifestations of dementia, CR has recently emerged as a relevant construct in stroke and traumatic brain injury (TBI). This systematic review aims to investigate whether CR could predict post-stroke and TBI clinical recovery and rehabilitation outcomes, and how different variables used to estimate CR (i.e., proxies) are related to the prognosis and effectiveness of rehabilitation in these clinical populations. <b>Method:</b> A search was made in Pubmed, Embase, and PsycInfo for articles published until 12 January 2023, following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) protocol guidelines. <b>Results:</b> 31 studies were included after completing all screening stages. Overall, results show that a higher CR was associated with a better prognosis and a more effective rehabilitation in most of the clinical aspects considered: cognitive functioning, functional, occupational, and socio-emotional abilities, as well as psychiatric and neurological scales. <b>Conclusions:</b> A higher CR seems to be associated with a more favorable prognosis and a better rehabilitation outcome after stroke and TBI. Results suggest that CR should be taken into account in clinical practice to make more accurate predictions about recovery and effectiveness of rehabilitation. However, some inconsistencies suggest the need for further investigations, possibly using multiple proxies for CR.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1450-1486"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301441","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":"Large-scale evidence for the validity of remote MoCA administration among people with cerebellar ataxia.","authors":"Yael De Picciotto, Avigail Lithwick Algon, Inbal Amit, Eli Vakil, William Saban","doi":"10.1080/13854046.2024.2397835","DOIUrl":"10.1080/13854046.2024.2397835","url":null,"abstract":"<p><p><b>Objective</b>: For over half a century, studies of rare diseases using in-person cognitive tools have faced challenges, such as long study periods and small sample sizes (e.g. <i>n</i> = 10). The Montreal Cognitive Assessment (MoCA) was widely employed to assess mild cognitive impairment (MCI). We aimed to validate a modified online version of the MoCA in a large sample of a rare disease (population prevalence < .01%). <b>Method</b>: First, we analyzed 20 previous findings (<i>n</i> = 1,377), comparing the MoCA scores between large groups of neurotypically healthy (NH; <i>n</i> = 837) and cerebellar ataxia (CA; <i>n</i> = 540), where studies were conducted in-person. Second, we administered the MoCA in-person to a group of NH (<i>n</i> = 41) and a large group of CA (<i>n</i> = 103). Third, we administered a video conferencing version of the MoCA to NH (<i>n</i> = 38) and a large group of CA (<i>n</i> = 83). <b>Results</b>: We observed no performance differences between online and in-person MoCA administration in the NH and CA groups (<i>p</i> > .05, <i>η</i>² = 0.001), supporting reliability. Additionally, our online CA group had lower MoCA scores than the NH group (<i>p</i> < .001, Hedges' <i>g</i> = 0.68). This result is consistent with previous studies, as demonstrated by our forest plot across 20 previous in-person findings, supporting construct validity. <b>Conclusion</b>: The results indicate that an online screening tool is valid in a large sample of individuals with CA. Online testing is not only time and cost-effective, but facilitates disease management and monitoring, ultimately enabling early detection of MCI.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1634-1650"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134552","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":"Enhanced detection of suboptimal effort in psychoeducational assessments for dyslexia.","authors":"Allyson G Harrison, Nathaniel Davin, Beth Pollock","doi":"10.1080/13854046.2024.2422139","DOIUrl":"10.1080/13854046.2024.2422139","url":null,"abstract":"<p><p><b>Objective</b>: Although performance validity tests (PVTs) are routinely administered in neuropsychological evaluations, they are employed less frequently in assessments for specific learning disabilities such as dyslexia, likely due, at least in part, to the limited availability of PVTs to evaluate effort on measures of academic achievement. This is troubling, as previous research suggests that up to 24% of postsecondary students undergoing learning disability assessments produce noncredible test scores indicative of symptom exaggeration or low effort. This paper discusses normative data collected for the revised Dyslexia Assessment of Simulation or Honesty- Revised (DASH-R), a PVT developed specifically to identify symptom exaggeration or magnification during dyslexia testing. <b>Method:</b> We administered the DASH-R to three groups of students: honest responding controls (<i>n</i> = 48), students with documented dyslexia (<i>n</i> = 232), and students coached to simulate dyslexia (<i>n</i> = 42). Students were also administered measures of reading and processing speed. <b>Results:</b> DASH-R scores differentiated simulators from both honest responding controls and those with dyslexia. Further, ROC curve analysis showed that a composite feigning index score derived from the DASH-R could be used diagnostically to detect low effort; an optimal cut score of ≥4 on a seven-variable index yielded high specificity (≥98%) and good sensitivity (71%), with positive predictive accuracy of 86%. Creation of a 9-variable index that included errors on an additional reading test produced improved positive predictive accuracy to 96% while retaining excellent specificity (99%). <b>Conclusions:</b> The DASH-R appears to be a promising disability-specific measure for detecting feigned reading problems in young adults undergoing evaluations for dyslexia.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1559-1580"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569930","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":"Disinhibition, rather than moderate-to-severe traumatic brain injury, moderates the impact of anger provocation on subjective emotional experience.","authors":"Michelle Mendez, Jodie Logan, Michaela Filipčíková, Skye McDonald, Travis Wearne","doi":"10.1080/13854046.2024.2406042","DOIUrl":"10.1080/13854046.2024.2406042","url":null,"abstract":"<p><strong>Objective: </strong>Altered reactivity to emotional stimuli is common after traumatic brain injury (TBI), which is suggested to reflect difficulties with emotion regulation. While disinhibition is common after moderate-to-severe TBI, limited research has investigated the link between disinhibition and emotional reactivity in this clinical group. The aim of this research, therefore, was to investigate the relationship between disinhibition and TBI to anger provocation.</p><p><strong>Method: </strong>Thirty-five individuals with moderate-to-severe TBI and thirty-one controls completed an anger induction task. Participants rated their experience of emotions and subjective arousal before and after the induction. Heart rate, respiration and skin conductance were also measured. Disinhibition was measured using the Frontal Systems Behavior Scale.</p><p><strong>Results: </strong>In the full sample, the mood induction led to increased skin conductance, respiration, and self-reported anger, tension, arousal and negative mood. There were no differences between those with TBI and controls. Disinhibition interacted with the impact of anger provocation on subjective, but not objective, outcomes such that those elevated in disinhibition reported increased feelings of anger and tension in response to the mood induction. Disinhibition did not interact with TBI across any subjective and objective emotional measures examined in response to mood induction.</p><p><strong>Conclusions: </strong>While anger causes emotional changes for all individuals, these changes are particularly pronounced among those who are disinhibited, irrespective of whether an individual has sustained a TBI. This is an important consideration when examining emotional regulation post-TBI as the degree of disinhibition appears to alter subjective interpretations of emotional events, which could lead to emotion dysregulation.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1525-1545"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332774","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":"Relationship of subjective and objective cognition with post-stroke mood differs between early and long-term stroke.","authors":"Andrea Kusec, Nele Demeyere","doi":"10.1080/13854046.2024.2417865","DOIUrl":"10.1080/13854046.2024.2417865","url":null,"abstract":"<p><p><b>Objective:</b> Depression and anxiety affects approximately 1 in 3 stroke survivors. Performance on standardized objective cognitive tests and self-reported subjective cognitive symptoms are associated with concurrent depression and anxiety, but longitudinal data on whether and how objective and subjective cognition relate to emotional outcomes are lacking. <b>Method:</b> <i>N</i><b> </b><i>=</i> 99 stroke survivors (<i>M</i> age = 68.9, <i>SD</i> = 13.1; Median NIH Stroke Severity = 5) completed measures of depression and anxiety (Hospital Anxiety and Depression Scale; HADS), objective cognition (Oxford Cognitive Screen) and subjective cognitive symptoms (Cognitive Failures Questionnaire) at 6-months, 4.5, and 5.5 years post-stroke. The contribution of objective and subjective cognition to depression and anxiety was determined <i>via</i> mixed-effects models. <b>Results:</b> We found no evidence that age, stroke severity, years of education, and participant sex related to changes in HADS-Depression or HADS-Anxiety scores (Marginal <i>R</i>²=0.03 and 0.05, respectively). Objective cognitive impairments at 6-months and increases in subjective cognitive symptoms at 5.5 years significantly related to increased HADS-Depression scores (Marginal <i>R</i>²=0.22). Only increases in subjective cognitive symptoms at 5.5 years significantly related to increased HADS-Anxiety scores (Marginal <i>R</i>²=0.20). When conducting models in reverse, HADS-Depression and HADS-Anxiety scores did not reciprocally explain changes in subjective cognitive symptoms. <b>Conclusions:</b> Objective cognitive abilities are more strongly associated with depression at 6-months post-stroke, while subjective cognitive symptoms are more relevant to both long-term post-stroke depression and anxiety. There may be a unique unidirectional influence of subjective cognitive symptoms to post-stroke depression and anxiety.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1651-1672"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513289","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":"Interpreting the direct- and derived-Trail Making Test scores in Argentinian children: Regression-based norms, convergent validity, test-retest reliability, and practice effects.","authors":"Vanessa Arán Filippetti, Marisel Gutierrez","doi":"10.1080/13854046.2024.2423414","DOIUrl":"10.1080/13854046.2024.2423414","url":null,"abstract":"<p><p><b>Objective:</b> We carried out two research studies (using a cross-sectional and a longitudinal design) to establish regression-based normative data, and to examine the convergent validity, the test-retest reliability, and the changes in performance with practice (1-month and 1-year interval) of the direct- and derived- (B-A, B + A, and B/A ratio) Trail Making Test (TMT) scores in Spanish-speaking children. <b>Method:</b> In S1 (<i>n</i> = 413 6- to 15-year-old children and adolescents), regression-based norming procedure and partial correlations were employed. In S2 (<i>n</i> = 110 6- to 12-year-old children), intraclass correlation coefficient (ICC_2,1), Pearson's r-product-moment correlations, and paired t-tests were used. <b>Results:</b> S1 demonstrated that age was associated with better performance on both TMT-A and TMT-B. This improvement was more strongly related to direct scores than derived measures B-A and B/A. Additionally, TMT-B was found to be more related to other executive functions (EF) compared to the performance of TMT-A. Among the derived scores, only the B-A was related primarily to cognitive flexibility, while the B + A index was associated with most EF, suggesting a general measure of cognitive functioning. In S2, fair to good test-retest reliability coefficients were found at Time 2 for TMT-A and TMT-B, as well as the B + A index, both in 6 to 8-year-olds (ICCs .61 to .74) and 9 to 12-year-olds (ICCs .53 to .65). There was a significant increase in performance on TMT-A and TMT-B from the first assessment (Time 1) to the follow-up testing at Time 2 in older children. However, this significant improvement was not observed for TMT-B in the younger group. Test scores on the TMT direct measures improved significantly across 1-year. The B-A and B/A ratio scores did not change across examinations. <b>Conclusions:</b> These findings have important implications for assessing EF and developing interventions that target cognitive flexibility in pediatric populations.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1696-1721"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591058","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":"New2Neuropsychology (N2N): An organization to promote diversity, equity, and inclusion in neuropsychology.","authors":"Taylor Rose Schmitt, Ryan Van Patten, Libby A DesRuisseaux, Milena Yurievna Gotra, Kelsey C Hewitt, Jennifer Peraza, Alexander Tan, Kristen L Votruba, John A Bellone, Cady Block, Leah D Talbert, Courtney Ray, Erin T Kaseda, Ronnise Owens, Michelle Nicole Martinez, Carol C Persad, Anthony Y Stringer","doi":"10.1080/13854046.2024.2417860","DOIUrl":"10.1080/13854046.2024.2417860","url":null,"abstract":"<p><strong>Objective: </strong>To introduce New2Neuropsychology (N2N), an organization that seeks to increase recruitment of historically underrepresented minoritized (URM) students, and to examine preliminary data on N2N's impact and effectiveness in increasing knowledge about neuropsychology for URM students.</p><p><strong>Method: </strong>This paper reviews relevant literature on factors informing the development of N2N. We also present descriptive data on N2N's impact to date, and results of pre- and post- surveys for presentations about neuropsychology delivered to 90 college students (mean age = 24.23, 64.4% juniors or seniors) between November 2021 - March 2023.</p><p><strong>Results: </strong>N2N has reached >500 students in events across 27 schools and, with the American Academy of Clinical Neuropsychology, disseminated $84,000 in scholarships to URM students. N2N presentation attendees reported increased understanding of neuropsychology and the training pathway (<i>p</i>s < .001, Cohen's <i>d</i>s = 0.94 - 1.73) and increased confidence in their ability to become neuropsychologists <i>(p < .</i>001, <i>d</i> = 0.41). There were no overall pre-post differences for interest in pursuing a career in neuropsychology (<i>p</i> > .05); however, a subset of students who reported low interest at baseline (<i>n =</i> 57) reported a statistically significant increase in their interest post-presentation (<i>p</i> < .01, <i>d</i> = 0.36).</p><p><strong>Conclusions: </strong>To date, N2N has progressed toward its goal, showing preliminary success increasing knowledge about neuropsychology for URM students. With continued development and support, N2N seeks to transform the pathway to neuropsychology for URM students, expanding accessibility of N2N resources across diverse groups and connecting URM students to neuropsychology research and clinical experiences.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1393-1416"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481308","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":"Determining whether false positive rates increase with performance validity test battery expansion.","authors":"Robert J Kanser, Martin L Rohling, Jeremy J Davis","doi":"10.1080/13854046.2024.2416543","DOIUrl":"10.1080/13854046.2024.2416543","url":null,"abstract":"<p><strong>Objective: </strong>Performance validity test (PVT) misclassification is an important concern for neuropsychologists. The present study determined whether expanding PVT analysis from 4-PVTs to 8-PVTs could lead to elevated rates of false positive performance validity misclassifications.</p><p><strong>Method: </strong>Retrospective analysis of 443 patients who underwent a fixed neuropsychological test battery in a mixed clinical and forensic setting. Rates of failing two PVTs were compared to those predicted by Monte Carlo simulations when PVT analysis extended from 4-PVTs to 8-PVTs. Indeterminate performers (IDT; <i>n =</i> 42; those who failed two PVTs only after PVT analysis extended from 4-PVTs to 8-PVTs) were compared to a PVT-Fail group (<i>n</i> = 148; those who failed two PVTs in the 4-PVT battery or failed >2 PVTs).</p><p><strong>Results: </strong>Rate of failing two PVTs remained stable when PVT analysis extended from 4- to 8-PVTs (12.9 to 11.9%) and was significantly lower than those predicted by Monte Carlo simulations. Compared to PVT-Fail, the IDT group was significantly younger, had stronger neuropsychological test performance, and demonstrated comparable rates of forensic referral and conditions with known neurocognitive sequelae (e.g. stroke, moderate-to-severe TBI).</p><p><strong>Conclusions: </strong>Monte Carlo simulations significantly overestimated rates of individuals failing two PVTs as PVT battery length doubled. IDT did not differ from PVT-Fail across variables with known PVT effects (e.g. age, referral context, neurologic diagnoses), lowering concern that this group is comprised entirely of false-positive PVT classifications. More research is needed to determine the effect of PVT battery length on validity classification accuracy.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1546-1558"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481390","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}