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A Précis of the Art and Science of Expert Witness Testimony: a Tribute to the Work and Ideas of Karen Postal. 专家证人作证的艺术与科学简述:向凯伦-波斯塔尔的工作和思想致敬》。
IF 2.1 4区 心理学
Archives of Clinical Neuropsychology Pub Date : 2025-02-18 DOI: 10.1093/arclin/acae088
Nancy Hebben, Elizabeth Leritz
{"title":"A Précis of the Art and Science of Expert Witness Testimony: a Tribute to the Work and Ideas of Karen Postal.","authors":"Nancy Hebben, Elizabeth Leritz","doi":"10.1093/arclin/acae088","DOIUrl":"10.1093/arclin/acae088","url":null,"abstract":"<p><p>In this article, we present a summary of Dr. Karen Postal's life's work on communication in neuropsychological testimony. Her central thesis was that providing effective testimony as a neuropsychological expert requires one to step outside of the traditional academic communication style to which we are accustomed. In her books, The Art and Science of Expert Witness Testimony (2022) and Testimony that Sticks (2019), Karen Postal described foundational principles she called \"disruptive shifts,\" which she saw as the basis from which experts can develop credible and masterful testimony. These shifts begin with the fundamental and somewhat counterintuitive idea that the juror has the hardest job in the courtroom and it is our job as experts to create a direct, dynamic, and unique relationship with each juror. The article then focuses on ways to ensure jurors understand our testimony, including using good metaphors and analogies, showing visuals, avoiding jargon, and speaking in a way that conveys common sense. As Dr. Postal argued, following these principles will serve to establish, and ultimately bolster our credibility as experts with the people who have the most critical job in the courtroom. Finally, we discuss how these shifts can help us handle cross examination in a way that maintains the credibility we establish. The article concludes with a discussion of how mentorship, an incredibly important part of Dr. Postal's work, is of utmost value when embarking in the field of forensic neuropsychology.</p>","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":" ","pages":"190-200"},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674956","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}
引用次数: 0
Constitutional and Judicial Foundations for Competency-Related Assessment in Criminal Forensic Neuropsychology. 刑事法医神经心理学中能力相关评估的宪法和司法基础。
IF 2.1 4区 心理学
Archives of Clinical Neuropsychology Pub Date : 2025-02-18 DOI: 10.1093/arclin/acae085
Robert L Denney
{"title":"Constitutional and Judicial Foundations for Competency-Related Assessment in Criminal Forensic Neuropsychology.","authors":"Robert L Denney","doi":"10.1093/arclin/acae085","DOIUrl":"10.1093/arclin/acae085","url":null,"abstract":"<p><strong>Objective: </strong>Clinical neuropsychologists wishing to consult in criminal cases have ethical requirements to familiarize themselves with this specialty prior to initiating services. This paper presents foundational knowledge for professional neuropsychological consulting in cases where competence to proceed through the criminal adjudication process is in question.</p><p><strong>Method: </strong>Reviewed are key foundations of knowledge for practice of clinical neuropsychology in relation to competency to stand trial or to proceed examinations. These foundations include a review of the criminal judicial system, relevant US Constitutional Amendments, and select mental health case law.</p><p><strong>Results: </strong>First, Fifth, Sixth, and Fourteenth Amendments to the US Constitution establish the rights of freedom of thought, due process, freedom from self-incrimination, assistance of counsel, and equal protection. As used in criminal legal proceedings, capacity generally refers to abilities (i.e., functional capabilities), while competency is a legal determination based on a set of capacities. Although competency to proceed is assumed, Dusky  v  United  States  (1960) establishes that defendants are not competent if they lack sufficient present ability to consult with their lawyers using a reasonable degree of rational and factual understanding. Case law and statutory law establish that the loss must be due to mental disease or defect.</p><p><strong>Conclusions: </strong>Clinical neuropsychologists wishing to consult in criminal forensic cases have ethical requirements to become familiar with this unique consultative arena before choosing to enter. The foundational knowledge for clinical consulting within the criminal forensic context is presented to help clinical neuropsychologists begin developing authentic professional competence in the criminal forensic arena.</p>","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":" ","pages":"245-255"},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674961","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}
引用次数: 0
Introduction to the Special Issue on Forensic Neuropsychology: Foundational Elements of Practice. 法医神经心理学特刊简介:实践的基本要素。
IF 2.1 4区 心理学
Archives of Clinical Neuropsychology Pub Date : 2025-02-18 DOI: 10.1093/arclin/acae075
Matthew A Clem, Ryan W Schroeder
{"title":"Introduction to the Special Issue on Forensic Neuropsychology: Foundational Elements of Practice.","authors":"Matthew A Clem, Ryan W Schroeder","doi":"10.1093/arclin/acae075","DOIUrl":"10.1093/arclin/acae075","url":null,"abstract":"","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":" ","pages":"157-161"},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675121","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}
引用次数: 0
Neuropsychological Validity Assessment Beliefs and Practices: A Survey of North American Neuropsychologists and Validity Assessment Experts. 神经心理学有效性评估信念与实践:北美神经心理学家和有效性评估专家调查。
IF 2.1 4区 心理学
Archives of Clinical Neuropsychology Pub Date : 2025-02-18 DOI: 10.1093/arclin/acae102
Phillip K Martin, Ryan W Schroeder, Anthony P Odland
{"title":"Neuropsychological Validity Assessment Beliefs and Practices: A Survey of North American Neuropsychologists and Validity Assessment Experts.","authors":"Phillip K Martin, Ryan W Schroeder, Anthony P Odland","doi":"10.1093/arclin/acae102","DOIUrl":"10.1093/arclin/acae102","url":null,"abstract":"<p><strong>Objective: </strong>The present study sought to identify changes in neuropsychological validity assessment beliefs and practices relative to surveys of North American neuropsychologists conducted in 2015 and 2016, obtain a more nuanced understanding of such beliefs and practices, and examine salient validity assessment topics not addressed by previous surveys.</p><p><strong>Methods: </strong>Adult focused neuropsychologists (n = 445) and neuropsychological validity assessment experts (n = 16) were surveyed regarding their perceptions and practices related to the following topics: (i) importance of validity testing; (ii) multiple performance validity test (PVT) administration and interpretation; (iii) suspected causes of invalidity; (iv) reporting on malingering; (v) assessment of examinees of diverse language, culture, and nation of origin; (vi) terminology; and (vii) most frequently utilized validity measures.</p><p><strong>Results: </strong>There was general agreement, if not consensus, across multiple survey topics. The vast majority of neuropsychologists and experts view validity testing as mandatory in clinical and forensic evaluations, administer multiple PVTs regardless of setting, believe validity assessment to be important in the evaluation of all individuals including older adults and culturally diverse individuals, and view evaluations with few to no validity tests interspersed throughout the evaluation as being of lesser quality. Divergent opinions were also seen among respondents and between neuropsychologists and experts on some topics, including likely causes of invalidity and assessment and formal communication of malingering.</p><p><strong>Conclusions: </strong>Current results highlight the necessity of formal validity assessment within both clinical and forensic neuropsychological evaluations, and findings document current trends and reported practices within the field.</p>","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":" ","pages":"201-223"},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675122","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}
引用次数: 0
How Mild Is the Mild Long COVID? A Comprehensive Neuropsychological Assessment of Patients with Cognitive Complaints. 轻度长程COVID有多轻?认知症状患者的综合神经心理学评估。
IF 2.1 4区 心理学
Archives of Clinical Neuropsychology Pub Date : 2025-02-18 DOI: 10.1093/arclin/acae071
Lucas Emmanuel Lopes-Santos, Diego de Lacerda Ferreira, Geisa de Angelis, Maria Paula Foss, Ana Carolina Trevisan, Kleython José Coriolano Cavalcanti de Lacerda, Vitor Tumas, Fernando Bellissimo-Rodrigues, Lauro Wichert-Ana
{"title":"How Mild Is the Mild Long COVID? A Comprehensive Neuropsychological Assessment of Patients with Cognitive Complaints.","authors":"Lucas Emmanuel Lopes-Santos, Diego de Lacerda Ferreira, Geisa de Angelis, Maria Paula Foss, Ana Carolina Trevisan, Kleython José Coriolano Cavalcanti de Lacerda, Vitor Tumas, Fernando Bellissimo-Rodrigues, Lauro Wichert-Ana","doi":"10.1093/arclin/acae071","DOIUrl":"10.1093/arclin/acae071","url":null,"abstract":"<p><p>The global impact of the Coronavirus Disease (COVID-19) pandemic has extended beyond physical health, leading to widespread mental health issues. Beyond respiratory symptoms, there is a growing concern about long-term cognitive effects, particularly in individuals who experienced mild cases of the infection. We aimed to investigate the neuropsychological aspects of long-term COVID-19 in non-hospitalized adults compared with a control group. This cross-sectional study included 42 participants, 22 individuals with a history of mild COVID, and 20 healthy controls. The participants were recruited from the community and underwent a comprehensive neuropsychological assessment. Participants from the mild COVID group reported cognitive symptoms persisting for an average of 203.86 days and presented a higher frequency of psychological treatment history (81.8%) compared with the control group (25.0%). History of anxiety disorders was more prevalent in the mild COVID group (63.6%) than in the control group (20.0%). Significant reductions in verbal working memory were observed in the mild COVID group. Levels of anxiety were found to have a significant impact on difficulties with visual recognition memory. This study reveals important neuropsychological alterations in individuals following mild COVID-19, emphasizing executive functions deficits. Our findings underscore the persistence of these deficits even in non-hospitalized cases, suggesting potential inflammatory mechanisms in the central nervous system. The study highlights the need for comprehensive assessments and targeted interventions to address the diverse cognitive impacts on individuals recovering from COVID-19.</p>","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":" ","pages":"302-309"},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144905","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}
引用次数: 0
User Experience of a (Semi-) Automated Cognitive Phone-Based Assessment Within a Memory Clinic Population. 基于电话的(半)自动化认知评估在记忆诊所人群中的用户体验。
IF 2.1 4区 心理学
Archives of Clinical Neuropsychology Pub Date : 2025-02-18 DOI: 10.1093/arclin/acae063
Daphne Ter Huurne, Inez Ramakers, Nina Possemis, Alexandra König, Nicklas Linz, Johannes Tröger, Kai Langel, Frans Verhey, Marjolein de Vugt
{"title":"User Experience of a (Semi-) Automated Cognitive Phone-Based Assessment Within a Memory Clinic Population.","authors":"Daphne Ter Huurne, Inez Ramakers, Nina Possemis, Alexandra König, Nicklas Linz, Johannes Tröger, Kai Langel, Frans Verhey, Marjolein de Vugt","doi":"10.1093/arclin/acae063","DOIUrl":"10.1093/arclin/acae063","url":null,"abstract":"<p><strong>Objective: </strong>We examined the user experience in different modalities (face-to-face, semi-automated phone-based, and fully automated phone-based) of cognitive testing in people with subjective cognitive decline and mild cognitive impairment.</p><p><strong>Method: </strong>A total of 67 participants from the memory clinic of the Maastricht University Medical Center+ participated in the study. The study consisted of cognitive tests in different modalities, namely, face-to-face, semi-automated phone-based guided by a researcher, and fully automated phone-based without the involvement of a researcher. After each assessment, a user experience questionnaire was administered, including questions about, for example, satisfaction, simplicity, and missing personal contact, on a seven-point Likert scale. Non-parametric tests were used to compare user experiences across different modalities.</p><p><strong>Results: </strong>In all modalities, user experiences were rated above average. The face-to-face ratings were comparable to the ratings of the semi-automated phone-based assessment, except for the satisfaction and recommendation items, which were rated higher for the face-to-face assessment. The face-to-face assessment was preferred above the fully automated phone-based assessment on all items. In general, the semi- and fully automated phone-based assessments were comparable (simplicity, conceivability, quality of sound, visiting the hospital, and missing personal contact), while on all the other items, the semi-automated phone-based assessment was preferred.</p><p><strong>Conclusions: </strong>User experience was rated high within all modalities. Simplicity, conceivability, comfortability, and participation scores were comparable in the semi-automated phone-based and face-to-face assessment. Based on these findings and earlier research on validation of the semi-automated phone-based assessment, the semi-automated assessment could be useful for screening for clinical trials, and after more research, in clinical practice.</p>","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":" ","pages":"319-329"},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Forensic Neuropsychological Foundations in Competency to Stand Trial Evaluations. 出庭资格评估中的法医神经心理学基础。
IF 2.1 4区 心理学
Archives of Clinical Neuropsychology Pub Date : 2025-02-18 DOI: 10.1093/arclin/acae084
Chriscelyn Tussey, Megan Lacritz, Beth C Arredondo, Bernice Marcopulos
{"title":"Forensic Neuropsychological Foundations in Competency to Stand Trial Evaluations.","authors":"Chriscelyn Tussey, Megan Lacritz, Beth C Arredondo, Bernice Marcopulos","doi":"10.1093/arclin/acae084","DOIUrl":"10.1093/arclin/acae084","url":null,"abstract":"<p><p>Neuropsychological assessment can play a vital role in competency to stand trial (CST) evaluations. This article provides an overview of the brain and behavior-based conditions that may impact an individual's ability to participate in their legal proceedings, as well as the relevant legal parameters that guide these types of forensic mental health evaluations. Circumstances that may warrant the involvement of a neuropsychologist in these evaluations are reviewed. For example, neuropsychologists' expertise with validity testing, as well as their specialized knowledge of cognition, is useful from the onset of the evaluation through the end, where involved parties often want to know about restoration interventions and feasibility. Select neuropsychological testing measures and cultural considerations are also addressed. The article concludes with illustrative case examples that demonstrate the real-world application of neuropsychological involvement in this specific forensic context. Given the expanding opportunities for neuropsychologists to assist triers of fact, this work contributes to the necessary and developing education base for neuropsychologists who wish to provide informed, effective, and culturally sensitive CST evaluations or related consultation to the legal system.</p>","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":" ","pages":"256-271"},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675119","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}
引用次数: 0
Traumatic Brain Injury and Risk of Incident Dementia: Forensic Applications of Current Research. 创伤性脑损伤与痴呆症发病风险:当前研究的法医应用。
IF 2.1 4区 心理学
Archives of Clinical Neuropsychology Pub Date : 2025-02-18 DOI: 10.1093/arclin/acae076
Matthew A Clem, Christian LoBue, Jeff Schaffert, C Munro Cullum
{"title":"Traumatic Brain Injury and Risk of Incident Dementia: Forensic Applications of Current Research.","authors":"Matthew A Clem, Christian LoBue, Jeff Schaffert, C Munro Cullum","doi":"10.1093/arclin/acae076","DOIUrl":"10.1093/arclin/acae076","url":null,"abstract":"<p><strong>Objective: </strong>Traumatic Brain Injury (TBI) has been identified as a risk factor for later developing neurodegenerative disorders, and there has been significant attention on this association in forensic settings. As a result, forensic neuropsychologists are frequently asked to comment on risk for dementia after an alleged TBI in litigation and criminal cases. This article provides an evidence-based foundation to aid forensic practice by synthesizing comprehensive information pertaining to: (i) the role of the neuropsychologist in TBI-related litigation, (ii) the complexities associated with identifying TBIs in forensic cases, (iii) the science of TBI in relation to incident dementia, and (iv) current scientific evidence for chronic traumatic encephalopathy.</p><p><strong>Results: </strong>Developing a neurodegenerative disorder after TBI is the exception rather than the rule. Prevalence rates suggest that only a small subset (< 5%) of individuals with moderate-to-severe TBI, and even fewer (< 1%) with mild TBI (mTBI), appear to develop certain neurodegenerative diseases, and the characteristics that place some at risk remain unclear. The literature is mixed in terms of identifying a relationship between mTBI and later-in-life dementia risk. Also, the quality of positive evidence for risk of dementia after mTBI is weak and mostly consists of observational studies characterized by methodological limitations.</p><p><strong>Conclusions: </strong>Methods used to establish the likely occurrence of a TBI in a forensic context are typically more extensive than those used in a routine clinical evaluation. Research methodology to define TBI is often even more rudimentary and inconsistent. Applying clinical research results of TBI and dementia outcomes to forensic cases at an individual level carries significant limitations. Estimating the contribution of remote head hits or concussion in a causal manner to dementia is a challenge forensic experts sometimes face, yet at present, the task is impossible beyond correlations and speculation.</p>","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":" ","pages":"289-301"},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675124","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}
引用次数: 0
Correction to: Language and Cognitive Impairments in Multiple Sclerosis: a Comparative Study of RRMS and SPMS Patients. 修正:多发性硬化症的语言和认知障碍:RRMS和SPMS患者的比较研究。
IF 2.1 4区 心理学
Archives of Clinical Neuropsychology Pub Date : 2025-02-18 DOI: 10.1093/arclin/acae119
{"title":"Correction to: Language and Cognitive Impairments in Multiple Sclerosis: a Comparative Study of RRMS and SPMS Patients.","authors":"","doi":"10.1093/arclin/acae119","DOIUrl":"10.1093/arclin/acae119","url":null,"abstract":"","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":" ","pages":"350"},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833768","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}
引用次数: 0
Mapping Longitudinal Psychiatric Signatures in Huntington's Disease.
IF 2.1 4区 心理学
Archives of Clinical Neuropsychology Pub Date : 2025-02-06 DOI: 10.1093/arclin/acaf011
Audrey E De Paepe, Alexia Giannoula, Clara Garcia-Gorro, Nadia Rodriguez-Dechicha, Irene Vaquer, Matilde Calopa, Ferran Sanz, Laura I Furlong, Ruth de Diego-Balaguer, Estela Camara
{"title":"Mapping Longitudinal Psychiatric Signatures in Huntington's Disease.","authors":"Audrey E De Paepe, Alexia Giannoula, Clara Garcia-Gorro, Nadia Rodriguez-Dechicha, Irene Vaquer, Matilde Calopa, Ferran Sanz, Laura I Furlong, Ruth de Diego-Balaguer, Estela Camara","doi":"10.1093/arclin/acaf011","DOIUrl":"https://doi.org/10.1093/arclin/acaf011","url":null,"abstract":"<p><strong>Objective: </strong>Although Huntington's disease is characterized by motor onset, psychiatric disturbances may present years prior and affect functioning. However, there is inter-individual variability in psychiatric expression and progression. This study therefore strives to stratify longitudinal psychiatric signatures that may inform Huntington's disease prognosis, with potential clinical applications.</p><p><strong>Methods: </strong>Forty-six Huntington's disease gene carriers (21 premanifest, 25 manifest; 31 female; age range 25-69) underwent short-Problem Behavior Assessment for depression, irritability, apathy, and dysexecutive behaviors for up to six longitudinal visits. The Disease Trajectories software, a machine-learning approach, was employed to perform unsupervised clustering of psychiatric trajectories. Linear fits were calculated for each cluster. Lastly, the main clusters of shared trajectories were assessed for group differences in demographic and clinical characteristics.</p><p><strong>Results: </strong>The Disease Trajectories analysis software identified two main psychiatric patterns comprising premanifest and manifest patients that explained 54% of the sample. These two clusters evinced a dissociation in the development of depression and irritability; the first cluster was defined by increasing irritability with no depression and the second by a rise-and-fall in depression with no irritability. Both clusters showed a longitudinal increase in clinically relevant apathy and dysexecutive behaviors.</p><p><strong>Conclusions: </strong>Ultimately, through the detection of individual-level psychiatric trajectories with machine-learning, this exploratory study reveals that a dissociation of depression and irritability is apparent even in premanifest stages. These findings underscore individual differences in the severity of longitudinal multivariate clinical characteristics for real-world patient stratification, with implications for precision medicine.</p>","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254539","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}
引用次数: 0
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