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Ancient Greek terminology continues to shape contemporary discourse; hubris is a case in point. Typically seen as the catastrophic yet common tendency to reach too high, only to fall, it remains a fixture in the contemporary discourse of business and politics. But hubris has also become a term of art for researchers in a number of academic disciplines; and it remains a hotly contested topic in Classics. This unique volume of essays explores the connections, continuities and differences between ancient hubris and its modern counterparts. Its distinguished multidisciplinary cast of experts in Classics, Business and Management Studies and Psychology explores what modern researchers can learn from the theorisation and deployment of hubris in ancient sources and how modern approaches to hubris can help us understand the ancient concept.
Language deficits are frequently described by patients with multiple sclerosis (MS); however, objective characterization remains somewhat limited due to its omission from standard MS cognitive evaluation and the inconsistent findings that arise from current language measures.
Objective:
To establish alternative approaches to characterizing single-word level language in MS, this study (i) validates the Sydney Language Battery (SYDBAT) visual confrontation naming subtest and (ii) examines the insights provided by examining naming errors and latencies.
Methods:
40 MS patients from Royal Melbourne Hospital’s Cognitive Neuroimmunology Clinic and 40 matched controls completed a series of neuropsychological tests, including the SYDBAT and ‘gold standard’ confrontation naming task, the Boston Naming Test (BNT). Error types and latencies on the SYDBAT were extracted from assessment audio recordings.
Results:
SYDBAT and BNT scores were highly correlated (r = 0.81, p < .001) and these tasks reported comparable receiver operating characteristic curves (p = .091). Latency analysis captured lexical retrieval difficulties, with patients displaying significantly longer mean latencies than controls on the SYDBAT (p = .012, β = 0.54).
Conclusions:
These findings support the validity of the SYDBAT and value of the latency analysis in characterizing language impairment in MS. Use of the SYDBAT and latency considerations contribute to a broader assessment with a briefer administration time compared to gold-standard evaluation. The study thereby offers clinicians an enhanced toolkit to more effectively and appropriately evaluate language functioning and supplement standard cognitive evaluation in this population.
Cognitive assessment is used to detect, characterize, and monitor the degree of cognitive impairment in dementia and its earlier stages. Brief cognitive assessments are frequently used across diverse clinical settings and offer scalability as a frontline marker aimed at enhancing the clinical efficiency of diagnostic work-up. These tools have a potential to facilitate early detection and diagnosis of symptomatic cognitive impairment, which is a crucial first step to providing medical and supportive care that benefits people with cognitive impairment and their care partners and for identifying pre-surgical or hospitalized patients who may benefit from delirium prevention interventions. This chapter provides an overview of the most commonly used brief cognitive measures in clinical practice, recent developments and novel measures, and future directions for use of brief cognitive tools across clinical settings including primary, dementia specialist, preoperative, and inpatient care. Recommendations for cultural considerations and optimal implementation paradigms are also discussed.
Hubris (in so many ways) is still with us: commentators and pundits still return repeatedly to this ancient Greek concept as a way of diagnosing the shortcomings of leadership and foresight that underpin contemporary political and business failures. These appeals to the notion of hubris rest on aspects of the ancient phenomenon that would have been familiar to an ancient theorist such as Aristotle. But beyond these popular understandings, hubris has become a term of art in contemporary academic approaches to leadership and management and is widely considered to have congeners and analogues in contemporary psychology. Yet these disciplines are rarely brought into dialogue with the intellectual history of classical Greece. This Introduction remedies that deficiency by outlining the approaches of contemporary classics, business and management studies and psychology and discussing the potential for each of these disciplines to draw and learn from the insights of the others.
There is no consensus on core curriculum content for neuropsychiatry and behavioural neurology training and the breadth of topic coverage is poorly understood. Using a scoping review, we identified 23 unique syllabuses from Australia, Argentina, Chile, Mexico, New Zealand, South Africa, the USA and the UK, and one explicitly international in scope.
Results
Syllabuses addressed a wide range of neuropsychiatric conditions, encompassing not only overlapping psychiatric and neurological disorders, but also functional, behavioural and cognitive disorders. Training integrated knowledge from neuropsychology, philosophy, ethics and social sciences. Core elements included clinical assessment, intervention skills and case management in social and institutional settings. Neuropsychiatry and behavioural neurology training integrates a broad spectrum of knowledge and skills, is aimed at a range of professionals and is delivered as both specialist training and embedded components within core training.
Clinical implications
The core components of neuropsychiatry curricula identified in this study provide a foundation for institutions to develop or enhance their neuropsychiatry training programs.
Body-focused repetitive behaviors (BFRBs) include activities like hair pulling and skin-picking that can lead to functional impairment. The neurocognitive underpinnings of BFRBs remain unclear, with inconsistent findings across domains.
Methods:
This online study aimed to investigate the neuropsychological capacities of individuals with self-reported BFRBs. We administered the Go/No-Go test to assess inhibitory control and attention and the Verbal Learning and Memory Test to evaluate learning, recall, and memory confidence. From the 2,129 participants who entered the survey, 412 individuals with self-reported BFRBs and 412 matched controls from the general population were included. Drop-out was high.
Results:
Individuals with BFRBs showed no inhibitory deficits on the Go/No-Go test but made fewer hits on the Go trials compared to controls, indicating attentional lapses. Regarding memory, only immediate recall was worse in the BFRB sample. Controls were biased toward being more confident. When we divided the sample by impairment (>1 SD below the mean of controls), a minority of the BFRB group showed deficits in attention and immediate recall.
Conclusions:
Our findings suggest that neurocognitive deficits are not prevalent in BFRB, affecting less than 20% of our sample. Yet, attentional problems in a subgroup of individuals with BFRB highlights the need to study heterogeneity within BFRBs. Potential moderators such as motivation, stress, and self-stigma remain to be explored. Our findings must be interpreted with caution given the study’s limited generalizability due to its online format, high drop-out rate, and absence of independent diagnostic confirmation.
The National Institutes of Health (NIH) Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research (EXAMINER) is a validated laptop-based battery of executive functioning tests. A modified tablet version of the EXAMINER was developed on the UCSF Tablet-based Cognitive Assessment Tool (TabCAT-EXAMINER). Here we describe the battery and investigate the reliability and validity of a composite score.
Methods:
A diagnostically heterogeneous sample of 2135 individuals (mean age = 65.58, SD = 16.07), including controls and participants with a variety of neurodegenerative syndromes, completed the TabCAT-EXAMINER. A composite score was developed using confirmatory factor analysis and item response theory. Validity was evaluated via linear regressions that tested associations with neuropsychological tests, demographics, clinical diagnosis, and disease severity. Replicability of cross-sectional results was tested in a separate sample of participants (n = 342) recruited from a frontotemporal dementia study. As this separate sample also collected longitudinal TabCAT-EXAMINER measures, we additionally assessed test-retest reliability and associations between baseline disease severity and changes in TabCAT-EXAMINER scores.
Results:
The TabCAT-EXAMINER score was normally distributed, demonstrated high test-retest reliability, and was associated in the expected directions with independent tests of executive functioning, demographics, disease severity, and diagnosis. Greater baseline disease severity was associated with more rapid longitudinal TabCAT-EXAMINER decline.
Conclusions:
The TabCAT-EXAMINER is a tablet-based executive functioning battery developed for observational research and clinical trials. Performance can be summarized as a single composite score, and results of this study support its reliability and validity in cognitive aging and neurodegenerative disease cohorts.
We examined cognitive performance in children with complicated mild-severe traumatic brain injury (TBI) versus orthopedic injury (OI) using the National Institutes of Health Toolbox Cognitive Battery (NIH TB-CB).
Method:
We recruited children ages 3–18, hospitalized with complicated mild-severe TBI (n = 231) or orthopedic injury (OI, n = 146). Cognition was assessed using the NIH TB-CB at six and twelve months post-injury. We used linear mixed models to assess associations of injury group (TBI versus OI), timepoint (six versus twelve months), and the interaction of injury group and timepoint with NIH TB-CB Total Cognition, Fluid Cognition, and Crystallized Cognition composites, adjusted for sex and socioeconomic status (SES), with Bonferroni correction. We evaluated differences in cognition stratified by injury severity (complicated mild–moderate TBI vs severe TBI) using ANCOVA, adjusting for sex and SES.
Results:
Neither injury group nor the interaction of group and timepoint were associated with Total (group: p = 0.50; timepoint*group: p = 0.185), Fluid (group: p = 0.297; timepoint*group: p = 0.842), or Crystallized Cognition (group: p = 0.039; timepoint*group: p = 0.017). However, children with severe TBI performed significantly worse on Fluid and Total Cognition than children with complicated mild–moderate TBI at six months (Fluid: p = 0.004, partial η2 = 0.06, moderate effect, Total: p = 0.012 partial η2 = 0.03, small–moderate effect) and twelve months post-injury (Fluid: p < 0.001, partial η2 = 0.11, moderate–large effect, Total: p = 0.002, partial η2 = 0.06, moderate effect).
Conclusions:
The NIH TB-CB detects worse cognitive functioning in children with severe TBI six-twelve months post-injury, largely driven by differences in Fluid Cognition. Our findings suggest the NIH TB-CB may be suitable for monitoring cognition in children with TBI.
Pediatric cancer survivors are at increased risk for neurocognitive challenges that can impact academic achievement and attainment. Educational supports via accommodations or special education can promote better outcomes for these youth; however, barriers often stand in the way of appropriate supports being implemented. Neuropsychological evaluation reports highlight a child’s neurocognitive strengths and needs, but an additional tool to assist parents and educators in understanding the extent to which a child’s neurocognitive needs are addressed by their educational supports may help ensure appropriate supports.
Method:
The present study piloted a novel neurocognitive needs-to-educational supports alignment rubric in a referred sample of pediatric survivors of cancer, bone marrow transplant, and cancer predisposition syndromes (i.e., neurofibromatosis).
Results:
Inter-rater reliability across disciplines was satisfactory. Among school-aged patients who were attending public school (n = 90), mean needs-to-supports alignment was 20.3%, indicating that on average, referred patients were receiving minimal classroom supports addressing identified neurocognitive needs. Among the 42.9% with a formal support plan, proportion of needs met by a support rose to only 47%, indicating that in spite of some recognition of patient needs, supports remain inadequate to the breadth of patient needs.
Conclusions:
This alignment tool can assist parents and educators in better tailoring a child’s educational supports to meet their needs, serve as a communication tool between healthcare and education teams, and provide a quantitative metric for evaluating educationally focused interventions (e.g., school liaison programming) in youth with a variety of chronic health conditions and developmental disabilities.
Research indicates that demographic (e.g., age, education) and sociocultural (e.g., acculturation) factors can impact neuropsychological test performance among ethnoculturally diverse adults. Some studies suggest that greater acculturation to the United States (U.S.) is associated with better neurocognitive functioning, though no meta-analysis to date has examined this relationship. This review provides a comprehensive synthesis of the literature and determines the magnitude of the relationship between acculturation and neuropsychological test performance.
Method:
A literature search explored all published articles through January 1, 2024, using three databases (i.e., PubMED/MEDLINE, PsycInfo, PsycNET). Data to calculate study effect sizes (i.e., Fisher’s z) were extracted from in-text results, tables, and figures.
Results:
Findings (k = 18 included in quantitative analyses) revealed a small to medium (r = 0.29, partial r = 0.20, p < .01), statistically significant relationship between higher U.S. acculturation and better neuropsychological test performance. Moderation analyses indicated that language of testing emerged as a significant moderator, testing in English yielded larger effect sizes compared to testing in other languages (B = 0.29, p < .05).
Discussion:
Neuropsychological test performance is significantly associated with U.S. acculturation, and results suggest that the magnitude may vary depending on study methodologies and samples (e.g., ethnocultural group, U.S. born vs. immigrant) examined. The current review also provides recommendations for incorporating acculturation assessment into clinical practice and highlights the need to examine the clinical utility of acculturation tools in conjunction with neuropsychological tests to assist in clinical decision-making with ethnoculturally diverse populations.
In recent years, the study of the neural mechanisms of emotion in humans has constituted one of the most fertile research areas in cognitive neuroscience. Human neuropsychology has provided crucial insights in this domain. Careful examination of patients with neurological disorders showed that emotion, like memory, language, and so on, could be differentially affected by brain damage, whether caused by stroke, tumors, or other disease. Lesion studies give us not only insight into the constellation of emotion disabilities linked to specific brain regions but also valuable information about structural reorganization, functional compensation, and, possibly, recovery of the deficit over time. Following a concise methodological introduction to neuropsychology and the lesion method, this chapter will examine the principal findings derived from the application of the lesion method in patients with neuropsychological disorders, specifically those with isolated lesions of the amygdala, ventromedial prefrontal cortex, and the insula. The discussion will aim to elucidate the functional significance of these brain regions and their roles in emotional processes.
Cognitive intra-individual variability (IIV) is a neuropsychological marker reflecting divergent performance across cognitive domains. In this brief communication, we examined whether clinical severity, apolipoprotein E (APOE) ε4 carriers, and higher polygenic risk were associated with higher cognitive IIV, and whether higher polygenic risk and cognitive IIV synergistically influence clinical severity.
Method:
This large study involved up to 24,248 participants (mean age = 72) from the National Alzheimer’s Coordinating Center (NACC) and multiple regression controlling for age, sex, and education was used to analyze the data.
Results:
We found that disease severity (B = 0.055, SE = 0.001, P < 0.001), APOE ε4 carriers (B = 0.02, SE = 0.003, P < 0.001), and higher polygenic risk (B = 0.02, SE = 0.004, P < 0.001) were associated with higher cognitive IIV. Polygenic risk and cognitive IIV also interacted to influence clinical severity, beyond APOE ε4 (B = 0.11, SE = 0.05, P = 0.02), such that individuals with high polygenic risk and cognitive IIV had the greatest clinical severity.
Conclusions:
Heightened polygenic risk and increased cross-domain cognitive variation are implicated in dementia and may impact clinical decline in tandem.
This study examined three neurocognitive patterns or “clinical pearls” historically viewed as evidence for executive dysfunction in Parkinson disease (PD): 1) letter < category fluency; 2) word list < story delayed recall; 3) word list delayed recall < recognition. The association between intraindividual magnitudes of each neuropsychological pattern and individual performance on traditional executive function tests was examined.
Methods:
A clinical sample of 772 individuals with PD underwent neuropsychological testing including tests of verbal fluency, word list/story recall, recognition memory, and executive function. Raw scores were demographically normed (Heaton) and converted to z-scores for group-level analyses.
Results:
Letter fluency performance was worse than category fluency (d = −0.12), with 28% of participants showing a discrepancy of ≥ −1.0 SD. Delayed recall of a list was markedly poorer than story recall (d = −0.86), with 52% of the sample exhibiting ≥ −1.0 SD deficits. Lastly, delayed free recall was worse than recognition memory (d = −0.25), with 24% showing a discrepancy of ≥ −1.0 SD. These patterns did not consistently correlate with executive function scores. The word list < story recall pattern was more common in earlier than later PD stages and durations.
Conclusion:
Among the three pearls, the most pronounced was stronger memory performance on story recall than word lists, observed in more than half the sample. Only ¼ the participants exhibited all three neurocognitive patterns simultaneously. The variability in patterns across individuals highlights the heterogeneity of cognitive impairment in PD and suggests that intra-individual comparisons may offer a more nuanced insight into cognitive functioning.
Most cognitive studies of bipolar disorder (BD) have examined case–control differences on cognitive tests using measures of central tendency, which do not consider intraindividual variability (IIV); a distinct cognitive construct that reliably indexes meaningful cognitive differences between individuals. In this study, we sought to characterize IIV in BD by examining whether it differs from healthy controls (HCs) and is associated with other cognitive measures, clinical variables, and white matter microstructure.
Methods
Two hundred and seventeen adults, including 100 BD outpatients and 117 HCs, completed processing speed, sustained attention, working memory, and executive function tasks. A subsample of 55 BD participants underwent diffusion tensor imaging. IIV was operationalized as the individual standard deviation in reaction time on the Continuous Performance Test-Identical Pairs version.
Results
BD participants had significantly increased IIV compared to age-matched controls. Increased IIV was associated with poorer mean performance scores on processing speed, sustained attention, working memory, and executive function tasks, as well as two whole-brain white matter indices: fractional anisotropy and radial diffusivity.
Conclusions
IIV is increased in BD and appears to correlate with other cognitive variables, as well as white matter measures that index reduced structural integrity and demyelination. Thus, IIV may represent a neurobiologically informative cognitive measure for BD research that is worthy of further investigation.
Normative data of neuropsychological tests in the Vietnamese population is considerably lacking. We aim to evaluate the effects of age, education, and sex on the performance of common neuropsychological tests, and to generate normative data for these tests in cognitively normal Vietnamese adults.
Method:
Participants were recruited from two hospitals in Ho Chi Minh City, with inclusion criteria as follows: age ≥ 40 years, normal cognition and function, and Mini-Mental State Examination (MMSE) scores ≥ 26. Neuropsychological tests were administered in a paper-and-pencil format, including the CERAD Word List, Trail Making Tests, Digit Span, Animal Naming, and Clock Drawing Test. Effects of age, education, and sex on test performance were evaluated using multiple linear regression analyses. Normed scores were reported as regression-based and discrete norms tables.
Results:
Participants included 385 cognitively normal Vietnamese, with age 61.4 ± 10.9 years (range 40 – 89), female 56%, who were relatively highly educated (42% attended college and beyond, 36% attended high school or equivalent institutions, 22% had less than high school education), and had MMSE scores 27.8 ± 1.0. Trail Making Test Part B was completed within 300 s by only 204/385 (53%) participants. Regression analyses demonstrated significant associations between age and education with performance on all or most tests, and between sex and all CERAD Word List measures and Clock Drawing Test.
Conclusions:
The present work provides the first known normative data for a relatively comprehensive neuropsychological battery in Vietnamese adults. Performance on all tests was significantly influenced by age and education.
Subjective cognitive concerns (SCCs) refer to individuals’ self-identified cognitive limitations, irrespective of objective neurocognitive performance. Previous literature has overwhelmingly found that psychiatric factors, not neurocognitive dysfunction, are a primary correlate of elevated SCCs across a wide range of clinical populations. However, the relationship between SCCs and objective neurocognitive performance is complex and may further be influenced by underlying mechanisms of various impairments or etiologies. Moreover, much of the extant literature has under-utilized performance validity tests (PVTs) when analyzing objective neuropsychological outcomes.
Methods
As such, this study examined the associations between SCCs, performance validity, neurocognitive performance, and psychiatric distress among adult clinical patients with primary medical/neurologic (n = 127) and psychiatric (n = 106) etiologies.
Results
Results showed that elevated SCCs are associated with greater degrees of performance invalidity and psychiatric distress, but not neurocognitive performance, among both groups.
Conclusions
Findings support the utility of PVTs in clinical research and further highlight the impact of psychiatric factors on SCCs, regardless of medical/neurologic or psychiatric etiology.
This chapter describes the many methods of Cognitive Neuroscience that are revealing the neural processes underlying complex cognitive processes in the brain. The benefits and limitations of each method are discussed, highlighting how there is no single “best” method and how the choice of method in any experiment should be motivated by the hypothesis being evaluated. Neuropsychology provides novel insights into the neural bases of cognitive processes but is limited because it relies on naturally occurring lesions. Neuroimaging methods (fMRI, PET, fNIRS) provide excellent spatial resolution but cannot assess the temporal order of neural activity across regions. Electroencephalography (EEG) and magnetoencephalography (MEG) can track neural activity in real time, but their spatial precision is limited because they are recorded from outside the head. Neurostimulation methods (TMS, tDCS, tACS) can uniquely assess causality by testing if, and when, a brain area is necessary for a particular function. Methods using non-human animals (e.g., single-unit recordings) can provide the highest levels of spatial and temporal precision, but they are limited to mental processes that the non-human animals can be trained to do. This chapter ends with a comparison of methods that includes portability, spatial precision, and temporal resolution.
People with multiple sclerosis (pwMS) commonly describe cognitive decline later in the day, but few studies have evaluated this perception’s validity. In a consecutive sample of 791 pwMS, this study evaluated whether time-of-testing predicted Minimal Assessment of Cognitive Function in MS raw scores, accounting for age, sex, educational years, disease duration, disability and disease-modifying therapy use. The mean age was 43.76 years (SD = 11.30), 76.74% were female and most had mild disability. Later time-of-testing independently predicted reduced Judgment of Line Orientation scores (p < 0.01), but not other cognitive variables. In pwMS, there is a diurnal decline in visuospatial cognitive test performance.
This systematic review aims to update the current evidence on the effects of institutionalisation in minors living in residential care homes, specifically focusing on alterations in neuronal systems and their association with psychopathological and neuropsychological outcomes.
Methods:
Searches were conducted in the Web of Science, Scopus, PubMed, and Google Scholar databases, following PRISMA methodology for peer-reviewed empirical articles. The final selection comprised 10 studies that met the inclusion criteria: (1) published articles with quantitative data, (2) aimed at observing the relationship between psychological and neuropsychological symptoms and the electroencephalogram (EEG) activity in institutionalised children, (3) published between 2016 and 2023, and (4) examining institutionalised minors in residential care homes.
Results:
The articles show that these children exhibit general immaturity in EEG patterns, with a predominance of slow waves (primarily in the theta band). They also demonstrate poorer performance in executive functions (e.g. working memory, inhibition, and processing speed) and cognitive processes, along with a higher risk of externalising problems. However, current evidence does not allow definitive conclusions on whether early EEG abnormalities predict long-term neuropsychological deficits, despite data showing associations between EEG changes and certain cognitive dysfunctions at the time of evaluation.
Conclusion:
The reviewed evidence suggests that EEG alterations in institutionalised minors are linked to executive dysfunction and increased psychopathological risk. These findings highlight the value of EEG in identifying at-risk children and inform the design of preventive interventions. Longitudinal studies are needed to clarify causal relationships.
While not always faithful to the professional field of developmental psychology, Howard Gardner treasures the concept of development – which was introduced to him through the writings of Heinz Werner, and was embodied by his first teachers, Jerome Bruner, Erik Erikson, and Jean Piaget. As soon as he joined Project Zero, a research group at the Harvard Graduate School of Education, Gardner proposed that “participation in the arts” is a viable end-state for a developmental perspective; with Ellen Winner and other colleagues, he sought to lay out a “developmental psychology of the arts.” Drawing on various disciplines, Gardner then introduced the concept for which he is best known –multiple intelligences. Ironically, “multiple intelligences” does not describe his own mind particularly well. Like most scholars and writers, he traffics in linguistic and logical-mathematical intelligences. Instead, his approach is better described as an effort to synthesize bodies of information in a way that is illuminating and that raises new questions, that he and his colleagues can ponder and pursue.