DSM Nosology Changes in Neuropsychological Diagnoses through the Years: A Look at ADHD and Mild Neurocognitive Disorder.

This article discusses the evolution of modern neuropsychology as a field and the concomitant changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Themes in neuropsychology through the years will be highlighted alongside discussion of how neuropsychologists and neuropsychological research have influenced and have been influenced by the DSM. The DSM 5 attention-deficit/hyperactivity disorder and mild neurocognitive disorder will be used as examples to reflect the evolution of the disorders in relation to neuropsychology and the DSM. In particular, recent criticism and research regarding the nosology of both disorders and future directions will be presented in the context of neuropsychology and DSM. Finally, influence regarding changes to the DSM 5 on neuropsychology in clinical decision making, test selection, and diagnosis will be discussed.

The Pillbox Test: an ecological measure of executive functioning and estimate of medication management abilities.

Studies indicate that executive functioning (EF) is a strong predictor of everyday function. However, assessment can be problematic as no single standardized instrument is known to measure all EF domains simultaneously. Thus, the Pillbox Test was developed as a new measure tapping four EF factors through the real-time assessment of medication management, a complex instrumental activity of daily living. The Pillbox Test showed good criterion-related validity and was effective in differentiating graduated levels of executive dysfunction between a mixed neurological group, medical control group, and healthy community control group. This test also showed good convergent validity as it correlated significantly in expected directions with established EF measures in all four of selected EF domains and the Direct Assessment of Functional Status. Finally, a receiver operator characteristic curve found a sensitivity of 75% and specificity of 87.5%, suggesting that the Pillbox Test is a promising new ecological measure of EF.

Use of Trial 1 of the Test of Memory Malingering (TOMM) as a screening measure of effort: suggested discontinuation rules.

Trial 1 of the Test of Memory Malingering (TOMM) has been suggested as a screening tool, with several possible cut-off scores proposed. The purpose of the present study was to replicate the utility of previously suggested cut-off scores and to characterize neuropsychological profiles of persons who "pass" the TOMM but obtain Trial 1 scores < 45 and of persons with cognitive disorders. A total of 229 veterans were administered the TOMM as part of a neuropsychological evaluation. Trial 1 scores ≥ 41 and ≤ 25 showed good utility as discontinuation scores for adequate and poor effort, respectively, beyond which administration of additional trials were unnecessary. Findings suggest better Trial 1 performance is significantly related to better speeded mental flexibility and memory.