Do "effort tests" really test effort?

OBJECTIVE: Little is known about how much effort to do well most people exert on cognitive testing. Here, we describe an experimental paradigm to manipulate and measure cognitive effort. METHOD: After baseline cognitive and performance validity testing (PVT), 38 participants were assigned to a standard (SI) or enhanced (EI) incentive condition. On retesting a week later, EI participants were told that they would receive a financial bonus whose amount depended on how much their retest performance improved over baseline. SI participants were told to do their best and promised a chance-based bonus. RESULTS: Larger improvements on retesting were assumed to reflect less effort at baseline. After calculating differences from baseline to follow-up, we compared the EI and SI groups using multivariate analysis of variance. We sought to identify predictors of lower cognitive effort at baseline by correlating change z scores with baseline PVT performance and other hypothesized markers of low cognitive effort. As hypothesized, the EI group showed larger improvements, including improvements on more cognitive tests, and were rated as and reported trying harder at retesting than the SI group. Standard PVT measures did not correlate with low baseline effort; however, resting one's head or slouching during cognitive testing signified low baseline cognitive effort. CONCLUSIONS: This study provides preliminary support for an experimental paradigm to manipulate and investigate cognitive effort, which still remains poorly understood. While PVTs can detect feigned cognitive impairment, they lack the sensitivity to detect low cognitive effort in persons who pass conventional PVT cutoffs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

History of "Frontal" Syndromes and Executive Dysfunction.

Elements of "frontal" syndromes and executive dysfunction have been pondered by humans since ancient times, perhaps because executive dysfunction often threatens the very characteristics that make us human. This chapter provides a historical account of scientific advancements related to frontal lobe functioning and how the term has transformed over time. From ancient Greek philosophy to early neuroscientific animal studies to the default mode network, knowledge about the neural underpinnings of executive functioning has blossomed, almost so broadly that the behemoth term comprising broad neuropsychological functions may struggle to be provide specificity on its own without further clarification.

A meta-analysis of neuropsychological, social cognitive, and olfactory functioning in the behavioral and language variants of frontotemporal dementia.

BACKGROUND: Though meta-analyses of neuropsychological and social cognitive deficits in behavioral variant frontotemporal dementia (bvFTD) have been conducted, no study has comprehensively characterized and compared the neuropsychological, social cognitive, and olfactory profiles in the behavioral and language variants of FTD. METHODS: Our search yielded 470 publications meeting inclusion criteria representing 11 782 FTD patients and 19 451 controls. For each domain, we calculated Hedges' g effect sizes, which represent the mean difference between the patient and control group divided by the pooled standard deviation. The heterogeneity of these effects was assessed with Cochran's Q-statistic using a random-effects model. Meta-regressions were employed to analyze the influence of demographic and disease characteristics. RESULTS: Though semantic variant primary progressive aphasia patients showed the greatest impairment across all task types, the three groups showed similar cognitive effect sizes once contributions from the language subdomain were excluded from analysis. Contrary to expectation, the magnitude of deficits in executive functioning, social cognition and olfaction were comparable between the three subgroups. Among indices, a metric of executive errors distinguished the behavioral variant of FTD from the language phenotypes. CONCLUSIONS: These data indicate that social cognitive and traditional executive functioning measures may not capture differences between FTD syndromes. These results have important implications for the interpretation of neuropsychological assessments, particularly when applied to the differential diagnosis of FTD. It is hoped that these findings will guide clinical and research assessments and spur new studies focused on improving the measurement of FTD syndromes.

Composite cardiovascular risk scores and neuropsychological functioning: a meta-analytic review.

BACKGROUND: The ability for patients to understand their risk for disease is important to early intervention and effective treatment. The link between individual cardiovascular risk factors and cognition has been well-established. PURPOSE: This study investigated the relationship between cognition and a combination of these factors through a single composite risk score. METHODS: This study quantitatively summarized the strength of the association between composite cardiovascular risk scores and cognitive test performance using meta-analytic methods. RESULTS: One hundred and nine effect sizes were obtained from 19 studies employing 54,564 participants. Composite risk scores showed a significant association (r=-0.16) with cognitive test performance. Cognitive domain and age did not significantly modify this relationship. CONCLUSIONS: Composite cardiovascular risk scores can be useful indicators of future cognition. The development of a dementia risk score using similar risk factors could aid in the assessment and lifestyle interventions of persons at risk for dementia.

I just want my research credit: frequency of suboptimal effort in a non-clinical healthy undergraduate sample.

Although performance validity testing is becoming fairly routine in clinical settings, research protocols involving neuropsychological tests infrequently include assessments of performance validity. The current study utilized an embedded measure of effort over two administrations of CNS Vital Signs to determine the frequency of poor effort in non-clinical healthy undergraduate students participating in a research study for course credit. Results indicate that more than 1 in 10 college students participating in a cognitive test battery for research showed test scores consistent with inadequate effort, which was associated with poor performance on testing across many domains. This conclusion was supported by poor performance on many other subtests. Healthy college students with suboptimal effort (n = 11) had an overall score in the 15th percentile on average compared to the 48th percentile in the rest of the students (n = 66). Those who failed validity indicators on the baseline administration were more likely to fail validity indicators on the repeat administration. Those who were tested in the morning were also more likely to fail validity indicators. The current study provides evidence for the potential limitations of conducting research using neuropsychological tests with healthy college student volunteers in the absence of performance validity testing. Revised college-level cutoffs are proposed.

Assessment of effort in children: a systematic review.

The assessment of response validity is now considered an important and necessary component of neuropsychological evaluations. One way for assessing response validity is with performance validity tests (PVTs), which measure the degree of effort applied to testing to achieve optimal performance. Numerous studies have shown that normal and neurologically impaired children are capable of passing certain free-standing PVTs using adult cutoffs. Despite this, PVT use appears to be more common in adults compared to children. The overall purpose of this systematic review is to provide the reader with a general overview of the existing literature on PVTs in children. As part of this review, goals are to inform the reader why PVT use is not as prevalent in children compared to adults, to discuss why PVTs and related methods are important in pediatric cognitive evaluations, and to discuss practical limitations and future directions.