Eighteen nonmedicated adults with attention-deficit hyperactivity disorder (ADHD) and 18 who did not have ADHD were evaluated in a full-day simulated workplace experience. It was hypothesized that adults with ADHD would evidence greater impairments on simulated tasks, off-task behavior, and self-reported ADHD symptoms than those without ADHD. Participants were compared on self-reported ADHD symptoms, objective observations, and performance on written tasks. Significant differences were noted in reading comprehension and math fluency as well as observer-rated and self-reported behavior, but not attention. The results of this study suggest that ADHD among adults is associated with significant deficits in performance of workplace tasks, internal experiences, and external observations of core symptoms of ADHD.

We examined the prevalence and clinical characteristics of oppositional defiant disorder (ODD) in a sample of clinically referred adults with attention deficit hyperactivity disorder (ADHD). Subjects were consecutively referred adults with a DSM-III R/IV diagnosis of ADHD with or without ODD. Nearly half of subjects (43%) had a history of ODD. Subjects with a childhood history of ODD had increased risk for bipolar disorder, multiple anxiety disorders, and substance use disorders relative to the ADHD subjects without ODD. We concluded, as in children with ODD, adults with a childhood history of ODD have high rates of psychiatric comorbidity and more impaired psychosocial functioning than those without this condition. A better understanding of the course, phenomenology, and clinical significance of ODD in adults is needed to better understand therapeutic approaches for this disorder.

Intellectual decline, a key component of cognitive impairment in schizophrenia, varies considerably across individuals. To examine such cognitive heterogeneity, we applied cluster analysis of IQ and oral reading scores in 73 patients with schizophrenia. The following 3 empirically-derived subtypes emerged: intellectually compromised (42%) with similarly subaverage IQ (M = 79.90) and oral reading (M = 84.03); intellectually deteriorated (29%) with subaverage IQ (M = 86.81) but average oral reading (M = 107.71); and intellectually preserved (29%) with average IQ (M = 108.38) and oral reading (M = 104.43). Compromised and deteriorated clusters showed impairments in both executive function and memory, whereas the preserved cluster showed only reduced executive functioning. The 3 clusters also differed in symptom patterns; with intellectually compromised and intellectually deteriorated both rated with higher negative than positive symptoms, in contrast to the opposite pattern of intellectually preserved. Cluster symptom and neuropsychological profiles may help to validate empirically-derived IQ subtypes in schizophrenia.

Summary:As the population has become both older and more technologically literate, a new class of "brain training" computer programs have gained in popularity. Though these programs have attracted substantial attention from scientists and consumers, the extent of their benefits, if any, remain unclear. Here we employ neuropsychological tests and behavioral metrics collected during periods of real-world driving (with and without manipulations of cognitive load) to evaluate the effects of training with Posit Science's DriveSharp software. We find that DriveSharp's training effects appear in in-lab measures of Useful Field of View but did not translate to changes in actual driving performance or changes in visual behavior in consistent or quantifiable ways in the sample assessed. The implications of these results and relevant limitations of the present research are discussed.

Objective Patients and other stakeholders generally report high satisfaction with neuropsychological evaluations (NPEs), but no research has examined effects of cognitive, emotional, and other factors that often prompt evaluations. A prospective, quasi-experimental study was conducted to examine self-reported cognitive and psychiatric symptoms, self-efficacy, motivation, and satisfaction following a NPE. Method Participants from a neuropsychology clinic who were diagnosed with AD/HD and/or a DSM-IV mood disorder based on a NPE were included, and excluded if diagnosed with dementia or failure on performance validity tests. Results To examine whether a NPE with an interventional feedback session was associated with outcomes, changes from baseline to post-feedback session were examined with repeated-measures analysis of variance. Pearson correlations determined whether changes in hypothesized mechanisms (i.e., self-efficacy, goal importance and confidence ratings, and use of cognitive strategies) were related to changes in cognitive or psychiatric symptom severity. At follow-up, participants reported reductions in psychiatric (change in Brief Symptom Inventory depression: M = -2.8, SD = 4.4, range = −11 to 8, ${\eta}_p^2$=.30; anxiety: M = 3.2, SD = 6.6, range = −21 to 10, ${\eta}_p^2$ = .20) and cognitive symptoms (change in Multiple Ability Self-Report Questionnaire attention: M = −0.3, SD = 0.5, range = −1.6 to 0.5, ${\eta}_p^2$ = .31; verbal memory: M = −0.3, SD = 0.5, range = −1.1 to 0.5, ${\eta}_p^2$ = .24; language: M = −0.4, SD = 0.4, range = −1.3 to 0.4, ${\eta}_p^2$ = .48), and improved cognition (change in Meta-Memory Questionnaire ability: M = 4.4,SD = 6.2, range = −10 to 16, ${\eta}_p^2$ = .35; contentment: M = 4.3, SD = 4.5, range = −7 to 14, ${\eta}_p^2$ = .49). Participants reported increased self-efficacy for general and evaluation-specific goals. Increased goal-specific self-efficacy was associated with large reductions in psychiatric symptoms. Conclusions Participants reported high levels of satisfaction with the NPE. Results support the clinical utility of NPE and feedback, and underscore the importance of individualized goal setting as part of the evaluation process.