The 22q11.2 deletion syndrome (22q11.2DS) is a known risk factor for development of schizophrenia and is characterized by a complex neuropsychological profile. To date, a quantitative meta-analysis examining cognitive functioning in 22q11.2DS has not been conducted. A systematic review of cross-sectional studies comparing neuropsychological performance of individuals with 22q11.2DS with age-matched healthy typically developing and sibling comparison subjects was carried out. Potential moderators were analyzed. Analyses included 43 articles (282 effects) that met inclusion criteria. Very large and heterogeneous effects were seen for global cognition (d = - 1.21) and in specific neuropsychological domains (intellectual functioning, achievement, and executive function; d range = - 0.51 to - 2.43). Moderator analysis revealed a significant role for type of healthy comparison group used (typically developing or siblings), demographics (age, sex) and clinical factors (externalizing behavior). Results revealed significant differences between pediatric and adult samples, with isolated analysis within the pediatric sample yielding large effects in several neuropsychological domains (intellectual functioning, achievement, visual memory; d range = - 0.56 to - 2.50). Large cognitive deficits in intellectual functioning and specific neuropsychological variables in individuals with 22q11.2DS represent a robust finding, but these deficits are influenced by several factors, including type of comparison group utilized, age, sex, and clinical status. These findings highlight the clinical relevance of characterizing cognitive functioning in 22q11.2DS and the importance of considering demographic and clinical moderators in future analyses.

No abstract

The current study sought to address the utility of the Rey Fifteen Item Test (Rey-15), with the use of a combined score [recall correct + (recognition correct - false positives)], to distinguish between valid and invalid performance among a sample of litigating persons referred for neuropsychological evaluation. Scores on the Rey-15 were analyzed across four comparison groups: (1) litigating persons with evidence of invalid performance (n = 29), (2) litigating persons with valid performance (n = 63), (3) learning-disabled patients (n = 36), and (4) a mixed clinical neuropsychological sample not involved in litigation (n = 54). A Rey-15 combined cutoff score of < 21 yielded the highest sensitivity (70%) and specificity (92.8%) rates. If the Rey-15 is to be used in clinical practice to detect invalid performance, the recognition trial with combined score < 21 should be used. Findings support the use of the combined Rey-15 score in place of the previously used recall Rey-15 score to improve sensitivity and specificity rates for detection of invalid performance in litigating neuropsychological referrals.

No abstract