Quantitative analysis of studies examining the effect of ecstasy on short-term and working memory in the verbal and visuo-spatial domain was undertaken. Thirty verbal short-term memory, 22 verbal working memory, 12 visuospatial short-term memory and 9 visuospatial working memory studies met inclusion criteria. Ecstasy users performed significantly worse in all memory domains, both in studies using drug-naïve controls and studies using polydrug controls. These results are consistent with previous meta-analytic findings that ecstasy use is associated with impaired short-term memory function. Lifetime ecstasy consumption predicted effect size in working memory but not in short-term memory. The current meta-analysis adds to the literature by showing that ecstasy use in humans is also associated with impaired working memory, and that this impairment is related to total lifetime ecstasy consumption. These findings highlight the long-term, cumulative behavioral consequences associated with ecstasy use in humans.

Ecstasy use has been associated with neurotoxicity and neurocognitive impairment in a variety of domains, including prospective memory (ProM), which involves the delayed execution of a previously encoded intention in response to a specific cue. The present study adopted the multiprocess theory of ProM to evaluate the hypothesis that ecstasy users would evidence differentially impaired ProM on longer versus shorter ongoing task delays. Ecstasy (n = 31) users, high-risk alcohol users (n = 21) and healthy nonusers (n = 31) completed the short (2-min) and long (15-min) delay ProM scales of the Memory for Intentions Screening Test. Results showed a significant group by ProM delay interaction, such that ecstasy users performed comparably to the comparison groups on short-delay trials, but were impaired on long-delay ProM, particularly for time-based cues. Among the ecstasy users, long-delay ProM was positively associated with risky decision-making, but not with retrospective memory or other aspects of executive functions. These findings suggest that ecstasy users may be particularly susceptible to deficits in strategic target monitoring and maintenance of cue-intention pairings over longer ProM delays. Findings are discussed in the context of their potential everyday functioning (e.g., academic, vocational) and treatment implications for ecstasy users.

Reversal of the order in which items are recalled reduces verbal span more than visuospatial span. We investigated behavioral performance and event-related potential components elicited during novel recognition span tasks with verbal (digits) and visuospatial (blocks) stimuli. Reversing item order reduced behavioral span and the amplitudes of the P3a and P3b event-related potential components in the verbal but not in the visuospatial tasks. P3a is thought to reflect detection of deviance from expectation, and hence the smaller P3a suggests expectancy of the stimulus sequence is attenuated in the digits backward task. P3b is thought to reflect allocation of attention to updating memory representations, hence the smaller P3b suggests attenuation of these attentional resources when the demanding operation of verbal order reversal is required in the digits backward span task.

Evaluation of resistance to coaching is an important step in the validation of symptom validity tests (SVTs) for clinical use in neuropsychological evaluations. In the present study coaching effects were evaluated for two recently developed SVTs, the Medical Symptom Validity Test (MSVT) and Nonverbal Medical Symptom Validity Test (NVMSVT) as compared with a well-validated existing SVT, the Test of Memory Malingering (TOMM). This study used a simulation design that included 103 healthy younger study volunteers who were randomly assigned into one of four conditions: Symptom Coaching, Test Coaching, Combined Coaching, or Best Effort Control. Specificity for all SVTs was excellent (96-100%). Test Coaching, either alone or combined with Symptom Coaching, was more effective than Symptom Coaching alone in producing raw scores suggestive of "better" effort for all SVTs. However, there were only modest declines in the obtained sensitivity, which remained above 80% for all SVTs. These results provide empirical support for the classification accuracy of the MSVT and NVMSVT, even when challenged with combined coaching interventions. However, further validation using known-groups designs and clinical samples is needed.

Ecstasy users' performance was suppressed more by the concurrent processing demands of the working memory task than that of the non-ecstasy-using controls. Non-ecstasy-using controls showed differential event-related potential wave forms in the short-term and working memory tasks, and this pattern was not seen in the ecstasy users. This is consistent with a reduction in the cognitive resources allocated to processing in working memory in ecstasy users.