Same room - different windows? A systematic review and meta-analysis of the relationship between self-report and neuropsychological tests of cognitive flexibility in healthy adults

Howlett, Caitlin A.; Wewege, Michael A; Berryman, Carolyn; Oldach, Annika; Jennings, Elizabeth; Moore, Emily; Karran, Emma L; Szeto, Kimberley; Pronk, Leander; Miles, Stephanie; Moseley, G. Lorimer

doi:10.1016/j.cpr.2021.102061

Cited by 31 publications

(29 citation statements)

References 89 publications

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“…Although the relation (or lack thereof) between self-report and neuropsychological tests for other executive functions has, more broadly, been of substantial interest to the field (e.g., Dang et al, 2020; Rabin et al, 2006; Spencer et al, 2010; Toplak et al, 2013), the association between self-report and neuropsychological tests of cognitive flexibility, more specifically, seems to have received little attention. We recently investigated this matter in healthy adults and found no evidence of a relationship (Howlett et al, 2021), but healthy cohorts are not for whom these tests were typically developed or for whom they guide clinical decisions. The current work solidifies that self-report and neuropsychological tests of “cognitive flexibility” are unlikely to assess the same underlying construct.…”

Section: Discussionmentioning

confidence: 99%

“…Johnco et al (2014a) reported small correlations between particular self-report and neuropsychological tests of cognitive flexibility in their healthy control sample ( n = 53), but no correlations were observed between any self-report and neuropsychological tests of cognitive flexibility in their clinical sample of older adults with comorbid anxiety and depression ( n = 47). We recently investigated self-report and neuropsychological tests of cognitive flexibility across healthy cohorts and did not detect a relationship between them (Howlett et al, 2021), but this may well be because including only healthy cohorts places floor and ceiling effects that conceal a relationship.…”

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confidence: 99%

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Back to the drawing board—The relationship between self-report and neuropsychological tests of cognitive flexibility in clinical cohorts: A systematic review and meta-analysis.

Howlett¹,

Wewege²,

Berryman³

et al. 2022

Neuropsychology

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Objective: Cognitive flexibility has been previously described as the ability to adjust cognitive and behavioral strategies in response to changing contextual demands. Cognitive flexibility is typically assessed via self-report questionnaires and performance on neuropsychological tests in research and clinical practice. A common assumption among researchers and clinicians is that self-report and neuropsychological tests of cognitive flexibility assess the same or similar constructs, but the extent of the relationship between these two assessment approaches in clinical cohorts remains unknown. We undertook a systematic review and meta-analysis to determine the relationship between self-report and neuropsychological tests of cognitive flexibility in clinical samples. Method: We searched 10 databases and relevant gray literature (e.g., other databases and pearling) from inception to October 2020 and used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. Eleven articles including 405 participants satisfied our eligibility criteria. Results: A multilevel random-effects meta-analysis revealed no relationship between self-report and neuropsychological tests of cognitive flexibility (0.01, 95% CI [−0.16 to 0.18]). Individual random-effects meta-analyses between 12 different tests pairs also found no relationship. Conclusion: Based on our results, it is clear that the two assessment approaches of cognitive flexibility provide independent information—they do not assess the same construct. These findings have important ramifications for future research and clinical practice—there is a need to reconsider what constructs self-report and neuropsychological tests of “cognitive flexibility” actually assess, and avoid the interchangeable use of these assessments in clinical samples.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Back to the drawing board—The relationship between self-report and neuropsychological tests of cognitive flexibility in clinical cohorts: A systematic review and meta-analysis.

Howlett¹,

Wewege²,

Berryman³

et al. 2022

Neuropsychology

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“…In addition, this study used a self-report assessment of cognitive flexibility. It is well known that self-report and neurocognitive assessments of cognitive flexibility do not relate well [ 3 , 47 , 48 , 49 ]; hence, the findings of this study cannot be generalised beyond self-reported cognitive flexibility. Future research may wish to replicate the current study using a neurocognitive task of cognitive flexibility.…”

Section: Discussionmentioning

confidence: 72%

Can Cognitive Flexibility and Clinical Perfectionism Be Used to Identify People with Anorexia Nervosa?

Miles

Nedeljkovic

Phillipou

2022

JCM

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Poor cognitive flexibility and perfectionism are common features in anorexia nervosa (AN). The current study aimed to investigate cognitive flexibility and clinical perfectionism as potential predictors of AN. Twenty women with a current diagnosis of AN (M age = 28.25, SD = 7.62) and 170 community participants with no lifetime history of an eating disorder (M age = 29.23, SD = 9.88) took part in an online cross-sectional study that included self-report questionnaires of cognitive flexibility and clinical perfectionism. It was found that compared to the community sample, women with AN self-reported significantly poorer cognitive flexibility and significantly greater clinical perfectionism. In a regression model, clinical perfectionism (but not self-reported cognitive flexibility) significantly predicted group membership. The specificity and sensitivity of the model were high. These preliminary findings indicate that clinical perfectionism may represent a key feature of AN and may accurately discriminate between participants with and without AN, though more research is required.

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“…EF and self-regulation are theoretically related insofar as self-regulation is the application of EF to daily life, but the two constructs are empirically distinct in general and in the present sample (31–34). Latent infection might associate with self-regulation but not EF because of factors influencing self-regulation but not EF when assessed with neuropsychological testing.…”

Section: Discussionmentioning

confidence: 81%

Cytomegalovirus and Toxoplasma Gondii Serostatus Prospectively Correlated With Problems in Self-Regulation but not Executive Function Among Older Adults

2022

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Objective: Cytomegalovirus (CMV) and Toxoplasma gondii are organisms that may infect the brain and have cognitive and behavioral consequences. We hypothesized that these latent infections would be prospectively associated with poorer cognition and more problems in self-regulation among older adults. Methods: Older adults (n = 138, mean age = 75.5 years, 59% women) had CMV and T. gondii serostatus tested, crystallized intelligence estimated (North American Adult Reading Test), and executive function (EF; e.g., Trail Making Test) and self-regulation (Behavior Regulation Inventory of Executive Function-Adult) assessed in visits occurring every 6 months (mean visits = 16). Results: CMV+ people (79%) had significantly poorer self-regulation versus CMV− people (21%; behavioral regulation: γ = 0.108, 95% confidence interval [CI] = 0.009-0.206; metacognition: γ = 0.117, 95% CI = 0.005-0.229), but not intelligence or EF. T. gondii+ people (24%) were not significantly different from T. gondii− people (76%) on any outcome. However, T. gondii+ men had better self-regulation versus T. gondii− men, and the opposite was true of women (behavioral regulation interaction: γ = 0.267, 95% CI = 0.093-0.441). Conclusions: CMV latent infection was associated with more problems in self-regulation, and the magnitude of this difference was clinically significant. T. gondii latent infection was associated with more problems, but only for women. Latent infection might associate with selfregulation but not EF because of factors influencing self-regulation but not neuropsychological test performance, such as values and emotion. Efforts to link latent infection with EFs might, in the future, include the application of those functions to self-regulation in daily life.

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Same room - different windows? A systematic review and meta-analysis of the relationship between self-report and neuropsychological tests of cognitive flexibility in healthy adults

Cited by 31 publications

References 89 publications

Back to the drawing board—The relationship between self-report and neuropsychological tests of cognitive flexibility in clinical cohorts: A systematic review and meta-analysis.

Back to the drawing board—The relationship between self-report and neuropsychological tests of cognitive flexibility in clinical cohorts: A systematic review and meta-analysis.

Can Cognitive Flexibility and Clinical Perfectionism Be Used to Identify People with Anorexia Nervosa?

Cytomegalovirus and Toxoplasma Gondii Serostatus Prospectively Correlated With Problems in Self-Regulation but not Executive Function Among Older Adults

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