Patients with probable Alzheimer's disease (AD) often have difficulties associated with semantic knowledge. Therefore, conceptual apraxia, a defect of action semantics and mechanical knowledge, may be an early sign of this disease. The Florida Action Recall Test (FLART), developed to assess conceptual apraxia, consists of 45 line drawings of objects or scenes. The subject must imagine the proper tool to apply to each pictured object or scene and then pantomime its use. Twelve participants with Alzheimer's disease (NINCDS–ADRDA criteria) and 21 age- and education-matched controls were tested. Nine Alzheimer's disease participants scored below a 2-standarddeviation cutoff on conceptual accuracy, and the three who scored above the cutoff were beyond a 2-standard-deviation cutoff on completion time. The FLART appears to be a sensitive measure of conceptual apraxia in the early stages of Alzheimer's disease. (JINS, 2000, 6, 265–270.)

Complaints on cognitive functioning are often reported in patients suffering from whiplash syndrome, although objective neuropsychological test results do not always support these. In addition, radiological abnormalities and anatomical lesions are found only in a minority of these patients. This has led to a controversy about its existence in the literature. In this systematic review, the results of 22 neuropsychological studies on whiplash were quantitatively analyzed, focusing on working memory, attention, immediate and delayed recall, visuomotor tracking, and cognitive flexibility. Our findings suggest that a consistent overall pattern of cognitive dysfunction can be demonstrated after whiplash injury through neuropsychological testing, both compared to healthy and to asymptomatic controls. Six months after the accident, improvement is found in working memory, attention, immediate recall, and visuomotor tracking. The results are discussed in the light of recent findings on the effect of cerebral dysfunction, malingering, pain-related factors, and the role of coping strategies and posttraumatic stress on neuropsychological test performance. (JINS, 2000, 6, 271–278.)

The occurrence of personality change due to traumatic brain injury (PC), and its clinical and neuroimaging correlates were investigated. Ninety-four children, ages 5 through 14 at the time of hospitalization following traumatic brain injury (TBI; severe TBI N = 37; mild–moderate TBI N = 57), were assessed. Standardized psychiatric, adaptive functioning, cognitive functioning, family functioning, family psychiatric history, severity of injury, and neuroimaging assessments were conducted. The Neuropsychiatric Rating Schedule (NPRS) was used to establish a diagnosis of PC. Approximately 40% of consecutively hospitalized severe TBI participants had ongoing persistent PC an average of 2 years postinjury. An additional approximately 20% had a history of a remitted and more transient PC. PC occurred in 5% of mild–moderate TBI but was always transient. Interrater reliability for the diagnosis of PC was good (Kappa = .70). In severe TBI participants, persistent PC was significantly associated with severity of injury, particularly impaired consciousness over 100 hr, adaptive and intellectual functioning decrements, and concurrent diagnosis of secondary attention deficit hyperactivity disorder, but was not significantly related to any psychosocial adversity variables. These findings suggest that PC is a frequent diagnosis following severe TBI in children and adolescents, but is much less common following mild–moderate TBI. (JINS, 2000, 6, 279–289.)

Individuals given a series of words to memorize normally show better immediate recall for items from the beginning and end of the list than for midlist items. This phenomenon, known as the serial position effect, is thought to reflect the concurrent contributions of secondary and primary memory, respectively, to recall performance. The present study compared the serial position effects produced on Trial 1 of the California Verbal Learning Test (CVLT) in mildly demented (N = 25; M MMSE = 20.0) and very mildly demented (N = 25; M MMSE = 25.5) patients with Alzheimer's disease (AD), and age- and education-matched normal control (NC) participants (N = 50). In addition, the serial position effects of the very mildly demented AD patients were compared to those of patients with a transient, circumscribed amnesia arising from a prescribed series of electroconvulsive therapy (ECT) treatments for the relief of depressive illness (N = 11). While the NC group exhibited the typical serial position effect, AD patients recalled significantly fewer words than NC participants overall, and exhibited a significantly reduced primacy effect (i.e., recall of the first 2 list items) with a normal recency effect (i.e., recall of the last 2 list items). Patients with circumscribed amnesia due to ECT were as impaired as the very mildly demented AD patients on most standard CVLT measures of learning and memory, but exhibited primacy and recency effects, which were within normal limits. These results suggest that a reduction in the primacy effect, but not the recency effect, is an early and ubiquitous feature of the memory impairment of AD. It is not, however, a necessary feature of all causes of memory impairment. (JINS, 2000, 6, 290–298.)

Two studies assessed the effects of a training procedure (Goal Management Training, GMT), derived from Duncan's theory of goal neglect, on disorganized behavior following TBI. In Study 1, patients with traumatic brain injury (TBI) were randomly assigned to brief trials of GMT or motor skills training. GMT, but not motor skills training, was associated with significant gains on everyday paper-and-pencil tasks designed to mimic tasks that are problematic for patients with goal neglect. In Study 2, GMT was applied in a postencephalitic patient seeking to improve her meal-preparation abilities. Both naturalistic observation and self-report measures revealed improved meal preparation performance following GMT. These studies provide both experimental and clinical support for the efficacy of GMT toward the treatment of executive functioning deficits that compromise independence in patients with brain damage. (JINS, 2000, 6, 299–312.)

In this study, we investigated 2 possible mechanisms by which interhemispheric interaction (IHI) might facilitate performance. Twenty university students performed 3- and 4-item versions of a less complex physical identity (PI) task in which they decided whether 2 letters were perceptually identical (e.g., ‘A’ and ‘A’) and a more complex name identity (NI) task in which they decided whether 2 letters had the same name (e.g., ‘A’ and ‘a’). Consistent with prior work, IHI facilitated performance more for the relatively complex NI task than for the simpler PI task regardless of how many items were in the display. However, for each task IHI facilitated performance less in the 4-item displays than in the 3-item displays. These results indicate that IHI facilitates performance by allowing (1) a division of processing across the hemispheres, and (2) task-relevant information to be processed by a hemisphere that receives a relatively light processing load. (JINS, 2000, 6, 313–321.)

The purpose of this study was to examine the independent and interactive effects of HIV-1 serostatus and cocaine on neuropsychological (NP) performance in a sample of 237 gay and bisexual urban-dwelling African American men. Consistent with current evidence, it was expected that the greatest neuropsychological performance deficits would be evident (1) in the symptomatic seropositives (SSPs), especially in domains affected by HIV (i.e., memory and psychomotor speed), and on tests that are sensitive to subtle slowing; (2) in those who are recent and frequent cocaine abusers; and (3) in those who are both HIV seropositive and cocaine abusers. Multivariate analyses controlling for age and alcohol use confirmed expectations, with symptomatic seropositives (SSPs) evidencing significantly poorer psychomotor speed than the seronegatives (SNs), and slower reaction time and poorer nonverbal memory than the asymptomatic seropositives (ASPs). Moderate to heavy recent cocaine use was associated with slower psychomotor speed. However, contrary to expectations, no interaction of serostatus and cocaine was noted for any NP domain, and the expected serostatus and cocaine effects on verbal memory and frontal systems were not obtained. Level of alcohol consumption exacerbated the detrimental effects of HIV-1 on a computerized reaction time test which is especially sensitive to subtle slowing. This study provides one of the first descriptions of the neuropsychological effects of HIV–AIDS in a noninjection drug-using community sample of gay and bisexual African American men. (JINS, 2000, 6, 322–335.)

Prominent apathy and/or irritability are frequently observed among individuals infected with the human immunodeficiency virus (HIV). Although these symptoms often occur as part of a mood disorder, compelling evidence suggests that they may occur independently of depression in neurologic disease/disorder. The current study examined the prevalence of both apathy and irritability among a sample of HIV-infected individuals and explored the degree to which these neuropsychiatric (NP) phenomena were associated with performance on neurocognitive measures thought to be sensitive to the potential CNS effects of HIV-1. Clinician-administered rating scales assessing apathy and irritability were administered to 65 HIV-seropositive (HIV+) and 21 HIV-seronegative (HIV−) participants who also completed a dual-task reaction time paradigm and the Stroop task. NP disturbance was significantly more prevalent among HIV+ participants compared with HIV− controls and was associated with specific neurocognitive deficits suggestive of executive dysfunction. Relative to both HIV− controls and to neuropsychiatrically intact HIV+ participants, those HIV+ individuals with evidence of prominent apathy and/or irritability showed deficits in dual-task, but not single-task, performance and on the interference condition of the Stroop. Unexpectedly, NP disturbance did not show a robust relationship with HIV disease stage. These results suggest that the presence of prominent apathy and/or irritability among HIV+ individuals may signify greater HIV-associated CNS involvement. In HIV/AIDS, the disruption of frontal–subcortical circuits may be a common mechanism causing both executive dysfunction and NP disturbance. (JINS, 2000, 6, 336–347.)

The performance of cognitive behaviors requires an activated, aroused cerebral cortex. Although studies have shown that there are decrements of cognitive functions in the elderly, changes in arousal with aging have not been fully studied. Our objective was to learn if there are attention–arousal changes associated with aging. Visual stimuli were presented to induce orienting responses or arousal reactions. Because changes in pupil size reflect changes in arousal, we recorded and compared pupillary responses of young and older normal participants using infared pupillography. During the 1 s that we recorded pupillary changes, we found major phases: a brief initial constriction (C1), then a maximal dilation (D1)—an arousal response, followed by constriction (C2), a habituation response. Although amplitude of these 3 phases was not different between the 2 groups, the interval between the D1 and C2 response was prolonged in the older group. Although the arousal response is not dramatically altered with aging, habituation appears to be delayed. (JINS, 2000, 6, 348–350.)

The development and organization of the corpus callosum is described as well as the relationship between the timing of insults and the type of partial agenesis of the corpus callosum are discussed. Neuropathology and callosal damage associated with spina bifida meningomyelocele, aqueductal stenosis, and prematurity–IVH are outlined. Relationships between corpus callosum/whole brain ratios and cognitive functioning as well as interhemispheric transfer in children with these disorders are outlined. Shortcomings of current research and future directions are suggested. (JINS, 2000, 6, 351–361.)

In a recent article, Temkin et al. (1999) contrasted four models for detecting significant change in individual performance on neuropsychological tests. Two of these models relied on the calculation of the Reliable Change Index (RCI) by Jacobson and Truax (1991), with and without a correction for practice associated with repeated testing. The other two models were based on simple linear regression and multiple regression, respectively. The models were contrasted based on the width of 90% prediction intervals (PI) and normal-distribution-based prediction accuracy of classifying unusual cases. Participants were tested twice (Time 1 and Time 2), on seven common neuropsychological measures. Prediction accuracy was based on the discrepancy between obtained and predicted Time 2 scores.

Hinton-Bayre (2000) raises a point that may occur to many readers who are familiar with the Reliable Change Index (RCI). In our previous paper comparing four models for detecting significant change in neuropsychological performance (Temkin et al., 1999), we used a formula for calculating Sdiff, the measure of variability for the test–retest difference, that differs from the one Hinton-Bayre has seen employed in other studies of the RCI. In fact, there are two ways of calculating Sdiff—a direct method and an approximate method. As stated by Jacobson and Truax (1991, p. 14), the direct method is to compute “the standard error of the difference between the two test scores” or equivalently [begin square root](s12 + s22 − 2s1s2rxx′)[end square root] where si is the standard deviation at time i and rxx′ is the test–retest correlation or reliability coefficient. Jacobson and Truax also provide a formula for the approximation of Sdiff when one does not have access to retest data on the population of interest, but does have a test–retest reliability coefficient and an estimate of the cross-sectional standard deviation, i.e., the standard deviation at a single point in time. This approximation assumes that the standard deviations at Time 1 and Time 2 are equal, which may be close to true in many cases. Since we had the longitudinal data to directly calculate the standard error of the difference between scores at Time 1 and Time 2, we used the direct method. Which method is preferable? When the needed data are available, it is the one we used.

Dr. Hinton-Bayre has correctly noted a discrepancy here between the Jacobson and Temkin procedures. His comparison of prediction bounds both confirms this and suggests too that the differences are minor.

Biased over 70 years of acquired preconceptions, I will discuss mainly Philosophical Debates, with occasional references to Consciousness Lost and Found. The bottom line is that neuropsychologists are more likely to benefit from Lost and Found than from Debates.

Readers! Throw away your Shallice, and run to the bookstore for Austin! This magisterial work, an un-Zen-like 844 pages, divided into 158 chapters, a smorgasbord of reminiscences, data, and observations on Buddhism and neuroscience, interspersed with exercises in Zen meditation. Austin preserves by inclusion rather than selection the skepticism and dialectic that are the essence of Zen teaching, laying out what there is in all its eclectic richness, from Perky to Pavlov, from alpha rhythms to syzygy. In its scholarship and detachment it is a welcome antidote to the assertive fatuity of so much contemporary theory, offering the thesis, even if tacitly, that a subjectivism inferred from symptoms, e.g., hallucination, imagery and altered states, is preferable to an externalist model of cognition inferred from deficits.

This edition of Developmental Disabilities in Infancy and Childhood includes two edited volumes: Neurodevelopmental diagnosis and treatment and The spectrum of developmental disabilities. This series is a good clinical reference for developmental pediatricians and other medical subspecialists in this field; however, because of its medical orientation its general usefulness to pediatric neuropsychologists and child psychologists is limited.

Larry Leonard's new book, Children With Specific Language Impairment, has the potential to become the definitive text and scholarly resource for students, clinicians, and scientists concerned with these children. This six-part book (comprising 14 chapters) provides a complete, detailed, and even-handed review of the multidisciplinary research in this field.

Because the corresponding author was out of the office on business, corrections could not be made to Table 2 that appeared in JINS, 6:1, p. 24. In the table footnote, for F = 6.39, the degree of freedom should have been added: df = 1,36.

Laird Cermak was to become President of INS in February 2000, taking over the responsibilities for leading a scientific society he loved and served for over a quarter of a century. In many ways he embodied the very values the INS has always hoped to promote in excellence of scholarship, keen interest in behavioral neurosciences, and an easy and reflexive interdisciplinary citizenship. His name has been synonymous with a distinctive line of intellectual inquiry in amnesia and memory mechanisms for as long as I have been in neuropsychology myself.