Arthur Benton, 97, died in Glenview, IL on December 27, 2006. He was born October 16, 1909 in New York City. He received his B.A. and M.A. degrees from Oberlin College, where Raymond Stetson was his mentor, and his Ph.D. in Psychology from Columbia University in 1935 under the mentorship of Carney Landis of the New York State Psychiatric Institute . Benton completed his training as a psychologist at the Payne Whitney Psychiatric Clinic of New York Hospital. Early in 1941, he volunteered for service in the United States Navy and was commissioned as a lieutenant in the medical department. His active duty lasted until 1945, followed by many years of service in the United States Navy Reserve, retiring at the rank of Captain. During his assignment at the San Diego Naval Hospital, Benton worked closely with neurologist Morris Bender and examined servicemen who had sustained penetrating brain wounds during combat. The experience of assessing servicemen with brain injury and Bender's influence led Benton to develop the Visual Retention Test, which still bears his name and continues to be widely used in clinical neuropsychological assessment.

Previous research suggests that reduced self-awareness is common following traumatic brain injury (TBI). However, few studies have examined the magnitude of this problem in a sample representative of hospitalized individuals. In this longitudinal study, individuals with complicated mild to severe TBIs and their significant others (SO) were evaluated at 1 and 12 months postinjury on the Sickness Impact Profile. Awareness was measured by comparing the level of injury-related problems reported by a person with TBI and their SO. Overall, individuals with TBI did not report fewer difficulties than their SO. In contrast, they frequently reported more injury-related difficulties than their SO. As there is no commonly or universally accepted definition for differential awareness, the magnitude of underreporting and overreporting problems is presented using four different cutoff scores. A minimum discrepancy is proposed for defining awareness difficulties that is based on the standard error of measurement of the test–retest difference of the measure. Reduced self-awareness was inconsistent across both time and functional domains. These results suggest that reduced self-awareness is not the norm at 1 or 12 months postinjury and highlight the need for a more standardized approach to the measurement and classification of self-awareness. (JINS, 2007, 13, 561–570.)

Individuals born very preterm (VPT) are at increased risk of perinatal brain injury and long-term cognitive and behavioral problems. Executive functioning, in particular, has been shown to be impaired in VPT children and adolescents. This study prospectively assessed executive function in young adults who were born VPT (<33 weeks of gestation) [n = 61; mean age, 22.25 (±1.07) years; range, 20.62–24.78 years] and controls [n = 64; mean age, 23.20 (±1.48) years; range, 19.97–25.46 years]. Tests used comprised the Wechsler Abbreviated Scale of Intelligence (WASI), the Hayling Sentence Completion Test (HSCT), the Controlled Oral Word Association Test (COWAT), the Animal and Object test, the Trail-Making Test (TMT), and the Test of Attentional Performance (TAP). VPT participants showed specific executive function impairments in tasks involving response inhibition and mental flexibility, even when adjusting for IQ, gender, and age. No significant associations were observed between executive function test scores and perinatal variables or neonatal ultrasound classification. The results suggest that, although free from major physical disability, VPT young adults perform worse than controls on tasks involving selective aspects of executive processing, such as mental flexibility and response inhibition. (JINS, 2007, 13, 571–581.)

Twenty-three chronic nonfluent aphasia patients with moderate or severe word-finding impairments and 11 with profound word-finding impairments received two novel picture-naming treatments. The intention treatment initiated picture-naming trials with a complex left-hand movement and was designed to enhance right frontal participation during word retrieval. The attention treatment required patients to view visual stimuli for picture-naming trials in their left hemispace and was designed to enhance right posterior perisylvian participation during word retrieval. Because the intention treatment addressed action mechanisms and nonfluent aphasia reflects difficulty initiating or maintaining action (i.e., language output), it was hypothesized that intention component of the treatment would enhance re-acquisition of picture naming more than the attention component. Patients with moderate and severe word-finding impairment showed gains with both treatments but greater incremental improvement from one treatment phase to the next with the intention than the attention treatment. Thus, the hypothesis that intention component would be a more active constituent than the attention component was confirmed for these patients. Patients with profound word-finding impairment showed some improvement with both treatments but no differential effects for the intention treatment. Almost all patients who showed treatment gains on either treatment also demonstrated generalization from trained to untrained items. (JINS, 2007, 13, 582–594.)

Some critically ill patients have dramatic recollections of the intensive care unit (ICU), whereas 23–50% have little or no recollection of their ICU stay. In addition, cognitive impairments are common following critical illness and ICU treatment. Little is known regarding the relationship between cognitive sequelae and ICU recall. We assessed recall of the ICU and its relationship to cognitive functioning at hospital discharge and 1 and 2 years after discharge in 70 consecutive acute respiratory distress syndrome (ARDS) patients. Seventeen patients (24%) had no recall of the ICU. Patients without ICU recall had increased rates of cognitive sequelae at hospital discharge and 1-year follow-up compared with the ICU recall group. Patients without ICU recall had a greater magnitude of cognitive impairments at hospital discharge, but not at 1- or 2-year follow-up. Profile analysis showed significant group differences in general intellectual functioning, executive function, processing speed, and spatial skills at hospital discharge, but not at 1- or 2-year follow-up. Estimated premorbid intelligence scores were inversely related to the magnitude of cognitive sequelae, suggesting greater “cognitive reserve” in patients with fewer cognitive decrements. (JINS, 2007, 13, 595–605.)

The goal of this study was to understand factors related to humor comprehension in old age. This study proposes that, in contrast to younger adults, older adults have greater difficulty with humor comprehension due to age-related cognitive decline. Tests of verbal and nonverbal humor comprehension and tests of cognitive flexibility, abstract reasoning, and short-term memory were administered to 40 younger and 41 older adults. In general, older adults scored lower than younger adults on tests of humor and cognitive abilities. Regression analyses support the idea that cognition affects humor comprehension, but the relative contribution of each specific mechanism remains unclear. The results of this study suggest that there may be age-related deficits in humor comprehension, but more importantly, that a more sophisticated model is needed to clarify the role of cognition in humor comprehension. Humor comprehension warrants further study because of the potential physical and psychological benefits of humor. (JINS, 2007, 13, 606–614.)

Many rehabilitation protocols following traumatic brain injury (TBI) utilize reinforcement and reward to influence behavior and facilitate recovery; however, previous studies suggest survivors of severe TBI demonstrate impairments in contingency utilization and sensitivity. The precise neurobiological mechanisms underlying these deficits have not been thoroughly explored, but can be examined using the “feedback-related negativity” (FRN)— an event-related potential (ERP) component evoked following performance or response feedback (e.g., whether a monetary reward is obtained) with a larger FRN following unfavorable than favorable outcomes—particularly when unfavorable feedback occurs in the context of high reward probability. We examined ERPs elicited by favorable (monetary gain: “reward”) and unfavorable (no monetary gain: “non-reward”) feedback during a guessing task where probability of reward outcome was manipulated in survivors of severe TBI and demographically matched healthy participants. Consistent with previous findings, controls showed larger amplitude FRN to non-reward feedback and the largest amplitude FRN following a non-reward when reward probability context was greatest. In contrast, FRN in TBI participants did not significantly differentiate non-reward from reward trials and their FRN was largest to reward trials in the low reward probability context. Findings implicate an electrophysiological marker of impaired reward context sensitivity following severe TBI. (JINS, 2007, 13, 615–625.)

We investigated the psychometric properties of the random number generation (RNG) task in four studies using a mixed sample of young adults (n = 306), middle-aged adults (n = 40), and patients diagnosed with schizophrenia (n = 26). Data in study 1 were best accounted for by a three-factor solution representing inhibition of stereotypical schemas (seriation), output inhibition (repetition), and monitoring of previous output (cycling). Modest test-retest correlations were found, with the seriation factor showing acceptable stability across time (study 2). In study 3, RNG task performance was related to scores on concurrent neurocognitive tasks to establish construct validity. RNG scores correlated with healthy controls' performance on the Stroop color-word test and patients diagnosed with schizophrenia with executive dysfunctions. Patients diagnosed with schizophrenia performed poorer on the seriation factor of the RNG than healthy control participants (study 4). Our results indicate that the RNG task has modest to acceptable psychometric properties. It primarily taps executive subfunctions (i.e., inhibition, updating, and monitoring), which are affected by psychopathological or neurological deficits. (JINS, 2007, 13, 626–634.)

The objective of this study is to determine (a) if decision making ability is impaired in patients with anorexia nervosa (AN) and in people with good recovery from AN and (b) whether any impairment in decision making is associated with alterations in skin conductance responses (SCR). Patients with AN (n = 29), healthy controls comparable in age and IQ (HC, n = 29), and women long term recovered from AN (n = 14), completed the Iowa Gambling Task (IGT) while their SCR were measured. AN patients performed poorly in the IGT compared to the HC and to the recovered AN participants. AN patients had decreased anticipatory SCR prior to choosing cards and reduced SCR after losses compared to HC. IGT performance and the SCR of recovered AN participants did not differ from the HC. Decision making ability is impaired in AN. It is associated with a significantly attenuated SCR. Neither of these features are found in recovered AN. The association between impaired decision making ability and a decreased autonomic response is consistent with the predictions of the Somatic Marker Hypothesis. (JINS, 2007, 13, 635–641.)

The study investigated the nature of the effects of maternal epilepsy on cognitive performance of the offspring. One hundred fifty-four children of mothers with epilepsy aged 5 to 11 years (study group), along with 130 control children, comparable with respect to IQ, socio-economic status, age, and gender underwent a neuropsychological assessment using subtests from the NEPSY: A Developmental Neuropsychological Assessment, tapping attentional, auditory-verbal, visuomotor, fine motor, and memory abilities. The study group scored significantly lower than the controls on measures of attention, memory, and fine-motor function. Deficits were more marked in but not limited to the subset of the study group exposed to maternal medication in utero. Group differences on auditory attention were found only in younger children. Valproate-exposed children obtained lower scores on sentence repetition, as well as on the more demanding part of a test of auditory attention, than other children in the study group, suggesting weaknesses in working memory in the former subgroup. Confounding by maternal epilepsy type and polytherapy complicate interpretation of this finding. Differences between subsets of children not exposed to anti-epileptic drugs in utero and controls suggest that both drug exposure and genetic factors may contribute to cognitive deficits associated with maternal epilepsy. (JINS, 2007, 13, 642–652.)

A hallmark of schizophrenia is impaired proverb interpretation, which could be due to: (1) aberrant activation of disorganized semantic associations, or (2) working memory (WM) deficits. We assessed 18 schizophrenia patients and 18 normal control participants on proverb interpretation, and evaluated these two hypotheses by examining within patients the correlations of proverb interpretation with disorganized symptoms and auditory WM, respectively. Secondarily, we also explored the relationships between proverb interpretation and a spectrum of cognitive functions including auditory sensory-memory encoding (as indexed by the mismatch negativity (MMN) event-related brain potential (ERP)); executive function; and social/occupational function. As expected, schizophrenia patients produced less accurate and less abstract descriptions of proverbs than did controls. These proverb interpretation difficulties in patients were not significantly correlated with disorganization or other symptom factors, but were significantly correlated (p < .05) with WM impairment, as well as with impairments in sensory-memory encoding, executive function, and social/occupational function. These results offer no support for disorganized associations in abnormal proverb interpretation in schizophrenia, but implicate WM deficits, perhaps as a part of a syndrome related to generalized frontal cortical dysfunction. (JINS, 2007, 13, 653–663.)

Reliable neuropsychological markers of right temporal integrity have proven elusive. Specifically it is unclear whether figural and spatial aspects of visual memory are differentially affected by right temporal lobe epilepsy (TLE) and subsequent resection. To investigate this we used the modified Rey Complex Figure (RCF) scoring system devised by Brier et al. (1996) to obtain separate indices of figural and spatial memory in TLE surgery candidates. We extended on their study by examining presurgical performance and change following right and left temporal lobectomy (RATL, n = 38, LATL, n = 42) in individuals from a cross-institutional sample with and without hippocampal sclerosis (HS+/HS−). Contrary to expectation neither figural nor spatial RCF recall were differentially sensitive to RTLE, right HS, or subsequent resection. Presurgically, laterality effects on both figural and spatial memory indices were not found although HS− individuals significantly outperformed HS+ individuals on both measures. Following surgery the largest decrements in both figural and spatial recall were observed among LATL HS− participants. We concluded that RCF recall is a poor marker of right temporal lobe function and suggest it may be a “surrogate” measure of left temporal lobe function possibly due to the verbalizability of many of its components. (JINS, 2007, 13, 664–671.)

This study compares neuropsychological functioning in a Japanese schizophrenia spectrum disorder group and a group of healthy Japanese volunteers. Participants were 37 patients diagnosed with schizophrenia, 28 schizotypal patients, and 99 psychiatrically-normal volunteers. A wide range of cognitive measures were examined. All participants completed a Japanese version of a neuropsychological battery assessing executive function, working memory, processing speed, language, verbal memory, and spatial organization. Comparisons of neuropsychological function demonstrated similarities and differences between patients diagnosed with schizotypal disorder and those diagnosed with schizophrenia. Impairments in verbal memory, language, and processing speed were common to both patient groups and may represent a vulnerability to schizophrenia. Impairments in aspects of working memory, spatial organization and executive function were preferentially observed in schizophrenia and may be features of the overt manifestation of psychosis. Possible differences in the contributions of prefrontal and temporolimbic structures provide direction for further studies. (JINS, 2007, 13, 672–682.)

The neural representation of peripersonal space may be distinct from the representation of extrapersonal space. Sex differences in the performance of motor tasks might relate to proximity to the body. In the spatial domain, females excel at tasks performed in peripersonal space, like the Object Location Memory Task (OLMT), whereas males excel at tasks performed in extrapersonal space, such as navigation. We compared performance on the OLMT in peripersonal space with performance on the same task in extrapersonal space (using a between-subjects design). As predicted, the typical female advantage was observed for the peripersonal OLMT. However, for the extrapersonal OLMT, the female advantage disappeared and males actually outperformed females. These results suggest that the sex differences observed in the OLMT, and potentially other tasks that exhibit sex differences in performance, may be related to sex differences to spatial-motor systems that are preferentially tuned to proximity. (JINS, 2007, 13, 683–686.)

This study evaluated the influence of cognitive reserve on neuropsychological test performance in 198 patients infected with the hepatitis C virus. IQ scores, educational level, and occupational rating were combined to calculate a Cognitive Reserve Score (CRS) for each patient. Similar to studies of infection with the human immunodeficiency virus, there was a significantly increased risk of impairment in neuropsychological test performance in individuals with lower CRSs. It is important to account for CRS when assessing cognitive findings in large-scale clinical trials. (JINS, 2007, 13, 687–692.)Financial relationships of the authors with Hoffmann-La Roche, Inc., are as follows: K.L. Lindsay is a consultant and receives research support; A.S.F. Lok is a consultant and receives grant support; and R.J. Fontana is on the speaker's bureau. Authors with no financial relationships related to this project are as follows: L.A. Bieliauskas, C. Back-Madruga, E.C. Wright, and Z. Kronfol.

Attention-deficit/hyperactivity disorder (ADHD) is characterized by inattention and/or hyperactivity/impulsivity. Impulsivity persists in adults with ADHD and might be the basis of much of the impairment observed in the daily lives of such individuals. The objective of this study was to address the presence, and more importantly, the three dimensions of impulsivity: attentional, non-planning and motor, in how they may relate to neuropsychological mechanisms of impulse control. We studied a sample of 50 adults with ADHD and 51 healthy comparison controls using the Barratt Impulsivity Scale Version 11 (BIS), and neuropsychological tasks, namely the Continuous Performance Task (CPT-II) and the Iowa Gambling Task (IGT). The ADHD group showed more signs of impulsivity on the three dimensions of BIS, committed more errors of omission and commission on the CPT-II, and made more disadvantageous choices on the IGT. These results support the existence of deficits related to three components of impulsivity: motor, cognitive, and attentional among adults with ADHD. Most importantly, this study also highlights the complementary nature of self-report questionnaires and neuropsychological tasks in the assessment of impulsivity in ADHD adults. (JINS, 2007, 13, 693–698.)

Affective instability is a core dimension of borderline personality disorder. The somatic marker hypothesis suggests that emotions play a crucial role in decision making. In this preliminary study, decision making was assessed in individuals with borderline personality disorder. Patients with borderline personality disorder (n = 20) and healthy comparison subjects (n = 15) were tested with the Iowa Gambling Task (IGT). The patients showed less advantageous choices on the IGT than did the healthy comparison subjects. The results could not be explained by indicators of general cognitive function or by symptoms of depression. These findings demonstrate that deficits in decision making in borderline personality disorder may manifest themselves in an ecologically valid neuropsychological test. Future studies should address whether those deficits are related to the behavioral characteristics of affective dysregulation and/or impulsivity, to the proposed dysfunctions and reduced volume of the orbitofrontal cortex and/or the amygdala, and to other neuropsychological functions. (JINS, 2007, 13, 699–703.)

This study evaluated cognitive set-shifting in 12 patients with focal lesions in the lateral prefrontal cortex (LPC) by examining their performance on the Trail Making Test from the Delis-Kaplan Executive Function System (D-KEFS). Patients with LPC lesions performed significantly worse than controls on the D-KEFS Trail Making Test on the Letter Sequencing, Number-Letter Switching (set-shifting), and Motor Speed conditions. Patients with LPC lesions performed significantly more slowly on the Number-Letter Switching condition even after controlling for performance on the four baseline conditions of the test. In addition, patients with LPC lesions exhibited significantly elevated error rates on the Number-Letter Switching condition. Results suggest that LPC lesions can lead to impaired cognitive set-shifting on a visual-motor sequencing task. (JINS, 2007, 13, 704–709.)

Recency discrimination has been conceptualized as an executive ability by some investigators and as an aspect of episodic memory by others. We compared the performance of 261 neurologically healthy adults on a recency discrimination task (RDT) with their performance on measures of executive functioning and explicit memory. Mean z-transformed raw scores were used to construct indices of visual and verbal explicit memory, fluency, and executive functioning. Analyses revealed that RDT performance correlated more closely with visual (r = 0.32; p < 0.001) and verbal memory (r = 0.25; p < 0.001) than with fluency (r = 0.16; p < 0.05) and executive functioning (r = 0.13; p < 0.05). These findings suggest that recency discrimination might be better understood as an aspect of episodic memory that is subserved primarily by hippocampal and medial temporal structures than as an executive function that is subserved primarily by prefrontal cortex. (JINS, 2007, 13, 710–715.)

A central role for neuropsychological evaluations is the measurement of change in cognitive functioning over time. However, change scores obtained from repeated neuropsychological assessments may be affected by normal variability because of measurement error and practice effects caused by repeated measurements. The current study uses reliable change estimates to establish normative rates of change on the Dementia Rating Scale from baseline to first follow-up testing among 1080 cognitively normal adults aged 65 and older. Results showed that a 6-point decline by European Americans or a 9-point decline by African American adults within a 9–15 month test-retest interval represents reliable change. Within a 16–24-month test-retest interval, a 7-point decline among European Americans or an 8-point decline among African American adults represents reliable change. In addition, preliminary cross-validation was performed in a clinical comparison sample of another 22 older adults. The findings are discussed in the context of potential clinical and research applications. (JINS, 2007, 13, 716–720.)