This study aimed to investigate which abilities are measured by the Austin Maze. One hundred and eight university students were administered a battery of eight neuropsychological tests including, the Austin Maze, the Tower of London, the Wisconsin Card Sort Test, Block Design, the Visual Spatial Learning Test, Digit Span Backwards, the Brown-Peterson Task and the Wide Range Achievement Test of Reading. Results indicated that visuospatial ability and memory both significantly contributed to performance on the Austin Maze, but differed in the degree to which they explained the performance depending on which measure of maze performance was employed. It appears that visuospatial ability is measured in early trials of the Austin Maze when individuals are orienting themselves to the path. In later trials individuals must call upon visuospatial memory to consolidate the details of the path. Executive function and working memory were not found to be significantly implicated in performance on the Austin Maze. (JINS, 1999, 5, 1–9.)

Thirty codependent cocaine and alcohol users were compared with age-, education-, race-, and sex-matched cocaine abusers (N = 30) and normals (N = 30) using an extended Halstead-Reitan Neuropsychological Test Battery to determine whether cocaine abusers with alcohol dependence were more cognitively impaired than singly addicted cocaine abusers. Tests were grouped and analyzed according to 8 major ability areas. Participants who abused both cocaine and alcohol did not differ from normals on the majority of test measures. An unexpected but consistent finding was the poorer performance of the cocaine sample relative to cocaine and alcohol abusers on measures of complex psychomotor and simple motor functioning (ps < .001). Pure cocaine abusers, but not abusers of both cocaine and alcohol, also performed more poorly than normals on a measure of global neuropsychological functioning (p < .01). These results are consistent with previous reports of generally mild cognitive dysfunction in cocaine abusers. The findings also suggest that cocaine and alcohol abusers of relatively young ages may be less cognitively impaired than demographically comparable cocaine abusers. Evidence from studies of vascular functioning in abusers of cocaine and alcohol alone and in combination is discussed as possible explanation for these findings. (JINS, 1999, 5, 10–19.)

Patients with dementia of the Alzheimer's type (DAT) and their matched controls wrote, on a computer graphics tablet, 4 consecutive, cursive letter ‘l’s, with varying levels of visual feedback: noninking pen and blank paper so that only the hand movements could be seen, noninking pen and lined paper to constrain their writing, goggles to occlude the lower visual field and eliminate all relevant visual feedback, and inking pen with full vision. The kinematic measures of stroke length, duration, and peak velocity were expressed in terms of consistency via a signal-to-noise ratio (M value of each parameter divided by its SD). Irrespective of medication or severity, DAT patients had writing strokes of significantly less consistent lengths than controls', and were disproportionately impaired by reduced visual feedback. Again irrespective of medication or severity, patients' strokes were of significantly less consistent duration, and significantly less consistent peak velocity than controls', independent of feedback conditions. Patients, unlike controls, frequently perseverated, producing more than 4 ‘l’s, or multiple sets of responses, which was not differentially affected by level of visual feedback. The more variable performance of patients supports a degradation of the base motor program, and resembles that of Huntington's rather than Parkinson's disease patients. It may indeed reflect frontal rather than basal ganglia dysfunction. (JINS, 1999, 5, 20–25.)

The standardization data for the California Verbal Learning Test–Children's Version (CVLT–C) were used to evaluate statistically significant discrepancies between key quantitative variables of this instrument, as well as the base rate of specific discrepancies. The results indicated that apparently large discrepancies between the respective standard scores were actually fairly common. However, for 3 of the 4 contrasts, discrepancies that equaled or exceeded 1.5 z-score points in the hypothesized direction were sufficiently unusual to be considered clinically significant. For a 4th contrast, discrepancies that equaled or exceeded 1 z-score point in the hypothesized direction appeared to meet this criterion. It is suggested that the interpretation of clinically obtained CVLT–C profiles should focus primarily on specific quantitative variables, with inclusion of consideration of the presented base rates of discrepancies between the respective z scores. (JINS, 1999, 5, 26–31.)

The ability to process emotional information was assessed in 42 individuals: 23 patients with Alzheimer's disease (AD) and 19 healthy elderly controls. Four tasks assessed the ability to recognize emotion in audiotaped voices, in drawings of emotional situations, and in videotaped vignettes displaying emotions in facial expression, gestures, and body movements. Hemispheric dominance for processing facial expressions of emotions was also examined. There were no consistent group differences in the ability to process emotion presented via the auditory domain (i.e., nonverbal sounds, such as crying or shrieking, and speech prosody). Controls were, however, significantly better than the AD patients in identifying emotions depicted in drawings of emotional situations and in videotaped scenes displaying faces, gestures, and body movements. These differences were maintained after statistically adjusting for the visuospatial abilities of the participants. After a statistical adjustment for abstraction ability, some of the tasks continued to differentiate the groups (e.g., the emotional drawings task, the videotaped displays of faces), but others did not. These results confirm and extend previous results indicating that AD patients do not have a primary deficit in the processing of emotion. They suggest that the difficulties of the AD patients in perceiving emotion are secondary to the cognitive impairments associated with AD. (JINS, 1999, 5, 32–40.)

Individuals infected with the acquired immunodeficiency syndrome (AIDS) are at risk for developing cognitive impairment. The extent to which the impairment represents the results of a single factor accounting for a wide degree of cognitive dysfunction, or is the result of the combined effects of multiple factors, has not been determined. In the present study, we analyzed data from 134 patients with AIDS and 105 HIV− controls using a recently developed analytical procedure. The results revealed that, by and large, the test variables shared a significant amount of variance related to disease status. Hence the AIDS-related influences on cognition are shared and thus cannot be considered independent. Two tests, Digit Symbol Substitution, and the primacy measure of verbal free recall, had a direct relationship with the group variable (AIDS vs. controls). These results suggest that a single factor is sufficient to account for a large proportion of the AIDS-related variance on a wide variety of neuropsychological tests. (JINS, 1999, 5, 41–47.)

Little is known about specific attentional sequelae following a closed head injury, their pattern of recovery or their interaction with ongoing development. The present study examined attentional abilities in a group of children who had sustained a mild, moderate, or severe head injury. Results showed that the severe head injury group exhibited greater deficits on a number of attentional measures at acute and 6 months postinjury phases, in comparison to children in the mild and moderate head injury groups. Specifically, deficits were most evident on timed tasks where speed of processing was an integral component. Difficulties persisted to at least 6 months postinjury and so may lead to cumulative deficits over time. (JINS, 1999, 5, 48–57.)

Previous studies of childhood traumatic brain injury (TBI) have emphasized injury-related variables rather than psychiatric or psychosocial factors as correlates of cognitive outcomes. We addressed this concern by recruiting a consecutive series (N = 24) of children age 5 through 14 years who suffered a severe TBI, a matched group who sustained a mild TBI, and a second matched group who sustained an orthopedic injury. Standardized intellectual, memory, psychiatric, family functioning, family psychiatric history, neurological, and neuroimaging assessments were conducted at an average of 2 years following injury. Severe TBI, when compared to mild TBI and orthopedic injury, was associated with significant decrements in intellectual and memory function. A principal components analysis of independent variables that showed significant (p < .05) bivariate correlations with the outcome measures yielded a neuropsychiatric factor encompassing severity of TBI indices and postinjury psychiatric disorders and a psychosocial disadvantage factor. Both factors were independently and significantly related to intellectual and memory function outcome. Postinjury psychiatric disorders added significantly to severity indices and family functioning and family psychiatric history added significantly to socioeconomic status in explaining several specific cognitive outcomes. These results may help to define subgroups of children who will require more intensive services following their injuries. (JINS, 1999, 5, 58–68.)

Left-to-right reorganization of verbal memory following early left hemisphere damage has been reported in patients whose expressive language is governed by the right hemisphere. We present a case in which verbal memory performance was intact, despite severe left mesial temporal damage, and despite aphasia on left internal carotid sodium amytal ablation. The distribution and degree of left mesial temporal damage was assessed visually and quantitatively on MRI. These findings raise the possibility that verbal memory may shift to the language-nondominant hemisphere as a result of early left mesial temporal damage. (JINS, 1999, 5, 69–74.)

Unilateral spatial neglect entails a failure to detect or respond to stimuli in the space opposite to a brain lesion. However, the contralesional hemispace can be determined by different frames of spatial coordinates, such as eyes-, head-, body-, or environment-centered coordinates. We observed 2 patients with a right hemisphere stroke whose left spatial neglect was modulated by distinct coordinates systems depending on the task. Four tasks were given in different conditions of central gaze and either the eyes or the head rotated 30° to the right or 30° to the left. While the 2 patients had a retinotopic defect in 1 visual field quadrant that remained the same irrespective of gaze direction (upper or lower quadrant in 1 case each), the other quadranopic field defect improved with eyes rotation to the right but not with head rotation, suggesting a head-centered spatiotopic deficit. Performance on line bisection was influenced both by eyes and head rotation, as well as by the position of the lines with respect to the trunk midline, suggesting the involvement of both head-centered and body-centered coordinates. Visual imagery and auditory extinction were not modified by changing the eyes or head position. These findings suggest that distinct spatial coordinates are brought into play depending on the tasks demands. (JINS, 1999, 5, 75–82.)

Of the many factors affecting test validity, ethnicity has received comparatively little attention. This has changed recently with a call for alternative norms or assessment measures that are appropriate for different cultural contexts and for examination of the impact of the variables of culture, ecological demands, primary language, and educational background (Ardila, 1995; Robinson, 1988; Sachdev, 1989; Segall, 1986).

Severely impaired memory deprives amnesics of a sense of personal continuity in their daily lives, yet there are no tests that accurately measure this impairment (see Lezak, 1995). Several neuropsychological tasks have been developed to document the severity of memory loss in terms of memory span, such as the Brown–Peterson Technique (Peterson & Peterson, 1959), but the ecological validity of such tasks as measures of personal or temporal continuity is not obvious (see Heinrichs, 1990). Instead they measure memory in terms of how much information could be held in working or short-term memory, not memory span in the sense of continuity. To develop a new measure of amnesia with greater relation to everyday function, we had to examine the integrity of memory function in terms of temporal continuity in a way that would engage the patient in everyday behavior, such as informal conversation, and still allow memory function to be quantifiable. Thus, we set out to create a bedside task that could measure the span in which the patient with amnesia experiences temporal continuity. We call this measure the “span of temporal continuity,” or “personal and present span of existence.”

In P.S. This Accident Has Changed Everyone and Everything, Kathleen Griffiths has provided a useful reference book for family members of head-injured persons. The title comes from a letter from one such family member; short segments from the experiences of relatives and friends dot the text, fleshing out the personal side in an otherwise “meat-and-potatoes” text. Dr. Griffiths is commended for her translation of the basics of brain injury (from neuropathology to medical assessment and rehabilitation) into plain English, so that fairly technical information is accessible to the layperson. This is perhaps the greatest strength of the book. Clinicians will find the book particularly helpful for family members of severely injured persons with a lengthy period of coma and/or posttraumatic amnesia, and for whom some degree of significant residual impairment is highly likely.

Coping With Mild Traumatic Brain Injury evoked mixed reactions, once my initial excitement to see such a book passed. Written by a psychologist who has survived a combined acquired and traumatic brain injury (cerebral bleed and associated car accident), and coauthored by a writer, the book does an admirable job of describing possible problems that occur following brain injury, along with numerous practical suggestions for coping with these. Excerpts from interviews with other BI survivors are included throughout the book to illustrate problems and solutions. Other strengths include the glossary and resource appendices at the end of the book.

Increasing survival rates after traumatic brain injury have spawned a proliferation of rehabilitation facilities and treatment programs during the past decade. The proliferation has created a diversity of challenging opportunities for neuropsychologists desiring to meet the full range of patients' needs. For many years, neuropsychology focused on diagnosis of neurological conditions, localization of impairment, and describing performance levels on tests measuring abilities. More recently neuropsychologists have been asked to participate as full members of rehabilitation teams and serve as consultants during the rehabilitation process. Now, on a more routine basis, psychologists are asked to provide family support and education, individual psychotherapy, social skills training, cognitive rehabilitation therapy, and vocational rehabilitation services.

This book is monumental in every sense of the word. Before he had the opportunity to complete and publish his project, the final stages of which had occupied him for the past decade, Pierre Gloor suffered a stroke in 1994 that rendered him aphasic. In what was undoubtedly a magnificent act of tribute, an editorial committee of his colleagues prepared the vast manuscript for publication.

This optimistic book about recovery of function after brain injury or disease is written by three neuroscientists specifically to counter the belief that brain injury is permanent and that the brain cannot be repaired. They point out that this belief leads to often inappropriate or no treatment, which then makes it a self-fulfilling prophecy. However there is an increasingly extensive body of evidence from laboratories around the world that given the right conditions and specific chemicals, for example, normal function can be restored. This literature is highly specialized, highly technical, and often apparently unrelated to human recovery. It is also produced at a prodigious rate. According to a 1989 survey, fact-based knowledge doubled every 18 months at that time, and it was predicted that by the year 2010 it will double every 4 weeks. It is not surprising, therefore, that members of a health-professional team have difficulty keeping up with the clinical rehabilitation literature, and that they do not have the time or the energy to read studies on laboratory animals or tissue studies which are not seen as high priority or of relevance to their work.