Capturing daily-life executive impairments in adults: Does the choice of neuropsychological tests matter?

Abstract

Objective

Standardized executive functioning (EF) measures do not reliably capture EF-related difficulties reported in daily life. We aim to determine if an ecologically relevant neuropsychological battery is more strongly associated with self-reported everyday EF impairments than classically used tests.

Method

Fifty-nine adults aged 18–49 self-rated their EF abilities using the Barkley Deficits in EF Scale (BDEFS) and were randomly assigned to complete either a test battery composed of EF measures with hypothesized ecological relevance (Six Elements, Zoo Map, Hayling Sentence Completion, Iowa Gambling, and Auditory Startle Tasks) or one composed of traditional EF tasks (Card Sorting, Trail Making, Color-Word Interference, and Verbal Fluency). Associations were examined using linear regression.

Results

There were no strong associations between BDEFS subscales and performance on either test battery. Only the regression model predicting Emotional Regulation from ecological tasks was significant. Iowa Gambling Task performance and corrugator muscle contraction in the Auditory Startle Task individually contributed significantly to the model, with small and moderate effect sizes respectively.

Conclusion

Results align with evidence that self-reported EF difficulties are not adequately captured by formal neuropsychological measures, even for performance-based measures which directly tap everyday constructs. Findings are interpreted cautiously in the context of a small, high-functioning sample.

Keywords:

• Assessment/diagnosis
• cognition
• measurement/statistics
• tests

Acknowledgements

We gratefully acknowledge the participants who dedicated their time to this research project. BLC is supported by a Canada Research Chair. HW is supported by a Social Sciences and Humanities Research Council (SSHRC) Doctoral Fellowship. SB is supported by a Canadian Institutes for Health Research (CIHR) Postdoctoral Fellowship.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Canada Research Chair in Adult Clinical Neuropsychology, Canadian Institutes of Health Research, Social Sciences and Humanities Research Council of Canada.