OBJECTIVE:People with a psychotic disorder often experience financial challenges. Financial competence problems might underlie these challenges, yet little is known about the extent and type of these problems, particularly in the recent-onset phase of psychosis. This study aimed to examine differences in financial competence between people with recent-onset psychosis and matched controls without psychosis. In addition, we assessed participants' financial situation and context. Last, we investigated cognitive functioning and its potential mediating role in group differences in financial competence. METHOD:Thirty-six people with recent-onset psychosis and 40 matched controls completed a comprehensive and standardized financial and cognitive test battery. RESULTS:Compared to controls, people with recent-onset psychosis performed more poorly on most aspects of financial competence. They also reported less favorable outcomes in their financial situation and context. Mediation analyses did not support a robust mediating role of cognitive functioning in explaining group differences in financial competence. CONCLUSIONS:Problems in financial competence, as well as a less favorable financial situation and context, may already be present in the recent-onset phases of psychosis. These difficulties appear to be multifaceted and cannot be explained by cognitive functioning. These findings highlight the need for assessment tools that go beyond cognitive assessment and are specifically designed to evaluate everyday competences such as financial competence. Integrating such assessments into clinical practice could support timely recognition of problems in financial competence and more appropriate, tailored referrals to financial support services for people in the recent-onset phases of psychosis. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Dit artikel gaat in op de resultaten van twee afzonderlijke studies naar hoe mensen met psychose uit twee grootschalige cohorten hun financiële situatie beoordelen en welke factoren daarbij een rol spelen. In beide studies blijkt dat ongeveer een kwart van de mensen met psychose hun financiële situatie negatief beoordeelt. Dat is veel meer dan onder familieleden of in de algemene bevolking. Het negatieve oordeel lijkt deels samen te hangen met middelengebruik, maar komt verder voor bij een heterogene groep mensen met psychose. Geldzorgen zijn een belangrijke stressfactor. De auteurs pleiten voor meer bewustzijn van dit onderbelichte onderwerp bij professionals die mensen met psychose ondersteunen, zodat ze zo nodig tijdig kunnen doorverwijzen naar passende ondersteuning.
Background: Financial capability, encompassing both financial competence and financial performance, is essential for independent living. However, individuals with neurological and psychiatric disorders often demonstrate difficulties with financial capability. This study examined the influence of common neurological and psychiatric conditions, i.e., Alzheimer's disease (AD), Parkinson's disease (PD), stroke, and affective disturbances, on financial performance. Methods: Prospective data from wave 8 (n= 53,695) and wave 9 (n= 69,477) of the Survey of Health, Retirement and Ageing in Europe were used, which included individuals aged 50+; part of Wave 8 and all of Wave 9 data were collected during the COVID-19 pandemic. Logistic regressions and group comparisons were conducted to analyze the influence of self-reported disease diagnosis on three aspects of (future) financial performance: difficulties in managing money, difficulties in making ends meet, and debt situation. Results: Compared to controls, participants with one of the four conditions reported significantly more often having difficulties managing money. Within the AD group, over half of the participants reported these difficulties. The different diagnoses also predicted both current and future difficulties in managing money and making ends meet. However, only affective disorders were associated with and predicted a higher likelihood of having household debts. Discussion and Implications: Compared to controls, individuals with PD, AD, stroke, or affective disorders are more prone to experiencing impairments with both current and future financial performance, potentially facing financial difficulties. These results emphasize the importance of recognizing financial difficulties in such individuals and offering financial assistance when needed.
BACKGROUND:Cognitive impairment in Parkinson's disease (PD) is a key non-motor complication during the disease course. OBJECTIVES:A review of detailed cognitive instruments to detect mild cognitive impairment (PD-MCI) or dementia (PDD) is needed to establish optimal tests that facilitate diagnostic accuracy. METHODS:We performed a systematic literature review of tests that assess memory, language including premorbid intelligence, and visuospatial domains (for tests of attention and executive functions see accompanying review) to determine suitability to assess cognition in PD. Based on in-depth scrutiny of psychometric and other relevant clinimetric properties, tests were rated as "recommended," "recommended with caveats," "suggested," or "listed" by the International Parkinson and Movement Disorder Society (IPMDS) panel of experts according to the IPMDS Clinical Outcome Assessment Scientific Evaluation Committee guidelines. RESULTS:We included 39 tests encompassing 48 outcome measures. Seven tests (different versions or subtests of the test counted once) were recommended, including four for memory, one for visuospatial domains, one for language (including three measures), and one for estimated premorbid intelligence. Furthermore, 10 tests (12 measures) were "recommended with caveats," 11 were "suggested," and 11 (15 measures) were "listed." CONCLUSIONS:Recommended neuropsychological tests in memory, visuospatial functions, and language are proposed to guide the assessment of cognitive impairment and its progression in PD-MCI and PDD, and for use in clinical trials to stratify participants or as outcome measures. Novel measures being developed will need extensive validation research to be "recommended." © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Impulsivity in adult attention-deficit/hyperactivity disorder (ADHD) represents a multidimensional construct rather than a unitary trait. This study examined a proposed three-factor model of impulsivity comprising (a) self-reported impulsive behavior (Barratt Impulsiveness Scale), (b) commission errors, and (c) reaction time measures from neuropsychological tests in 654 adults undergoing routine clinical assessment of adult ADHD. Using confirmatory factor analyses on split subsamples, we found consistent support for the proposed three-factor structure, whereas the network analysis favored a two-group conceptualization that separates performance-based from self-report-based measures. Self-reported impulsivity demonstrated the highest severity levels, followed by commission errors, with reaction times being least affected. Demographic and clinical characteristics significantly predicted self-reports and commission error measures but not reaction times. The results emphasize the importance of interpreting self-reports independently of performance-based tests. The coherence between commission errors and reaction time variables across tasks of related constructs suggests that administering multiple tasks may yield redundant information in the clinical assessment of impulsivity.
PURPOSE:Financial problems are of influence on mental health, and vice versa. Indeed, finances are a key challenge for people with psychosis. To gain deeper insights into these challenges, a qualitative approach focusing on all perspectives within the therapeutic triad is needed. This study aims to investigate perspectives of people with psychosis, family members and mental healthcare professionals on people with psychosis' financial problems, and associated factors. METHODS:Fourteen people with psychosis, 15 family members and 16 professionals were recruited using purposive sampling, and participated in semi-structured, one-on-one interviews. Data was analysed using iterative thematic data-analysis. RESULTS:Interviews revealed five themes of financial problems: Covering expenses, Financial performance, Living conditions and housing, Personal conflicts and victimization, and Regulations and legislation. Five themes were identified as factors associated with financial problems: Psychotic symptoms, Indirect factors related to psychosis, Substance use and addiction, Financial upbringing and life events, and Societal contextual factors. DISCUSSION:People in the therapeutic triad largely mentioned similar, wide-ranging, and often co-occurring (factors associated with) financial problems of people with psychosis, risking vicious cycles. Fostering awareness and collaborative efforts among stakeholders is essential to breaking these cycles of financial problems for individuals with psychosis.
Cognitive difficulties are frequently mentioned by individuals reporting to perceive Low-Frequency Noise (LFN), i.e., noise around and below the average human hearing threshold between the frequencies of 20 Hz and 125/100 Hz. Yet, previous research on the effect of LFN on cognition has shown mixed results and does not provide clear evidence for impaired cognitive performance in relation to LFN. In this cross-sectional study, cognitive functions of individuals reporting LFN perceptions (LFN = 68) and individuals reporting no LFN perceptions (CG = 67) were compared using an extensive test battery measuring several aspects of (complex) attention, memory, and executive functions. In addition, cognitive performances were compared between individuals reporting LFN perceptions during testing (n = 35) and reporting no LFN perceptions during testing (n = 32). The LFN group showed significantly worse performance on the aggregated domain scores of attention and complex attention but not on memory or executive functions. However, these group differences were of small size. Further, no group differences were observed on the cognitive domain scores between individuals reporting LFN perceptions during testing and those reporting no LFN perceptions during testing. Concluding, cognitive difficulties do not seem to be overall strong or profound in individuals with reported LFN perceptions. Future research on factors distinguishing individuals with and without cognitive deficits, such as fatigue or sleep, are recommended.
Parkinson's disease (PD) is a neurodegenerative disorder affecting 1% of people older than 60 years. One of the abilities that seems vulnerable to the cognitive impairments associated with PD is financial capability. This explorative study aimed to evaluate the extent and type of problems in financial capability of people with PD without a diagnosis of dementia. Participants were 31 people with PD and 62 matched controls. Participants completed an extensive test-battery, including measures for financial capability and cognitive functioning. Compared to controls, the PD-group performed significantly poorer on two financial competence tasks and showed a comparable performance on the other financial capability measures. For 45% of the PD-group, cognitive test performance was indicative of mild cognitive impairment, yet no significant difference was observed in overall cognitive functioning between the PD and control group. In the total sample, only small or medium correlations were found between financial competence and cognition, and between financial capability and the contextual factors of income and financial experience. The findings suggest that in the earlier stages of PD, when cognitive impairments are relatively mild, some problems may be observed in financial competence, yet other domains of financial capability appear less affected. The absence of strong correlations between financial competence and overall cognitive functioning indicates that standard neuropsychological assessments seem inadequate to make financial capability determinations. By offering insight into the financial capability of people in the milder stages of PD, the findings of the present study may aid in the development and provision of tailored support.
Background: Subjective everyday hindrances associated with low-frequency noise (LFN) can be high; however, there is still a lot unknown about experienced complaints. This study aims to investigate (1) subjective complaints and (2) coping strategies of individuals reporting everyday hindrances from LFN. Methods: Cognition, depressive symptoms, sleeping, fatigue, stress, and coping questionnaires were administered to participants sampled for their LFN complaints (LFN1 = 181), LFN complainants derived from a community sample (LFN2 = 239), and a comparison group without LFN complaints (CG = 410). Results: Individuals reporting LFN perceptions reported complaints in all domains and showed a higher proportion of above average symptom severity compared to the CG. Most complaints were reported by the LFN1 group, the least by the CG. However, on some sleeping, fatigue, and stress-related variables, a similar or even higher symptom severity was observed in the LFN2 group. Further, all groups used a similar combination of multiple coping strategies, although the LFN1 group scored higher on support seeking. Conclusions: There might be differences in the complaint severity between different LFN subgroups and future investigations of primary and secondary complaints are necessary. Also, more research about the use and success of coping strategies for LFN-related hindrances are needed for clear conclusions.
Subjective cognitive complaints (SCCs) are not directly related to objective impairments in cognition. This study examines the role of psychological factors in predicting SCCs in the domains of executive functioning, memory, and attention in older adults. A community sample of 1,219 Dutch adults, aged 40 year or older, completed the BRIEF-A, MSEQ, FEDA, NEO-FFI, DASS-21, and a demographic questionnaire. Participants were randomly divided into exploratory (n = 813) and confirmatory samples (n = 406). In the exploratory sample, we analyzed whether personality factors, symptoms of depression and anxiety, perceived stress, and demographics could predict SCCs in the different cognitive domains. For this purpose, a two-step regression approach with bootstrapping was used. To independently validate the results, these analyses were repeated in the confirmatory sample. Concerning executive functioning, complaints regarding the ability to regulate behavior and emotional responses were predicted by lower agreeableness levels and higher levels of neuroticism and perceived stress. Complaints regarding the ability to actively solve problems in different circumstances were predicted by a lower conscientiousness level, higher agreeableness level, and more depressive symptoms. Attentional complaints were predicted by lower levels of conscientiousness and extraversion, together with a higher level of neuroticism. For memory, no significant predictors were consistently found. Psychological factors are of influence on the subjective experience of cognitive complaints. In particular personality factors, perceived stress, and symptoms of depression, seem to predict SCCs in the domains of executive functioning and attention. Clinicians should take these factors into account in older adults who have SCCs.
Psychotic disorders have a strong negative impact on multiple aspects of daily life, including people's financial situation. This exploratory study examines the level of financial dissatisfaction and its correlates in a large cohort of people with psychotic disorders. Data from the first assessments of people with psychotic disorders (n = 5271) who were included in the Pharmacotherapy Monitoring and Outcome Survey (PHAMOUS; 2006-2020), which is conducted in the northern Netherlands, were used. The Manchester Short Assessment of Quality of Life (MANSA) was used to measure financial dissatisfaction. In addition, sociodemographic and psychiatric characteristics, substance use and global and social functioning were assessed. One -fifth to one-third of people with psychotic disorders report financial dissatisfaction, fluctuating over the year in which they were assessed. These proportions are considerably higher than in the general population. Cannabis and other substance use were associated with higher levels of financial dissatisfaction (small to medium effect). The other significant associations showed (very) small effect sizes. Therefore, we conclude that financial dissatisfaction in people with psychotic disorders appears to be relatively independent of other demographic and psychiatric characteristics, and global and social functioning. These findings are an important first step for increasing knowledge on financial dissatisfaction among people with psychotic disorders. The findings can also contribute to raising awareness about the topic for healthcare professionals working in this field.
Performance validity tests (PVTs) can be seen as gatekeepers for valid neuropsychological assessment, by marking cognitive test scores that may not reflect true ability levels. The present study explored the significance of repeated validity testing of adults with attention-deficit/hyperactivity disorder (ADHD), by exploring the potential value of performance consistency across assessments. The operational definition of performance consistency was determined by calculating the mean variation in a participant's PVT scores across three separate assessments. Neuropsychological test data of 24 individuals diagnosed with ADHD were complemented by an analogue study involving 69 typically developing individuals who were allocated to either a control group or a simulation group instructed to feign ADHD. All individuals were assessed with embedded and stand-alone PVTs three times with one-month intervals between each assessment. The rate of failed validity testing remained rather stable across assessments. Significant differences in neuropsychological performance scores occurred between individuals with ADHD and experimental simulators, however, mostly nonsignificant effects of small size emerged when considering performance consistency. Our data demonstrate that the consistency of cognitive performance over repeated assessments may be no effective approach to complement validity assessment. Replication is needed in independent research on larger samples.
Background. Psychotic disorders have a strong negative impact on people's lives, including their financial situation. This study aimed to examine differences in unmet financial needs between people with psychotic disorders, parents, siblings, and controls. Secondly, we aimed to examine whether family clustering contributes to unmet financial needs. Lastly, we aimed to examine to what extent demographic, economic, psychiatric, functional, and cognitive characteristics and substance use predict unmet financial needs in people with psychosis. Methods. Data from the first assessment of people with psychosis (n = 956), siblings (n = 889), parents (n = 858), and controls (n = 496) included in the Genetic Risk and Outcome of Psychosis study were used. Group differences were assessed with Kruskal-Wallis tests (aim 1), while a mixed-effects logistic regression analysis and explorative and confirmative ordinal logistic regression analyses were conducted for aims 2 and 3, respectively. Results. Twenty-four percent of people with psychotic disorders reported unmet financial needs. These levels of unmet financial needs were significantly higher than levels for siblings, parents, and controls. We found a negligible influence of (direct) familial clustering on unmet financial needs. Lastly, cannabis and tobacco use significantly and consistently predicted higher levels of unmet financial needs of people with psychosis. Conclusions. Relatively high levels of unmet financial needs occurred in a heterogeneous group of people with psychosis, especially when people used cannabis or tobacco. Unmet financial needs can have detrimental consequences for mental health, stigmatization, leisure time activities, and social engagement. Thus, it is pivotal to recognize unmet financial needs, especially combined with substance use, as a crucial stressor for people with psychosis.
Alcohol use disorder (AUD) forms a major health concern and is the most common substance use disorder worldwide. The behavioural and cognitive deficits associated with AUD have often been related to impairments in risky decision-making. The aim of this study was to examine the magnitude and type of risky decision-making deficits of adults with AUD, as well as to explore the potential mechanisms behind these deficits. To this end, existing literature comparing risky decision-making task performance of an AUD group to a control group (CG) was systematically searched and analysed. A meta-analysis was performed to address overall effects. In total, 56 studies were included. In the majority of studies (i.e., 68%), the performance of the AUD group(s) deviated from the CG(s) on one or more of the adopted tasks, which was confirmed by a small to medium pooled effect size (Hedges' g = 0.45). This review therefore provides evidence of increased risk taking in adults with AUD as compared to CGs. The increased risk taking may be due to deficits in affective and deliberative decision-making. Making use of ecologically valid tasks, future research should investigate whether risky decision-making deficits predate and/or are consequential to the addiction of adults with AUD.
This study applied network analysis to explore the relations between neuropsychological functions of individuals in the clinical evaluation of attention-deficit/hyperactivity disorder (ADHD) in adulthood. A total of 319 participants from an outpatient referral context, that is, 173 individuals with ADHD (ADHD group) and 146 individuals without ADHD (n-ADHD group), took part in this study and completed a comprehensive neuropsychological assessment. A denser network with stronger global connectivity was observed in the ADHD group compared to the n-ADHD group. The strongest connections were consistent in both networks, that is, the connections between selective attention and vigilance, and connections between processing speed, fluency, and flexibility. Further centrality estimation revealed attention-related variables to have the highest expected influence in both networks. The observed relationships between neuropsychological functions, and the high centrality of attention, may help identify neuropsychological profiles that are specific to ADHD and optimize neuropsychological assessment and treatment planning of individuals with cognitive impairment.
Impairments in executive functions (EFs) are common across disorders and can greatly affect daily functioning. Frontal-midline (FM) theta neurofeedback (NF) has been shown effective in enhancing EFs in healthy adults, prompting interest in exploring its potential as an alternative treatment for EFs in (sub)clinical samples. This study aims to determine the effects of FM theta NF on EFs in a sample of 58 adults (aged 20–60 years) with pronounced subjective EF complaints in daily life. Using a pre/post/follow-up design with a sham NF group, the present study assessed upregulation of FM theta in an eight-session individualized FM theta NF training and its immediate and long-term transfer effects on objective and subjective measures of EFs. These included behavioral performance on EF tasks assessing working memory updating (N-back task), set-shifting (Switching task), conflict monitoring (Stroop task), and response inhibition (Stop-signal task), as well as FM theta power during these tasks, and subjective EFs in daily life (BRIEF-A). The results indicate that there are only differences in FM theta self-upregulation between the NF group and sham group when non-responders are excluded from the analysis. Regarding behavioral transfer effects, NF-specific improvements are found in working memory updating reaction time (RT) and conflict monitoring RT variability at 6-month follow-up, but not immediately after the NF training. The effects on FM theta power during the EF tasks and subjective changes in EFs in daily life were not specific to the NF training. As a next step, research should identify the best predictors to stratify NF training, as well as explore ways to improve NF responsiveness, for instance by increasing neuroplasticity.
Although low-frequency noise (LFN) is associated with various complaints, there is still much unknown about this phenomenon. This research aims to provide an extensive description of (1) LFN perceptions, (2) LFN-related complaints, and (3) the characteristics of LFN complainants. In an explorative observational cross-sectional survey study, a sample of Dutch adults reporting to experience LFN (n = 190) and a group not experiencing LFN (n = 371) completed a comprehensive questionnaire. Descriptions of LFN perceptions varied individually and were dependent on different circumstances, although some common patterns were observed. Complaints were wide-ranging and individual, with a reported high impact on daily living. Common complaints included sleeping difficulties, fatigue, or annoyance. Societal consequences were described regarding housing, work, and relationships. Attempts to stop or escape the perception were manifold but often unsuccessful. The LFN sample differed regarding sex, education level, and age from the Dutch adult population, indicating more frequent inability to work, less full-time work, and less years lived in their homes. No further differences in occupational or marital status or living circumstances were found. Although this research supports some previous findings and identifies common patterns, it also highlights the individual nature of LFN-related experiences and the heterogeneity of this group. It is advised to pay attention to the complaints of affected individuals, to inform concerned authorities, and to conduct more systematic and multidisciplinary research using standardized and validated measuring instruments.
Adequate financial capability is crucial in everyday life. This capability might, however, not be given to adults with ADHD. The present study aims to determine strengths and weaknesses regarding everyday financial knowledge and judgment skills in adults with ADHD. In addition, the impact of income is explored. Forty-five adults with ADHD (Mage = 36.6, SDage = 10.2) and 47 adults without ADHD (Mage = 38.5, SDage = 13.0) were included and were assessed with the Financial Competence Assessment Inventory. Adults with ADHD showed decreased scores regarding awareness of the arrival of bills, knowledge of own income, having a reserve fund for unexpected expenses, the ability to state long-term financial goals, own preferences for estate management, understanding of assets, legal action for debt, access to financial advice/counseling, and the ability to compare medical insurance plans as compared with adults without ADHD (all p < 0.001). However, no effect of income was found. In conclusion, adults with ADHD have difficulties with many aspects of everyday financial knowledge and skills, which might result in a plethora of personal and legal consequences. It is, therefore, of the utmost importance that professionals who support adults with ADHD proactively ask about everyday financial functioning so that assessment, financial support, and coaching can be provided.