Interview-Based Assessments of Cognition

Interview-based assessments of cognition are appealing as a supplement to neuropsychological assessments, because they are easy to administer, score, and interpret. Some conditions cannot be diagnosed without a subjective cognitive complaint (i.e., Mild Cognitive Impairment [MCI]). An example of this type of measure is the Cognitive Assessment Interview (CAI) (Ventura et al., 2013), a brief, 10-item, interview-based measure of cognitive functioning that is often used in patient populations such as patients with schizophrenia.

Measures of Functional Skills/Performance

The real target of cognitive enhancement is to improve functioning in real-world situations, whether it is the workplace, school, or managing one’s life with more efficiency. However, the assessment of real-world outcomes differs substantially in the context of ongoing clinical studies of some pharmacological agent versus behavioral intervention studies. A 12-week clinical trial is very different because some functional changes require time or may not be benefitted by a pharmacological agent alone.

Assessment of real-world functioning might seem to be a trivial task, in that it would be expected that most people would know where they live, what they do for work, and how many friends they have, and how they manage their finances and medications. However, some of the subpopulations targeted for cognitive enhancement and other skills training programs may present challenges in these areas. Further, for individuals who have experienced challenges and are functioning suboptimally, there may be a complex array of factors, other than skills, that contribute to real-world functioning. These include disability compensation, opportunities in the local area for intervention programs, and the complex interaction between environments, care systems, families, and the patients (Harvey et al., 2009; Rosenheck et al., 2006). Many people can perform skilled acts with person support, even minimal support, but are unable to do so without this assistance. While many of these issues are related to assessments with data collected from various observers or informants, there are technology-based assessments of real-world functioning, including ecological momentary assessment (EMA), which are evolving (especially with developments in technology) and are important in addressing these issues.

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