In 1999 JINS is celebrating its fifth birthday. It was in July, 1994 that I had the honor of being appointed Editor-in-Chief of our Society's fledgling Journal by the INS Governing Board; and it was with some pride that all of us received the inaugural issue of the Journal in January, 1995. It has been a busy 5 years. At this juncture, it seems appropriate to reflect briefly on what has been, and comment on future directions.

Alcohol and other drug use are common in youth, but neurocognitive sequelae are unclear. This study examines the relationship between neuropsychological functioning and protracted substance use in adolescence. One hundred fifteen adolescents, ages 13 to 19 years, were recruited from inpatient substance abuse treatment programs and followed for 4 years. Adolescents were administered a comprehensive battery of neuropsychological tests and evaluated on substance use involvement during treatment, and at 6-month, 1-year, 2-year, and 4-year follow-up time points. Protracted substance abuse over the 4 years of follow-up was associated with significantly poorer subsequent functioning on tests of attention. In addition, alcohol and drug withdrawal accounted for significant variance in visuospatial functioning, above and beyond demographic, educational, and health variables in detoxified late adolescents and young adults. Results suggest that alcohol and drug withdrawal may be a more powerful marker of protracted neuropsychological impairments than other indices of youthful alcohol and drug involvement. (JINS, 1999, 5, 481–493.)

Memory functioning has been studied extensively in nongeriatric schizophrenic patients, leading to the suggestion that schizophrenic patients manifest a “subcortical” pattern of memory deficits. Few previous studies examined very poor outcome patients with a chronic course of hospitalization. This study examined the association of age and global cognitive dysfunction with verbal and spatial learning and delayed recall, as well as examining differential impairments in delayed recall as compared to delayed recognition memory. Sixty-six chronic schizophrenic patients were studied, with 30 of these patients over the age of 65. Verbal (California Verbal Learning Test) and spatial (Biber Figure Learning Test) serial learning and delayed memory tests were administered. All aspects of memory functioning were correlated with estimates of global cognitive status. When global cognitive status was controlled, age effects were still found for the majority of the memory measures. Delayed recognition memory was not spared, being performed as poorly as delayed recall. In contrast to previous studies of better-outcome patients with schizophrenia, geriatric patients with chronic schizophrenia performed more poorly than nongeriatric patients. The lack of sparing of delayed recognition memory suggests that previous findings of specific recall memory deficit and a subcortical profile of memory impairments may apply to schizophrenic patients with less severe global cognitive impairments. These data suggest that poor-outcome patients may have a pattern of memory impairments that has some features in common with cortical dementia. (JINS, 1999, 5, 494–501.)

The Clock Drawing Test (CDT) is widely used in the assessment of dementia and is known to be sensitive to the detection of deficits in neurodegenerative disorders such as Alzheimer's disease (AD). CDT performance is dependent not only on visuospatial and constructional abilities, but also on conceptual and executive functioning; therefore, it is likely to be mediated by multiple brain regions. The purpose of the present study was to identify component cognitive processes and regional cortical volumes that contribute to CDT performance in AD. In 29 patients with probable AD, CDT performance was significantly related to right-, but not left-hemisphere, regional gray matter volume. Specifically, CDT score correlated significantly with the right anterior and posterior superior temporal lobe volumes. CDT scores showed significant relationships with tests of semantic knowledge, executive function, and visuoconstruction, and receptive language. These results suggest that in AD patients, CDT performance is attributable to impairment in multiple cognitive domains but is related specifically to regional volume loss of right temporal cortex. (JINS, 1999, 5, 502–509.)

In the problem of large-scale multiple testing the p-plot is a graphically based competitor to the notoriously weak Bonferroni method. The p-plot is less stringent and more revealing in that it gives a gauge of how many hypotheses are decidedly false. The method is elucidated and extended here: the bootstrap reveals bias and sampling error in the usual point estimates, a bootstrap-based confidence interval for the gauge is given, as well as two acceptably powerful blanket tests of significance. Guidelines for use are given, and interpretational pitfalls pointed out, in the discussion of a case study linking premortem neuropsychological and postmortem neuropathologic data in an HIV cohort study. (JINS, 1999, 5, 510–517)

This study describes two experiments undertaken to explore the clinical significance and cognitive substrates of Block Design broken configurations in children. Broken configurations were defined as instances in which the child placed a block outside the 2 × 2 or 3 × 3 square matrix. In Experiment 1, 336 normal children between the ages of 6 and 14 were administered WISC–III Block Design. Broken configurations were fairly common, but almost always self-corrected. The tendency to break configurations was inversely related to overall Block Design performance and mother's level of education, and directly related to the perceptual cohesiveness of the design. In Experiment 2, children were administered WISC–III Block Design and a global–local similarity judgment task. The frequency of broken configurations was inversely related to global perceptual bias. Taken together, the results of these experiments indicate that while broken configurations are common, particularly on designs with high perceptual cohesiveness, a high number of broken configurations or final answers containing broken configuration are associated with weaker visuospatial skills. Broken configurations are also made more frequently by children whose perception is less influenced by the global properties of spatial stimuli. (JINS, 1999, 5, 518–524.)

A version of the category fluency test including the categories of animal and transportation, was administered to 316 Chinese native speakers ranging in age from 7 to 95. Results indicated that the number of items generated in the category fluency test increases with age from childhood to adulthood with a peak performance in adults aged from 19 to 30, and then declines subsequently into late life. All participants, regardless of their age, generated more animal than transportation names. Educational level, but not gender, was a significant factor affecting their performance. The participants in all age groups committed very few intrusion and perseveration errors. The results of the present study were in general consistent with those reported in the western countries. Thus, it seems to be appropriate to apply the category fluency test, which was originally developed in western countries, for clinical use in Hong Kong. (JINS, 1999, 5, 525–533.)

The relationship between neurocognitive impairment and employment in a cohort of 130 predominantly symptomatic individuals with HIV–1 infection was examined. Participants were classified as employed (full or part-time for pay) or unemployed (N = 64) and administered a neuropsychological test battery. When covarying for CD4 count, age, and physical limitations, the results revealed that unemployed men performed below that of employed participants on tasks of memory, set shifting–cognitive flexibility, and psychomotor speed. The results are discussed within the context of similar findings in other illnesses. (JINS, 1999, 5, 534–539.)

Limbic system atrophy and memory dysfunction are common in patients with temporal lobe epilepsy (TLE). However, the relationship between extrahippocampal limbic structures and memory functioning within TLE has received little attention. The present study examined associations of MRI volumetric measurements of the mammillary body, fornix, amygdala, and hippocampus to measures of episodic verbal and visual memory. The Logical Memory and Visual Reproduction subtests from the Wechsler Memory Scale were administered to 47 unilateral TLE patients (25 right, 22 left). Normalized right and left MRI volumes were determined for each patient by cursor tracing 1.5 mm slices from 3D-MRI. Significant associations were found between left hippocampal volume and the immediate, delayed, and percent retention scores of the Logical Memory Test; between the left mammillary body volume and the Logical Memory Test delayed and percent retention scores; immediate Visual Reproduction performance was significantly related to the right and left amygdala volumes, and right mammillary body volume; only the right amygdala and right mammillary body volume were associated with the delayed Visual Reproduction trial. However, neither right nor left hippocampal volumes were related to visual memory performance. Multiple limbic system structural volumes were independently associated with verbal and nonverbal memory performance. Results suggest that visual memory, as measured by the Visual Reproduction Test, may be uniquely associated with extrahippocampal volumes in patients with TLE. (JINS, 1999, 5, 540–548.)

Although mesial temporal lobe brain damage is frequently associated with memory loss, it is unclear whether the deficit results entirely from a disruption in the processing of relevant information or whether it also reflects interference from irrelevant information. Directed forgetting is one procedure that can be used, along with standard tests of memory, to investigate this distinction. Seventeen patients with a diagnosis of complex–partial seizures of temporal lobe origin and 17 healthy volunteers were compared on lexical decision, free recall, and recognition tests in a directed-forgetting paradigm. These tests created a memory profile to measure the influence of task relevant and irrelevant information in implicit and explicit memory. Compared with healthy volunteers, the patients were significantly impaired on the memory tasks overall [F(5,25) = 5.01, p < .01]. Specifically, directed forgetting in lexical decision and recognition both discriminated between the groups [stepdown F(1,26) = 6.84, η2 = .26, p < .05 and stepdown F(1,25) = 5.36, η2 = .13, p < .05, respectively]. The results suggest that interictal memory performance in temporal lobe epilepsy may be disrupted in part because of a deficit in the differential processing of task relevant and task irrelevant information, particularly at retrieval. (JINS, 1999, 5, 549–555.)

Structural and physiological frontal brain system deficits in patients with schizophrenia are reviewed quantitatively. We report effect sizes from studies since 1980 that used structural (CT, MRI), and functional (PET) neuroimaging methods. We found both literatures to be distinguished by heterogeneity whereby most patients show normative frontal function and structure, a minority shows diminished values and some patients demonstrate augmented function and structure rather than deficit. The average magnitude of difference between patients and controls is generally too modest to support the idea that frontal brain dysfunction is a necessary component of schizophrenia. This modesty is most apparent in average effects obtained for frontal brain volume (M = −.36), left frontal brain volume (M = −.16), frontal resting metabolism, and blood flow (M = −.64). Effect sizes of this magnitude imply that schizophrenia and control distributions overlap by as much as 88% and no less than about 60% on frontal brain measures. It is only when behavioral measures are employed as activation tasks during frontal blood flow and metabolism studies, that average effect sizes rise in magnitude to indicate patient–control distribution overlaps that are less than 50%. Overall, the findings are hard to incorporate within single disease models that propose major involvement of the frontal system, at least at the degree of resolution obtained with current imaging technology. (JINS, 1999, 5, 556–566.)

Neglect in the horizontal and vertical axes of space has been observed after acute right anterior choroidal artery (AChA) lesions. How spatial processing is affected in the radial axis during the acute period following infarction in this region is unknown. We report the case of a 69-year-old man with acute left hemineglect and deficits in 3-dimensional spatial processing following right AChA infarction. His line bisections in 4 spatial conditions, oriented in the 3 primary axes of space, were compared with 6 control participants. The patient's bisections were different from true center and from control performance in all axes. His bisections were to the right, below, and distal to the arithmetic midpoint. This patient's bisection errors show a 3-dimensional neglect pattern following right AChA infarction, supporting the view that processing of all 3 spatial dimensions may be simultaneously disturbed following unilateral right hemisphere lesions. (JINS, 1999, 5, 567–571.)

This is an encyclopedic report on the state of neuropsychology at the end of the 20th Century. Some individual chapters will have enduring pertinence; some are destined to become historical mileposts as new developments succeed one another in this rapidly evolving discipline. For now and well into the next century, much of what is contained in these volumes will remain pertinent for practitioners, researchers, and theoreticians alike.