Cognitive Variability in High-functioning Individuals & its Implications for the Practice of Clinical Neuropsychology

Knowledge of the literature pertaining to patterns of performance in normal individuals is essential if we are to understand intraindividual variability in neurocognitive test performance in neuropsychiatric disorders. Twenty-five healthy individuals with a high-level of education were evaluated on a short neuropsychological battery which spanned several cognitive domains. ---Results indicated that cognitive abilities are not equally distributed within a sample of healthy, high-level functioning individuals. This may be of interest to neuropsychologists who might base clinical inference about the presence of cerebral dysfunction, at least in part, on marked variation in a patient’s level of cognitive test performance. The practice of deductive reasoning in clinical neuropsychology may be prone to false-positive conclusions about cognitive functioning in neuropsychiatric disorders where base-rates of cognitive impairments are low and pre-existing educational achievements are high.MAS