The National Institutes of Health Toolbox-Cognition Battery (NIHTB-CB) is a tablet-based cognitive assessment intended for individuals with neurological diseases of all ages. NIHTB-CB practice effects (PEs), however, need clarification if this measure is used to track longitudinal change. We explored the test–retest PEs on NIHTB-CB performance at 3 months in young healthy adults (n = 22). We examined corrected T-scores normalized for demographic factors and calculated PEs using Cohen’s d. There were significant PEs for all NIHTB-CB composite scores and on 4/7 subtests. This work suggests the need to further assess NIHTB-CB PEs as this may affect the interpretation of study results incorporating this battery.

The ethical principle of autonomy requires physicians to respect patient autonomy when present, and to protect the patient who lacks autonomy. Fulfilling this ethical obligation when a patient has a communication impairment presents considerable challenges. Standard methods for evaluating decision-making capacity require a semistructured interview. Some patients with communication impairments are unable to engage in a semistructured interview and are at risk of the wrongful loss of autonomy. In this article, we present a general strategy for assessing decision-making capacity in patients with communication impairments. We derive this strategy by reflecting on a particular case. The strategy involves three steps: (1) determining the reliability of communication, (2) widening the bandwidth of communication, and (3) using compensatory measures of decision-making capacity. We argue that this strategy may be useful for assessing decision-making capacity and preserving autonomy in some patients with communication impairments.

The present study is the first to assess phenotypic correlations between alexithymia and the Dark Triad traits of personality in a community sample, as well as the common genetic and environmental factors underlying these correlations. Participants were 232 North American adult twin pairs who completed the Narcissistic Personality Inventory, the Self-Report Psychopathy Scale, the MACH-IV, and the Toronto Alexithymia Scale. Results revealed that alexithymia correlates significantly and positively with psychopathy and Machiavellianism, and negatively with narcissism. Subsequent bivariate behavioral genetic analysis demonstrated that these phenotypic correlations were primarily attributable to common genetic and common non-shared environmental factors. The implication of these findings regarding the maladaptive functions of alexithymia within the antisocial realm of behavior and the need for replication are discussed.