Relationship between subjective cognitive concerns and objective neurocognitive performance in primary medical versus primary psychiatric populations

Psychol Med. 2025 May 22:55:e156. doi: 10.1017/S0033291725001084.

Abstract

Background: Subjective cognitive concerns (SCCs) refer to individuals' self-identified cognitive limitations, irrespective of objective neurocognitive performance. Previous literature has overwhelmingly found that psychiatric factors, not neurocognitive dysfunction, are a primary correlate of elevated SCCs across a wide range of clinical populations. However, the relationship between SCCs and objective neurocognitive performance is complex and may further be influenced by underlying mechanisms of various impairments or etiologies. Moreover, much of the extant literature has under-utilized performance validity tests (PVTs) when analyzing objective neuropsychological outcomes.

Methods: As such, this study examined the associations between SCCs, performance validity, neurocognitive performance, and psychiatric distress among adult clinical patients with primary medical/neurologic (n = 127) and psychiatric (n = 106) etiologies.

Results: Results showed that elevated SCCs are associated with greater degrees of performance invalidity and psychiatric distress, but not neurocognitive performance, among both groups.

Conclusions: Findings support the utility of PVTs in clinical research and further highlight the impact of psychiatric factors on SCCs, regardless of medical/neurologic or psychiatric etiology.

Keywords: anxiety; assessment; cognition; depression; neuropsychology; subjective cognitive concerns.

MeSH terms

  • Adult
  • Cognitive Dysfunction* / physiopathology
  • Female
  • Humans
  • Male
  • Mental Disorders* / complications
  • Mental Disorders* / psychology
  • Middle Aged
  • Neuropsychological Tests