Concordance Between Objective Psychometric Neuropsychological Test Findings and Subjective Self-report and its Relationship to Functional Impairment in Depression

Abstract

Depression is associated with a number of cognitive deficits that are associated with increased functional impairment. Cognitive functioning can be examined by way of subjective self-report measures and/or objective performance-based neuropsychological test measures grounded in psychometrics. Depression is associated with impairment on objective psychometric neuropsychological test measures in the domains of attention, memory, executive functioning, and visuospatial functioning. Using subjective self-report of cognitive functioning, depression has also been found to be associated with greater self-reported impairments in attention, memory, and executive functioning. Previous research on the concordance between these types of measures has however produced mixed findings and none have made domain-specific comparisons. Furthermore, if research is able to identify whether one type of measure is a better predictor of functional impairment, this would eliminate the need to use both types of measures, thereby decreasing health care costs. The purpose of the present study was to investigate the concordance between objective psychometric neuropsychological test measures and subjective self-report of cognitive functioning and its relationship to functional impairment in depression. Participants included individuals who had a history of a major depressive episode or major depressive disorder (depressed group: 27 women, 18 men, M(age) = 34.98, SD = 15.73) and university students who had no history of depression (control group: 20 women, 9 men, M(age) = 19.76 years, SD = 5.22). Diagnoses were obtained using a semi-structured clinical interview. Groups were compared on psychometric measures of attention, memory, language, visuospatial functioning, and executive functioning using a neuropsychologist test battery and in terms of subjective self-report of cognitive functioning in the same domains using two self-report measures. Participants also completed questionnaires that examined functional impairment, severity of depression and anxiety symptoms, as well as medical and sociodemographic questionnaires. Results demonstrated that the control group performed significantly worse on objective measures of executive functioning and self-reported greater visuospatial deficits than the depressed group. Furthermore, the depressed group was found to self-report greater functional impairment than controls. Within the depressed group, severity of depression was related to subjective attention, memory, executive functioning, and language, and functional impairment in all domains, but not with objective psychometric neuropsychological test performance. Significant correlations were also found between objective psychometric neuropsychological test measures and subjective self-report of cognitive functioning in the domains of attention and executive functioning. Finally, results suggest that subjective self-report of cognitive functioning may be a better predictor of self-reported functional impairment than objective psychometric neuropsychological test measures.