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This report provides new evidence that neuromedical risk factors influence levels of behavioral impairment in alcoholics. Using a factorial model, the effects of age, neuromedical risk history, and duration of sobriety were studied in relation to neuropsychological performance. The data showed a consistent interaction between duration of abstinence and risk status: Recently detoxified alcoholics (sober 1 month) with a positive premorbid risk history had worse neuropsychological performance than did those without such historical risk events. By contrast, long-term abstinent alcoholics (sober 4 years) did not demonstrate the interaction between alcohol history and positive premorbid risk history. The present results are held to mean that neuromedical risk factors may exert a differential influence on test scores of recently detoxified men, suggesting a source of variance in neurobehavioral studies of alcoholism requiring attention by investigators.

This study indicates that the Lachar MMPI interpretation system is useful in this setting. Overall and specific paragraph accuracy for 98 psychiatric patients' reports suggest clinician acceptance, diagnostic utility, and the potential realization of time savings for the psychologist.

An assessment strategy using multiple levels of observation permitted description of problems in everyday living experienced by cerebral revascularization candidates. We contrasted the neuropsychological deficits and real-world dysfunction displayed by candidates for cerebral revascularization with that manifested by patients with severe spinal complaints. Correlations between selected neuropsychological scores and life quality measures were modest. Prediction of real-world performance in individuals likely will require multivariate combinations of measures. Relationships between life quality measures and neuropsychological scores may differ for patients with known or suspected neurological disease and patients with disorders which do not threaten cognitive functioning.

In a sample of 31 cerebral revascularization candidates, severity and dissemination of atherosclerosis on the cerebral angiogram were correlated with two of three global indicators of neurobehavioral impairment. Additionally, the angiographic rating was correlated with age and with an index of medical risk factors, but not with duration of the longest symptomatic episode. It seems likely that several variables, particularly collateral circulation, help to determine whether a given pattern of stenoses results in neuropsychological dysfunction and what type of behavioral deficit occurs. In many cases, the configuration of neuropsychological test scores may not directly mirror the pattern of cerebrovascular stenoses.