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Appl Neuropsychol Adult. 2014;21(1):28-35. doi: 10.1080/09084282.2012.721148. Epub 2013 Jun 14.

Emotional distress affects attention and concentration: the difference between mountains and valleys.

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a Meyers Neuropsychological Services , Mililani , Hawaii.


The current study tests the hypothesis that the "mountains and valleys pattern" (MVP) observed within the Attention and Concentration domain of the Meyers Neuropsychological Battery reflects the interference of emotional distress/anxiety on the patient's cognitive test performance. First, the MVP was objectively quantified using a formula that took into account both increased and decreased scores, rather than canceling them out through averaging. Using a total sample of 787 subjects, the Minnesota Multiphasic Personality Inventory-Second Edition Restructured Form (MMPI-2-RF) profile scores of cases with and without this pattern were then compared using an extensive database followed by a smaller, matched-groups design. The presence of the MVP was related to MMPI-2-RF test performance. In particular, this pattern was related to emotional distress/anxiety scales but was not related to scales reflecting neurological or cognitive complaints. The degree of emotional distress experienced may affect attention and concentration test performance in a way that sometimes heightens focus and at other times disrupts focus. The MVP may be used to assess the effects of emotional distress on the consistency of an individual patient's attention and concentration test performance.


MMPI-2-RF; Meyers Neuropsychological Battery; anxiety; attention; concentration; emotional distress; neuropsychological assessment

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