Abstract: There is a larger proportion and number of older adults in the labor force than ever before. Furthermore, older adults in the workforce are working until later ages. Although a great deal of research has examined physical health and well-being of working older adults, less research has focused on cognitive functioning. The purpose of this article is to provide a broad contemporary and multidisciplinary review of the intersection between cognitive functioning, aging, and work as a follow-up to a paper previously written by Fisher et al. (2014). We begin by providing definitions and background about cognitive functioning and how it changes over the life span. Next we discuss theories relevant to the intersection of cognitive functioning and work, including the use-it-or-lose-it hypothesis, the cognitive reserve hypothesis, hypotheses regarding environmental influences on intellectual functioning, and the job-demands-resources model. Then we summarize recent research about the effects of work on cognitive functioning, as well as ways that cognitive functioning may influence work motivation, learning, development, training, and safety. We conclude by emphasizing the importance of person-environment fit, suggesting avenues for future research, and discussing practical implications for the field of occupational health psychology. (PsycINFO Database Record

Abstract: Objectives The objectives of this Introduction to the Journal of Gerontology: Psychological Sciences special issue on "50 Years of Cognitive Aging Theory" are to provide a brief overview of cognitive aging research prior to 1965 and to highlight significant developments in cognitive aging theory over the last 50 years. Method Historical and recent theories of cognitive aging were reviewed, with a particular focus on those not directly covered by the articles included in this special issue. Results Prior to 1965, cognitive aging research was predominantly descriptive, identifying what aspects of intellectual functioning are affected in older compared with younger adults. Since the mid-1960s, there has been an increasing interest in how and why specific components of cognitive domains are differentially affected in aging and a growing focus on cognitive aging neuroscience. Discussion Significant advances have taken place in our theoretical understanding of how and why certain components of cognitive functioning are or are not affected by aging. We also know much more now than we did 50 years ago about the underlying neural mechanisms of these changes. The next 50 years undoubtedly will bring new theories, as well as new tools (e.g., neuroimaging advances, neuromodulation, and technology), that will further our understanding of cognitive aging.

Abstract: Byline: Choudhary. Narayan, Thomas. John Introduction After India signed and ratified the UNCRPD in 2007, the process of enacting a new legislation in place of the Persons with Disabilities Act, 1995 (PWD Act, 1995) began in 2010 to make it compliant with the UNCRPD. After series of consultation meetings and drafting process, the Rights of PWD Act, 2016 (RPWD Act, 2016) was passed by both the houses of the Parliament. It was notified on December 28, 2016 after receiving the presidential assent.[sup][1] Principles stated to be implemented for empowerment of persons with disabilities (PWD) are respect for inherent dignity, individual autonomy including the freedom to make one's own choices, and independence of persons. The Act lays stress on nondiscrimination, full and effective participation and inclusion in society, respect for difference and acceptance of disabilities as part of human diversity and humanity, equality of opportunity, accessibility, equality between men and women, respect for the evolving capacities of children with disabilities, and respect for the right of children with disabilities to preserve their identities. The principle reflects a paradigm shift in thinking about disability from a social welfare concern to a human rights issue. The Persons with Disabilities Act, 1995 The PWD (Equal Opportunities, Protection of Rights, and Full Participations) Act, 1995 was enacted to give an effect to the “Proclamation on the Full Participation and Equality of the People with Disabilities in the Asian and Pacific Region.”[sup][2] The Proclamation was issued in a meeting of the Economic and Social Commission for Asia and the Pacific Region in December 1992 at Beijing, to launch the “Asian and Pacific Decade of Disabled Persons 1993–2002.” The Act listed seven conditions of disabilities, which were blindness, low vision, leprosy cured, hearing impairment, locomotor disability, mental retardation, and mental illness. Mental retardation was defined as “a condition of arrested or incomplete development of mind of a person which is specially characterized by subnormality of intelligence.” Mental illness was defined simply as “any mental disorder other than mental retardation.” The Act adopted an approach of social welfare in respect of PWD and the main focus was on prevention and early detection of disabilities, education and employment of the PWD. The Act also provided 3% reservation in Government jobs and educational institutions. It stressed on making the barrier-free situations as a measure of nondiscrimination. Salient Features of the Rights of Persons with Disabilities Act, 2016 In the RPWD Act, 2016, the list has been expanded from 7 to 21 conditions and it now also includes cerebral palsy, dwarfism, muscular dystrophy, acid attack victims, hard of hearing, speech and language disability, specific learning disabilities, autism spectrum disorders, chronic neurological disorders such as multiple sclerosis and Parkinson's disease, blood disorders such as haemophilia, thalassemia, and sickle cell anaemia, and multiple disabilities. The nomenclature mental retardation is replaced by intellectual disability which is defined as “a condition characterized by significant limitation both in intellectual functioning (reasoning, learning, problem-solving) and in adaptive behavior which covers a range of every day social and practical skills including specific learning disabilities and autism spectrum disorders.” The Act provides an elaborate definition of mental illness which is “a substantial disorder of thinking, mood, perception, orientation, or memory that grossly impairs judgment, behavior, and capacity to recognize reality or ability to meet the ordinary demands of life but does not include retardation which is a condition of arrested or incomplete development of mind of a person, especially characterized by subnormality of intelligence. …

Abstract: Objective: Increasing numbers of students with attention-deficit/hyperactivity disorder (ADHD) are attending college; however, little empirical information is available concerning the functional impairment experienced by these students. Although preliminary studies suggest that college students with ADHD are more likely to experience a variety of psychosocial and academic difficulties compared to their peers without the disorder, findings regarding neuropsychological functioning have been inconsistent with some studies reporting that college students with ADHD perform more poorly on various cognitive and neuropsychological tasks while others report no differences compared to their peers without ADHD. Method: The purposes of the present study, the Trajectories Related to ADHD in College project, a longitudinal study following the 4-year outcomes of college students with and without ADHD, were to (a) examine the performance of 436 first-year college students with and without ADHD (51.6% female) on measures of executive function (EF) and intelligence and (b) investigate the association of self-reported use of stimulant medication and neuropsychological performance in students with ADHD. Participant data from their first year of involvement in the study were analyzed. Results: Participants with ADHD performed more poorly on task-based and self-report EF measures relative to the comparison group. In contrast, no significant group differences were found with respect to intellectual performance. Within the ADHD group, use of prescription stimulant medication was associated with improved performance on some, but not all, neuropsychological tasks. Additional analyses also revealed significant group differences in EF based on clinical diagnostic status. Conclusion: College students with ADHD demonstrated poorer EF than their peers without ADHD and psychostimulant medication was associated with improved EF performance. No group differences were found with respect to intellectual functioning, Lastly, having one or more comorbid psychiatric diagnoses in addition to ADHD was associated with poorer EF outcomes.

Abstract: Background: This study explored the effectiveness of eye movement desensitisation and reprocessing (EMDR) therapy for post-traumatic stress disorder (PTSD) in persons with mild to borderline intellectual disability (MBID) using a multiple baseline across subjects design. Methods: One child and one adolescent with MBID, who met diagnostic criteria for PTSD according to a PTSD clinical interview (i.e., ADIS-C PTSD section), adapted and validated for this target group, were offered four sessions of EMDR. PTSD symptoms were measured before, during and after EMDR, and at six weeks follow-up. Results: For both participants, number of PTSD symptoms decreased in response to treatment and both no longer met PTSD criteria at post-treatment. This result was maintained at 6-week follow-up. Conclusions: The results of this study add further support to the notion that EMDR can be an effective treatment for PTSD in children and adolescents with MBID. Replication of this study in larger samples and using a randomized controlled design is warranted.

Abstract: OBJECTIVE To review selected research in cognitive aging incorporating an individual differences approach. METHOD Three contributions of the individual differences perspective in cognitive aging are illustrated with data from the Virginia Cognitive Aging Project. RESULTS Research capitalizing on the variability among individuals has been used to: (a) improve sensitivity and validity of measurement of cognitive functioning, and evaluate possible age differences in the meaning of the measures; (b) investigate relations between age and individual cognitive measures in the context of other types of cognitive measures; and (c) examine the degree to which age-related influences on target measures are statistically independent of age-related influences on other cognitive measures. DISCUSSION Although the primary focus of much of the research in cognitive aging has been on mean differences between people of different ages, people differ in many respects besides age. A fundamental assumption of the individual differences perspective is that at least some of those differences may be informative about the nature, and causes, of the relations between age and cognitive functioning.

Abstract: This study examined the prevalence of learning and psychological diagnoses and associated neurological and personal-environmental risk factors following perinatal and childhood arterial ischemic stroke. In our sample of 126 children and youth, 52.4% received a diagnosis following their assessment. Specifically, 32% had a single diagnosis and 21% had two or more diagnoses. Learning disability, attention deficit-hyperactivity disorder, and intellectual disability were the most prevalent diagnoses. Associated risk factors varied by diagnosis with lower intellectual functioning being the common risk factor across categories. Seizure status was associated with intellectual disability whereas family history was related to ADHD and comorbid diagnoses.

Abstract: Schizophrenia is a severe psychiatric disorder associated with IQ deficits. Rare copy number variations (CNVs) have been established to play an important role in the etiology of schizophrenia. Several of the large rare CNVs associated with schizophrenia have been shown to negatively affect IQ in population-based controls where no major neuropsychiatric disorder is reported. The aim of this study was to examine the diagnostic yield of microarray testing and the functional impact of genome-wide rare CNVs in a community ascertained cohort of adults with schizophrenia and low (< 85) or average (≥ 85) IQ. We recruited 546 adults of European ancestry with schizophrenia from six community psychiatric clinics in Canada. Each individual was assigned to the low or average IQ group based on standardized tests and/or educational attainment. We used rigorous methods to detect genome-wide rare CNVs from high-resolution microarray data. We compared the burden of rare CNVs classified as pathogenic or as a variant of unknown significance (VUS) between each of the IQ groups and the genome-wide burden and functional impact of rare CNVs after excluding individuals with a pathogenic CNV. There were 39/546 (7.1%; 95% confidence interval [CI] = 5.2–9.7%) schizophrenia participants with at least one pathogenic CNV detected, significantly more of whom were from the low IQ group (odds ratio [OR] = 5.01 [2.28–11.03], p = 0.0001). Secondary analyses revealed that individuals with schizophrenia and average IQ had the lowest yield of pathogenic CNVs (n = 9/325; 2.8%), followed by those with borderline intellectual functioning (n = 9/130; 6.9%), non-verbal learning disability (n = 6/29; 20.7%), and co-morbid intellectual disability (n = 15/62; 24.2%). There was no significant difference in the burden of rare CNVs classified as a VUS between any of the IQ subgroups. There was a significantly (p=0.002) increased burden of rare genic duplications in individuals with schizophrenia and low IQ that persisted after excluding individuals with a pathogenic CNV. Using high-resolution microarrays we were able to demonstrate for the first time that the burden of pathogenic CNVs in schizophrenia differs significantly between IQ subgroups. The results of this study have implications for clinical practice and may help inform future rare variant studies of schizophrenia using next-generation sequencing technologies.

Abstract: Aboriginal children in Canada are at high risk of fetal alcohol spectrum disorder (FASD) but there is little research on the cognitive impact of prenatal alcohol exposure (PAE) in this population. This paper reviews the literature on parent report of executive functioning in children with FASD that used the Behavior Rating Inventory of Executive Function (BRIEF). New data on the BRIEF is then reported in a sample of 52 Aboriginal Canadian children with FASD for whom a primary caregiver completed the BRIEF. The children also completed a battery of neuropsychological tests. The results reveal mean scores in the impaired range for all three BRIEF index scores and seven of the eight scales, with the greatest difficulties found on the Working Memory, Inhibit and Shift scales. The majority of the children were reported as impaired on the index scores and scales, with Working Memory being most commonly impaired scale. On the performance-based tests, Trails B and Letter Fluency are most often reported as impaired, though the prevalence of impairment is greater for parent ratings than test performance. No gender difference is noted for the parent report, but the boys had slightly slower intellectual functioning and were more perseverative than the girls on testing. The presence of psychiatric comorbidity is unrelated to either BRIEF or test scores. These findings are generally consistent with prior studies indicating that parents observe considerable executive dysfunction in children with FASD, and that children with FASD may have more difficulty with executive functions in everyday life than is detected by laboratory-based tests alone.

Abstract: Persons with mild intellectual disability or borderline intellectual functioning are often studied as a single group with similar characteristics. However, there are indications that differences exist within this population. Therefore, the aim of this study was to identify classes of persons with mild intellectual disability or borderline intellectual functioning and to examine whether these classes are related to individual and/or environmental characteristics. Latent class analysis was performed using file data of 250 eligible participants with a mean age of 26.1 (SD 13.8, range 3–70) years. Five distinct classes of persons with mild intellectual disability or borderline intellectual functioning were found. These classes significantly differed in individual and environmental characteristics. For example, persons with a mild intellectual disability experienced fewer problems than those with borderline intellectual disability. The identification of five classes implies that a differentiated approach is required towards persons with mild intellectual disability or borderline intellectual functioning.

Abstract: Background There has been substantial increase in the number of people with mild intellectual disability (MID) or borderline intellectual functioning referred to long-term care. Insight into the specific characteristics and needs of these people is essential to provide appropriate support and gain insight into the increase in referrals.Method This retrospective descriptive study was based on a structured case analysis of a sample of 250 participants.Results Mental health problems and exposure to social and familial disadvantages were common. Care provided before referral tended to be suboptimal. Individuals with borderline intellectual functioning had more personal and contextual problems than people with MID.Conclusion People with MID or borderline intellectual functioning are confronted with a wide range of complex problems; even after years of professional support they may still need intensive support. Differences in the characteristics and contexts between individuals with MID or borderline in...

Abstract: Background One of the difficulties in assessing and treating PTSD in people with intellectual disability is that it may not present with the typical symptoms associated with the disorder. This may be why there is a dearth of literature on the treatment of PTSD using cognitive behavioural approaches for people with intellectual disability (e.g. Ehlers et al. Behav Res Ther, 43, 2005, 413–431). This paper reports the treatment for PTSD in a young man diagnosed with autism and a mild intellectual disability. Method Treatment involved 12 sessions of cognitive therapy for PTSD using the approach developed by Ehlers et al. Results There was an overall reduction in symptoms and a self-reported elevation in mood. With careful questioning, adaptation of language and elucidation of concepts, the patient was able to fully engage in therapy. Discussion This case suggests that cognitive approaches to treating PTSD can be successful in people with intellectual disability and autism.

Abstract: BACKGROUND: People with intellectual disability or borderline intellectual functioning may have poorer mental health than their peers. The present authors sought to (i) estimate the risk of poorer mental health among British adults with and without intellectual impairments and (ii) estimate the extent to which any between-group differences in mental health may reflect between-group differences in rates of exposure to common social determinants of poorer health. MATERIALS AND METHODS: The present authors undertook secondary analysis of confidentialized unit records collected in Wave 3 of Understanding Society. RESULTS: British adults with intellectual impairments living in general households are at significantly increased risk of potential mental health problems than their non-disabled peers (e.g. GHQ Caseness OR = 1.77, 95% CI (1.25-2.52), P < 0.001). Adjusting for between-group differences in age, gender and indicators of socio-economic position eliminated this increased risk [GHQ Caseness adjusted OR = 1.06, 95% CI (0.73-1.52), n.s]. CONCLUSIONS: Our analyses are consistent with the hypothesis that the increased risk of poor mental health among people with intellectual impairments may be attributable to their poorer living conditions rather than their intellectual impairments per se. Greater attention should be given to understanding and addressing the impact of exposure to common social determinants of mental health among marginalized or vulnerable groups.

Abstract: This book examines the influence others have on the lives of people with intellectual disabilities and how this impacts on their psychological well-being. Based on the authors’ clinical experiences of using cognitive behavioural therapy with people who have intellectual disabilities, it takes a social interactionist stance and positions their arguments in a theoretical and clinical context. The authors draw on their own experiences and several case studies to introduce novel approaches on how to adapt CBT assessment and treatment methods for one-to-one therapy and group interventions. They detail the challenges of adapting CBT to the needs of their clients and suggest innovative and practical solutions. This book will be of great interest to scholars of psychology and mental health as well as to therapists and clinicians in the field.

Abstract: Objective: This retrospective cohort study characterized cognitive and motor outcomes in a large sample of adults who underwent frontal lobe resections for treatment of pharmacoresistant epilepsy. Methods: Ninety patients who underwent unilateral frontal lobe resection for epilepsy (42 language-dominant hemisphere/48 nondominant hemisphere) between 1989 and 2014 completed comprehensive preoperative and postoperative neuropsychological evaluations that included measures of verbal and nonverbal intellectual functioning, attention/working memory, processing speed, language, executive functioning, verbal and visual memory, and motor functioning. Objective methods were used to assess meaningful change across a wide range of abilities and to identify factors associated with neuropsychological decline following frontal lobectomy. Detailed postoperative neuroimaging analysis was conducted to characterize region, extent, and volume of resection. Results: Forty-eight percent of patients did not demonstrate meaningful postoperative declines in cognition and an additional 42% demonstrated decline in 1 or 2 cognitive domains. When cognitive decline was observed, it usually occurred on measures of intelligence, visuomotor processing speed, or executive functioning. Side and site of resection were unrelated to cognitive outcome, but played a role in decline of contralateral manual dexterity following supplementary motor area resection. Higher preoperative ability, older age at surgery, absence of a malformation of cortical development on MRI, and poor seizure outcome were related to cognitive decline on some measures, but had poor sensitivity in identifying at-risk patients. Conclusions: The vast majority of patients who undergo frontal lobectomy for treatment of pharmacoresistant epilepsy demonstrate good cognitive and motor outcomes.

Abstract: Knowledge regarding substance-related problems and offending behavior in individuals with mild intellectual disability or borderline intellectual functioning (MBID; IQ 50-85) has increased over the last years, but is still limited. The present study examined differences in prevalence and clinical characteristics of individuals with and without MBID in a forensic addiction treatment center. Participants were 190 court mandated male clients of a low to high security forensic addiction treatment center in the Netherlands (aged between 21 and 59 years old, 82% of Dutch origin). Of the total sample 39% could be identified with MBID which is much higher than the estimated 12% to 15% of the general population. Results showed that clients with MBID reported significantly lower scores on desire for help, compared to clients without MBID (F (1, 73) = 5.12, p = .027). Against expectations, no significant group differences were found for aggression during treatment while controlling for impulsivity, treatment duration and type of substance use and offense. As results of the present study showed that clients with MBID are overrepresented in the forensic addiction treatment center, future research should further explore characteristics and responses to treatment of these clients. More knowledge about the characteristics of clients with MBID will not only help to better identify these clients, but will also to improve treatment for this group

Abstract: Across the last century, the condition known as intellectual disability (ID) has been labeled by assorted terms, its key features have varied, and recommendations for its identification have been divided. In light of recent changes to the diagnostic criteria for ID and to federal legislation, this study was designed to compile and summarize information about the state special education criteria for this condition and its associated assessment process, as they guide school-based and associated practices. Authors independently double-coded components of all ID regulations and guidelines from the 50 United States and the District of Columbia in pairs, which was then checked and corrected for inconsistencies. A total of 10% of states provided only the federal definition of ID. Intellectual disability was the most common term used across states, but it was used by only 63% of them. To meet the intellectual deficit criterion, 37% of states referenced a fixed IQ cutoff, and 49% referred to a flexible IQ cutoff. In contrast, most states did not refer to what score types or criteria should be referenced when identifying adaptive behavior deficits. The influence of the recently updated diagnostic criteria for ID and federal legislation was evident, as several patterns of changes were apparent since the last studies of this type. The assessment in intellectual functioning was more well defined than the assessment of adaptive behavior. Health-related features associated with ID were not commonly referenced. These results can inform school psychology practice, training, and related research. (PsycINFO Database Record

Abstract: Cognitive impairment is a prevalent problem among the homeless and seems related to more psychosocial problems. However, little is known about the care needs of the subgroup of homeless people with an intellectual disability compared to those without an intellectual disability and how their care needs develop over time. This study explores self-reported care needs within a broad range of life domains among Dutch homeless people with and without a suspected intellectual disability to gain insight into the transition of self-reported care needs from baseline to follow-up in both subgroups. This longitudinal study is part of a cohort study among homeless people who had been accepted for an individual programme plan in four major Dutch cities. The initial cohort consisted of 513 participants who were interviewed in 2011. At 1.5-year follow-up, 336 participants (65.5%) were also interviewed and screened for intellectual disability. Of these participants, 31% (95% CI 26.2-36.1) had a suspected intellectual disability. For both groups, between baseline and follow-up, the number of 'unmet care needs' decreased significantly and the number of 'no care needs' increased significantly, while at follow-up, participants with a suspected intellectual disability reported 'no care needs' on significantly fewer life domains than those without a suspected intellectual disability (mean numbers 16.4 vs. 17.5). Between baseline and follow-up, 'met care needs' decreased significantly on housing for both groups, and increased on finances and dental care for participants with a suspected intellectual disability. At follow-up, participants with a suspected intellectual disability more often preferred housing support available by appointment than those without a suspected intellectual disability. These findings suggest that homeless people who had been accepted for an individual programme plan with a suspected intellectual disability have care needs for a longer period of time than those without a suspected intellectual disability. Providing care to homeless people with a suspected intellectual disability might require ongoing care and support, also after exiting homelessness. Support services should take this into account when considering their care provision and planning of services.

Abstract: Although a percentage of patients report cognitive side-effects when taking lithium, it can be difficult to determine from the literature whether any cognitive changes reflect lithium itself, the lithium serum level, residual mood symptoms, the underlying nature of bipolar disorder, or biological alterations such as hypothyroidism. This review was carried out to synthesize and evaluate relevant literature examining any cognitive impact of lithium in those with bipolar disorder. The effect of lithium in those with bipolar disorder was examined across the cognitive domains of attention, psychomotor speed, processing speed, working memory, intellectual functioning, verbal memory, visual memory, and executive functioning by reviewing the published empirical literature. Any impact of hypothyroidism and lithium toxicity was also examined. The literature supports the conclusion that lithium has a distinct impact on psychomotor speed in participants with bipolar disorder. In contrast, there appears to be no impact on attention. Any impact of lithium on memory in patients with bipolar disorder is unclear as the literature is contradictory and any such effect may be overshadowed by the greater impact of residual mood symptoms. The impact on processing speed, intellectual abilities, and executive functioning also remains unclear. Several clinical management strategies are recommended.

Abstract: Borderline intellectual functioning (BIF) is associated with several neuropsychological deficits. We used national data to establish the prevalence of psychosis and psychotic symptoms, and the role of potential mediators. The BIF group were more than twice as likely to have probable psychosis (adjusted odds ratio (OR)=2.3, 95% CI 1.4-4.0) and to report hallucinations (adjusted OR = 2.9, 95% CI 1.9-4.4) but not persecutory ideation. Salient mediators were depressive symptoms and the cumulative total of life events. Our findings suggest mechanisms other than drug use that are contributing to the strong relationship between BIF and severe mental illness and that may be amenable to treatment.

Abstract: Criminal forensic evaluations are complicated by the risk that examinees will respond in an unreliable manner. Unreliable responding could occur due to lack of personal investment in the evaluation, severe mental illness, and low cognitive abilities. In this study, 31% of Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008/2011) profiles were invalid due to random or fixed-responding (T score ≥ 80 on the VRIN-r or TRIN-r scales) in a sample of pretrial criminal defendants evaluated in the context of treatment for competency restoration. Hierarchical regression models showed that symptom exaggeration variables, as measured by inconsistently reported psychiatric symptoms, contributed over and above education and intellectual functioning in their prediction of both random responding and fixed responding. Psychopathology variables, as measured by mood disturbance, better predicted fixed responding after controlling for estimates of cognitive abilities, but did not improve the prediction for random responding. These findings suggest that random responding and fixed responding are not only affected by education and intellectual functioning, but also by intentional exaggeration and aspects of psychopathology. Measures of intellectual functioning and effort and response style should be considered for administration in conjunction with self-report personality measures to rule out rival hypotheses of invalid profiles.

Abstract: Summary Many patients with epilepsy caused by hypothalamic hamartomas (HHs) have cognitive impairments during the course of the disease or following neurosurgical treatment. The purpose of this study was to assess cognitive function in these patients, as well as factors influencing preoperative cognitive performance and cognitive outcome after neurosurgical treatment. Using the two largest and most detailed neuropsychology datasets on HH and epilepsy from two centers, we retrospectively report on cognitive functions in 48 patients with structural epilepsy due to HH (mean age ± standard deviation [SD] 20 ± 12 years, range 5–53 years, median 16 years; disease duration mean 17 ± 11 years). Intelligence, verbal learning and recall, and speed and executive functions (processing speed and cognitive flexibility) were assessed before and on average 19 (±11) months after surgery (interstitial radiosurgery: N = 22; neurosurgical resection/disconnection: N = 26). Prior to neurosurgical treatment, 52% of patients showed impaired executive and 62% showed reduced verbal memory functions. A trend for a detrimental effect of higher drug load on cognitive functioning was found. After neurosurgical treatment, intellectual functions for the entire cohort tended to increase. This correlated with improved seizure frequency and decreased number of antiepileptic drugs (AEDs). However, postoperative outcomes for individual patients were highly variable, with significant deteriorations in 17% (processing speed) to 34% (cognitive flexibility and verbal learning), and performance increases in 17% (intellectual functioning) up to 39% (processing speed) of the patients. Higher levels of presurgical performance were significant predictors of cognitive decline after surgery. These results are highly relevant for patient consultation and may help with therapeutic decisions.