Do sex differences influence test habituation and internal data validity in neurocognitive testing? A blinded...

Area of Science:

• Neuroscience
• Cognitive Psychology
• Psychometrics

Background:

• Reliable neurocognitive assessment is vital for accurate diagnosis and tracking of cognitive function.
• Habituation to testing procedures minimizes learning effects, ensuring results reflect stable cognitive performance.
• Understanding sex differences in cognitive tasks and their reliability is essential for equitable assessment.

Purpose of the Study:

• To investigate the impact of repeated testing on the reliability and internal validity of common neurocognitive tasks.
• To examine sex differences in neurocognitive task performance and habituation.
• To determine optimal familiarization periods for enhancing the reliability of neurocognitive assessments.

Main Methods:

• One hundred healthy young adults (47 men, 53 women) underwent repeated assessments of the Trail Making Test, Stroop Test, and Choice Reaction Time (CRT) task over five days.
• Tasks were administered twice daily to capture within- and between-day habituation effects.
• Reliability (relative and absolute) and agreement metrics were calculated to quantify errors.

Main Results:

• Significant habituation effects were observed, with most improvements occurring between the first two sessions and stabilizing after 2-4 days.
• Reliability varied across tasks: Choice Reaction Time tasks demonstrated the highest stability, followed by Stroop tasks, and the Trail Making Test B showed the lowest reproducibility.
• Men consistently outperformed women in choice reaction performance, with task-dependent sex differences in habituation rates.

Conclusions:

• Sufficient task familiarization is essential for minimizing systematic and random errors in neurocognitive assessments.
• The Trail Making Test B exhibits low reproducibility, limiting its use for longitudinal tracking or cross-sectional analyses without adequate habituation.
• While overall reliability metrics were similar across sexes, task-specific performance and habituation patterns differed, highlighting the need for sex-informed assessment protocols.