A process-oriented functional capacity assessment: First application of the neuropsychological evaluation of the UPSA...

In this study we describe the Neuropsychological Evaluation of the UPSA (NEUPSA), a structured scoring system of the UCSD Performance-based Skills Assessment-2 (UPSA-2) aimed at capturing the cognitive processes that underlie functional capacity. We sought to apply the NEUPSA in both healthy and clinical populations (psychiatric disease, substance use), compare NEUPSA scoring against standardized cognitive test performance and test whether the NEUPSA was sensitive to effects of cannabis use and bipolar disorder (BD) on neuropsychological functioning. Eighty-eight participants from a larger study on the cognitive effects of cannabis use and BD were administered the UPSA-2. During the administration of the UPSA-2, participant behavior was assessed and scored in five cognitive domains (memory, attention, inhibition/impulsivity, speed of information processing, executive function) using the NEUPSA scoring system. Participants were also administered validated computerized cognitive tests, including the Iowa Gambling Task (IGT; executive functioning) and the 5 Choice-Continuous Performance Task (5 C-CPT; attention, speed of information processing and inhibitory control). Performance in the NEUPSA was significantly correlated with performance in the IGT and 5 C-CPT for some cognitive domains. Performance on the NEUPSA differed among groups with BD and cannabis use, with healthy comparison participants generally performing better than clinical groups. This pilot study highlights the potential of the NEUPSA as a novel tool for evaluating cognition within performance-based functional assessments. Further refinement and validation of the NEUPSA is necessary and could serve as a valuable resource in both clinical and research settings, advancing our understanding and treatment of cognitive deficits in clinical populations.