Dorien Bangma

GENERAL DISCUSSION AND CONCLUSION | 219 well studied in clinical samples, in both patients with NDDs as well as adults with ADHD, in order to draw reliable conclusions. The systematic review as presented in chapter 4 revealed that FDM capability was related to disease severity and motor symptoms in patients with MS and in patients with PD. Furthermore, a negative influence of symptoms of depression on FDM tests measuring financial competence was found in patients with MCI and patients with PD. Within the context of other NDDs this relation between symptoms of depression and FDM capability was not found or studied. The number/severity of depressive symptoms was also found to be positively related to the use of an intuitive financial decision style ( chapter 8 ). Symptoms of depression were, however, not sufficiently examined in the other studies included in this thesis in order to draw reliable and generalized conclusions about the influence of symptoms of depression on FDM capability. The last study presented in this thesis ( chapter 8 ) evaluated the relations between specific personality traits and two aspects of FDM (i.e., the tendency to buy on impulse and the use of specific financial decision styles) in a community sample. Personality was found to play an important role, explaining up to 20% of variance of these aspects of FDM. Specifically traits of neuroticism and extraversion were found to be positively related to impulsive buying and two decision styles that are considered to be less adequate (i.e., avoidant and spontaneous financial decision styles), while traits of agreeableness and conscientiousness were found to be negatively related with these aspects of FDM. Prospective longitudinal research is, however, needed to further evaluate these relations since no direct causal conclusions can be drawn. This also applies to contextual factors such as severity of depression. Nevertheless, the potential negative as well as positive influence on FDM capability of these and other contextual factors, such as financial experience and social support, is important to keep in mind when evaluating the capability to make financial decisions of an individual. Conclusion, limitations and future directions In summary, according to the performances on performance-based FDM tests and questionnaires, patients with NDDs and adults with ADHD are more likely to have FDM capability problems than healthy individuals. The capability to make financial decisions is (at least partly) related to the severity of cognitive impairment in these patients. As a result, the FDM capability of healthy individuals and patients without or with relatively mild cognitive deficits appears to be unaffected or patients have (mild) problems in some, but not all, aspects of FDM. Patients with more severe cognitive problems perform worse compared to cognitively intact patients and healthy controls on all aspects of FDM capability. In both patients and healthy individuals, several contextual factors (e.g., age, level of education or personality) seem to play a role which are of influence on the FDM capability of individuals in a negative (or positive) way. Since problems with FDM capability can have serious negative consequences in everyday life, a careful and thorough evaluation of this capability appears paramount. Currently in clinical settings, mostly self- or informant-reports and/or standard measures of cognition are used in order to evaluate everyday functioning, including FDM capability (Loewenstein &