Dorien Bangma

220 | CHAPTER 9 Acevodo, 2010). Indirect evaluations, such as self- and informant reports, are, however, not or only weakly correlated with performances on direct measures of FDM of cognitively impaired patients and healthy individuals (Gerstenecker et al., 2019; Okonkwo et al., 2009; Sunderaraman et al., 2018, 2020; Wadley et al., 2003). Furthermore, FDM performance was overestimated by both patients and informants, although informants also frequently tended to underestimate the FDM capability of their relatives (Sunderaraman et al., 2018). The validity and reliability of decisions based on solely informant- and/or self-reports about the FDM capability of an individual should therefore be questioned. Furthermore, standard measures of cognition are not able to predict everyday functioning, including FDM, properly. Only small to moderate amounts of variance of aspects of FDM can be predicted with performances on standard measures of cognition ( chapters 3, 4 and 7 ). It is, therefore, also not recommended to use standard measures of cognition in order to make decisions about an individual’s capability to make financial decisions. For these reasons, the (additional) use of more objective FDM tests and questionnaires in clinical practice in order to evaluate FDM capability in patients with neurological and psychiatric conditions should be considered. Nevertheless, more insight in the relation between cognition and FDM capability can help determine in which patients undergoing neuropsychological assessment further evaluation of the capability to make financial decisions is needed. The use of other outcome measures/modalities, such as across- task inter-individual variability and network analyses, might enhance the predictive value of standard measures of cognition to evaluate the FDM capability of an individual. A strong point of the current thesis is that a new FDM test battery was introduced and studied ( chapter 2 ) in order to objectively and comprehensively evaluate FDM capability. In accordance with the theoretical framework of Appelbaum et al. (2016), the FDM test battery evaluates not only the financial competence of individuals, but also their financial performance and related contextual factors. The FDM test battery was found to be sensitive in different (clinical) samples and is able to distinguish strengths and weaknesses on several aspects of FDM in patients with NDDs, adults with ADHD and individuals who age normally from 18 years and older. Most FDM tests and questionnaires showed adequate reliability ( chapters 7 and 8 ). Also, the divergent validity of the current FDM tests and questionnaires seemed to be sufficient. Weak to negligible correlations between the FDM tests and questionnaires indicate that different and unique aspects of FDM are evaluated with each test ( chapter 3 ). Furthermore, in general only relatively weak correlations were found between the FDM tests and questionnaires and standard measures of cognition ( chapter 3 ) suggesting that the FDM test battery captures abilities that cannot be assessed with standard (neuro)psychological measures. The current FDM test battery is, however, not yet suitable for clinical use because of several reasons. First, no normative data is available yet for most FDM tests and questionnaires, which makes the comparison and interpretation of individual performances not possible. Second, with a total administration time of approximately 2 to 2.5 hours, the current FDM test battery is rather extensive. It is possible to select specific FDM tests and questionnaires in order to minimize the administration time. However, for (clinical) decisions about an individual’s FDM capability it is important to investigate a broad spectrum of aspects related to FDM with the use of several tests and questionnaires. Therefore, the development of shorter versions of