Inclusion Criteria:  Patients with cirrhosis with clinical appointments in the pretransplant liver clinic Patients in the general gastroenterology clinic without a diagnosis of cirrhosis (controls)  Exclusion Criteria:  Individuals <18 years cirrhotic patients with hepatocellular cancer individuals with uncontrolled neuropsychiatric illnesses or overt hepatic encephalopathy ongoing alcohol or illicit substance use non-English speakers, as the language barrier may impact psychometric test results