Issues associated with repeated neuropsychological assessments

Distinguishing practice effects from other factors in repeated neuropsychological assessments are discussed in the context of research studies and clinical/forensic assessments. Potential methodological procedures for reducing the impact of practice effects in research settings are outlined. In contrast, the potential clinical utility and interpretation of practice effects in clinical assessments and forensic evaluations are highlighted.

[Clinical neuropsychology]

The article reviews the development of clinical neuropsychology as a professional discipline and comments on important contributions from various research fields and clinical disciplines. The consequences of disturbances in the neurotransmitter systems for neuropsychological functioning are discussed, as well as various clinical issues and the applications of clinical neuropsychology, and of neuropsychological evaluations.

Metacognitive and frontal lobe processes: at the interface of cognitive psychology and neuropsychology

During the past several decades, research in both cognitive psychology and neuropsychology has become increasingly concerned with the processes that monitor and control human cognition. In the area of cognitive psychology, this research has focused on metacognition or metacognitive processes, and in the area of neuropsychology, it has focused on frontal lobe processes. It is evident that both areas have been referring to very similar concepts, with some variations, but with notably little acknowledgement of each other. The principal purpose of this study was to conduct an analysis of the main research within each of these areas and to examine the continuities and discontinuities in the theoretical premises and empirical results between the two areas. Results indicated that the two areas are remarkably similar in both theoretical premises and empirical results, but that cognitive psychology emphasizes monitoring and control, whereas neuropsychology tends to emphasize control only. A synthesis that unites the work in cognitive psychology and neuropsychology would supply many new directions for research.

Neuropsychology in Denmark

The origins and development of neuropsychology in Denmark are briefly overviewed, as are the education and training opportunities for Danish neuropsychologists. Areas of application and research are presented, and the role of the rehabilitation of brain injury is emphasized, with specific reference being made to the Center for the Rehabilitation of Brain Injury at Copenhagen University, wherein the rehabilitation program and pertinent research ensuing from the center is presented. Future trends in Danish neuropsychology are also considered.

Clinical neuropsychology and brain injury rehabilitation in Israel: a twenty-year perspective

The development of the field of neuropsychology in Israel is primarily the result of the development of rehabilitation services for traumatic brain-injured patients. The responsibility to care for and help disabled veterans has always been an important motivation for the establishment of rehabilitation services. Israel is probably one of the first countries in the world to develop community-based services specifically designed to address the needs of young patients with severe traumatic brain injury. The fairly extensive therapeutic and community services available today for both military and civilian brain-injured persons in Israel ae the result of initiatives and funding by the Israel Ministry of Defense's Department of Rehabilitation. There are two principles that characterize most of the programs in Israel: (1) multidimensional remedial intervention and (2) life-time commitment to provide support. The accessibility of patients in a small country enables professionals to conduct follow-up studies in order to evaluate the long-term effects of brain injury. Current developments in neuropsychology are in three directions. First, formal training programs in neuropsychology are being set up. Second, the involvement of neuropsychologists is being extended beyond the treatment of young patients suffering from traumatic brain injury to include the treatment of different brain pathologies in children and the elderly. Third, sophisticated neuroimaging techniques are being applied to studies in cognitive neuropsychology.

One hundred years of neuropsychology in Japan: retrospect and prospect

The development of neuropsychology in Japan since the end of the 19th century will be outlined, including a number of pioneering works that gave a scientific basis to contemporary Japanese neuropsychology. The activities of societies/associations of related disciplines as well as the educational systems of clinical and experimental neuropsychology, which represents in Japan an interdisciplinary field, will be described. After national and international activities are mentioned, a review of significant Japanese contributions to main topics in neuropsychology will be given in some detail: dementia, memory disorders, frontal lobe syndromes, aphasia-alexia-agraphia, callosal syndromes, and specific right hemisphere syndromes. The issues of these interdisciplinary scientific investigations have found application in language and cognitive disabilities of brain-damaged patients, as well as evaluation of medical treatments and comedical rehabilitational effects, care, and counseling. Finally, some comments will be presented on possible and desirable developments of Japanese neuropsychology in the future.

Neuropsychology in France

The main steps in the development of neuropsychology in France are briefly reviewed, from the early contribution of Paul Broca (1861) up until the early 1990s. The current epistemological and institutional crises is analyzed with respect to some general factors inherent to the domain (e.g., disputes between the proponents of the psychological and biological dimensions) and to particular factors related to the French situation (e.g., retirement of prominent neuropsychologists). As regards clinical practice and research activities, the future will probably show some fractionation of goals and techniques prior to new synthesis.

Clinical neuropsychology: 1960-1990

Clinical neuropsychology has made significant progress during the past 30 years. Practice and research have expanded remarkably in scope and are more incisive and more highly focused. There has been an explosive development of test methods but clinical neuropsychologists have yet to take full advantage of them. An effort should be made to combine the strengths of the "fixed battery" and "flexible" approaches to assessment. Further advances in neuropsychological assessment will come about only to the degree that they are linked to evolving concepts of brain-behavior relationships. Neuropsychologists now require a deeper understanding of basic neuroscience and cognitive psychology than was true in the past. Steps should be taken to insure that training to achieve that understanding is provided to the upcoming generation of neuropsychologists.

Cognitive rehabilitation: a neuropsychological speciality comes of age

In its first decade cognitive rehabilitation has emerged from infancy with the energy and much of the turmoil of youth. It has become an established speciality in brain-injury rehabilitation and has inspired many neuropsychologists to broaden their expertise beyond diagnosis and address their efforts to intervention. Restoration, although controversial, is an important and valid goal at the outset of cognitive rehabilitation, whereas the substitution of other means of goal achievement and environmental redesign are significant components of a comprehensive neuro-rehabilitative treatment programme. Efficacy is being demonstrated in many ways, ranging from increased patterns of use to controlled empirical studies. Few continue to raise the naive issue of whether there is any scientific basis for this neuropsychological speciality; instead, questions have become more focused on understanding the process of change to best serve human needs. In the next decade the refinement of current approaches can be anticipated, as well as the breaking of new ground. Neuropsychologists specializing in cognitive rehabilitation are likely to be turning their attention to underserved populations, such as those emerging from protracted coma, individuals suffering from 'progressive' neurological conditions, and persons whose brains were injured early in development. Scientific (theoretical, methodological and empirical) developments in cognitive psychology will help to delve more precisely into the underlying basic processes, including the sensory substrate. We will be challenged to address specific applications, such as advising people with known or suspected cognitive deficits who wish to drive.

Cognitive neuropsychology. Resolving enigmas about Wernicke's aphasia and other higher cortical disorders

Cognitive neuropsychology is a young branch of neuroscience whose ancestral influences include a rich pool of experimental (eg, cognitive, psychology), theoretical (eg, epistemology), and clinical (eg, neurology, neuropsychology) disciplines. An essential principle of cognitive neuropsychology is that disorders of higher cortical functions can be understood in terms of breakdowns of one or more information-processing modules. Each module is the most basic element of intelligence that can be defined based on current knowledge. This approach is a refinement of-not a fundamental departure from-the 19th-century "localizationist" view of language disorders. Wernicke's aphasia, for example, classical attributed to a single cognitive deficit (loss of word sounds), is shown in this review to require damage to multiple distinct information-processing modules. Cognitive neuropsychology provides the tools for the type of fine-grained analyses of behavior that are needed to capitalize on recent advances in neuroimaging techniques, including the development of more sophisticated models of brain-behavior relationships.