A. John McSweeny

Relationship of neuropsychological status to everyday functioning in healthy and chronically Ill persons

Three hundred and three patients with chronic obstructive pulmonary disease and concomitant neuropsychological impairment plus 99 healthy control subjects matched on the basis of socio-demographic variables were administered an expanded version of the Halstead-Reitan Battery and a battery of instruments measuring the quality of everyday-life functioning. The results indicated that neuropsychological measures can be used to predict everyday-life functioning in impaired persons, but few significant relationships were observed in the normals. Neuropsychological status was more consistently related to activities of daily living and basic social role performance than to emotional status. Complex, multifunctional neuropsychological tasks were found to be the best overall predictors of life functioning, whereas more specific tasks served as better predictors of specific dimensions of life functioning.

Nursing home care for mental patients: descriptive data and some propositions.

Nursing homes play an important role in the community-based care of chronic mental patients, yet there is little research in that setting. The present study gathered and analyzed descriptive data on 20 nursing homes in a large urban area, including data about structure, staffing, policy, treatment, residents, discharge, psychosocial climate, and neighborhood characteristics. Results suggested a clear difference between skilled nursing versus intermediate care facilities, with the latter playing a larger role in caring for mental patients. More important, data suggested such facilities play primarily a custodial rather than treatment role, and that managers expect patients in nursing homes to stay indefinitely. In view of this, our justifications for community care, such as social integration, need to be examined anew.

Regarding ethics in forensic neuropsychological consultation: A comment on guilmette and hagan

Abstract Guilmette and Hagan present an issue that is important to neuropsychologists who engage in forensic practice: the applicability of the APA Ethics Code to situations where neuropsychologists consult with attorneys but do not testify or otherwise reveal their identity to opposing attorneys or consultants. The resulting anonymity could encourage the misuse of neuropsychological knowledge, according to Guilmette and Hagan. A review of the APA Ethics Code reveals that deliberate use of neuropsychological knowledge to assist attorneys in misleading juries and others is clearly not consistent with the spirit or the letter of the Code. Neuropsychologists are advised to behave in a manner consistent with the Code, even when seemingly protected by a cloak of anonymity.

More thoughts on the practice of routinely appending raw data to reports: Response to freides and matarazzo

Abstract Our initial paper arguing against the practice of routinely appending raw data to reports of neuropsycholog-ical examinations (Naugle & McSweeny, 1995) elicited two responses in favor of doing so (Freides, 1995; Matarazzo, 1995). This paper reviews the major points raised by those two writers and provides our responses to their objections. We continue to recommend that the type and amount of data to be included with a report be tailored to the needs and competency of the referral source who receives that report.

Memory Function after Temporal Lobectomy for Seizure Control: A Comparative Neuropsychiatric and Neuropsychological Study

Publisher Summary This chapter deals with often differing data and prognosis provided by the neuropsychiatrist and the neuropsychologist. It reflects the general psychology literature that raises the question as to whether laboratory testing of memory function truly reflects memory function in everyday life. Present practice in surgical epilepsy centers is a preoperative neuropsychological evaluation, particularly of memory function. The longitudinal study of epilepsy patients who have undergone temporal lobectomy at the Medical College of Ohio has emphasized utilization of neuropsychiatric evaluation as well as neuropsychological testing. Data and prognosis reported by the neuropsychologist are frequently in contrast with neuropsychiatric assessment, which provides subjective reports by the patient as well as review of performance-demanding memory ability, in the spheres of education and work. Comparisons of neuropsychological and neuropsychiatric data were expressed in terms of concordant or discordant findings.

Two Regional Mental Health Treatment Facilities

One of the major social programs of the 1960s was the development of community mental health centers. As with most early attempts at evaluation, the results were pessimistic. This article reanalyzes one of the earliest, and best-known, evaluations of a community-based treatment facility. Following the conceptual framework of Campbell and his associates, it was found that the various threats to the validity of the findings indicate a consistent and systematic bias against detecting a positive effect for the new mental health center. In light of recent federal legislation mandating formal evaluations, appropriate procedures are discussed.

Board Certification in Clinical Neuropsychology: A Response to Rohling et al.

Board certification is intended to protect the public by identifying practitioners that have met minimum standards for education and training in their specialty or discipline. For varied reasons, clinical neuropsychology, like professional psychology as a whole, has struggled to achieve levels of board certification comparable to the medical profession. Rohling, Lees-Haley, Langhinrichsen-Rohling, & Williamson (2003) have recently published a critique of the board certification process in clinical neuropsychology as it is conducted by American Board of Clinical Neuropsychology (ABCN), arguing that one reason for this failure is the overly restrictive nature of the process. In their paper, Rohling et al. provide a signal detection analysis that makes several assumptions about the process and conclude with recommendations for improving the process to better identify “competent” neuropsychologists in practice. While we agree in principle with many of their recommendations, and ABCN had, in fact, implemented several prior to publication of their article, the article contains many faulty assumptions and logical inconsistencies that we believe are harmful to constructive review of the certification process. In this article, we provide a critical review of their analysis and present new and additional data that demonstrate the procedure is not overly restrictive. A primary consideration is the low incidence of seeking board certification among professionals who identify themselves as neuropsychologists (i.e., a low application rate), rather than an overly restrictive process. We describe steps taken to improve the process and conclude that there are numerous areas of agreement with Rohling et al., including the need for ongoing review and continued improvement in the board certification process in all psychological specialties.

Cognitive and language anomalies in two brothers with a rare form of genetic abnormality (deletion of 9p24)

Abstract Two brothers, ages 7 and 9, had an identical rare genetic abnormality: deletion of a segment of chromosome nine (9p monosomy). Neuropsychological evaluation revealed similar patterns of cognitive anomalies involving general retardation of intellectual capabilities and specific problems with the production of behavior including speech articulation and graphomotor skills. The findings suggest that a specific region of chromosome nine is crucial to the development of normal brain function as reflected by cognitive and language skills. Although CT and MRI studies of the subjects were normal, the pattern of cognitive deficits suggests that the frontal lobes may be at particular risk in 9p monosomy.

The Personal Imagery Questionnaire: Description, Evaluation and Initial Applications

Mental imagery plays an important role in the theory and practice of several behavior therapy techniques including desensitization, flooding and covert sensitization (Gambrill, 1977). Indeed, existing experimental evidence led Singer (1974) to conclude that desensitization “depends essentially on the production of visual imagery” (p. 510).