For those professionals looking for a small package filled with reviews of targeted adult neuropsychology science and practice information, look no further than the edited book Neuropsychology: Science and Practice. The book has 10 chapters covering topics of current neuropsychology science and practice that range from a review of evidence-based practice principles to summaries of several disease-specific areas. It begins with an overview of evidence-based neuropsychology and its development. Chapters 2 and 3 summarize modern aspects of essential clinical practice, including information about variability in test scores and symptom validity testing. Chapters 4 and 6 offer readers updates and various theoretical perspectives on cerebral lateralization and aging effects on language, respectively. Neuroimaging as a tool to evaluate functional neuroanatomical correlates is reviewed in Chapters 7 and 8. Other chapters cover timely topics of controversy in the literature, including mild traumatic brain injury (TBI) and PTSD, the evidence-base for cognitive rehabilitation, and use of the MMPI-2/MMPI-2-RF in neuropsychological assessment.
The reader will learn that evidence-based medicine has a long history, dating back to the early 1900s and education theorist named Abraham Flexner. Readers of Chapter 1 are also treated to a review of how clinicians may apply evidence-based science to clinical practice and to a review of the evidence-based literature from 2010 to 2013 in the areas of: (1) differential diagnosis in neuropsychology, (2) outcomes, and (3) neuropsychological interventions. This chapter provides a practical summary of evidence-based science and practice in neuropsychology and could be considered required reading for students of neuropsychology.
Chapter 2 is a review of intra-individual variability in cognitive test performance based on the amount of ‘scatter’ of scores found in the Wechsler intelligence scales. Careful consideration is given to reviewing how various factors including demographic characteristics, levels of intellectual ability, and disease factors affect observations of test score variability in the Wechsler intelligence scales.
Critical reviews and commentary of symptom/performance validity tests are provided in Chapters 3 and 10. Chapter 3 is an overview of the peer-reviewed literature from 10/2009 to 8/2011 for stand alone, embedded and questionnaire-based methods for evaluating symptom validity in neuropsychological assessments. Chapter 10 focuses on the MMPI-2/MMPI-2-RF literature and overlaps only with some of the questionnaire-based methods section of Chapter 3. While Chapter 3 is comprehensive and provides readers with sensitivity and specificity rates achieved by several validity measures, some clinicians may go wanting as the chapter does not provide cut-off scores for any scale/test. Alternatively, cut-off scores are provided in the text for several of the MMPI-2-RF validity scales in Chapter 10. However, clinicians interested in understanding how the reviewed literature augments the interpretation of the MMPI-2/MMPI-2-RF will find the chapter devoid of explicit instruction. Despite these weaknesses, Chapters 3 and 10 extend the foundation of symptom (performance) validity testing in neuropsychological assessment.
Even for readers who think they know everything interesting about cerebral lateralization, Chapter 4 is likely to surprise. There is a critical review of several different theories to explain the development of cerebral asymmetry in animals more broadly than simply focusing on humans. The critical analysis of the potential benefit of lateralization in enhancing cognitive processing is intriguing.
The available evidence on blast injury resulting in mild TBI (concussion) and PTSD is reviewed in Chapter 5, and is remarkable in its breadth and critical hypothesis-driven evaluation of the data. The content spans the literature regarding outcome from blast injury, including a summary of the effect of selected blast overpressures on body and building structures as well as comparing outcomes of blast-related mild TBI to non-blast mild TBI. The reader will find evidence that supports conceptualizing symptoms in terms of mild TBI and PTSD rather than a more traditional mild TBI or PTSD perspective. Readers will find the tables that summarize the strength of various factors to predict adverse outcomes of mild TBI, including headache, pain, psychiatric symptoms, and cognitive complaints valuable.
Evaluation of aging effects on language function is reviewed in the broader context of cognitive aging in Chapter 6. The authors review the evidence supporting several theoretical models to explain the variable decline in cognitive function with aging. The reader is treated to a review of the changes in the neural substrates of language and motor function using structural and functional neuroimaging techniques including fMRI, transcranial magnetic stimulation (rTMS), and transcranial direct current stimulation (tDCS). The findings will doubtless be of interest to those involved in aging, dementia, language/aphasia, and cognitive rehabilitation.
Chapters 7 and 8 provide critical reviews of structural neuroimaging as it relates to uncovering functional neuroanatomical correlates. Chapter 7 reviews the implications of structural neuroimaging for understanding the neuroanatomical substrates of neuropsychological function, with an emphasis on evaluating outcome from TBI***. The functional connectivity data reviewed for selected clinical groups (MCI/Alzheimer's disease, multiple sclerosis, TBI and neurodevelopmental disorders) in Chapter 8 is fascinating.
The evidence-base for cognitive rehabilitation is summarized in Chapter 9, including the effect sizes uniquely attributable to cognitive rehabilitation. The summary of the techniques that have empirical evidence for improving specific neuropsychological domains (e.g. attention/working memory, learning/memory, and executive functions), particularly those addressing behavioral/emotional problems, was both brief and clinically valuable. This chapter can serve as a foundational overview of the evidence-base for cognitive rehabilitation to both novices and experts alike.
In summary, Neuropsychology: Science and Practice (Volume 1) offers neuropsychologists a critical review of targeted topics in adult neuropsychology and suggestions for further research to address unanswered or controversial areas of neuropsychological practice and science. The topics are timely, some controversial, and all involve important areas in the clinical neurosciences; but by design, the book is not a comprehensive review. Other health professionals with interests in behavioral neurology, neuropsychiatry, cognitive rehabilitation, and speech/language therapy are also likely to find the targeted critical reviews of interest.