Faculty Bibliography

OBJECTIVE:Although psychology has become a female-dominated field, this pattern of gender representation has not held true within the specialty of neuropsychology. In recent years more women have been pursuing careers in neuropsychology, and while the balance of male and female neuropsychologists as a whole has shifted, it is unclear whether the gender composition of leadership has also changed. Our goal was to survey various neuropsychological organizations, training programs, editorial boards, and organizations granting board certification to determine the current gender composition of leadership positions within neuropsychology. METHOD/METHODS:A literature review was conducted to examine past trends of gender composition in neuropsychology, psychology, medicine, and academia. Data on current gender compositions of the field were culled from publicly available websites and through personal communication with representatives from major psychological and neuropsychological organizations. RESULTS:We found that the overall composition of the field has changed over time, but notable gender disparities in leadership positions remain. Women still comprise the minority of leadership positions within most neuropsychological organizations, editorial boards for neuropsychology journals, and fellow positions in major neuropsychological organizations. More equitable representation has been achieved in the directorships of training programs and ABPP/ABCN board certification. CONCLUSION/CONCLUSIONS:We review the historical trends in gender discrepancies in leadership in neuropsychology and discuss these within the broader arenas of academia, research, and medicine. We conclude with a summary addressing potential causes for these discrepancies, including work-life balance issues, discrimination, institutional bias, and various other factors. We also provide pragmatic suggestions to help address these continued disparities.

The ever expanding role of a forensic neuropsychologist in civil litigation has rightfully led to a higher level of expectation for this expert, in realms such as clinical and courtroom knowledge, objectivity, and work product utility. The onus is on forensic neuropsychologists to ensure that these expectations are met. Recognizing that bias is inherent in clinical and forensic work, it is imperative that in high stakes situations such as forensic neuropsychological assessment, the evaluator is proactively conscientious in recognizing, and minimizing, the effects of these biases. This article highlights 12, of many, common biases about which the prudent forensic neuropsychologist should always be mindful of, during evaluation as well as the provision of deposition or trial testimony. Role, cognitive, and practice biases are defined and illustrated with examples. Specific suggestions are extracted from both empirical literature and forensic experience on how to recognize and mitigate these biases. The information contained in this article is intended to provide sound and practical strategies that can be useful for forensic neuropsychological practitioners. Attorneys will also find the content useful when working with such experts, including during deposition and cross examination preparation.

Neuropsychologists face many opportunities and challenges in the modern health care system. New technologies such as the electronic medical record, pressure to provide services to an increasing number of patients, especially in rural areas, and health care professionals expanding their scope of work, can present with ethical challenges. This article outlines several potential ethical dilemmas in modern health care and offers possible solutions utilizing an ethical decision-making strategy. A positive ethics approach is emphasized, and neuropsychologists are encouraged to adopt this perspective to aspire to the highest level of ethical practice.

This study examined the clinical utility of a performance validity test (PVT) for screening consecutive referrals (N = 436) to a neuropsychology service at a state psychiatric hospital treating both civilly committed and forensic patients. We created a contingency table with Test of Memory Malingering (TOMM) pass/fail (355/81) and secondary gain present/absent (181/255) to examine pass rates associated with patient demographic, clinical and forensic status characteristics. Of the 81 failed PVTs, 48 had secondary gain defined as active criminal legal charges; 33 failed PVTs with no secondary gain. These individuals tended to be older, female, Caucasian, and civilly committed compared with the group with secondary gain who failed. From estimations of TOMM False Positive Rate and True Positive Rate we estimated base rates of neurocognitive malingering for our clinical population using the Test Validation Summary (TVS; Frederick & Bowden, 2009 ). Although PVT failure is clearly more common in a group with secondary gain (31%), there were a number of false positives (11%). Clinical ratings of patients without gain who failed suggested cognitive deficits, behavioral issues, and inattention. Low scores on PVTs in the absence of secondary gain provide useful information on test engagement and can inform clinical decisions about testing.

At the intersection of neuroscience and psychological science stands neuropsychology, providing patients, triers of fact, and other parties a quantifiable, evidence-based method for understanding cognitive, emotional, and behavioral changes that occur in the context of injury or disease. The purposes of this special issue of Psychological Injury and Law are to (1) illustrate the ways in which neuroscience, psychological practice, professional ethics, and laws are intertwined in the evaluation and treatment of persons who have been injured or are experiencing a neurological disease, (2) demonstrate the ways in which neuropsychological practice is applied to forensic questions, and (3) promote quality neuropsychological practice and services to patients, courts, and other consumers of neuropsychological services. This special issue provides a sample of the types of ways that practitioners integrate neuroscience and clinical psychology, informed by and consistent with relevant laws and professional ethics, to understand people who have cognitive, emotional, and/or behavioral problems stemming from neurological injuries or other disorders.

Competency issues can arise at any point beginning with an individual's initial interaction with the justice system until the same individual is facing the imposition of a sentence. Neuropsychologists are commonly introduced to the criminal arena through referrals related to competence issues, and much can be gained from understanding how cognitive and psychological functioning can impact an individual's ability to understand and appreciate current circumstances. The present article focuses on three less frequently explored domains of competency, including competence to waive Miranda rights, competence to consent to or refuse treatment, and competency for execution. Pertinent diagnostic considerations are discussed, and relevant legal standards and ethical issues are described. Lastly, evaluation procedures for each type of competence evaluation are discussed. This primer on competency assessment offers a review of the current practices, and limitations, in this burgeoning intersection of law, brain-behavior relationships, and psychology.