Summary Articles Advanced Clinical Neuropsychology
PSMNB-1, University of Groningen
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Contents
Week 1. Introduction & Brain damage as a family affair
- Prigatano & Jeannine Morrone (2010)………………………………………… 3
- Glen et al (2020)…………………………………………………………………… 5
- Austrom & Lu (2009)……………………………………………………………….. 8
- Chwalisz & Dollinger (2010)………………………………………………………. 10
Week 2. Fatigue
- Calabrese & Pitteri (2018)………………………………………………………… 13
- DeLuca (2005)………………………………………………………………………. 15
- Leavitt & DeLuca (2010)………………………………………………………….. 18
Week 3. Disorders of awareness
- Fotopoulou (2008)………………………………………………………………….. 21
- Prigatano & Sherer (2020)…………………………………………………………. 24
- Startstein (2014)……………………………………………………………………… 27
Week 4. Suicidality in people with neurological disorders
- Lupton et al (2020)…………………………………………………………………. 31
- Harcourt (2020)……………………………………………………………………… 32
Week 5. Sexual functioning in people with neurological disorders
- Latella et al (2018)………………………………………………………………….. 35
- Baird et al (2007)……………………………………………………………………. 36
- Cipriani et al (2015)……………………………………………………………….... 38
Week 6. Ethics in clinical neuropsychology and the capability to make decisions
- Fields & Calvert (2015)……………………………………………………………... 41
- Cornett & Hall (2008)……………………………………………………………….. 43
- Martin & Bush (2008)………………………………………………………………... 44
Week 7. Personality and neurological disorders
- Terracciano & Sutin (2019)………………………………………………………… 47
- Maggio et al (2020)………………………………………………………………… 50
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Week 1
Introduction
(Prigatano & Jeannine Morrone, 2010)
Advancing the Profession of Clinical Neuropsychology with Appropriate Outcome
Studies and Demonstrated Clinical Skills
Introduction
• Clinical neuropsychologists struggle to receive financial reimbursement for their
services, as insurers and other decision-makers have professional and economic
reasons to approve or deny coverage
• To secure reimbursement and ensure the profession’s growth, two types of
evidence are essential:
- Objective studies (economic and scientific): research proving the efficacy
and cost-effectiveness of neuropsychological interventions
o RCTs for scientific evidence
o Cost-outcome studies for economic evidence
- Clinical subjective value: subjective value to patient, family and physician
® Regarding physicians: they must be willing to pay for it
• Without strong evidence, the profession may lose financial stability, leading to:
- Limited access to neuropsychological services, affecting patient diagnosis
and treatment
- A shift toward forensic work rather than clinical practice, which could alter the
profession’s focus
Professional Identity of Neuropsychologists
• While technical expertise (scientific knowledge) is essential, successful clinical
practice also requires effective communication and application to improve
patient care
• The value of neuropsychological work is assessed by patients, family members,
referral sources, and payors (e.g. insurance provider), emphasizing the need for
patient-centered approaches
• Neuropsychologists should blend scientific knowledge with an understanding of
patient and family concerns > scientist-practitioner
Scope Of Practice of Clinical Neuropsychologists
• The practice of clinical neuropsychology encompasses a wide range of
assessments from infancy to elderly patients, focusing on managing
neuropsychological disturbances
• Objective outcome studies are necessary to evaluate diagnostic and
interventional effectiveness, as well as cost-benefit considerations
® They must demonstrate to physicians the logic behind what they say
concerning a patient, and how their knowledge contributes to patient care
Focused Goals
• Clarify two types of data needed for field of neuropsychology:
objective/subjective
• Describe types of outcome studies
• Identify clinical and professional skills for practicing clinicians and training
programs
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Previous And Continuing Efforts
• Outcome studies must demonstrate both the objective economic value and
subjective satisfaction of neuropsychological services to patients and families
• Various cost-analysis methods, including cost-effectiveness studies, are essential
for establishing the value of neuropsychological interventions
Future Efforts
Outcome Studies
• Neuropsychologists should conduct outcome studies to demonstrate …
- Neuropsychological testing/evaluations lead to practical decisions for patients
(and their families)
- Neuropsychological testing/evaluations lead to the development of new
knowledge relevant to patient diagnosis and care
- Neuropsychological knowledge/tests can be combined with neuroimaging to
improve patient care
- Intervention programs, based on neuropsychological and psychological
principles, result in important cognitive and behavioral changes for the patient,
and these changes are mirrored in brain structure and activation pattern
changes
- Neuropsychological interventions with patients not only reduce disability and
improve the quality of life of the patient, but also improve the quality of life of
caregivers
- The economic impact of not receiving neuropsychological assessments and
interventions in a timely fashion
Developing The Clinical and Professional Skills of Neuropsychologists
Primary clinical skills
• Neuropsychologists need to develop primary clinical skills that enhance patient
engagement and care, such as effective interviewing and establishing
therapeutic alliances