This concise reference clarifies the gray areas between traumatic brain injury and PTSD while providing an empirically sound framework for neuropsychological evaluation and differential diagnosis. Its extended research review summarizes findings on key topics including the neuroanatomy of brain injury, test battery design and selection, and the salience of accurate diagnosis to ensuring appropriate specialized treatment. The authors offer the possibility of combined diagnosis as well as injuries that may fall through the diagnostic cracks, and consider possible relationships between TBI, PTSD, and the dementias, including Alzheimer’s disease. This knowledge base and the practical guidelines it informs are presented so that readers can better:

· Understand the clinical distinctions between TBI and PTSD, and among forms of TBI.

· Recognize cognitive, behavioral, emotional, and social components of the disorders.

· Identify skill areas for neuropsychological evaluation of patients.

· Select appropriate instruments for individualized assessment.

· Address test administration and interpretation concerns.

· Make an accurate differential diagnosis between PTSD and TBI.

With its sharp focus on the nuances of trauma and recovery, The Intercorrelation of Traumatic Brain Injury and PTSD in Neuropsychological Evaluations will find a wide, interested audience among psychologists, neuropsychologists, neurologists, psychiatrists, social workers, mental health counselors, undergraduate and graduate level students, and researchers. In addition, this text may be useful for those interested in psychology and neurology.


The inter-comparison of specific skills as represented by performance on neu- psychological tests is at the heart of the neuropsychological assessment process. However, there is a tendency to regard the interpretation of single tests as a process that is independent of performance on other tests, with integration of test information representing a summary of these individual test performances. As neuropsychology has become increasingly sophisticated, it has been recognized that many factors influence the performance on any given test. The meaning of the same score may vary considerably from one person to another, depending on his or her performance on other neuropsychological tests. Thus, a low score on the Halstead Category Test may indeed reflect frontal lobe damage, but only if we first rule out the influence of visual-spatial problems, emotionality, attentional issues, motivation, fatigue, and comprehension of the instructions. Simplistic interpre- tions that assume a common interpretation based on a specific score will inva- ably lead to errors in interpretation and conclusions. The purpose of this book is to provide each test that is described with a compendium of the possible interpretations that can be used with a variety of common tests that are often included in a neuropsychological test battery. The first chapter discusses some of the pitfalls and cautions when comparing the tests, while the second chapter examines administrative and scoring issues that may be unclear or unavailable for a given test.
Neuropsychology has become an increasingly active participant in forensie issues over the past decade. This has been the result of increased recognition by psychologists of the potential role they can play in evaluating patients involved in lawsuits and the increasing sophistication of lawyers who have recognized that damages can go beyond claims of physical and motoric impairment. However, this increase in involvement has not always been matched by a more sophisticated recognition of how the client (whether plaintiff or defendant) can best be served by the neuropsychologist. I have personally seen or reviewed many cases in which the psychologists involved did not effectively present their case. This partially occurred because they failed to recognize the difference in presentations aimed at clinical audiences and those aimed at a legal proceeding. It also occurred because they failed to recognize that the standard of proof necessary is very different in a hospital and in a courtroom. Finally, it occurred because they rarely recognized what the unique role of the psychologist can be in either countering or supporting the testimony of medical specialists. The purpose of this volume is to bring some light on these questions. The presentations here are write-ups of the work presented at the Third Annual Conference on the Luria-Nebraska Neuropsychological Battery held in Omaha during May, 1985. All of the papers emphasize the role of the Luria-Nebraska but the ideas can be used with almost any test.
Clinical neuropsychology has become a field of major prominence dur ing the past several years, as well as a field of great complexity. As a result of the extensive amount of activity that neuropsychology has experienced recently, two major developments have emerged. First, several approaches have evolved regarding comprehensive neuro psychological assessment. There are presently several standard test bat teries in common use, as well as an approach to assessment that does not make use of standard batteries, but rather fits the evaluation accom plished to the particular diagnostic problems presented by the indi vidual patient. Second, a great deal of specialization has emerged, with assessment procedures developed for evaluation of specific types of neuropsychological deficit. The purpose of this volume is to review these developments, particularly with reference to their implications for application in clinical settings. The history of this book's development is of particular interest. Some years ago, the Veterans Administration became concerned with developing an optimal method of neuropsychological assessment for its many health-care related facilities. Initially, the problem was con ceptualized in terms of whether the VA should encourage wider use of the long-established Halstead-Reitan Neuropsychological Test Battery (HRB) or promote more extensive use of the recently developed Luria Nebraska Neuropsychological Test Battery (LNNB). A conference was funded to bring together authorities in clinical neuropsychology to dis cuss this matter and present a series of papers to invited psychologists from various VA facilities.
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