November 2010  << Back  

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 BOOK REVIEWS

The Handbook of Forensic Neuropsychology

Galit Askenazi, PhD, ABPP

Neuropsychology and Forensic Psychology, Specialty Services, Cleveland, OH, USA

Edited by Arthur MacNeill Horton, Jr and Lawrence C. Hartlage. New York, NY; Springer; 2010; ISBN: 978-0-8261-1886-8; pp 588; $125 (hardcover).

Although forensic neuropsychology is a young field, it has grown by leaps and bounds in recent years in terms of utilization of neuropsychologists in legal proceedings, new case holdings, and research. Drs. Horton and Hartlage have updated their 2003 book to not only include more legal and research material but also to address application of neuropsychology to special groups and discuss future issues in the field.

The first section, foundations of neuropsychology, provides an introduction to brain functioning assessed by neuropsychologists and brain taxonomy. Given that brain structure is not the focus of this book, this is an adequate abstract of neuroanatomy, with charts summarizing brain lobe functions and hemispheric lateralization serving as good resources to those already knowledgeable about neuropsychology. Those not well versed in neuropsychology may use this book as a resource, however, the information on specific brain areas controlling certain cognitive and personality functioning may be misinterpreted as being absolute.

The history of clinical neuropsychology in the forensic world and key issues, such as fixed vs flexible battery approach, are well enunciated even for the layperson. The current status of neuroimaging in the legal world, particularly in the area of aggression and the connection to psychopathy and personality disorders, is introduced with appropriate descriptions of how results can be applied and interpreted and possible limitations.

An area that I, as a forensic neuropsychologist, found exceedingly useful was information on malingering. Certain relevant issues, however, are missing, such as the emerging issue of using the Minnesota Multiphasic Personality Inventory-2 vs the Minnesota Multiphasic Personality Inventory-2 Restructured Form, and the use of symptom questionnaires (ie, Structured Inventory of Malingered Symptomatology, Structured Interview of Reported Symptoms, Miller Forensic Assessment of Symptoms Test) in conjunction with neuropsychological tests of malingering, given the frequent presentation of both exaggerated psychological symptoms and cognitive impairment.

The second section deals with ethical and legal issues. These chapters provide crucial information to the practicing forensic neuropsychologist, including solutions when dealing with practice issues. Letter samples and case examples are well utilized in this section. I believe the chapter dealing with test security should be required reading by not only neuropsychologists but also psychologists who conduct any testing, whether or not they engage in forensic practice.

The chapter reviewing civil competencies is brief despite listing important competencies, including those related to medical decision-making, consenting to treatment, consenting to research, and fiduciary and testamentary abilities. The chapter on criminal competencies has extensive legal information. However, neither the section on civil competencies nor criminal competencies lists neuropsychological measures that would be useful in conducting various evaluations.

The chapter on privacy, confidentiality, and privilege is comprehensive, and is useful for neuropsychologists and general psychologists involved in forensic issues with excellent use of clinical examples. The conflict of interest chapter is extensive and reviews practical issues including testifying, fees, and providing depositions.

The third section, practice issues in neuropsychology, segues well from the previous chapters. Here you see the integration of issues that are unique to neuropsychology, such as brain lateralization of functioning and issues unique to forensic neuropsychology, such as third party observers, positions by professional organizations, and relevant research.

The section on measuring change in functioning is quite technical, but an important area of neuropsychology to be elucidated because it provides evidence necessary to determine not only clinically but also statistically meaningful change. In this section, graphs and tables are very useful in explaining complex issues, and the utilization of specific test examples, such as the Wechsler Memory Scale, is beneficial.

Similarly, information regarding the estimation of premorbid IQ is easily understood through specific test examples, and the concept of traditional “hold” tests is included. For regression equations, such as the Barona, I would prefer to see a list of the factors that are part of the equations, if not the actual equations themselves.

In the fourth section, special issues and populations are discussed extensively, including fitness for duty, disabled individuals, older clients, children and youth, autism spectrum disorders, substance abuse, and neurotoxicology. However, there is great variability in the structure of these chapters. Some are short and lack information on specific tests that are appropriate and useful to conduct evaluations and base legal opinions and some are extensive with specific recommendations for neuropsychological evaluation and helpful case examples. Reviewing these chapters, I found myself wanting to know if there are any case holdings specific to autism because there is no mention and to read a summary of how drug use pertains to recidivism, for which there is extensive literature.

The conclusion addresses important future issues, such as utilization of the Internet. There also is mention of certifications in neuropsychology but, surprisingly, not in forensic psychology.

Overall, I found the Handbook of forensic neuropsychology to be useful in providing survey information for many issues associated with the field. The strongest and most useful chapters were those with charts, examples, and/or sample materials. However, I have an issue with the inconsistency of the information provided across chapters, with some providing information only on forensic psychology or only on general neuropsychology, rather than all chapters addressing issues of forensic neuropsychology. In the next edition of the book, I would like to see more integration as well as integration of assessment of psychological symptoms (such as psychosis) with assessment of cognitive functioning.