Clinical Neuropsychology Research Articles

Bridging Experimental Neuroscience and Clinical Neuropsychology: Fluid Intelligence in Frontal Lobe Assessments

This viewpoint explores the gap between theoretical frameworks in experimental neuroscience and clinical neuropsychology. It highlights how John Duncan's theory of the Multiple Demand (MD) system, which links the frontal lobe to fluid intelligence (g), helps explain general performance on classical executive tests. However, it also discusses how traditional scores often fail to capture the complexity of behaviours associated with frontal lobe damage, and we suggest that developing improved scoring methods could be useful for integrating experimental and clinical neuropsychology insights.

Biomarker-only diagnosis of Alzheimer's disease: Not ready for prime time.

The Alzheimer's Association Workgroup research criteria for diagnosis and staging of Alzheimer's disease hypothesize diagnostic meaning in the absence of clinical symptoms. If operationalized, this would trivialize neuropsychological assessment but would also expand the pool of candidates for anti-amyloid therapies. A recent survey of the reactions of clinical neuropsychologists to these criteria suggested that the purpose lacked clarity, among other concerns. Given the current landscape in Alzheimer's disease therapeutics, with substantial toxicity and unclear benefit, as well as the poorly understood relationships between biomarkers and clinical signs at the individual level, the roll out of biomarker-only disease seems premature.

Constitutional and Judicial Foundations for Competency-Related Assessment in Criminal Forensic Neuropsychology.

Clinical neuropsychologists wishing to consult in criminal cases have ethical requirements to familiarize themselves with this specialty prior to initiating services. This paper presents foundational knowledge for professional neuropsychological consulting in cases where competence to proceed through the criminal adjudication process is in question. Reviewed are key foundations of knowledge for practice of clinical neuropsychology in relation to competency to stand trial or to proceed examinations. These foundations include a review of the criminal judicial system, relevant US Constitutional Amendments, and select mental health case law. First, Fifth, Sixth, and Fourteenth Amendments to the US Constitution establish the rights of freedom of thought, due process, freedom from self-incrimination, assistance of counsel, and equal protection. As used in criminal legal proceedings, capacity generally refers to abilities (i.e., functional capabilities), while competency is a legal determination based on a set of capacities. Although competency to proceed is assumed, Dusky v United States (1960) establishes that defendants are not competent if they lack sufficient present ability to consult with their lawyers using a reasonable degree of rational and factual understanding. Case law and statutory law establish that the loss must be due to mental disease or defect. Clinical neuropsychologists wishing to consult in criminal forensic cases have ethical requirements to become familiar with this unique consultative arena before choosing to enter. The foundational knowledge for clinical consulting within the criminal forensic context is presented to help clinical neuropsychologists begin developing authentic professional competence in the criminal forensic arena.

Forensic Neuropsychology Goes from Nowhere to Almost Everywhere: Lessons Learned During Decades of Practice.

To provide a narrative overview of the development of forensic neuropsychology (FN) in the last 40-plus years. Personal history description, highlighted by key data-based publications. Anecdotal and relevant data-based findings converge to present a perspective of a wealth of FN resources currently available to the well-documented growing numbers of practitioners. The de facto subspecialty of FN is now a visible and prominent part of the landscape of clinical neuropsychology.

Neurocognitive correlates of cerebral mitochondrial function and energy metabolism using phosphorus magnetic resonance spectroscopy in older adults.

The goal of the current study was to learn about the role of cerebral mitochondrial function on cognition. Based on established cognitive neuroscience, clinical neuropsychology, and cognitive aging literature, we hypothesized mitochondrial function within a focal brain region would map onto cognitive behaviors linked to that brain region. To test this hypothesis, we used phosphorous (31P) magnetic resonance spectroscopy (MRS) to derive indirect markers of mitochondrial function and energy metabolism across two regions of the brain (bifrontal, left temporal). We administered cognitive tasks sensitive to frontal-executive or temporal-hippocampal systems to a sample of 70 cognitively unimpaired older adults with subjective memory complaints and a first-degree family history of Alzheimer's disease and predicted better executive function and recent memory performance would be related to greater frontal and temporal 31P MRS indirect markers, respectively. Results of separate hierarchical linear regressions indicated better recent memory scores were related to 31P MRS indirect markers of lower static energy and higher energy reserve within the left temporal voxel; these findings were associated with moderate effect sizes. Contrary to predictions, executive function performance was unrelated to 31P MRS indirect markers within the bilateral frontal voxel, which may reflect a combination of theoretical and/or methodological issues. Findings represent a snapshot of the relationship between cognition and 31P MRS indirect markers of mitochondrial function, providing potential avenues for future work investigating mitochondrial underpinnings of cognition. 31P MRS may provide a sensitive neuroimaging marker for differences in aspects of memory among persons at-risk for mild cognitive impairment or dementia.

Japanese Performance Profile on the WAIS-IV and Purported Cultural Influences.

The present exploratory study aimed to examine the potential impact of culture on cognitive skills and intelligence by comparing the Japanese Wechsler Adult Intelligence Scale-IV (WAIS-IV) (JW) subtests, IQs, and index scores to those of the U.S. WAIS-IV (USW). JW raw scores corresponding to a scaled score of 10 for each subtest were scored with USW norms. Subtest, index, and IQ scores were then calculated for each age range. The impact of education on scores was evaluated through ratio of educational attainment for each cohort of the Japanese and US samples. Japanese and US data were compared using one-sample t-tests. Correlations between subtest, index, and IQ scores and education were calculated. The USW sample performed higher than the JW sample on verbal comprehension subtests, while the JW sample demonstrated stronger performances in processing speed and perceptual reasoning subtests. However, all scores with the exception of Block Design, Matrix Reasoning, and Figure Weights were significantly associated with differential educational attainment between the two countries. Educational differences were linearly associated with age with the higher educational attainment for younger Japanese age groups and higher attainment for the older US cohorts. The present study demonstrates cognitive differences between Japan and the USA. Performance on the WAIS-IV subtest and composite measures are highly correlated with education. Cultural factors impacting the cognitive profile of the Japanese sample such as differences in worldview, customs, educational systems, and writing system, were proposed. Clinical neuropsychologists should take these aspects into account when administering and interpreting test results.

An improved diagrammatic procedure for interpreting and scoring the Wisconsin Card Sorting Test: An update to Steve Berry’s 1996 edition

The Wisconsin Card Sorting Test (WCST) is a popular neuropsychological test that is complicated to score and interpret. In an attempt to make scoring of the WCST simpler, Berry (The Clinical Neuropsychologist 10, 117–121, 1996) developed a diagrammatic scoring procedure, particularly to aid scoring of perseverative responses. We identified key limitations of Berry’s diagram, including its unnecessary ambiguity and complexity, use of terminology different from that used in the standardized WCST manual, and lack of distinction between perseverative errors and perseverative responses. Our new diagrammatic scoring procedure scores each response one-by-one; we strongly suggest that the diagram is used in conjunction with the 1993 WCST manual. Our new diagrammatic scoring procedure aims to assist novice users in learning how to accurately score the task, prevent scoring errors when using the manual version of the task, and help scorers verify whether other existing computerized versions of the task (apart from the PAR version) conform to the Heaton et al. (1993) scoring method. Our diagrammatic scoring procedure holds promise to be incorporated into any future versions of the WCST manual.

Improving equivalent scores for clinical neuropsychology: a new method for regression model selection.

Equivalent Scores (ES) represent a statistical gold standard to obtain thresholds for clinical inference from normative data. The procedure to obtain ES requires a preliminary mandatory step: to perform a regression model selection to obtain adjusted scores that take into account age, education, and sex. The current article, starting from theoretical considerations, focuses on this step and proposes a new and improved regression model selection method. Results from data simulation show that the newly proposed method outperforms the current one on a wide range of simulation parameters and conditions, leading to better performance in classifying impaired or unimpaired performances, and more precise ES. The article is associated with an online app and R code to allow to easily apply the method to other normative data. This new model selection procedure can be easily incorporated also with other regression-based norm approaches.

New2Neuropsychology (N2N): An organization to promote diversity, equity, and inclusion in neuropsychology

Objective To introduce New2Neuropsychology (N2N), an organization that seeks to increase recruitment of historically underrepresented minoritized (URM) students, and to examine preliminary data on N2N’s impact and effectiveness in increasing knowledge about neuropsychology for URM students. Method This paper reviews relevant literature on factors informing the development of N2N. We also present descriptive data on N2N’s impact to date, and results of pre- and post- surveys for presentations about neuropsychology delivered to 90 college students (mean age = 24.23, 64.4% juniors or seniors) between November 2021 – March 2023. Results N2N has reached >500 students in events across 27 schools and, with the American Academy of Clinical Neuropsychology, disseminated $84,000 in scholarships to URM students. N2N presentation attendees reported increased understanding of neuropsychology and the training pathway (ps < .001, Cohen’s ds = 0.94 − 1.73) and increased confidence in their ability to become neuropsychologists (p < .001, d = 0.41). There were no overall pre-post differences for interest in pursuing a career in neuropsychology (p > .05); however, a subset of students who reported low interest at baseline (n = 57) reported a statistically significant increase in their interest post-presentation (p < .01, d = 0.36). Conclusions To date, N2N has progressed toward its goal, showing preliminary success increasing knowledge about neuropsychology for URM students. With continued development and support, N2N seeks to transform the pathway to neuropsychology for URM students, expanding accessibility of N2N resources across diverse groups and connecting URM students to neuropsychology research and clinical experiences.

A survey of practicum training practices in clinical neuropsychology

Objective: While previous survey research has focused on various training constituencies such as trainees, and postdoctoral/internship supervisors, no previous survey research has examined the needs and perspectives of practicum level supervisors and training programs. This study was designed to address this limitation. These results were used in forming the North American Association of Practicum Sites in Neuropsychology (NAPSN). Method: A 41-item survey was developed and distributed to practicum supervisors across the United States and Canada via listserv. A total of 142 supervisors completed the survey; the majority were employed at academic medical centers (62%) and located in the U.S. (93%). Most participants evaluated adults (61%), while a minority evaluated children (27%), or patients across the lifespan (12%). Results: Most respondents supervise one (44%) or two (26%) students per year and prefer advanced trainees (>90%). The majority (78%) indicated students see one case per week. The number of clinical contact hours and reports varied based on location (U.S. vs. Canada) and population (adult vs. pediatric). Supervisors found professional papers and publicly available didactics to be the most helpful resources. Commonly endorsed needs included help with policies and procedures (53%), supervising trainees from underrepresented groups (49%) and nontraditional backgrounds (44%), and access to didactics (49%). Conclusions: The survey provided insights into current practices and the needs of practicum supervisors. These findings will inform NAPSN’s development of materials and policies to support trainees and supervisors and can guide other professionals in supporting their practicum trainees as they navigate training in neuropsychology.

Surgical treatment of meningiomas improves neurocognitive functioning and quality of life – a prospective single-center study

Background and purposeEarly diagnosis and the refinement of treatment of patients with intracranial meningiomas have brought quality of life (QoL) and neurocognitive functioning as outcome measures into focus. The aim of this study is a comprehensive assessment of neurocognitive function, quality of life and the presence of depression in meningioma patients before and after surgery.MethodsPatients with MRI diagnosis of intracranial meningioma and indication for surgery were prospectively included. A clinical neuropsychologist performed neurocognitive assessments within 3 months before and 12 months after surgery. The test battery included investigation of selective and divided attention, verbal and figural memory, executive functioning, and word fluency. Self-report questionnaires to assess depressive symptoms, QoL, and disease coping were administered. Raw values and t-values were compared pre-and postoperatively. Outcome was stratified by tumor- and peritumoral brain edema (PTBE) volumes, postoperative resolution of PTBE and WHO grade. The study included 18 predominantly female patients (83%) with a median age of 59 years and mostly CNS WHO grade 1 meningiomas (83%).ResultsThere was a significant postoperative improvement in the ability to selectively react under stress, in working memory and improved delayed reproduction of verbal and visual memory content. QoL improved regarding a reduction in physical problems, an improvement in energy, and social functioning. There was a trend towards worse preoperative scores in all tests, and greater postoperative improvement in patients with PTBE. Tumor volume had no effect on the measured outcome. The patients did not suffer from depressive symptoms before the surgery but improved postoperatively and most patients had an active, problem-oriented coping strategy.ConclusionResection of intracranial meningiomas leads to an improvement in multiple neurocognitive domains and QoL. There is a trend towards poorer preoperative neurocognitive functioning and greater postoperative improvement in patients with PTBE. Depression appears to play a minor role in the context of neurocognitive functioning and disease coping.

Neuropsychological performance labels: do patients understand?

Objective: Descriptive labels to communicate performance are integral in neuropsychological reports. Although the American Academy of Clinical Neuropsychology (AACN) reached consensus on standardizing uniform labels of performance, consumer understanding of these labels is unclear. This pilot prospective cohort study evaluated patient, family member, and medical provider understanding of neuropsychological performance labels. Method: Patients (n = 62), family members (n = 31), and referral sources (n = 34) completed a 13-question survey evaluating the uniform label system and an alternative, patient-centered language system (PCL). Questions assessed label knowledge and associated percentiles and relative relationships between labels. Results: Patients had significantly higher accuracy on knowledge questions using PCL labels (54.8%) versus AACN labels (32.2%) as were families (51.6% versus 35.5%). When ranking labels, providers and patients were more accurate when using PCL labels compared to AACN labels, although no significant difference was seen in the family group. Generally, participants were more accurate in identifying highest/lowest scores using AACN labels and more accurate in identifying relatively higher and lower scores using PCL terminology. Conclusions: Results illustrate that current and alternative score labels may not be understandable for audiences who read and base decisions on neuropsychological reports. The findings highlight the need for further consideration of patient-centered language to improve understanding of neuropsychological score labels.

A - 77 A Systematic Review of Current Diversity Representation in Neuropsychological Research

Abstract Objective This study investigated current representation of diverse samples in research published in four leading neuropsychology journals. Methods We reviewed 367 articles published in 2023 from Archives of Clinical Neuropsychology, Neuropsychology, Journal of the International Neuropsychological Society, and The Clinical Neuropsychologist. 34 review articles and 4 editorial/announcements were excluded leaving 321 articles coded for age, education, gender/sex, race/ethnicity, and sample country. Results Overall, 89.41% of studies reported gender/sex and 50.46% reported race/ethnicity. Out of 63 original articles that included European populations (e.g., France, Sweden, Denmark, etc.), 93.65% reported gender/sex and 12.7% reported race/ethnicity. Out of 172 original articles that included United States (U.S.) samples, 95.93% reported gender/sex and 80.23% reported race/ethnicity. Studies of U.S. samples reported the following average sociodemographic variables: education 14.94 years (SD = 3.72), age 50.32 years (SD = 21.39), gender/sex 48.09% female and 51.90% male, and race/ethnicity was 65.11% White, 6.64% Black/African American, 2.18% Asian, 1.06% American Indian/Alaskan Native, 0.43% Native Hawaiian/Pacific Islander, and 24.57% unknown/other/mixed race. Additionally, 9.82% of participants were Hispanic/Latino. Conclusions Roughly half of studies did not report on race/ethnicity and this was particularly notable for European samples with more homogeneous populations. Studies with U.S. samples had equitable gender/sex representation but participants were predominantly White and older middle aged. Inconsistencies in how studies stratified race/ethnicity resulted in a large percentage of individuals being classified as unknown/other/mixed. This review highlights the need for more diverse representation in neuropsychological research as Hispanic/Latino, Black/African American, and Asian groups were represented at half their actual numbers in the U.S. population (18.5%, 12.2%, and 5.9% respectively).

B - 112 Challenges and Opportunities for Training in a New Era in Neuropsychology: a Survey Study

Abstract Objective The field of neuropsychology is undergoing significant changes, especially as the Minnesota Update Conference (MUC) drafts are developed. In late 2023, a group of neuropsychology trainee-leaders, united through the Clinical Neuropsychology Trainee Forum (CNTF), surveyed trainees in the United States and Canada to better understand their needs and perception of the neuropsychology training climate. Method Survey items were written by a CNTF task force consisting of trainee-leaders from major neuropsychology organizations before being refined by four independent neuropsychologists, including two current neuropsychology postdoctoral fellowship training directors. The survey was distributed via listservs and social media. Results 220 respondents completed a majority of the survey, and they were primarily female (86%), White (71%), and training in the United States (92%). More than 75% of respondents reported satisfaction with their doctoral program, internship, and/or fellowship. Similarly, 90% and 73% of respondents, respectively, felt their opinions on the future of the field are listened to and/or valued in discussions with peers and supervisors/mentors. However, only 57% of respondents felt their opinions are valued by neuropsychology organizational leadership, and nearly 70% were uncertain or disagreed that trainees’ opinions were valued during the MUC draft development and review period. Conclusions Most neuropsychology trainees are satisfied with their training programs yet expressed concern about their opinions on the future of the field being heard by neuropsychology leadership. Trainee stakeholder engagement will be key to the vitality of neuropsychology in light of anticipated MUC Guidelines. Recommendations for supervisors, training directors, and neuropsychology organizational leadership will be discussed.

B - 141 Research Review of Symptom and Performance Validity Tandem: Inventory of Problems-29 and Memory Module

Abstract Objective Consistent with the NAN expectations, the American Academy of Clinical Neuropsychology (Sweet et al., 2021) asserted that neuropsychologists should include symptom validity tests (SVT) and performance validity tests (PVT) to assess the credibility of psychological and cognitive complaints. Aligned with this declaration, the Inventory of Problems–29 (IOP-29), an SVT, and its Memory Module (IOP-M), a PVT based on the respondent’s recall of the IOP-29 items. Our objective is to evaluate the research support of these measures to discriminate credible from noncredible presentations. Data Selection Since the IOP was introduced in 2017, more than 20 peer-reviewed research studies on the IOP-29 and 10 studies including both the IOP-29 and IOP-M have been published with 4 meta-analyses or systematic reviews. These publications present various, commonly used statistical analyses of validity and efficacy, e.g., sensitivity and specificity, along with comparisons to other SVTs and PVTs. Data Synthesis In the quantitative research literature, the IOP-29 and IOP-M have demonstrated efficacy across countries and languages in discriminating credible from noncredible presentations related to psychosis, PTSD, depression, anxiety, and neuropsychological disorders. Conclusions These findings support adding this tandem to the multi-method evaluation of the credibility of mental health and neuropsychological presentations. The brevity of administering these two tests, i.e., approximately 20 minutes total, suggests that the cost–benefit might be strong. More research with biomarkers and specific neuropsychological disorders might be needed along with more publications for which the authors do not include the test developers.

On the Clinimetrics of the Montreal Cognitive Assessment: Cutoff Analysis in Patients with Mild Cognitive Impairment due to Alzheimer's Disease.

In the era of disease-modifying therapies, empowering the clinical neuropsychologist's toolkit for timely identification of mild cognitive impairment (MCI) is crucial. Here we examine the clinimetric properties of the Montreal Cognitive Assessment (MoCA) for the early diagnosis of MCI due to Alzheimer's disease (MCI-AD). Data from 48 patients with MCI-AD and 47 healthy controls were retrospectively analyzed. Raw MoCA scores were corrected according to the conventional Nasreddine's 1-point correction and demographic adjustments derived from three normative studies. Optimal cutoffs were determined while previously established cutoffs were diagnostically reevaluated. The original Nasreddine's cutoff of 26 and normative cutoffs (non-parametric outer tolerance limit on the 5th percentile of demographically-adjusted score distributions) were overly imbalanced in terms of Sensitivity (Se) and Specificity (Sp). The optimal cutoff for Nasreddine's adjustment showed adequate clinimetric properties (≤23.50, Se = 0.75, Sp = 0.70). However, the optimal cutoff for Santangelo's adjustment (≤22.85, Se = 0.65, Sp = 0.87) proved to be the most effective for both screening and diagnostic purposes according to Larner's metrics. The results of post-probability analyses revealed that an individual testing positive using Santangelo's adjustment combined with a cutoff of 22.85 would have 84% post-test probability of receiving a diagnosis of MCI-AD (LR+ = 5.06). We found a common (mal)practice of bypassing the applicability of normative cutoffs in diagnosis-oriented clinical practice. In this study, we identified optimal cutoffs for MoCA to be allocated in secondary care settings for supporting MCI-AD diagnosis. Methodological and psychometric issues are discussed.

Assessing Kurt Goldstein's lasting influence in the neuropsychology of language versus his use of aphasic symptoms as diagnostic insights into brain injuries.

In the history of the neurological relationship between human behavior and brain function in Europe and North America, various perspectives on brain localization and holistic functioning have been addressed. One of the founding figures of modern neuropsychology, Professor Hans-Lukas Teuber (1916-1977) of the Massachusetts Institute of Technology, reminded the scholarly community of its negligence of preceding traditions in day-to-day research endeavors. Teuber particularly emphasized that during the development of the aphasiology field (1950s-1960s) even major figures, such as the German-American neurologist Kurt Goldstein (1878-1965), had been neglected in the scientific community's collective memory. This happened despite Goldstein's contributions to cortical blindness, vicarious brain functioning, and neurorehabilitation. The outcome of the debates regarding the neurology of language had to be incompletely relearned in later decades. Neuropsychological concerns regarding the relationship between cortical localizationism and functional holism have made recourse to Goldstein's work necessary for reviving historical answers for current conundrums. It is therefore opportune to review Goldstein's work in the light of the history of aphasiology. Contemporary scholarship has once more drawn research attention to the works of Goldstein along with Norman Geschwind (1926-1984) and his pupils. It has also resurrected the underlying research of Carl Wernicke (1848-1905). This review article explores deep and lasting questions regarding the positioning of Goldstein's holism among the contemporary holistic perspectives. It does so by firstly discussing Wernicke's traditional model of distributed localizationism. Secondly, it describes Goldstein's previous work in the German brain sciences. Thirdly, it examines his aphasiological contributions on both sides of the Atlantic. Fourthly, it addresses the advancement of a dynamic localizational perspective by Geschwind and his pupils. This article intends to render a historical analysis fruitful for those exploring modern-day problems in the neurology of aphasia and clinical speech neuropsychology.

Challenges and prospects in advancing clinical neuropsychology

In the ever-evolving field of clinical neuropsychology, significant methodological and conceptual limitations hinder progress. To ensure the continued relevance of this discipline amidst remarkable advancements in neuroscience, medicine, and methodology, these obstacles must be addressed. This opinion article identifies inherent limitations within current clinical neuropsychology, including issues such as multi-collinearity in neuropsychological assessments, lack of validated tools reflecting contemporary cognitive function models, and the use of divergent theoretical frameworks in evaluations, leading to a gap between theory and practice. The disconnect between behavior and biomarkers, particularly evident in neurodegenerative diseases but also relevant for other pathologies, together with the rise of genetic analyses, necessitate change. Methodological improvements are crucial for ensuring the discipline's future relevance. Looking ahead, key perspectives and challenges are outlined, emphasizing the need for a holistic approach to cognitive functioning and congruent tools, patient engagement in experimental studies, rectification of biases, and exploration of variables like personality. Training professionals to bridge the gap between practice and research is essential. By addressing these challenges, clinical neuropsychology can not only adapt to the evolving landscape but also shape it, ensuring a brighter future for the field.

The impact of a primary brain tumor diagnosis on caregivers: Insights from the patients’ perspective

PurposeThe diagnosis of a primary brain tumor (PBT) causes significant distress for the caregiver-patient dyad, warranting increased supportive care intervention. Although researchers have previously assessed caregivers’ perceptions of their own supportive care needs, no study to date has identified how patients perceive the caregiving experience and/or patients’ recommendations for integrating supportive care of caregivers in neuro-oncology. This qualitative study examined caregiver distress as well as caregiver supportive care needs from the patients’ perspective to inform future intervention development.MethodsAdults with PBT (N = 15; Mage = 45; 53% female; 93% White) were divided into four, 90-min focus groups moderated by a clinical neuropsychologist. Patients responded to semi-structured interview questions regarding various supportive care needs throughout the course of disease. Each discussion was transcribed and coded using thematic content analysis and NVivo software. Inter-rater reliability was excellent (MKappa = 0.92, range = 0.85–0.93).ResultsSeven distinct codes related to PBT caregivers emerged and were classified into two broader themes: Caregiver Impact (47% of coded content) and Caregiver Support (53% of coded content). Caregiver Impact refers to patients’ perspective of the practical and emotional demands of caregiving. Under Caregiver Support, patients cited a strong need for increased support of caregivers, including bereavement care, individual psychotherapy, and joint caregiver-patient dyad sessions.ConclusionPatients with PBT expressed profound concerns regarding the demands of caregiving and its impact on the well-being of their loved ones. Findings emphasize the need for comprehensive dyadic support in neuro-oncology throughout the disease trajectory to enhance the overall quality-of-life for both patients and their caregivers.

Cultural and multicultural topics in Neuropsychology Journal titles from 2010-2020

Objective The values of a field are reflected in the science it publishes. The goal of this study was to present a historical analysis of the extent to which the field of clinical neuropsychology publishes journals with titles that address culture in the context of brain function and behavior between 2010 and 2020. Methods Titles from articles published in 13 neuropsychology journals from 2010–2020 were collected and coded with regard to culture and multicultural content. The aims of the study were to (1) determine how often cultural or multicultural topics were represented in journal titles, (2) determine if cultural or multicultural content in neuropsychology journal publication titles increased over time, and (3) to explore other neuropsychological content that was most and least likely to appear in publications pertaining to culture or multicultural issues. Results Results indicated that titles for publications in clinical neuropsychology journals with content relevant to cultural or multicultural neuropsychology represented 1.1% to 13.4% of titles across the 13 journals. The number of cultural/multicultural titles increased over time. The number of cultural/multicultural titles per journal was not significantly correlated with the journal impact factor. Normative data were addressed significantly more often in cultural/multicultural titles versus non-cultural/multicultural titles, whereas psychiatric issues were addressed significantly less often. Conclusions There are many actions that clinical neuropsychologists can take to increase the field’s attention to the effects of culture on brain function and behavior. It is vital to update our data from 2021 to the present, given the substantial increase in awareness of social justice issues that occurred since 2020.