The State of Published Science in Clinical Neuropsychology's Lifespan Journals: A Mixed Methods Examination of Scope, Approaches, and Content.

ObjectiveApathy is a common symptom across neurodegenerative diseases with origins still debated. “Vascular apathy hypothesis” by Van der Mast suggests vascular pathologies precede apathy. Other evidence points to dysfunction in dopamine pathways, driving apathy by impairing goal-directed behaviour. The impact of apathy on cognitive decline and autonomy, particularly with coexisting depression, remains unclear. This cross-sectional study aimed to (1) characterize apathy in vascular dementia, Parkinson’s disease (PD), and Mild Cognitive Impairment-Alzheimer Disease (MCI-AD) regarding incidence, severity, and cognitive specificity; (2) differentiate effects of apathy and depression on cognitive impairment and daily autonomy (Activities of Daily Living [ADL]).MethodFifty-three patients underwent neuropsychological testing and completed the Geriatric Depression Scale, Starkstein’s Apathy Scale, and ADL questionnaire at a clinical neuropsychology outpatient setting in Milan.Results56% patients had cardiovascular pathologies, 20% had PD, and 22% had MCI-AD. Neither prevalence nor severity of apathy or depression differed significantly across diseases. Hierarchical regression showed apathy predicted language initiative controlling for depression (R2 = 0.249; F(2) = 4.144; p = .028), and inversely correlated with working memory, language and frontal functioning, while depression predicted autonomy controlling for apathy (R2 = 0.234; F (2) = 3.821; p = .036).ConclusionsApathy is prevalent across different neurodegenerative diseases and exacerbates specific cognitive impairments. Distinguishing vascular apathy from other forms remains challenging.

Objective The Community Outreach Subcommittee (COS) of the American Psychological Association’s (APA) Division 40 (Society for Clinical Neuropsychology, SCN) is a new committee created to support neuropsychologists in community outreach practices and public education. To understand the needs of constituents, the committee conducted a survey to identify current practices. Method An online survey of neuropsychologists was conducted to assess current practices, gaps, and needs for providing community outreach and public education in the field of neuropsychology. Results 112 neuropsychologists responded to the survey. Results highlighted the growing need for resources in a wide variety of languages to meet the needs of communities rich in cultural diversity. Respondents expressed a desire to educate the public and other members of the healthcare field not only about the purpose and utility of neuropsychological evaluation, but in brain-behavior relationships more broadly. Finally, respondents identified several misconceptions and misunderstandings shared by the public and referral sources, which may be targets for educational opportunities. Conclusions The findings of this survey will be used to guide future projects and address needs expressed by fellow neuropsychologists in their clinical and community practices. Practical recommendations are provided for neuropsychologists interested in initiating outreach projects and practices in their community.

BackgroundThe Remote Cognitive Aging and Alzheimer's Disease REsearch (R‐CARE) Toolbox advances Alzheimer's disease and related dementias (ADRD) research by providing innovative, accessible, and standardized tools for remote neuropsychological assessments. R‐CARE addresses barriers including logistical challenges of in‐person assessments and limited access for underrepresented populations. By leveraging digital technologies, it adapts established assessments like the Preclinical Alzheimer's Cognitive Composite 5 (PACC‐5) and Uniform Data Set Version 3 (UDS v3.0) batteries for remote use.MethodThe R‐CARE Team collaborated with clinical neuropsychology experts to adapt “gold standard” neuropsychological tests commonly used in ADRD trials and cohort studies for remote use. Tests unsuitable for direct remote implementation were modified or digitized to best maintain their key features. The toolbox incorporates measures from the UDS v3.0 and PACC‐5, physical measures, self‐ and informant questionnaires related to self‐perceived cognition, mood, functional capacity, social support, habits, and other relevant attitudes, experiences, and behaviors. The team programmed all instruments for delivery on the REDCap platform, and all digital cognitive assessments via the M2C2kit, supporting both in‐person and remote (videoconference) administration of tests. To promote open science and facilitate the adoption of digital and remote measures across the field, the R‐CARE Team aims to share all REDCap measures and digital measures via a publicly accessible resource‐sharing platform, GitHub, to allow for extension, translation, widespread use, and standardization.ResultThe R‐CARE Toolbox includes 59 individual measures programmed for REDCap and 14 digital measures developed using the M2C2kit. These measures span cognitive, behavioral, physical, and functional health domains. A comprehensive list of these instruments is provided in Table 1. All instruments are shared here [https://github.com/rcare‐toolbox/redcap‐measures] to foster collaboration, support the standardization of in‐person and remote tests, and provide a foundational resource for further expansion by the wider research community.ConclusionThe R‐CARE Toolbox provides an open‐source solution for remote cognitive and functional assessment with the goal of improving accessibility, inclusivity, and scalability in ADRD research. By addressing logistical and sociodemographic challenges, the toolbox seeks to pave the way for innovative methodologies in clinical trials and cohort studies.

Clinical neuropsychology is a specialty of psychology that is closely related to neuroscience in that it assesses cognitive and functional brain-behavior relationships across a range of clinical diagnoses. As with many other related disciplines including neuroscience, educational outreach to students about clinical neuropsychology to increase vocational interest is essential to the field. This manuscript examines the feasibility of implementing one statewide educational outreach program for undergraduate students to learn about the specialty of clinical neuropsychology as a possible career path. The current program was developed by the authors of this manuscript, both of whom are clinical neuropsychologists and co-lead a committee for student outreach within a state organization which represents such professionals. As students in metropolitan areas are more likely to have exposure to neuropsychology, the emphasis of our program has been on outreach to university psychology and neuroscience departments, especially in more rural and geographically underrepresented areas of our state. The process of this outreach, the content of the presentations conducted through this program, and descriptive feedback from participants based on qualitative survey data (2023-2025) is presented. Based on the response and successful engagement rate from the colleges and universities that we have outreached, we have determined that our model offers a feasible means to conduct education about possible careers in neuropsychology to undergraduate students statewide. Practical recommendations for neuroscientists, psychologists, and other such professionals interested in initiating and implementing their own outreach programs within their specialties are also provided.

Functional Cognitive Disorder (FCD) is a subtype of Functional Neurological Disorder (FND), with diagnostic criteria that have only recently been established in a major disease classification system. Although objective neuropsychological measures are not required for diagnosing FCD, they can provide valuable insights into discrepancies between subjective cognitive complaints, functionality, and objective neuropsychological performance. We present the case of a 51-year-old Malay female with a history of Major Depressive Disorder who developed neurocognitive complaints affecting her occupational and social functioning following the sudden death of her husband. A comprehensive assessment, including neuropsychological testing, brain MRI, and laboratory investigations, was conducted. Neuropsychological evaluation revealed significant impairments across multiple neurocognitive domains. However, the presence of situational and mood-related variability in memory performance, along with an inconsistency between the severity of her objective cognitive impairments and her largely preserved ability to perform instrumental activities of daily living (IADLs), supported a diagnosis of FCD. The diagnosis and management of FCD require a multidisciplinary approach. Clinical neuropsychology plays a crucial role in both diagnosing and understanding FCD by assessing neurocognitive functioning and intrapsychic processes. The use of various psychological instruments can help elucidate the neurocognitive profile of FCD to inform a more comprehensive and individualized management plan.

BackgroundAdvance care planning (ACP) is a process that helps individuals identify and communicate their preferences regarding end‐of‐life decisions and future medical needs. It is an ongoing and evolving process, particularly for informal caregivers of persons with cognitive decline (PWCD), whose care recipient's (CR) ability to decide and express their wishes may change as their disease progresses. Informal PWCD caregivers may not know their CR's preference for end‐of‐life care or feel prepared to follow through on established preferences on their CR's behalf. While several formal assessments of ACP have been previously published, many are lengthy or not psychometrically validated to assess ACP self‐efficacy and preparedness in informal PWCD caregivers who are actively involved in ACP with their CR; therefore, the present study aims to address this current gap in the literature.MethodThe present study utilized a conceptual framework based on Behavior Change Theory, positing that knowledge, self‐efficacy, and preparedness are required for ACP to be translated into action (Sudore et al., 2013). A team of nine healthcare providers involved in the provision of clinical care in a Memory Disorders Clinic identified existing self‐report ACP measures with the goal of developing a brief, self‐report measure that would adequately assess ACP self‐efficacy and preparedness in informal PWCD caregivers who are engaging in ACP actions for their CR.ResultAfter reviewing PubMed, Google Scholar, Medline, and PsycINFO, 10 publications describing formal measures of ACP were identified. These publications were reviewed in a focus group of four clinical neuropsychologists, one neuropsychology fellow, and four dementia care coordinators, with the goal of creating a brief, self‐report measure to assess ACP self‐efficacy and readiness in informal PWCD caregivers. Keywords used during the literature review, item selection criteria, and an overview of the proposed survey items will be presented.ConclusionThe proposed ACP survey may be useful to clinicians and researchers evaluating ACP self‐efficacy and preparedness in informal PWCD caregivers who are engaging in ACP activities with their CR. Future directions include administering the proposed survey to a clinical sample of informal PWCD caregivers to evaluate its psychometric properties, including internal consistency, test‐retest reliability, and construct validity.

Laying the Groundwork for Clinical Neuropsychology in Romania: Beliefs and Practices of Psychologists Regarding Validity Testing in Clinical Assessment.

Neuropsychological testing is the standard of care in the United States for assessing functional deficits related to cognitive impairment. However, there are well-known limitations of neuropsychological testing, including issues of reliability and validity, appropriate norming, predictive and ecological validity, and cultural appropriateness. The goal of this case example is to differentiate assessment from testing and to describe how assessment of brain-behavior relationships can be conducted when testing data are not available. This case example describes a neuropsychological differential diagnosis where the individual being examined was unable to participate in any standardized testing and had no available brain imaging. By necessity, the entirety of the differential diagnosis rests on the history and behavioral observations. This case is presented as a fact-finding exercise, as it would be in a board examination to assess neuropsychological competencies. The diagnostic value of history and behavioral observations are discussed in the context of disease base rates to rule in/rule out differential diagnoses involving the peripheral and central nervous systems. Clearly, standardized neuropsychological testing would add important data to revise and refine diagnoses and to develop treatment interventions. Neuropsychological competency examinations usually observe clinicians in a controlled environment with comprehensive information, similar to demonstrating swimming skills in a swimming pool. However, neuropsychologists should also be able to swim in the ocean, where the setting is not well controlled, comprehensive information may not be available, and the waters are often murky, such as when assessing patients where standardized testing is not possible. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Comparing the Neuropsychology Knowledge Base of Publicly Available Large Language Models.

Objective: We provide a case report, narrative literature review, and clinical guidance addressing the complexities of differential diagnosis of psychosis among young adults who present for neuropsychological evaluation. We highlight the potential for misdiagnosis of Huntington’s Disease (HD) as schizophrenia or other neuropsychiatric conditions and describe implications for clinical neuropsychology practice. Method: We present the case of a 31-year-old male with eighth grade education initially diagnosed with schizophrenia who was ultimately found to have HD of probable juvenile onset via genetic testing following a neuropsychological evaluation. Family history of HD was not known to the patient until his late 20s due to being raised in an adoptive setting. Results: The patient had a history of apathy, anxiety, aggression, and academic challenges in childhood, with increasing need for assistance with activities of daily living and recent-onset gait instability, dysarthria, dysphagia, auditory hallucinations, compulsive behaviors, and depressive symptoms. Neuropsychological evaluation revealed difficulties with attention and set shifting, ideational dyspraxia, variable memory performance, slowed processing speed, blunted affect and impaired affect perception, shuffling unstable gait with reduced arm swing, and a subcortical pattern on language testing. Illness onset and course, neurocognitive, neuropsychiatric, and motor symptomatology, and genetic findings were suggestive of juvenile onset HD (JHD). Conclusions: This case exemplifies the complexities involved in diagnosing HD in young adults who present with neuropsychiatric symptoms. Valuable insights into the neuropsychological and neuropsychiatric profile of young adults with HD are shared, and clinical guidance regarding differential diagnosis is provided with an emphasis on HD and schizophrenia.

Mental health difficulties in individuals with neurological conditions can impact quality of life, exacerbate cognitive difficulties, and are associated with poorer clinical outcomes. This audit reviewed the incidence of clinically-elevated psychological distress in patients attending a neurology department referred to a Neuropsychology Service (N=400) in an acute tertiary hospital. Overall, 79% of patients endorsed clinically elevated symptoms in at least one symptom domain, with a high incidence of anxiety, psychological distress, and depression symptoms. A substantial proportion of individuals experienced moderate or severe symptoms of psychological distress (38%), anxiety (37%) and depression (20%). These findings have implications for both specialist neuropsychology service development with a view to utilising the full range of clinical neuropsychologists’ psychological intervention competencies, as well as the development of integrated care pathways to support the mental health and psychological needs of those with neurological conditions in a wide range of settings across the continuum of care.

Current practices and challenges in providing doctoral training in clinical neuropsychology

ABSTRACT Introduction International students pursuing neuropsychology training in the U.S. face unique and multifaceted challenges that impact their academic, clinical, and professional development. This paper provides an overview and definitions of issues relevant to international students, with special focus on those enrolled in doctoral programs with an emphasis on neuropsychology. Methods To complement a review of guidelines and issues, an online survey sampled 37 students from different regions. Participants provided information about their experiences and recommendations to improve the climate of support and outcomes for international doctoral students in clinical neuropsychology programs. Results Key challenges include navigating visa regulations, financial constraints, cultural adjustment, language barriers, and limited institutional support. Notably, 75% of participants reported difficulties with visa and immigration requirements, whereas 78% highlighted financial challenges as significant obstacles. Language-related issues, including academic writing and oral communication, were reported by 48% of the participants, which were exacerbated by limited institutional resources. Participants also identified gaps in mentorship and opportunities compared to domestic students, with many perceiving low preparedness for securing clinical placements, internships, and postdoctoral fellowships. Participants utilized strategies such as networking, self-driven research, and mentorship to overcome barriers. Recommendations for improving the training experience include increased support for visa navigation, responsive mentorship, and supportive language resources at program and institutional levels. Advocacy for policy changes, such as designating clinical psychology as a STEM discipline to expand OPT eligibility, is also critical. Conclusions The findings underscore the critical need for systemic changes within graduate programs and broader policy frameworks to support international students in adhering to visa stipulations, managing financial burdens, overcoming language barriers, and securing internships and fellowships. Addressing these barriers would benefit international trainees and strengthen the field by broadening perspectives and improving practice and research.

ABSTRACT Introduction Despite available resources, there have been calls for increased literature regarding evidence-based practices in psychology doctoral education. The field of medicine has a robust literature around educational optimization which may enrich doctoral education in psychology. Utilization of medical education literature may be particularly valuable for doctoral training of students interested in specialties which are typically embedded in the medical system, like clinical neuropsychology. Method The current article provides a brief summary of some of the evidence-based medical education literature and provides examples of its possible application to doctoral education specifically within a clinical neuropsychology framework. Results The authors summarize some of the support for the efficacy of selected medical education principles, including the concepts of holistic review, multidisciplinary training and integration of clinical and academic training. Examples of implementation are provided from a single doctoral program. Conclusions We provide examples of evidence-based medical education principles that we believe can be applied to doctoral training in clinical neuropsychology, with the goal of disseminating ideas, models and practices for doctoral program faculty to consider in the developing and refinement of their educational programs.

ABSTRACT Objective Doctoral trainees and early career neuropsychologists lack resources on the topics of job application, selection, and negotiation. The absence of such resources may place trainees entering the workforce at a critical disadvantage. This manuscript provides substantive information and recommendations for trainees and early career psychologists to achieve early career success. Method The following manuscript includes a narrative review of considerations for prospective employment in neuropsychology. Results We begin with a discussion of the job application process and then provide a summary of factors to consider in job selection and negotiation in clinical neuropsychology in multiple settings, including the topics of compensation, benefits, and productivity expectations. Conclusions This manuscript provides an overview of critical topics for early career success in clinical neuropsychology that could be incorporated into graduate and post-doctoral training curricula.

ABSTRACT Introduction By 2050, the U.S. population is projected to become increasingly heterogeneous, requiring a culturally competent neuropsychology workforce equipped to serve this evolving demographic. International graduate trainees bring valuable cultural and linguistic assets to the field of clinical neuropsychology but face significant structural barriers involving restrictive immigration policies. Methods This paper explores structural and institutional challenges by presenting results from a survey of 118 training directors across doctoral (n = 40), internship (n = 50), and postdoctoral (n = 28) levels, alongside personal narratives from four international trainees. Results Results reveal low international trainee enrollment — particularly at the postdoctoral level — and widespread immigration-related challenges, such as limited visa sponsorship and duration, unawareness of visa-related training restrictions, and discomfort among directors in supporting visa issues. Despite the potential benefits of STEM designation for clinical and counseling psychology programs to ease visa barriers, few programs have attempted and succeeded in this process. Personal narratives also highlighted the burdensome STEM conversion process, and the role of trainee-led efforts in overcoming bureaucratic hurdles. Conclusions To urgently address these issues, we advocate for systemic reforms including national-level STEM reclassification of psychology programs, extended visa durations, enhanced national pipelines and institutional support for visa sponsorship, and improved education on immigration policies. These efforts align with the Multicultural Orientation (MCO) model and AACN’s Relevance 2050 goals by fostering a culturally and linguistically responsive workforce equipped to meet evolving mental health needs and to ensure the continued relevance of clinical neuropsychology.

This research evaluates memory function, depression and anxiety symptoms in elderly individuals and examines the relationship between these variables. The Digit Span Test and the 10/36 Spatial Recall Test were used to evaluate memory function, and the Depression, Anxiety and Stress Scale-21 was used to evaluate mental health. Participants were reached through Healthy Ageing and Support Centres, Public Education Courses and an easily accessible sampling method. Participants were included in the research based on inclusion and exclusion criteria. The tests and questionnaires were administered by a clinical psychologist and a clinical neuropsychologist. The study sample consisted of 160 volunteer participants aged between 66 and 74. The average age of the participants was M= 68.00 (SD=2.31). The correlation analysis revealed that increasing levels of depression and anxiety were associated with decreasing memory performance. In gender comparisons, while there was no significant difference between female participants and male participants in terms of memory functionality, it was determined that female participants had higher levels of depression and anxiety than male participants. The findings of the research draw attention to the relationship between mental health and cognitive functionality. In conclusion, managing depression and anxiety in older adults is critical for preserving cognitive function. In this regard, multidisciplinary approaches are needed to develop strategies that support both the cognitive and mental health of older adults.

ABSTRACT Background A growing concern in neuropsychology is whether neuropsychological test measures (NTMs) can predict functional outcome (i.e. ecological validity). The relationship between neuropsychological tests and return to work (RTW) outcomes following mild traumatic brain injury (mTBI) found that the majority of tests were either weakly or completely unrelated. As such, many have opined that clinical neuropsychology should adopt new tests that relate test performance to real-world functioning, such as the Behavioural Assessment of Dysexecutive Syndrome (BADS). Further investigation into the BADS sensitivity to employment status in a mTBI sample is needed. Present study We aimed to investigate if the BADS is better at differentiating between employment status compared to traditional pen-and-paper neuropsychological test measures in a sample of patients in the post-acute period of recovery after mTBI. Results Following correction of family-wise error, neither the BADS nor traditional tests could differentiate employment status in patients with mTBI who were in the post-acute period of recovery. Conclusions The lack of significant findings in the majority of the tests highlights the importance of other facets of a complete neuropsychological assessment. Furthermore, researchers may benefit from investigating other forms of assessment that could prove to be more ecologically valid.

ABSTRACT Objective To investigate the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with cognitive behavioral therapy (CBT) on neuropsychological status, cognitive function, and sleep microstructure in first-episode depression patients with insomnia. Methods The clinical data of 95 first-episode depression patients with insomnia were retrospectively analyzed. The patients were divided into groups according to the different therapeutic regimens, 45 cases in the control group received conventional treatment, and 50 cases in the research group received rTMS combined with CBT on the basis of conventional treatment. The clinical efficacy, depression level, cognitive function, neuropsychology and sleep quality of the two groups were compared. Results The overall efficacy rate was higher in the research group compared to the control group (96.00% vs. 80.00%) (p < .05). Conclusion In addition to conventional pharmacological treatment, the combination of rTMS and CBT may serve as a promising adjunctive intervention for first-episode depression patients with insomnia, demonstrating potential benefits in improving neuropsychological status, cognitive function, and sleep microstructure.