PhD/PsyD Neuropsychology diagnoses?

[Healthinfo104]

What exactly can neuropsychologists diagnose?

Can they diagnose various neurological diseases/ disorders like dementia, parkinsons, stroke, TBI, etc?

Or do they only diagnose the functional deficits of these conditions, like memory loss, impaired speech, etc?

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[WisNeuro]

Yes.

 

[erg923]

What exactly can neuropsychologists diagnose?

Can they diagnose various neurological diseases/ disorders like dementia, parkinsons, stroke, TBI, etc?

Or do they only diagnose the functional deficits of these conditions, like memory loss, impaired speech, etc?

TBI is not a diagnosis, btw, its an event.

 

[WisNeuro]

TBI is not a diagnosis, btw, its an event.

Oh, it is if you want a monthly tax-free check for the rest of your life. Or should I say "traumatic brain disease."

 

[Healthinfo104]

TBI is not a diagnosis, btw, its an event.

Sorry, I should have put conditions rather than "disease" and "disorder"

 

[Therapist4Chnge]

The "old guard" coming through in spades.



To answer your question...yes, we make those dxs all of the time.

 

[PsyDr]

Depends on state law. In general we can diagnose any neuro or psych thing.

Neuropsych started as a diagnostic profession. Before CT, before MRI, etc we were it. The super duper old guys were exceptional. Diagnosing tumor, location, and type of tumor. From neuropsych test data. Seriously, neurosurgery cut open people's heads based upon neuropsych data. There are old books specifically dedicated to diagnosis.

When imaging advanced, some diagnoses became easier to make without neuro psych. Brain tumors are probably better diagnosed with MRI than neuropsych data now. Other disorders are remain best diagnosed by neuropsych (e.g., bensons disease).

For disorders of cognition, neuropsych is the gold standard. Because you have to measure something in order to figure out if it's low or high. Things like dyslexia would fit in here.

 

[BuckeyeLove]

Piggybacking off of the OP...Have any of the old guard ever encountered non-neuro folks making these diagnoses? (i.e., forensic psych's diagnosing a very circumscribed and specific neurocognitive condition from data gleaned from clinical interview, minimal collateral, and let's say...a DRS...or screener of some sort).

 

[Healthinfo104]

Depends on state law. In general we can diagnose any neuro or psych thing.

Neuropsych started as a diagnostic profession. Before CT, before MRI, etc we were it. The super duper old guys were exceptional. Diagnosing tumor, location, and type of tumor. From neuropsych test data. Seriously, neurosurgery cut open people's heads based upon neuropsych data. There are old books specifically dedicated to diagnosis.

When imaging advanced, some diagnoses became easier to make without neuro psych. Brain tumors are probably better diagnosed with MRI than neuropsych data now. Other disorders are remain best diagnosed by neuropsych (e.g., bensons disease).

For disorders of cognition, neuropsych is the gold standard. Because you have to measure something in order to figure out if it's low or high. Things like dyslexia would fit in here.

Awesome! That's real cool, so what is your training like for neuropsych? I know it's 2 years postdoctoral, but what does it include? Do you learn the anatomy and physiology of the brain? Is there an internship? Or is it all didactics?

 

[WisNeuro]

Piggybacking off of the OP...Have any of the old guard ever encountered non-neuro folks making these diagnoses? (i.e., forensic psych's diagnosing a very circumscribed and specific neurocognitive condition from data gleaned from clinical interview, minimal collateral, and let's say...a DRS...or screener of some sort).

Primary care providers make diagnoses of neurodegenerative conditions all the time. Unfortunately they are wrong a lot of the time, and I get to deal with the normally aging 75 year old who is deathly terrified that he's going to die of Alzheimer's, and has had increased anxiety since his PCP told him this more than a year ago, even though he is just showing signs of normal forgetfulness and natural decline in some abilities. Non-neuro people delve into this stuff all of the time. Often without thinking about what impact their incompetence has on the patient's well-being.

 

[Therapist4Chnge]

Non-neuro people delve into this stuff all of the time. Often without thinking about what impact their incompetence has on the patient's well-being.

This is a huge pet peeve of mine. I see it from chiropractors diagnosing concussion off of a self-report checklist, to neurologists diagnosing cognitive impairment based on pt report, PCPs diagnosing Dementia w only exam and pt report, etc.

Now that I'm doing more medico-legal work, the stuff I get to review can really be cringeworthy.

 

[AcronymAllergy]

Awesome! That's real cool, so what is your training like for neuropsych? I know it's 2 years postdoctoral, but what does it include? Do you learn the anatomy and physiology of the brain? Is there an internship? Or is it all didactics?

There's some variability, and most folks will start getting neuropsych training while still in grad school and on internship. So yes, there is internship, although trainees typically start seeing patients before they (most often during their first or second year or grad school). In addition to much of the general clinical/counseling psychology info, you'll spend time in didactics and supervision learning about tests and measurement (e.g., test design/development and psychometrics), brain-behavior relationships, neuroanatomy, etc.

The postdoc, while able to make up some ground for absences in prior training, is often where all those loose ends are tied together to form the basis for more advanced knowledge and understanding.

 

[psych.meout]

I have a related question.

My program offers several neuropsych practica that I'm definitely going to complete, but there's also an interesting assessment practicum at a juvenile detention facility.

Would this latter practicum be helpful for a neuropsych-based career outlook even though the assessment is not strictly neuropsych in focus?

 

[erg923]

Would it be helpful for furthering a neuropsych career? Probably not. But diversity of training experiences is always a plus for internship committees...and for your training as psychologist in general.

 

[WisNeuro]

I have a related question.

My program offers several neuropsych practica that I'm definitely going to complete, but there's also an interesting assessment practicum at a juvenile detention facility.

Would this latter practicum be helpful for a neuropsych-based career outlook even though the assessment is not strictly neuropsych in focus?

Won't hurt, but may not help much either. These positions focus more on psych assessment rather than neuropsych assessment. The one situation that could help is if you have little experience interpreting certain instruments (mmpi, PAI, etc) and this could supplement some of that.

 

[smalltownpsych]

Piggybacking off of the OP...Have any of the old guard ever encountered non-neuro folks making these diagnoses? (i.e., forensic psych's diagnosing a very circumscribed and specific neurocognitive condition from data gleaned from clinical interview, minimal collateral, and let's say...a DRS...or screener of some sort).

Consistent with what other posters have said, if they are conducting a clinical interview, obtaining collateral, and administering a DRS, then they are doing more than what I have often seen done. Nonetheless, the findings should be reported along the lines of "results are consistent with dementia, recommend further evaluation by neurologist and neuropsychologist to clarify and rule out alternative explanations." I typically would administer a WAIS in addition to a DRS-2. Also, I wouldn't be testifying in court that the person has a specific diagnosis as I don't have sufficient training, education, or experience to differentiate between types of dementia. I'm pretty good at differentiating delirium from dementia though as I get enough experience with the periodic sudden-onset we-think-it-could-be-dementia referrals when covering the hospital.