A new neuropsychology for the XXI century

A.R. Luria’s cultural neuropsychology in the 21st century

Luria has long been one of the most influential authors in cognitive neurosciences, in particular in neuropsychology. New scientific advances and clinical observations have confirmed many of his proposals and hypotheses. In this paper one of his major ideas is analyzed: the influence of cultural factors on human cognition. The systemic-dynamic Lurian analysis of brain activity is based on Vygotsky's concept of higher mental functions, which are social in origin and complex and dynamic in their structure. Higher mental functions are based on a complex system of operations and means both external and internal. Living conditions and hence cultural characteristics have dramatically changed during the last half century with the development of new media and new virtual ways of communication. Review of contemporary developments supporting the appropriateness and usefulness of these concepts is presented. It is finally concluded that Luria is one of the major founders of contemporary neuropsychology not only from the clinical point of view, but also from the cultural perspective. His influence has continued undiminished during the 21st century.

Introduction to the special issue: Are modern neuropsychological assessment methods really "modern"? Reflections on the current neuropsychological test armamentarium

OBJECTIVE

We introduce this special issue which focuses on how advances in neuroscience and technology can modernize and transform clinical neuropsychological assessment.

METHOD

We included both invited and solicited papers to reflect on the strengths and weaknesses of currently used, standardized neuropsychological tests and to explore how we might incorporate new technologies and neuroscientific advances to modernize neuropsychological assessment methods.

RESULTS

The papers are organized along the following themes: (1) A critique of the current clinical neuropsychological test armamentarium; (2) A description of new opportunities for collecting neurobehavioral data with technology; (3) Digital science, biomedical big data and the internet; (4) Integrating neuropsychological, neuroimaging, and neurophysiological assessments; (5) Modernization, globalization and culture.

CONCLUSION

The process of modernizing methods of assessment in clinical neuropsychology is laborious and requires a coordinated, sustained effort among clinicians, researchers, and the test industry. While embracing technology is necessary, we must also be aware of unintended consequences as we navigate this exciting new territory.

The neuropsychological aspects of performance-based Internet navigation skills: A brief review of an emerging literature

OBJECTIVE

Over the last 20 years, the Internet has become a fundamental means by which many people with neurocognitive disorders manage their activities of daily living (e.g. shopping) and engage in health behaviors (e.g. appointment scheduling). The aim of this review is to summarize the emerging literature on the neuropsychology of performance-based tasks of Internet navigation skills (INS) as measures of everyday functioning.

METHOD

We performed a structured, qualitative review of the extant literature on INS using PRISMA guidelines.

RESULTS

Seventeen peer-reviewed studies met inclusion criteria and their results suggest that performance-based tests of INS: (1) discriminate healthy adults from some neuropsychological populations [e.g. human immunodeficiency virus (HIV), multiple sclerosis (MS), traumatic brain injury (TBI)]; (2) are associated with performance-based tests of everyday functioning capacity, domain-specific declines in manifest everyday functioning, and self-reported Internet behavior, but not global manifest functional status; (3) correlate with standard clinical neuropsychological tests, particularly executive functions and episodic memory; (4) may relate to demographic factors, most notably age; and (5) have largely unknown psychometric properties (e.g. reliability).

CONCLUSION

This review provided early support for the construct validity of performance-based tasks of INS as modern measures of everyday functioning in neuropsychological populations. Future work is needed to refine these tasks, establish their psychometrics, and evaluate their construct validity in diverse populations, as well as to develop effective remediation and compensatory strategies to improve Internet functionality among persons with neurocognitive disorders.

The profession of neuropsychology in Spain: results of a national survey

OBJECTIVE

To examine the current status of professional neuropsychology in Spain, with particular focus on the areas of professional training, current work situation, evaluation and diagnostic practice, rehabilitation, teaching, and research.

METHODS

Three hundred and thirty-nine self-identified professionals in neuropsychology from Spain completed an online survey between July and December of 2013. Respondents had an average age of 35.8 years and 77% were women.

RESULTS

Ninety-seven percent of the respondents identified as psychologists; 82% of the sample had a master's degree, and 33% a doctoral degree. The majority (91%) received their neuropsychological training at a graduate level; 88% engaged in neuropsychological evaluation, 59% in rehabilitation, 50% in research, and 40% in teaching. Average number of hours per week dedicated to work in neuropsychology was 29.7, with 28% of the respondents reporting working in hospitals, 17% in not-for-profit rehabilitation centers, 15% in universities, and 14% in private clinics. Clinicians primarily work with individuals with stroke, traumatic brain injury, and dementia. The top perceived barriers to development of neuropsychology in Spain included lack of clinical and academic training opportunities, and negative attitude toward professional collaboration.

CONCLUSIONS

The field of neuropsychology in Spain is young and rapidly growing. There is a need to regulate professional neuropsychology, improve graduate curricula, enhance existing clinical training, develop professional certification programs, validate and create normative data for existing neuropsychological tests, and create new, culturally relevant instruments.