In 2005, Glenn Larrabee, in collaboration with a team of neuropsychologists known for their expertise in the rapidly developing field of forensic neuropsychology, assembled a thoughtful and comprehensive guide intended to educate other neuropsychologists about the interface of neuropsychology with the legal issues that have become de rigueur in clinical practice. The resultant text, Forensic Neuropsychology: A Scientific Approach, became a valuable resource and the libraries of many neuropsychologists likely now contain dog-eared copies on their shelves. One might reasonably inquire then whether or not a second edition just a half dozen years later might be considered redundant and premature. After review of the second edition, however, the answer to such a question would be a resounding, “No.” As the contributors, Kaufman, Sweet and Morgan amply demonstrate in this text there has been a steady growth of references to neuropsychology in legal cases over the last decade, with an especially accelerated growth in the latter half of the decade. Given the influence of neuropsychology in both civil and criminal cases at this time, it is a rare clinical neuropsychologist who at one stage or another does not find him or herself embroiled in a case with legal repercussions and who cannot benefit from the expertise and wisdom available in this book.
Comparison of this new edition with the first edition reveals updated and expanded versions of all the original chapters, along with the addition of five chapters about issues that have emerged as important since 2005. Larrabee's book can be artificially divided into three sections. The first section comprises six chapters concerned with specific aspects of the practice of scientific forensic neuropsychology. In Chapter 1, Larrabee sets the tone of the text by explicitly detailing the principal concepts required for the scientific application of neuropsychology to forensic issues. In addition to describing the basics of a scientific approach, he discusses the importance of using classification accuracy statistics in diagnosis and he reviews other relevant scientific factors, such as reducing bias and using validated and standardized tests that measure all the core cognitive domains. He also reminds us that abnormality is the norm in neuropsychological assessment and cautions, based on Binder et al. (Reference Binder, Iverson and Brooks2009), that we do not have base rates that allow consideration of all discrepancies among test scores simultaneously. In this regard, nearly parallel with the publication of Larrabee's second edition, we also have Iverson, Brook and Holdnack's chapter in Neuropsychological Assessment of Work-Related Injuries (Reference Iverson, Brooks and Holdnack2012) that demonstrates their attempts to at least partially remedy that problem with the development of base rates of low scores for the Wechsler Adult Intelligence Scale-IV, Wechsler Memory Scale-IV and the Neuropsychological Assessment Battery across levels of intelligence and education.
In Chapter 2, Greiffenstein, aided by Kaufman, guide the reader through the intricacies of a productive relationship between the attorney and the neuropsychologist. They emphasize that it is the responsibility of the neuropsychologist to understand legal issues and be familiar with the courtroom, but also to practice competent neuropsychology while acting ethically and remaining objective in what is necessarily an adversarial setting. They advise about the multitude of potential conflicts that can and will occur and how to handle them; walk the practitioner through all the phases of the collaboration between the neuropsychologist and the attorney; point out issues that might be encountered and the appropriate proactive and reactive solutions; instruct the neuropsychologist as to his or her role; and provide useful summary tables, including one converting legal issues into neuropsychological issues. In their conclusions, they offer suggestions for a basic resource library among which they include Faust, Ziskin and Hiers’ 1991 Brain Damage Claims: Coping with Neuropsychological Evidence despite concerns about its predating Daubert and the emergence of symptom validity testing, unaware –unless prescient– that essentially simultaneously with the publication of their chapter, Faust has published a Sixth Edition of Coping with Psychiatric and Psychological Testimony (Reference Faust2012) that addresses these concerns. The third chapter, an entirely new one by Kaufman, who is both a neuropsychologist and an attorney, addresses the admissibility of expert testimony by neuropsychologists first by informing the reader of the history of the use of expert witnesses and second by presenting particular challenges facing the neuropsychologist expert. He discusses in great detail the challenges of battery selection, the science of symptom validity testing, causation opinions, and also when non-neuropsychologists offer neuropsychological opinions. Kaufman spends the remainder of the chapter highlighting those rules and issues specifically applicable to criminal cases and he warns about the threat posed to the admissibility of neuropsychological opinions when psychological tests are wrongfully disclosed to the public.
Chapter 4, by Grote and Pyykkonen, sets out the requirements for the ethical practice of neuropsychology, placed within the overarching principle of practicing competent neuropsychology. They discuss competent disclosure of raw test data and then use the rest of the chapter to elucidate obstacles to the competent practice of neuropsychology and advise on how to approach and overcome each. Chapter 5, by Larrabee, provides an introduction to malingering necessary for any neuropsychologist engaged in forensic practice. Rather than attempt to distill his entire textbook (Reference Larrabee2007) or Boone's textbook (Reference Boone2007) on malingering down to the size of one chapter, Larrabee focuses on engaging the reader in understanding malingering by defining it and presenting research designs for investigating it, as well as on some of the specialized tests and pattern analyses available for detecting both malingering and symptom exaggeration. Ricker, in Chapter 6, reviews advances in functional neuroimaging as adjunct techniques to neuropsychological assessment useful in the courtroom and although he concludes that most are not yet “from a scientific perspective, ready for routine deployment in forensic evaluations,” (p. 172), he also asserts that with additional research they hold promise for eventual applications in forensic settings.
The second section of this new edition is concerned with specific types of brain injury and diseases and medical illnesses commonly encountered by forensic neuropsychologists, and the application of forensic neuropsychology to each. The first of these, Chapter 7 on Perinatal Brain Injury by Taylor, new to this edition, thoroughly covers the neuropathological features and developmental consequences of the most common forms of brain injuries acquired during the perinatal period and then the forensic assessment of these injuries, as well as the tasks of formulating opinions and communicating expert findings. The next three chapters in this section focus on the application of forensic neuropsychology to traumatic brain injury (TBI). In Chapter 8, Donders offers an update on pediatric TBI, while in Chapters 9 and 10, Larrabee and then Roebuck-Spencer and Sherer do the same for mild TBI and moderate and severe TBI, respectively. This division of labor is highly effective as a means to specify the distinguishing characteristics of these acquired disorders especially in relationship to forensic issues. Bolla, in Chapter 11, presents guidelines for forensic evaluation of possible neurotoxic injuries, but offers the important caution that all possible etiologies, including neurotoxicant exposure and neuropsychiatric disorders, be rigorously explored. New to this edition, Chapter 12 by Greve, Bianchini and Ord is an excellent overview of the forensic assessment of chronic pain. Pain related issues frequently complicate forensic referrals and these authors share their particular and substantial expertise in this area. Especially helpful is the review of the most common chronic pain conditions, relevant diagnostic procedures, and medical treatments appended to this chapter. Binder, in Chapter 13, reprises his instruction in the forensic assessment of medically unexplained symptoms, reminding the neuropsychologist that cognitive symptoms are not injury or impairment. Binder sets out an excellent discussion of the assessment and implications for forensic practice of disorders of pseudoneurological illness, fibromyalgia, chronic fatigue syndrome, multiple chemical sensitivities, toxic mold, and sick building syndrome and psychological stress. Chapter 14, by Andrikopoulos and Greiffenstein, is the final chapter in this section and also new, but most welcome as it addresses whether or not the neuropsychologist is in a position to opine in the medicolegal arena on the issue of Posttraumatic Stress Disorder, an issue that is not uncommonly part of the reasons for referral in a forensic practice.
Like the second section, the third section of this book is comprised of three chapters also concerned with the application of neuropsychology to forensic questions, but specifically issues of competency in civil and criminal cases. The first of these chapters, Chapter 15 by Marson, Hebert and Solomon, offers the neuropsychologist evidence-based guidance on assessing consent capacity, financial capacity, and testamentary capacity in the ever-growing elderly population of the United States. The next two chapters, both by Denney, provide an excellent comprehensive discussion of the assessment of competency and responsibility in criminal forensic settings. Denney, a seasoned expert in this area, clarifies the essential differences between the clinician and the forensic provider and effectively counsels the neuropsychologist in the practice of neuropsychology in the criminal forensic setting.
The culmination of Larrabee's book is a final chapter by Sweet and Meyer that summarizes the trends in forensic neuropsychology practice and research. Using historical data, evidence-based data, practice surveys, and legal rulings they track the progress of forensic neuropsychological practice in the American civil and criminal legal system and suggest areas for future research based on the top ten forensic topics as evident from neuropsychology journals in the decade from 1990 to 2000. They conclude with a reminder of the importance of practicing ethical and objective competent neuropsychology.
Each chapter in Forensic Neuropsychology: A Scientific Approach, Second Edition is uniquely contributory to the neuropsychologist engaged in forensic practice; collectively, their effect is multiplicative, bound to expand the knowledge base of neuropsychologists concerned with the competent practice of neuropsychology in general and with the scientific application of neuropsychology to forensic cases specifically. This book is essential reading for all neuropsychologists, including those who only occasionally – perhaps without actively eliciting such – become involved in forensic cases, as well as for those neuropsychologists who combine clinical and forensic work in their practice.
