Neuropsychological Assessment of Work-Related Injuries Hardcover – Dec 23 2011
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Review"This work provides an objective review of the role and function of neuropsychology in assessing work-related injuries, an area in which clinical neuropsychologists have long participated, but without such a comprehensive resource. From explanations of the underlying science to best-practice guidelines, the book is thorough, readable, and a tribute to the editors' ability to attract such quality authors. My copy will become worn very quickly."--Cecil R. Reynolds, PhD, Emeritus Professor of Educational Psychology and Neuroscience and Distinguished Research Scholar, Texas A&M University
"Given the paucity of books on the neuropsychological assessment of individuals who have been injured at work, this is a welcome contribution. Neurological and psychological injuries specific to the workplace are summarized. The book succeeds in promoting evidence-based neuropsychological assessments by integrating the latest research and facilitating biopsychosocial understanding. Graduate students and experienced clinicians alike will benefit from the authoritative reviews and guidelines for practice in both clinical and forensic settings."--Ronald M. Ruff, PhD, private practice, San Francisco, California
"Bush, Iverson, and their well-known contributing authors have targeted an area of neuropsychological practice that is important, yet underserved, in terms of books that provide needed guidance. Clinicians will find a diversity of topics relevant to practice with individuals who have--or may have--work-related injuries."--Jerry J. Sweet, PhD, ABPP, NorthShore University HealthSystem and University of Chicago Pritzker School of Medicine
“Chapters are logically sequenced, clearly written, and well-referenced….Neurological Assessment of Work-Related Injuries is an authoritative, evidence-based text that is easy to read, understand, and apply to real-world situations. Given the relatively few number of meaningful resources on the topic, this book serves as an excellent resource and is strongly recommended to professionals across a variety of disciplines, including but not limited to healthcare providers involved in neuropsychology, clinical psychiatry and psychology, forensic psychiatry and psychology, occupational medicine, and rehabilitation medicine.”
From the Inside Flap
Millions of workers are injured on the job every year. Unique in its focus, this volume provides an evidence-based framework for neuropsychological assessment of work-related injuries. Leading authorities present up-to-date information on a wide range of neurological and psychological problems and offer guidelines for conducting effective evaluations. Addressing important scientific, legal, ethical, and professional issues, this book is essential reading for practitioners in clinical or forensic settings. Parts I and II describe common injuries sustained in the workplace that can cause time-limited or permanent cognitive impairment. Coverage encompasses traumatic brain injury, sports concussion, electrical injury, exposure to neurotoxic substances, posttraumatic stress, depression, chronic pain, and brain and psychological injuries experienced in combat. Contributors review the epidemiology and pathophysiology of each type of injury, its typical symptom presentation and course, the impact on day-to-day functioning and job performance, diagnostic dilemmas, and approaches to neuropsychological assessment and treatment planning. Part III turns the lens on professional practice issues, with particular attention to the practitioner's role in helping to make determinations about disability status and compensation claims. The complexities of conducting independent examinations and consulting to attorneys, government agencies, and insurance companies are discussed. The book also presents keys to preparing reports that are relevant for vocational rehabilitation planning. Grounded in the best available knowledge -- while also identifying areas where further research is needed -- this is a rich resource for practicing clinicians and advanced trainees in neuropsychology, clinical and forensic psychology, psychiatry, and rehabilitation.
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The next heading is "Criterion A and the Assumption of a Specific Etiology". They say that the use of Criterion A is so fraught with problems that it has become known as "the criterion A problem". All one has to do is read the fourth volume of the DSM-IV sourcebook, and one will see that those who wrote DSM-IV were perfectly well aware that the cut off for severity of symptoms was arbitrary. They left Criterion A in for "instructional" purposes, they said. I have heard that it is in there for political reasons. I suppose that "instructional" and "political" can be the same thing here. They found that if Criterion A was left out, then the rate of PTSD would go up by 5%. The problem here is not that there is a problem with Criterion A, the problem is that the authors of this chapter present the problem as if it is some unforseen thing that has crept up on PTSD, whereas in fact it was there all along. In Australia, it does not really matter. If someone gets PTSD symptoms but does not meet the criteria (and you want to apply the criteria strictly) they simply get a diagnosis of GAD and specific phobia; the level of disability is the same, the treatment is the same, and life goes on. Perhaps in the US people get payments for specific diagnoses: I do not know. But perhaps they do not want to compensate egg-shell litigants too much.
Which brings us to the next problem. The authors of the chapter state (first paragraph of page 167) that PTSD can be completely taken account of using the diagnostic criteria for MDD and specific phobia. If that were true, so what? But, it's not true. The Criterion B element of PTSD do not overlap with the Criteria for specific phobia, because the Criteria for specific phobia deal with future encountering of the phobic stimulus, and don't say that memories count. There is no chance that the Viet Nam vets will return to war in Viet Nam, but they still have PTSD.
(If PTSD really could be covered by the criteria for MDD and specific phobia, so what? I thought that psychologists wanted to view conditions as existing on a spectrum? People with PTSD do not have the same overall clinical feel as a person with major depression and a specific phobia, unless the specific phobia arose because of a traumatic event... And if the specific phobia arose from a traumatic event, then it probably has features of PTSD. In other words, the DSM version of specific phobia ignores the presentation of specific phobia that arises out of a traumatic event: the description is for specific phobia that does not arise from a traumatic event, but the definition of specific phobia is for phobias that arise spontaneously and that arise out of trauma. So, it is the construct of specific phobia that is wrong, not the construct of PTSD. Thanks for stimulating that thought.)
Then the authors talk about "Criterion Creep" (heading, page 167). I have already dealt with this by referring to the Sourcebook. The Sourcebook, published in 1994, said that people can occasionally get PTSD symptoms that meet criteria (except criterion A) from unexpected divorce or job loss. Get over it. Or at least read the book.
The authors of the chapter in question also quote someone complaining that the causes of PTSD vary too greatly in magnitude: "any unit of classification [PTSD diagnosis] that simultaneously encompasses the experience of... Auschwitz and told rude jokes [workplace bullying] must, by any reasonable standard, be a nonsense, a patent absurdity". I guess we can write off major depressive disorder then. Duh. Major depression can be caused by workplace bullying ("told rude jokes" is a little bit of a straw man) and is the most common psychological response to traumatic events.
I get it that the authors of the chapter would reasonably want to deconstruct the diagnosis and be a bit analytical of it, and look cool and clever, but they have over egged the pudding, and have not provided balance. Worse, they have taken frankly dumb criticism of PTSD ("a patent absurdity"... major depression) and included it without thinking it through at all. It seems not to have occurred to them that some of the criticism of PTSD as a diagnosis is just silly. That review reviews only 6 pages of the book. Don't like a two-star review from just 6 pages? Well, that volume of criticism came from just 6 pages of the book, and it cuts both ways, Shane.
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