As neuropsychologists increasingly work with culturally and linguistically diverse populations, unique considerations arise in neuropsychological evaluations. This study explores the expert-rated importance and feasibility of items developed through a literature review to enhance cultural responsiveness. As part of a two-round modified Delphi study, 15 experts in cultural neuropsychology were invited to evaluate a set of items through online surveys. The experts were identified based on their highly cited publications in the field through academic databases. Data collection involved quantitative ratings on a 7-point Likert scale to assess the importance and feasibility of each item, along with additional qualitative feedback. Descriptive analyses were conducted to examine the ratings for both importance and feasibility. A total of 47 items were developed through a literature review and expert consensus, focusing on key clinical neuropsychology activities throughout the evaluation process. Based on experts’ ratings of the items on their importance, one item received a median score of 5, nine items scored 6, and 37 items scored 7. For feasibility, five items scored 4, 13 scored 5, 17 scored 6, and 12 scored 7. Differences between importance and feasibility ratings were analyzed using interquartile ranges. This tool aims to enhance neuropsychological assessments for culturally and linguistically diverse populations by identifying culturally relevant key factors and addressing the feasibility of these items in clinical practice. These items can help evaluate clinical practices, pinpoint areas for improvement, and guide training and research. Future research is needed to refine these items for better utility in clinical settings.

Neuropsychologists’ conclusions and courtroom testimony on malingering can have profound impact. Intensive and ingenious research has advanced our capacities to identify both insufficient and sufficient effort and thus make worthy contributions to just conflict resolution. Nevertheless, given multiple converging factors, such as misleadingly high accuracy rates in many studies, practitioners may well develop inflated confidence in methods for evaluating effort/malingering. Considerable research shows that overconfidence often increases diagnostic and predictive error and may lead to fixed conclusions when caution is better advised. Leonhard’s work thus performs an important service by alerting us to methodological considerations and shortcomings that can generate misimpressions about the efficacy of effort/malingering assessment. The present commentary covers various additional complicating factors in malingering assessment, including other factors that also inflate confidence; subtle and perhaps underappreciated methodological flaws that are inversely related to positive study outcomes (i.e., the worse the flaws the better methods appear to be); oversimplified classifications schemes for studying and evaluating effort that overlook, for example, common mixed presentations (e.g., malingering and genuinely injured); and the need to expand research across a greater range and severity of neuropsychological conditions and diverse groups. More generally, although endorsing various points that Leonhard raises, a number of questions and concerns are presented, such as methods for calculating the impact of case exclusions in studies. Ultimately, although Leonhard’s conclusions may be more negative than is justified, it seems fair to categorize methods for assessing malingering/effort as advancing, but not yet advanced, with much more needed to be done to approach that latter status.

The global fight against Alzheimer's disease (AD) poses unique challenges for the field of neuropsychology. Along with the increased focus on early detection of AD pathophysiology, characterizing the earliest clinical stage of the disease has become a priority. We believe this is an important time for neuropsychology to consider how our approach to the characterization of cognitive impairment can be improved to detect subtle cognitive changes during early-stage AD. The present article aims to provide a critical examination of how we define and measure cognitive status in the context of aging and AD. First, we discuss pitfalls of current methods for defining cognitive impairment within the context of research shifting to earlier (pre)symptomatic disease stages. Next, we introduce a shift towards a more continuous approach for identifying early markers of cognitive decline and characterizing progression and discuss how this may be facilitated by novel assessment approaches. Finally, we summarize potential implications and challenges of characterizing cognitive status using a continuous approach.

Throughout the years, various terminologies have been used to describe problematic digital gaming use. Due to differing definitions and criteria, there have similarly been a large number of measurement tools developed. Although the DSM-5 term “Internet gaming disorder” has recently become the most commonly used, it is likely that the ICD-11 could replace it with the term “gaming disorder.” This chapter provides a brief review of measurement tools and provides recommendations to strengthen future problematic gaming measurements. Recommendations include an agreed-upon definition of the problem; accounting for positive effects of gaming; accounting for careless and random responding; strengthening reliability; improving norms and reference groups; improving positive and negative predictive powers by strengthening sensitivity and specificity; utilizing additional longitudinal studies; producing more studies examining risk factors and course of problem gaming; comparing and contrasting various measurement tools; adjusting for age, language, and cultural factors; measuring time frame, outcome, and severity; and establishing proper balance in brevity and comprehensive measurement for ease of use in research and clinical practice.

Although an expanding body of research demonstrates the potential benefits of telepsychology, little is known about its application with ethnoracial minority populations. Research with ethnoracial minority populations points to various factors that predict positive treatment outcomes; thus, it should be considered in multiculturally sensitive telepsychology practice. In this chapter, the authors discuss the multicultural telepsychology literature and provide recommendations for practice and research. The respective literature in multicultural psychology and telepsychology and their intersection suggest that multicultural telepsychology offers substantial promise for improving the lives of vulnerable and underserved ethnoracial minority populations by increasing access to health information and mental health treatment and reducing mental illness stigma. The chapter ends by discussing potentially fruitful avenues for research.

OBJECTIVE:The most commonly used computerized neurocognitive test in concussion assessment and management, Immediate Post-concussion and Cognitive Testing (ImPACT), has demonstrated varying and sometimes concerning levels of test-retest reliability. This study aimed to further examine ImPACT's psychometric qualities and whether ceiling effects may suppress its reliability.METHOD:A total of 300 consecutively selected ImPACT score reports for students attending a secondary school between 2010 and 2015 were reviewed. Test-retest reliabilities for composite scores and subscales were computed using Pearson product moment correlations (r) and intraclass correlation coefficients. To examine the potential influence of ceiling effects, we conducted frequency analyses of scores falling at, or near, the maximum possible score.RESULTS:A total of 92 score reports met inclusion criteria. Test-retest reliabilities ranged from 0.42 to 0.69 for composite scores and 0.19 to 0.71 for subscales. Subscales comprising the Verbal and Visual Memory composites evidenced the most prominent ceiling effects.CONCLUSIONS:Obtained test-retest reliabilities were consistent with a large segment of the literature and add to concerns about ImPACT's reliability. Furthermore, at least in a select sample, this study identified sizeable ceiling effects that likely diminish the reliability of some composite scores. To mitigate the risk of false-negative errors on post-injury testing, ImPACT users should be cognizant of such ceiling effects. Supplemental, or alternative, approaches to protect against underestimating baseline functioning also warrant consideration.

This chapter focuses on the psychological treatment of problem Internet and digital technology use (PRIU), such as excessive gaming, and also briefly overviews pharmacological approaches. Forms of Internet and digital technology use that provide alternative vehicles for more specific problem or addictive behavior, such as excessive gambling or shopping, and which often seem to present with differing features, are not covered here [editors’ comment: but rather addressed in other chapters of this book]. Although treatment research is still in an early stage of development, an accumulating body of literature involving a diverse range of presentations and populations and a variety of treatment strategies has often yielded positive and robust effect sizes. Hence, a relatively compelling justification can be provided for therapeutic intervention, especially when using treatments of demonstrated effectiveness with similar clients, when PRIU seems to be associated with significant malfunction or worsening of co-occurring conditions, and when trends suggest that problems are not remitting or are worsening. Beyond these broad conclusions, research on PRIU in general and treatment studies, although often considerably less complete than preferable, provide varying levels of guidance for tailoring or designing intervention in lines with client presentation. Hence, the chapter also covers various specific topics and possible guides for therapeutic planning and implementation.

Forensic assessment experts and practice guidelines strongly endorse appraisal of response styles that can distort psychological assessment results and lead to serious interpretive errors, including careless and random responding (C/RR). Little attention has been directed to the implications of C/RR for juvenile forensic mental health assessment. To address this gap in the literature, we reviewed frequently used measures in juvenile forensic assessment. We found that many such measures do not include built-in checks for detecting C/RR. We then conducted simulation studies examining two frequently used measures, one without a built-in check for C/RR and one with such a scale: the Youth Self-Report (YSR) and the Millon Adolescent Clinical Inventory (MACI), respectively. Results indicated that random responding substantially influenced scores on the YSR, raising most scales well above normative levels, yet often producing protocols that seemed genuine. On the MACI, random responding was undetected 25% of the time and another 50% of the time appears to yield computer-based reports that do not explicitly reject the test results as invalid. Taken together, these simulations suggest that randomly generated assessment protocols may often be mistaken for genuine results. Implications for both practitioners and applied researchers involved in juvenile forensic assessment are discussed.

Problematic or addictive digital gaming (including all types of electronic devices) can and has had extremely adverse impacts on the lives of many individuals across the world. The understanding of this phenomenon, and the effectiveness of treatment design and monitoring, can be improved considerably by continuing refinement of assessment tools. The present article briefly overviews tools designed to measure problematic or addictive use of digital gaming, the vast majority of which are founded on the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for other addictive disorders, such as pathological gambling. Although adapting DSM content and strategies for measuring problematic digital gaming has proven valuable, there are some potential issues with this approach. We discuss the strengths and limitations of current methods for measuring problematic or addictive gaming and provide various recommendations that might help in enhancing or supplementing existing tools, or in developing new and even more effective tools.

Even when relatively infrequent, careless and random responding (C/RR) can have robust effects on individual and group data and thereby distort clinical evaluations and research outcomes. Given such potential adverse impacts and the broad use of self-report measures when appraising addictions and addictive behavior, the detection of C/RR can reduce error substantially. Based on earlier research using a video game questionnaire as an exemplar, we cross-validated promising items for detecting C/RR and developed an expanded set of items, in this case using an Internet questionnaire to examine efficacy and generalization. Research participants were instructed to complete the questionnaire in standard fashion (i.e., cooperatively) or to adopt either a careless or random response set. Careless and random responders often obtained elevated mean questionnaire scores. Most items for detecting careless or random responding demonstrated significant differences across groups, and combinations of items showed high levels of accuracy, particularly in detecting random responders. Results suggest that a relatively small number of items, which might only add a minute or two to questionnaire completion time, can detect the great majority of random responders and most careless responders. Guidelines are provided for the development and application of items.

This chapter considers the current state of the literatureregarding computer-based testing (CBT) and computer-based test interpretation (CBTI), particularly as relates to their usein the legal context. Three facets of computer-assisted testingwill be covered: Administration (i.e., CBT), scoring,and interpretation (i.e., CBTI). It begins with an overviewof research literature and commentary, followed by considerationof ethical guidelines and standards of practice inpsychology, followed by coverage of admissibility issues.Brief discussion is given to testing administeredover the Internet

Even when relatively infrequent, deviant response sets, such as defensive and careless responding, can have remarkably robust effects on individual and group data and thereby distort clinical evaluations and research outcomes. Given such potential adverse impacts and the widespread use of self-report measures when appraising addictions and addictive behavior, the detection of deviant response sets is an important clinical and research objective. Using a video game questionnaire as an exemplar, we examined the capacity of individuals to manipulate questionnaire scores and the effectiveness of various items to detect defensive, careless, and random responding. Individuals who obtained elevated questionnaire results when instructed to respond honesty often reduced their scores to unremarkable levels under “fake good” instructions. Most types of items for detecting defensive responding were ineffective with a possible exception, although items for detecting random and careless responding seemed promising. Potential guides for item development and use are provided.

The aim of this chapter is to provide an overview of neuropsychology,especially its application in legal settings, including the aims of neuropsychological evaluation, the objectivity of neuropsychological assessment, training and credentials, certification in neuropsychology, surveys of professional practices, and methodological issues.

This chapter discusses criteria for appraising scientific status, and focuses on distinguishing features of science that set it apart from nonscience, the relative strengths of different investigative methods, and desirable versus undesirable features of research design and their consequences. The emphasis is on key concepts of practical importance that generally do not require sophisticated technical knowledge (e.g., familiarity with advanced statistical procedures). This chapter aims to provide workable knowledgeof science to nonscientists, specifically, members of the legalprofession.