Neuropsychology Defined

While different authors have advanced multiple definitions of neuropsychology, in the context of this contribution the following definition was selected: "Neuropsychology is the scientific study of brain-behavior relationships" (Meier, 1974). Some limitations of this definition will be briefly mentioned. The definition ignores distinctions among the many fields of neuropsychology that have developed over the years (Davison, 1974; Horton, Wedding, & Phay, 1981). In order to provide further clarification, the following will offer a brief definition of behavioral neuropsychology.

Behavioral neuropsychology is the most recent addition to the principal subfields of neuropsychology. Horton (1979) has offered the following definition of behavioral neuropsychology:

Essentially, behavioral neuropsychology may be defined as the application of behavior therapy techniques to problems of organically impaired individuals while using a neuropsy-chological assessment and intervention perspective. This treatment philosophy assumes that inclusion of data from neuropsychological assessment strategies would be helpful in the formulation of hypotheses regarding antecedent conditions (external or internal) for observed phenomena of psychopathology. (p. 20)

This new area of research and clinical interest combines elements of both clinical neuropsychology and behavior therapy. Despite a focus on applied aspects of neuropsychology, behavioral neuropsychology may be easily discriminated from related subfields of neuropsychology by its reliance on behavior therapy/applied behavior analysis research for its treatment/intervention techniques. The major emphasis of behavioral neuropsychology is on the problems of management, retraining, and rehabilitation (Horton, 1994). In contrast, the related areas of clinical neuropsychology and behavioral neurology are more associated with the problems of clinical diagnosis. Furthermore, it should be clear that experimental neuropsychology can be easily separated from clinical neuropsychology, behavioral neurology, and behavioral neuropsychology by the primary research aims of the former and the more clinical aims of the latter (Horton & Wedding, 1984).

Essentially, the biological problem that behavioral neuro-psychology addresses is that of impaired brain functioning due to cerebral dysfunction. The distinctive knowledge and skills that define the specialty which reflect the problem are knowledge of functional neuroanatomy, clinical neurology and neurosurgery, behavioral neurology, neuropathology, and psychopharmacology. The essential understanding is how the brain functions and how the functioning of the brain on multiple levels is related to behavioral functioning at various levels. The problem of impaired neuropsychological functioning can be seen in a number of varied settings with respect to physical and organizational aspects. Impaired functioning may be relatively obvious in terms of a stroke victim or relatively subtle in terms of a child with attention deficit disorder syndrome. The range of settings in which disordered brain functioning may cause behavioral disturbances can encompass a private practice setting, an educational setting, an industrial or occupational setting, a substance abuse treatment facility, a rehabilitation setting a neurology or psychiatry ward in a major teaching hospital or in a community hospital. In all of these settings, or impaired brain functioning may cause disturbances that are responsible for specific problems in terms of adapting to the behavioral demands of the setting. The sorts of problems that the biological insult causes may be related to cognitive skills, sensory-perceptual abilities, motor skills, or emotional/ personality functioning. This may have psychological ramifications with respect to the person's adequacy or inability to self-manage his or her own behavior or may have social complications with respect to the person's ability to interact with others to maintain a productive lifestyle. The person may be unable to contribute through vocational activities to the welfare of society and also be limited in assuming mature roles in relationships and family activities such as parenting. The problem in terms of psychological or social aspects to a degree is related to the fit of the person in the special circumstances in which he or she finds him- or herself.

Examinations of major currents in behavioral therapy can help delineate the scope of behavioral neuropsychology. Behavior therapy can be seen as having developed three salient subareas: behavior, cognitive, and affective. Due to the work of Watson (1913), Skinner (1938), and others several decades ago, behavior therapy is premised on the principle that behavior is a function of environmental consequences and utilizes positive and negative reinforcement as major concepts.

The affective trend in behavior therapy owes much to the early work of Joseph Wolpe, M.D. (1958), the South African psychiatrist who is credited with the establishment of clinical behavior therapy. His techniques of systematic desensitization and assertiveness training have, in large part, sparked the clinical behavior therapy movement.

In contrast, the cognitive-behavioral trend postulates that inferred variables, such as thoughts and images, should be seen as legitimate concepts in the functional analysis of human behavior (Mahoney, 1974). The cognitive trend in behavior therapy has been a subject of controversy (Beck & Mahoney, 1979; Ellis, 1979; Lazarus, 1979; Wolpe, 1978). More recent contributions such as this volume demonstrate the current wide acceptance of cognitive-behavioral therapy and its preeminence in the human services and mental health fields.

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