Neuropsychology in the Courtroom: Expert Analysis of Reports and Testimony

This book serves as a sequel to the editor's previous volume, Forensic Neuropsychology Casebook, published in 2005. Both publications are primarily intended for graduate students in neuropsychology, although forensic psychiatry fellows, attorneys, and judges are also likely to benefit from reading this new contribution. Individual chapters are written by subspecialty neuropsychology experts who use a curious mixture of conversational tone and technical interpretation of neuropsychological test performance to illustrate concepts and to educate readers.

Heilbronner divides the text into three parts: case analyses, forensic case analyses with opposing expert reviews of the same materials, and special topics. Topics of interest to forensic psychiatrists include adult and child traumatic brain injury, anoxic brain injury, electrical brain injury, personal injury litigation, toxic torts, disability assessments, and independent educational evaluations.

Contributors comment on their individual methods of case review and forensic examination; this material lends a supervisory tone to the entire work. The analyses of specific neuropsychological tests and profiles are quite technical. Familiarity with the specific instruments is almost essential for readers to benefit optimally from the discussions; however, they should be relatively easy for the seasoned forensic neuropsychiatrist to follow.

There is considerable commentary about forensic practice ethics, confidentiality, Daubert challenges, the Individuals with Disabilities Education Act (IDEA), and neuropsychological report review that will reinforce basic concepts for the beginner, but may prove somewhat tedious for the more experienced forensic practitioner. Some authors display an entertaining degree of bravado as they recount the march to case settlement.

Two chapters devoted to multiple chemical sensitivity syndrome could have been combined to improve the introduction to the entity and to sharpen the authors' focus on disability claims review. On the other hand, separate chapters on opposing expert reviews of the same materials related to a case of minor traumatic brain injury are well-designed and quite instructive. The chapter on misdiagnosis of minor traumatic brain injury contains superb discussions about false-positive diagnoses and the psychometrics of test batteries. The chapter deserves a place on required reading lists for forensic fellows.

There are particularly excellent discussions for the novice forensic examiner, including: detecting incompetent reports, the effects of pain on neuropsychological test performance, the selection of fixed or flexible approaches to testing, the pitfalls of deficient analysis of case material, the development of questions for cross-examination, and the misdiagnosis of minor traumatic brain injury. Bibliographic references at the end of each chapter are sparing, though well selected, and include professional organization guidelines current to 2007.

Areas of concern include the occasional superficial discussion of neuropsychiatric disorders such as concussion, and chapters written by non-physician authors who stretch their scope of practice by offering specific medication recommendations. While this practice is often encountered in the clinical setting, it seems inappropriate as a model for trainees, practitioners, or forensic specialists. On balance, this book has much to offer clinically and pedagogically to forensic practitioners.

• American Academy of Psychiatry and the Law