Neuropsychologists v. Neuropsychiatrists
The discussion by the majority and dissenting opinions in the case today about neuropsychological versus neuropsychiatric testing reveals just how detailed and technical the debates over cognitive neuroscience are becoming in legal cases. The dissent explains in considerable detail the type of neurological testing that the plaintiff in this case, a car-accident victim, already underwent. The dissent characterizes the defendants’ motion to compel the plaintiff the appear for a neuropsychological evaluation as a harassing tactic, and clearly unwarranted because the plaintiff’s cognitive deficits so clearly stemmed from the head injury suffered.
The majority, however, buys the distinction the defendant claims arises between neuropsychological and neuropsychiatric testing, and the need to have both to accurately establish damages in this case. The defendants claim that neuropsychological testing “would quantify the type of brain injury and the degree of cognitive dysfunction” related to possible damage of the brain. By contrast, they argue that neuropsychiatric testing focuses on emotional and psychiatric functioning. The court ultimately grants the motion to allow the defendants to establish the degree of cognitive impairment attributable to the head injuries sustained.
The dissent seems right to me on this one, but weigh in on the comments below. Are both neuropsychological and neuropsychiatric testing needed? In both civil and criminal cases? When do you need both?
“Objective” Evidence, Tort Cases, Neuropsychiatrists vs. Neuropsychologists
Chaudhary v. Gold, 2011 WL 1364432, 2011 N.Y. Slip Op. 02929 (Sup. Ct. N.Y. 2011)
This appeal followed an order denying Defendant’s motion to compel the Plaintiff to appear at a neuropsychological examination by an expert designated by the defendant or to preclude Plaintiff from presenting evidence of damages at the time of trial. The court reversed the order and granted the defendants’ motion, directing the plaintiff to appear for said examination. The court found that the trial court erred in denying defendants’ motion to compel plaintiff to submit to a neuropsychological examination. This suit arose from a motor vehicle accident, when plaintiff’s taxi was struck from behind by a truck being driven by defendant. Plaintiff alleges that as a result of the collision, his head struck the car’s windshield, causing him to suffer traumatic brain injury. The primary diagnosis, upon admission to the emergency room, was left frontal lobe contusion. An initial CT scan showed a questionable hyperdense focus in the left frontal lobe but a follow-up CT showed no areas of abnormal attenuation and no evidence of acute intracranial hemorrhage, midline shift or mass effect. Plaintiff was subject to neurological exam by two different experts. Nevertheless, over a vigorous dissent, the court found that Defendants established significant differences between a neuropsychiatric examination (already conducted by defense expert Fayer) and the proposed neuropsychological examination. Defendants asserted that a neuropsychologist utilizes a different methodology and would administer a standardized battery of psychological tests that would quantify the type of brain injury and the degree of cognitive dysfunction related to possible damage of the brain. By contrast, a neuropsychiatrist focuses on emotional and psychiatric functioning. In support of their motion, defendants submitted an affidavit from a neuropsychologist. That expert stated that his examination of plaintiff would quantify the type of brain injury that he allegedly suffers and would help distinguish between what is functional (i.e., psychiatric depression) or organic (i.e., cognitive dysfunction). He further stated that a neuropsychological examination would provide quantitative data about plaintiff’s functioning, such as his IQ score and memory test score. The expert also stated that his testing could aid in forming an ultimate opinion as to the nature and cause of plaintiff’s injury as well as to any symptom amplification or exaggeration, an essential defense for defendant. Having found that defendants demonstrated that a neuropsychological examination is material and necessary in order to defend against plaintiff’s claim that he has suffered head injuries with cognitive impairment, the court reversed.