The scientist-practitioner model: how do advances in clinical and cognitive neuroscience affect neuropsychology in the courtroom?

One of the core tenets of the scientist-practitioner model, slightly modified to make it applicable to modern neuropsychology, is that assessment procedures should be developed, applied, and interpreted in a relevant scientific framework. However, over the last 30 years, the general structure of a neuropsychological assessment has changed little, if at all. It has continued to focus mainly on the assessment of cognitive constructs such as intelligence, memory, attention, and perception. During the same time period, cognitive neuroscience has focused on integrative systems, largely controlled by frontal mechanisms, that allow individuals to utilize cognitive functions in an adaptive way, especially in the context of novel situations or when social stimuli are ambiguous. Consequently, the gulf between cognitive neuroscience and the practice of clinical neuropsychology has grown uncomfortably large. This article attempts to review some of the developments in cognitive and affective neuroscience that are relevant to an evaluation of neuropsychological abilities, especially in a medicolegal context, to determine whether conventional neuropsychological methods can be considered fit for purpose.