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推进临床神经心理学面临的挑战与展望。

Challenges and prospects in advancing clinical neuropsychology.

机构信息

Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Switzerland.

出版信息

Cortex. 2024 Oct;179:261-270. doi: 10.1016/j.cortex.2024.08.001. Epub 2024 Aug 19.

Abstract

In the ever-evolving field of clinical neuropsychology, significant methodological and conceptual limitations hinder progress. To ensure the continued relevance of this discipline amidst remarkable advancements in neuroscience, medicine, and methodology, these obstacles must be addressed. This opinion article identifies inherent limitations within current clinical neuropsychology, including issues such as multi-collinearity in neuropsychological assessments, lack of validated tools reflecting contemporary cognitive function models, and the use of divergent theoretical frameworks in evaluations, leading to a gap between theory and practice. The disconnect between behavior and biomarkers, particularly evident in neurodegenerative diseases but also relevant for other pathologies, together with the rise of genetic analyses, necessitate change. Methodological improvements are crucial for ensuring the discipline's future relevance. Looking ahead, key perspectives and challenges are outlined, emphasizing the need for a holistic approach to cognitive functioning and congruent tools, patient engagement in experimental studies, rectification of biases, and exploration of variables like personality. Training professionals to bridge the gap between practice and research is essential. By addressing these challenges, clinical neuropsychology can not only adapt to the evolving landscape but also shape it, ensuring a brighter future for the field.

摘要

在不断发展的临床神经心理学领域,存在显著的方法学和概念性限制,阻碍了该领域的进展。为确保该学科在神经科学、医学和方法学方面取得显著进步的背景下保持相关性,必须解决这些障碍。本文认为,目前临床神经心理学存在固有局限性,包括神经心理学评估中的多重共线性、缺乏反映当代认知功能模型的验证工具,以及在评估中使用不同的理论框架等问题,导致理论与实践之间存在脱节。行为与生物标志物之间的脱节,特别是在神经退行性疾病中明显,但也与其他病理相关,再加上基因分析的兴起,都需要改变。方法学的改进对于确保该学科的未来相关性至关重要。展望未来,本文概述了关键的观点和挑战,强调需要采用整体方法来研究认知功能和使用一致的工具,让患者参与实验研究,纠正偏差,并探索个性等变量。培训专业人员来弥合实践与研究之间的差距至关重要。通过应对这些挑战,临床神经心理学不仅可以适应不断变化的环境,还可以塑造它,为该领域的未来带来更光明的前景。

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