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Ask the Mental Health Expert Archives 2001-2004

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Psychologist vs. Neurologist Testing

Q. Would you explain the difference between neuropsych testing done by a psychologist and neurological testing done by a neurologist?

A. Traditionally, neurologists have focused more on gross sensory, motor, and perceptual abnormalities as part of the neurological examination. Psychologists have focused more on cognitive, psychomotor, and linguistic functions. For example, a typical neurological examination is geared toward finding focal signs, such as a weakened arm or leg, reduced sensation to pinprick in one part of the body, abnormalities in reflexes, gross visual deficits, and abnormalities in gait.

Neuropsychological or Neuropsychiatric testing is usually aimed at defining and specifying more subtle abnormalities in calculation, memory, language function, abstraction, visual-motor ability, and specific aspects of intelligence (IQ). Sometimes, personality testing is also part of a complete neuropsychological testing procedure; e.g., use of the Minnesota Multiphasic Personality Inventory (MMPI). But these distinctions are often blurred. A very comprehensive neurological examination done by a psychologically sophisticated neurologist may contain many elements of neuropsychological testing done by a psychologist or neuropsychologist--though usually, in much more basic forms.

For example, a neurologist might ask the patient a question like, "How do you spell 'world' backwards?" This tests attention and language skills in a very basic way. In partial contrast, neuropsychological tests, such as the Wechsler Adult Intelligence Scale (WAIS), will have dozens of questions that zero in on attention and language function in a much more detailed way.

Here's another way of thinking about it: when you visit a neurologist, you probably won't be picking up a pencil and paper for more than a minute or two. When you visit a neuropsychologist, you better be prepared for some heavy pencil-and-paper lifting! For more details on neuropsychological testing, I recommend the book "Assessment of Neuropsychological Functions" (American Psychiatric Press, 1999) by Abraham Calev.

September 2001

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