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The Forensic Neuropsychology Casebook - Review of Chapter One

Posted Jan 14 2009 7:23pm

As I stated in my main review of this book,  I plan on providing briefer reviews with each individual chapter I find helpful, including all of the chapters related to criminal forensic psychology. However, today I will start with chapter one, which was written by Neil Pliskin and addresses a civil case related to an electrical injury.

I found this chapter interesting for two primary reasons: 1) I am unfamiliar with the literature related to the neuropsychological impact of electrical injuries, and 2) the jurisdiction in question was British rather than American. While the jurisdiction issue in this particular case is only interesting in the abstract (I don’t plan on having to testify under British rules anytime soon), the issues related to the electrical injury very well may be of practical use at some point.

Without too much detail, the case itself deals with the injuries suffered by a construction worker on a Caribbean island. The client was working on a job site for a steel construction company when a steel angle iron came into contact with an electrical power line that was supposed to have been shut down by the power company. Witnesses reported hearing an explosion, and seeing the client fall backward. He immediately stopped breathing, and his brother (also a coworker) provided CPR for approximately 15 minutes before paramedics were able to provide treatment via six defibrillations. He was transported first to a local hospital, then a hospital in Southern Florida where he remained for 18 days. In short, he required significant treatment for some period of time.

One interesting aspect about this particular chapter was that the evaluation required an assessment of the individual’s executive functioning (planning, goal setting, motivation, etc.) in addition to the usual areas of cognitive functioning. This required obtaining a detailed history of the client’s habits, experiences, and skills in these areas in addition to the usual testing. One point you will see me make again and again as I review the chapters of this book is the importance of obtaining relevant information outside of the formal testing session, whether through interviews, requests for information from previous treatment facilities, or observations of the individual outside of one’s office. In this particular case, what appeared to be extremely helpful were interviews with individuals who knew the client well both before and after the accident, and their descriptions of his behaviors relative to executive functioning. As an example, the individual profiled in the chapter demonstrated significant levels of initiative prior to his injury, including completing high school rolling, and starting his own business. Post-injury, the same individual displayed significant difficulty initiating any activity on his own. Interviews with his wife, brother, and friends helped the evaluator document this change.

The chapter also outlines some of the specific neurological difficulties that can result from electrical injuries. Without going into details, I found this interesting to the specificity of the injury.  serves as  an excellent reminder that different types of trauma experiences can have different types of neuropsychological (as well as psychological) impacts. The chapter identified one or two references for additional information specific to this particular type of injury, but the more important point is to consider the injuries in question during any evaluation.

One final point - know your jurisdiction! The rules regarding the evaluation, and how it fits in to the overall legal framework, will depend on what jurisdiction the case resides. In this chapter, the evaluation and fell under British law, which made in for some interesting reading. The more general point is that if you are conducting an evaluation, know whether you fall under federal or state law, and which state, as each one will have different criteria, definitions etc. The chapter provided detailed test data in the summary of the findings, which I always find interesting and helpful. Oh, one other thing - having to go and testify in the Caribbean wouldn’t be the worst thing in the world...

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