Information for Medical Professionals

The most common professional referral sources to clinical neuropsychologists are neurologists, neurosurgeons, psychiatrists, internists, and other psychologists. The most common referral questions are: What are the functional effects of this patient’s neurological or neuropsychiatric disorder? How are intellectual, behavioral, and emotional functioning effected by the disorder? What is the prognosis for the observed impairments in functioning? Are there effective treatments to assist in the recovery? What are the limitations on this patient’s competence, vocational status (e.g., return to work), learning and adaptability, and activities of daily living (e.g., independence, driving).

Outpatient services can be scheduled in my office where comprehensive evaluations can take place. If necessary, patients may be evaluated in a community-based setting or in their home.

Inpatient services are available in acute medical settings (e.g., hospitals and rehabilitation units) as well as intermediate and long-term care facilities (e.g., brain injury rehabilitation centers, substance abuse treatment programs, skilled nursing facilities).

A neuropsychological consultation can be helpful to you by qualitatively and quantitatively assessing:

• Attention and executive functions
• Arousal, activation, and motivation
• Activities of daily living and functioning
• Dissimulation, malingering, factitious disorder
• Functional relationships between the brain and behavior
• Strengths and weaknesses in cognitive functioning
• Evaluation of treatment effectiveness
• Guidance for treatment and rehabilitation plans
• Personality and emotional functioning
• Repeated measures to chart progress over time
• Special needs accommodations
• Appropriate educational placements
• Return to work status
• Information relevant to differential diagnosis

Making the referral and preparing the patient for the exam

Referrals are made as they are to any other health specialty. However, the integrity of the neuropsychological examination, because it deals with the patient’s mental, emotional, and behavioral state, requires certain additional preparations:

1. Patients should be given an accurate expectation of the length of the examination, which could last as long as a full day or a couple of half days.


2. Patients should not drink alcoholic beverages, smoke or ingest marijuana, or take over-the-counter sleeping or allergy medications (decongestants or antihistamines) within 24 hours of the examination


3. Psychoactive medications can affect the results of neuropsychological testing, particularly in high doses. To the extent possible, patients should refrain from taking the following within 48 hours of the appointment:
   • Narcotic analgesics (e.g., Vicodin, Darvocet, Percocet, Demerol)
   • Sleeping medications (e.g., Ambien, Restoril)
   • Anti-convulsants
   • Benzodiazepines (e.g., Valium, Xanax)
   • Mood stabilizers (e.g., lithium carbonate)
   • Antidepressants (e.g., tricyclic, conventional, or SSRI’s)
   • Anti-hypertensives (e.g., beta-blockers, thiazides).
   Please make the determination whether any of these medications, if prescribed, may be reduced or withdrawn before the evaluation, and instruct the patient accordingly.


4. Please ask patients to bring a list of all medications they are taking with them and to indicate on it which, if any, they have taken in the prior 48 hours.


5. Patients should be instructed to bring and use any assistive devices that have been prescribed or recommended to them such as these:
   • Eye glasses/ contact lenses
   • Hearing aid
   • Neck brace
   • Lumbar pillow

For more information, or to schedule an appointment, please click here to email

Relevant Experience

Education

Academic Positions

Professional Positions

Internships

Relevant Publications

Bernard, L. C., & Krupat, E. (1994). Health psychology: Biopsychosocial factors in health and illness. Ft. Worth, Texas: Harcourt Brace.

Bernard, L. C., McGrath, M.J., & Houston, W. (1993). Discriminating between simulated malingering and closed head injury on the Wechsler Memory Scale-Revised. Archives of Clinical Neuropsychology, 8, 539-551.

Bernard, L. C., & Belinsky, D. (1993). Hardiness, stress, and maladjustment: effects on self-reported retrospective health problems and prospective health center visits. Journal of Social Behavior and Personality, 8, 97-110.

Bernard, L. C., Houston, W., & Natoli, L. (1993). Malingering on neuropsychological memory tests: Potential objective indicators. Journal of Clinical Psychology, 49, 45-53.

Bernard, L. C. (1991). The detection of faked deficits on the Rey Auditory Verbal Learning Test: The effect of serial position. Archives of Clinical Neuropsychology, 6, 81-88.

Bernard, L. C. (1990). Prospects for faking believable memory deficits on neuropsychological tests and the use of incentives in simulation research. Journal of Clinical and Experimental Neuropsychology, 12, 715-728.

Bernard, L. C., & Fowler, W. (1990). Assessing the validity of memory complaints: Performance of brain-damaged and normal individuals on Rey's task to detect malingering. Journal of Clinical Psychology, 46, 432-436.

Bernard, L. C. (1989). Halstead-Reitan Neuropsychological Test performance of Black, Hispanic, and White young adult males from poor academic backgrounds. Archives of Clinical Neuropsychology, 4, 267-274.

Additional information, publications, and research, are available in my curriculum vitae.