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A survey of neuropsychologists' ethical beliefs and practices
756
Abstracts from the 19th Annual Meeting
changes in the last 5 years will also be presented, including changes in yearly income and hourly reimbursement changes in referral patterns due to Medicare or managed care, and compensatory adjustments in patient load and work activities by full-time and parttime clinicians. Of note, data indicated that neuropsychologists are working longer hours and engaging in more forensic activities than in the past.
Ryan, E. L., & Feldman, D. J. Implementation of the Houston Conference Guidelines: The Residents' Survey. The 1997 Houston Conference on Specialty Education and Training in Clinical Neuropsychology produced guidelines for an integrated model of specialty training at the predoctoral, internship, and residency levels. We surveyed neuropsychology residents at APPCN programs to ascertain baseline data regarding the implementation of the Houston Conference Guidelines. Residents (N = 36) from 21 out of 33 active sites completed the survey yielding a response rate of 46%. Demographically, most respondents were female (64%), White (83%), and the mean age was 32 (SD = 4.7). Most residents (86%) had PhDs and received their doctorates from clinical psychology programs (89%). Half of the residents completed their graduate work in programs specialized for clinical neuropsychology. Almost all (97%) received training in clinical neuropsychology on internship and spent 10-100% of their time in this endeavor (M = 48%, SD = 20.9). Slightly more than half of the respondents were in their first (53%) as opposed to their second year of residency. On average, 77% of residents' work is supervised by a board-certified neuropsychologist. Residents spend the majority of their time providing clinical service (M = 67.9%, SD = 14.6), followed by clinical research (M = 19%, SD = 14.4), and educational activities (M = 13%, SD = 5.9). The Houston Conference Guidelines delineate core knowledge and skill areas. Residents rated their competency in each knowledge and skill area from no expertise (0) to expert proficiency (10). Residents were significantly more confident in their knowledge of clinical neuropsychology than brain-behavior relationships (p < .001). In regard to skills, residents were more confident in their expertise in assessment than in treatment/interventions (p < .001). Overall, residents were more confident in their skills than in their knowledge base (p = .01). Only 25% of residents responded that there is formal evaluation of the defined exit criteria (advanced understanding of neuropsychological evaluation, brain-behavior relationships, and scholarly activity) indicating a need for programs to address this area. Brown, L. B., Gfeller, J. D., Ross, M. J., & Heise, R. A Survey of Neuropsychologists' Ethical Beliefs and Practices. Approximately 25% of the professional members of National Academy of Neuropsychology (NAN) and the American Academy of Clinical Neuropsychology (AACN) were surveyed regarding their ethical beliefs and practices. Topics covered included demographic and professional information, confidentiality, informed consent, release of information, provision of feedback, appending raw data to reports, litigation issues, and the use of archival data for research. The usable response rates of NAN (40%) and AACN (38%) members did not differ significantly. Although there were many similarities in the responses of the two groups, some differences in professional background were noted, indicating that AACN members were more focused on the specialty of neuropsychology. Also, the two groups exhibited different opinions regarding provision of feedback and legal consultation. Majority practices and ethical beliefs (i.e., 80% consensus) were calculated for 33 behaviors. Overall, 11 behaviors were identified as majority practices and 13 behaviors were identified as majority beliefs. Only 7 of the 33 behaviors
Abstracts from the 19th Annual Meeting
757
were viewed as both a majority practice and belief. Additional details and discussion regarding respondents' beliefs and practices are provided.
Weber, M., Duff, K., Palav, A., & McCaffrey, R. J. Publication Trends in Archives of Clinical Neuropsychology from 1994-1998: Looking to the Next Millennium. Clinical and experimental advances in neuropsychology have been guided by published research reports. Clinically, practitioners gain a better understanding of assessment techniques, case conceptualization, and variables that moderated neuropsychological performancel Experimentally, investigators are aided in the development of new hypotheses, implementation of new methodologies, and identification of possible sources of error variance. In these ways, past research guides future directions within the field. In an attempt to see where neuropsychology has been in the past, and where it is likely to head in the future, a review of the publication trends of the journal Archives of Clinical Neuropsychology was conducted for the years 1994-1998. Two hundred and one empirical articles were reviewed and the following variables were coded: population(s), number, age of subjects, gender of subjects, dependent measure(s), and imaging data. Frequency counts were conducted on each of the coded variables. As expected, for the 5-year period, populations studied were predominantly "neuropsychological" in nature (e.g., head injury, dementia, stroke), followed by "controls" and "psychiatric" (e.g., depression, schizophrenia) groups. The most widely used measures included Wechsler Adult Intelligence Scale-Revised, Trail Making Test, Controlled Oral Word Association Test, and Wisconsin Card Sorting Test. The majority of these studies over the 5-year period examined males in the 18 to 64 year age range. Although rarely investigated, CTs and MRIs were the most frequently used techniques of brain imaging. Trends across the 5-year period are also reviewed. Implications for clinical and experimental neuropsychology of the present and future are discussed.
PSYCHIATRIC CONDITIONS Gouvier, W. D., Pinkston, J. B., Santa Maria, M. P., Lovejoy, J. C., Smith, S., & Bray, G. Neuropsychological and Emotional Changes During Simulated Space Flight and Microgravity with Countermeasures. The microgravity of space travel is stressful to humans and produces physical changes including bone mineral loss, muscle atrophy, neuromuscular weakness, and fatigue. Increased understanding of the mechanisms by which microgravity adversely affects both the physical and resultant/concomitant psychological and neurocognitive effects in humans, and more effective treatments to slow or halt these changes, will allow healthier, happier, and longer stays in space. The effects of microgravity on humans are often studied by having subjects confined to bedrest with a 6 ° head-down tilt. Hormonal modifications may also be made to accelerate the bone mineral loss and muscle atrophy seen in microgravity. It is important to understand both the neurocognitive and emotional effects of simulated microgravity, as well as implemented hormonal changes, in order to determine how such interventions may effect the well-being of further research participants and future astronauts. We present the results of a two experiment (N1 = 23; N2 = 24) study designed to evaluate the neurocognitive and psychological effects of 6 ° head-down bedrest and pharmacological interventions with 3, 5, 3'-triiodothyronine (T3) implemented to enhance the muscle and bone atrophy associated with simulated microgravity and subse-
Abstracts from the 19th Annual Meeting
changes in the last 5 years will also be presented, including changes in yearly income and hourly reimbursement changes in referral patterns due to Medicare or managed care, and compensatory adjustments in patient load and work activities by full-time and parttime clinicians. Of note, data indicated that neuropsychologists are working longer hours and engaging in more forensic activities than in the past.
Ryan, E. L., & Feldman, D. J. Implementation of the Houston Conference Guidelines: The Residents' Survey. The 1997 Houston Conference on Specialty Education and Training in Clinical Neuropsychology produced guidelines for an integrated model of specialty training at the predoctoral, internship, and residency levels. We surveyed neuropsychology residents at APPCN programs to ascertain baseline data regarding the implementation of the Houston Conference Guidelines. Residents (N = 36) from 21 out of 33 active sites completed the survey yielding a response rate of 46%. Demographically, most respondents were female (64%), White (83%), and the mean age was 32 (SD = 4.7). Most residents (86%) had PhDs and received their doctorates from clinical psychology programs (89%). Half of the residents completed their graduate work in programs specialized for clinical neuropsychology. Almost all (97%) received training in clinical neuropsychology on internship and spent 10-100% of their time in this endeavor (M = 48%, SD = 20.9). Slightly more than half of the respondents were in their first (53%) as opposed to their second year of residency. On average, 77% of residents' work is supervised by a board-certified neuropsychologist. Residents spend the majority of their time providing clinical service (M = 67.9%, SD = 14.6), followed by clinical research (M = 19%, SD = 14.4), and educational activities (M = 13%, SD = 5.9). The Houston Conference Guidelines delineate core knowledge and skill areas. Residents rated their competency in each knowledge and skill area from no expertise (0) to expert proficiency (10). Residents were significantly more confident in their knowledge of clinical neuropsychology than brain-behavior relationships (p < .001). In regard to skills, residents were more confident in their expertise in assessment than in treatment/interventions (p < .001). Overall, residents were more confident in their skills than in their knowledge base (p = .01). Only 25% of residents responded that there is formal evaluation of the defined exit criteria (advanced understanding of neuropsychological evaluation, brain-behavior relationships, and scholarly activity) indicating a need for programs to address this area. Brown, L. B., Gfeller, J. D., Ross, M. J., & Heise, R. A Survey of Neuropsychologists' Ethical Beliefs and Practices. Approximately 25% of the professional members of National Academy of Neuropsychology (NAN) and the American Academy of Clinical Neuropsychology (AACN) were surveyed regarding their ethical beliefs and practices. Topics covered included demographic and professional information, confidentiality, informed consent, release of information, provision of feedback, appending raw data to reports, litigation issues, and the use of archival data for research. The usable response rates of NAN (40%) and AACN (38%) members did not differ significantly. Although there were many similarities in the responses of the two groups, some differences in professional background were noted, indicating that AACN members were more focused on the specialty of neuropsychology. Also, the two groups exhibited different opinions regarding provision of feedback and legal consultation. Majority practices and ethical beliefs (i.e., 80% consensus) were calculated for 33 behaviors. Overall, 11 behaviors were identified as majority practices and 13 behaviors were identified as majority beliefs. Only 7 of the 33 behaviors
Abstracts from the 19th Annual Meeting
757
were viewed as both a majority practice and belief. Additional details and discussion regarding respondents' beliefs and practices are provided.
Weber, M., Duff, K., Palav, A., & McCaffrey, R. J. Publication Trends in Archives of Clinical Neuropsychology from 1994-1998: Looking to the Next Millennium. Clinical and experimental advances in neuropsychology have been guided by published research reports. Clinically, practitioners gain a better understanding of assessment techniques, case conceptualization, and variables that moderated neuropsychological performancel Experimentally, investigators are aided in the development of new hypotheses, implementation of new methodologies, and identification of possible sources of error variance. In these ways, past research guides future directions within the field. In an attempt to see where neuropsychology has been in the past, and where it is likely to head in the future, a review of the publication trends of the journal Archives of Clinical Neuropsychology was conducted for the years 1994-1998. Two hundred and one empirical articles were reviewed and the following variables were coded: population(s), number, age of subjects, gender of subjects, dependent measure(s), and imaging data. Frequency counts were conducted on each of the coded variables. As expected, for the 5-year period, populations studied were predominantly "neuropsychological" in nature (e.g., head injury, dementia, stroke), followed by "controls" and "psychiatric" (e.g., depression, schizophrenia) groups. The most widely used measures included Wechsler Adult Intelligence Scale-Revised, Trail Making Test, Controlled Oral Word Association Test, and Wisconsin Card Sorting Test. The majority of these studies over the 5-year period examined males in the 18 to 64 year age range. Although rarely investigated, CTs and MRIs were the most frequently used techniques of brain imaging. Trends across the 5-year period are also reviewed. Implications for clinical and experimental neuropsychology of the present and future are discussed.
PSYCHIATRIC CONDITIONS Gouvier, W. D., Pinkston, J. B., Santa Maria, M. P., Lovejoy, J. C., Smith, S., & Bray, G. Neuropsychological and Emotional Changes During Simulated Space Flight and Microgravity with Countermeasures. The microgravity of space travel is stressful to humans and produces physical changes including bone mineral loss, muscle atrophy, neuromuscular weakness, and fatigue. Increased understanding of the mechanisms by which microgravity adversely affects both the physical and resultant/concomitant psychological and neurocognitive effects in humans, and more effective treatments to slow or halt these changes, will allow healthier, happier, and longer stays in space. The effects of microgravity on humans are often studied by having subjects confined to bedrest with a 6 ° head-down tilt. Hormonal modifications may also be made to accelerate the bone mineral loss and muscle atrophy seen in microgravity. It is important to understand both the neurocognitive and emotional effects of simulated microgravity, as well as implemented hormonal changes, in order to determine how such interventions may effect the well-being of further research participants and future astronauts. We present the results of a two experiment (N1 = 23; N2 = 24) study designed to evaluate the neurocognitive and psychological effects of 6 ° head-down bedrest and pharmacological interventions with 3, 5, 3'-triiodothyronine (T3) implemented to enhance the muscle and bone atrophy associated with simulated microgravity and subse-