The Handbook of Cognitive Neuropsychology: What Deficits Reveal About the Human Mind. B. Rapp. Philadelphia: Psychology Press, 2002. 656 pages, paperback, $39.95.
At first glance, cognitive neuropsychology may not appear to be a topic of interest to many clinicians. Cognitive neuropsychologists are believed to be interested in esoteric constructs such as "numerical cognition" as opposed to common clinical constructs such as neglect or amnesia. Although cognitive neuropsychology typically seeks to define and explain normal cognition, clinical neuropsychologists working in applied settings typically approach case material alert for the presence of pathology. Editor Rapp has attempted to address diverse needs by assembling an impressive group of contributing authors with expertise in cognitive psychology, cognitive neuropsychology, and neuroscience. Individual contributors provide a theoretical and conceptual framework for understanding human cognition, as well as a sophisticated clinical perspective on many neuropsychological disorders. In some circles, cognitive neuropsychologists are pejoratively referred to as "diagram makers." Although there is no shortage of basic and complex diagrams in this text, clinical disorders are woven into many of the chapters in a way that will stimulate most readers thinking.
Highly interesting are the first and last chapters that focus on the assumptions (Coltheart) and future (McCloskey) of cognitive neuropsychology. These chapters give a frame of reference for the reader, particularly those unfamiliar with assumptions and methods in cognitive neuropsychology. The overview of basic assumptions is pragmatic and addresses presumed misperceptions about cognitive neuropsychology and cognitive neuropsychologists. The chapter contains one of the most lucid discussions of dissociation and double dissociation I have read. Coltheart is able to present complex theory while maintaining a sense of humor. After presenting his four basic assumptions (functional modularity, anatomical modularity, uniformity, and subtractivity), Coltheart reflects on the meaning of these assumptions being erroneous and concludes that "the worst case scenario is happy oblivion." He then goes on to discuss how to theoretically address inconsistent findings in case material.
Discussing the future of cognitive neuropsychology, McCloskey discusses why he believes clinical disorders provide a perspective on "normal" cognition. He also revisits the issue of functional localization and discusses the utility of "lesion-deficit" correlation, concluding that neuroimaging including functional techniques have not displaced traditional techniques focused on lesion-impairment (test) association, but serve as a complementary method of investigation. Whether this assumption will stand the test of time remains to be seen. Finally, McCloskey presents several ideas for expanding the focus of cognitive neuropsychology, including the development of cognitive neuropsychological theories of remediation, an area of long-standing, pragmatic importance for clinicians. Considering the state of cognitive rehabilitation, development of interventions based on empirically derived cognitive models may provide clinicians with a sound conceptual basis for designing remedial therapies.
Most clinicians will easily relate to Parkin's chapter on memory. The text is decidedly clinical in nature with an organized and coherent discussion of memory systems and syndromes. Although well-written and informed, there is little new information on memory disorders. There is a nice but brief discussion of executive memory disorders that is a welcome addition to any chapter on memory even if it is somewhat limited in scope. Dodson and Schacter's chapter on "memory distortion" is a refreshing and revealing discussion of memory gone wrong. The authors present a model of a "constructive memory" and discuss failures of memory which should be considered by researchers and clinicians alike. The topic of false recognition is covered in considerable detail, but the chapter lacks the breath and clarity of Schacter's recent discussion of "the seven sins of memory," 1 an article that should be required reading for all students in psychology. In all fairness, the current chapter and "seven sins" article were written for different audiences and cover somewhat different topics. In any case, most clinicians would benefit from reading both discussions of common memory failures. Concluding the section on memory functions, Shelton and Caramazza review semantic memory and focus considerably on category specific learning and memory loss. The authors argue against a modality specific organization in semantic memory and offer evidence for a domain specific approach. The chapter is interesting, but suffers from discussion of a very narrow topic that may nonetheless interest readers who are engaged in clinical service or research with memory disorders.
Farah's chapter on consciousness notably does not focus on the traditional arousal-attentional network of the brain, but specific syndromes such as blind sight, preserved perception, and recognition in visual agnosia, prosopagnosia, and neglect. Much of the discussion is an expanded review of information presented in other texts including some of Farah's previous work. 2 Nonetheless, the implications of perception without awareness is intrinsically interesting, particularly when one has witnessed these phenomena in the clinical setting. In the chapter dedicated to attention, Umilta reviews a number of constructs not commonly addressed in clinical texts. Some of the conceptual distinctions such as overt versus covert orienting and endogenous versus exogenous attention are clearly described in a practical context and supplement typical clinical nomenclature. The author also integrates neuropsychology, neuroanatomy, and neurophysiology in a constructive manner.
Eight chapters are dedicated to various aspects of language including morphology (Allen and Badecker), word reading (Rapp, Folkand, and Tainturier), spelling (Tainturier and Rapp), word production (Nickels), and sentence production (Berndt) and comprehension (Martin). These chapters are well-written, but despite attempts to familiarize readers with the lexicon and provide the foundation necessary for understanding reading, spelling, speaking, and comprehension from a cognitive neuropsychological perspective, most clinicians will find these chapters require several readings. There are intermittent allusions to clinical disorders (Broca's and Wernicke's aphasia) that facilitates comprehension of proposed cognitive schemas, but in general, the discussion focuses on various complex cognitive-linguistic models that will be unfamiliar to most clinicians unless they have had formal education and training in the cognitive neuropsychology of language.
In their intriguing chapter "Planning and Execution of Everyday Actions," Humphreys, Forde, and Riddoch review cognitive processes necessary for "action" and discuss various models of executive processes such as the supervisory attentional system and contention scheduling system. Neuropsychological disorders such as utilization and action disorganization syndrome are also reviewed. Most importantly, the authors provide a context for analyzing and intervening in cases of executive disorders commonly observed after brain injury.
Although the text is well-organized and has chapters that will interest educators, researchers, and clinicians, readers should have basic knowledge in cognitive neuropsychology or be prepared to spend time digesting concepts and models that may prove somewhat unfamiliar. The text is disproportionately devoted to language, but presents a host of other topics (methodology, awareness, executive functions, and memory) that will please most readers.
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