Perhaps you or a loved one need neuropsychological testing or psychological assessment. If you have been referred for testing to be completed by a psychologist, but aren’t totally sure what a “neuropsych eval” or “psych testing” means, this information may give you a clearer idea of the differences between these two types of testing. Along with what to expect either way. Or, if you want to pursue testing for your own interest and self-understanding, you may not have a referral, but could use some guidance about the type of testing you should look for.
Neuropsychological Assessment: An Overview
If you are seeking a neuropsych evaluation, odds are you’re experiencing some cognitive symptoms. This means some area of your brain function is not working the way you’re used to or is causing problems for you. A neuropsychological assessment can help you understand these symptoms, possibly get a diagnosis, or learn how to manage them.
cognitive symptoms assessed in A Neuro psych eval:
Changes in memory
New difficulty focusing or concentrating
More impulsive speech or behaviors
Difficulty finding words or slower tracking in conversations
New problems with getting lost
Difficulty doing complex mental tasks that you used to do without a problem (like managing medications or finances)
If you have symptoms like this or other problems that suggest your brain has changed or isn’t doing what it should, your physician, psychologist, occupational therapist, social worker, or other health professionals might refer you for a neuropsychological assessment.
What is Measured in a neuropsychological assessment
Neuropsychological testing involves using several tests (or “testing battery”) to measure the functions of your brain in different areas. A neuropsych test battery will most likely include measures of:
Attention. The ability to focus your attention on a task for as long as needed.
Working memory. The ability to hold information in your mind and work with it. For example, looking up the number for the pizza place, then repeating it out loud to remember it while you dial.
Executive function. Your brain’s capacity for organization and impulse control. As well as how quickly you move from one mental task to another and communicate across brain areas.
Memory. This is the measure of your ability to learn, retain, and recall information. It includes different tasks to look at different types of memory.
Processing speed. How quickly you take in and respond to information.
Visual/spatial function. The ease with which you understand and use the information presented visually, like abstract shapes and pictures. Think of the skill you might need for a game of tetris…this brain function is crucial!
Intellectual function. This is a way to estimate your overall IQ (sometimes called “intelligence,” though this is an often-misunderstood term). This can be important because it gives your doctor a basis for comparison. For example, if your IQ is average and your scores on attention measures are much lower than that, this gives a clue about what’s going on with your symptoms, and more importantly, how to help.
Questionnaires about mood or symptoms. These are usually a small part of neuropsych testing. Even though mood and symptoms aren’t the primary targets of testing, things like depression and anxiety CAN impact cognition. We measure them in case they contribute to the problem because they are often treatable.
A LOOK AT hISTORY & oVERALL hEALTH
In some cases, neuropsych testing might also involve measures of academic abilities, or interviews with teachers, parents, or caregivers. This depends on the question at the heart of testing, and your neuropsychologist will tailor a testing battery to meet your specific needs. In all cases, your doctor will do a clinical interview with you to gather information about your history, symptoms, and overall health.
what happens after a neuropsychological assessment?
Once the testing is done (this can be anywhere from 4 hours to 10 hours or more, depending on the reason for testing), your doctor will score your tests and consider all of the information together. This helps to understand patterns and the big picture, so we can offer insight into what is causing the symptoms, and make recommendations about how to manage them.
Psychological Evaluation: An Overview
If you are considering a psychological evaluation, also called “psychodiagnostic assessment,” you are most likely experiencing emotional or other psychiatric symptoms that are causing you distress or problems in relationships, at work, or in other areas. Psych testing can help you understand your symptoms, often by providing a diagnosis that can make sense of your experience.
symptoms assessed in A psychodiagnostic assessment
Here are some examples of psychiatric symptoms that might prompt someone to seek a psychological evaluation:
Low mood that persists and doesn’t seem related to an obvious cause
Frequent worry
Panic attacks
Difficulty in interpersonal relationships
Difficulty maintaining jobs
A history of abuse or trauma
Problems with anger
Low motivation
Difficulty making decisions or lack of confidence
Mood highs and lows
Hypervigilance
Social anxiety or fear
Specific fears that cause problems in your life
Nightmares
Low self-esteem
Feelings of loneliness or emptiness
Wishing for better self-understanding*
*not really a symptom, but often a reason folks want testing
There are many types of emotional symptoms that might cause you concern enough to seek a psychological evaluation. Sometimes, people are referred for a psychodiagnostic evaluation by a therapist or physician. But just as often, people are seeking better insight and awareness for themselves.
What is Measured in a Psychological Evaluation
Similar to neuropsych testing, a psychological evaluation will involve a test battery using several different tests to answer your specific question. This allows your doctor to collect enough data for a broad understanding of you and your symptoms. Unlike a neuropsychological assessment, there are not specific functions we’re measuring in a psychodiagnostic assessment, rather, a broad understanding of your overall psychological function. A thorough psych testing battery will likely include:
Personality measures. Long tests that ask many questions about how you see yourself and what characteristics define your personality
Mood measures. Tests that ask you about your mood and symptoms related to mood in the recent past
Specific symptom measures. These are likely to differ depending on your reasons for coming in for testing and can include questionnaires about specific symptoms you’re having. For example, if you suspect you may have posttraumatic stress disorder (PTSD) after a traumatic experience, your doctor might give you a questionnaire specifically measuring PTSD symptoms.
Similar to neuropsychological testing, when you undergo a psychological evaluation, your psychologist will do a thorough clinical interview to gather information about your background and what you’re experiencing. This interview provides important data, just like test results. Also similarly, your doctor will consider all of the data together, make a diagnosis (or not, if there is no diagnosis), and offer recommendations based on the results.
A Brief Comparison of a Psychological Evaluation & a neuropsychological assessment
You may have noticed that there are some shared themes across both types of assessment, which is part of what creates confusion when you are referred for testing, or think you might want to seek testing on your own. Here are a few things psychological assessment and neuropsychological assessment have in common:
Conducted by a specially trained psychologist
Psychologists are the only professionals who are trained, qualified, and licensed to conduct either psychological or neuropsychological assessments. These are highly complex evaluations that require significant knowledge of statistics, research methods, tests and measures, psychological assessment, diagnosis, and psychological interventions in order to be done properly. There is no other profession or licensure that involves training in all the elements of comprehensive psychological or neuropsychological testing, and even within the field of psychology, only a subset of clinical psychologists receive training in neuropsychological testing, or specialize in psych assessment. This is why it’s so important to find a well-qualified clinical psychologist for your testing.
Involve several different tests
There is no single test that can offer comprehensive information about something as complex as cognition or mental health. Psychologists put together test batteries that cover a broad range to get the full picture. This is good because it means we don’t miss important information. For example, if someone requests an “ADHD test” and I only do that one test, I may miss other symptoms that could also play a role in attention problems, like anxiety, grief, or a learning disorder. Like any good investigator, psychologists gather as much data as is necessary not only to confirm a suspected diagnosis, but also to rule out other possibilities and catch anything else that may be going on.
Begin with a question
Any psych or neuropsych eval starts with a question. This can come from another doctor, a therapist, a family member, or the patient themselves, but it is always our starting point. The question guides the testing battery, the interview, and the recommendations I might make after considering all of the data together. For example, let’s say you come in already knowing you have a traumatic brain injury from an accident and wanting to know your strengths and vulnerabilities as well as recommendations for how to manage them. If all I offer is a diagnosis of traumatic brain injury, I’ve wasted everyone’s time and money. It’s crucial to find a psychologist who will listen and address your specific question!
Include an interview
The clinical interview is a crucial part of testing, because although I may have expertise in clinical psychology and neuropsychology, YOU are the expert in your own experience. These types of assessments are not done to the patient, they are done with the patient. Your input and observations are the most important piece of the puzzle (and in cases of dementia or other situations where a patient may not have insight, caregiver input is invaluable).
You may have noticed that neuropsych assessment and psychological assessment also have some differences. Here are a few ways these types of testing differ:
Different focus
Neuropsych testing is about brain function, in terms of cognition, and is easiest to understand when we think about the specific tasks we measure, like memory and attention. In contrast, psych assessment is about psychological symptoms. Obviously, the brain is also involved in emotional and mental health functions, but a psychological assessment is less focused on the nuts and bolts of cognition, and more focused on overall emotional wellbeing, and specific psychiatric symptoms.
Different tests
These two types of testing may have some overlap in the tests involved (for example, a short measure of depressive symptoms is likely included in both), but generally speaking, neuropsych testing involves a totally different test battery than psychological evaluation, because we’re measuring different things.
Different types of diagnoses
When someone goes in for neuropsych testing, if they receive a diagnosis, it is likely to be a diagnosis related to neurocognitive function, like cognitive disorders due to dementia, traumatic brain injury, ADHD, stroke, or multiple sclerosis. These diagnoses are often used in medical settings. Psychological testing is more likely to result in a psychiatric diagnosis, related to mood or other mental health factors. These might include things like PTSD, depression, or anxiety disorders.
Different recommendations
Although both types of testing will result in a list of recommendations from your doctor about how to cope with or treat symptoms, the lists often look different. For example, neuropsych recommendations may include strategies to compensate for brain changes, like using a notebook to write things down, being allowed extra time for tests in school, or using a pill organizer to track medications. In contrast, psych recommendations are more likely to be aimed at treatment and ways to manage symptoms; things like specific types of psychotherapy that could be helpful, or a recommendation to see a psychiatrist for a medication eval.
This is an overview of what is involved in neuropsychological assessment and psychological evaluation. If you need either type of evaluation, hopefully, you now have a better understanding of the purpose of the testing you’re seeking, as well as what to expect from testing.
Do you need a psychological evaluation or a neuropsychological assessment in Los Angeles?
Whether you are interested in, or need, a psychological evaluation or a neuropsychological assessment Dr. Reger can help. As a Psychologist in Los Angeles, she offers these evaluations at several locations throughout Southern California. Follow these steps to set up your assessment.
Schedule your appointment, remember it might take most of the day
Other Services Available with Dr. Reger in Los Angeles
Dr. Reger specializes in assessments for med-legal capacity, workers’ compensation, and before surgery or operations. Additionally she provides individual therapy for older adults, trainings, and public speeking.