2015 Bulletin

NAN Fall 2015 Bulletin

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26 | Bulletin vol. 29 no. 2 importance to the field. For example, over an approximately 10- year period, surveys administered to lay people across multiple North American cities indicated essentially no substantive changes in public understanding of brain injury and recovery. 16 Public beliefs about concussion and dementia also tend to be inaccurate. 17,18 Primary care providers have indicated that they often learn about cognitive health online or through popular media, rather than from neuropsychologists or others with expertise in brain-behavior relationships. 19 Public education efforts take many forms, including public speaking, media interviews, web-based or newspaper articles, and outreach to local schools and community groups. 20 NAN has engaged in important related efforts, producing neuropsychology-oriented public education materials for practitioners to use in schools and for athletes and allied sports professionals. 5. Positive cognitive outcomes While practitioners and researchers in neuropsychology typically focus on characterizing symptoms and deficits in various neuropsychiatric conditions, there is also value in better understanding patients with positive cognitive outcomes. One example to consider is multiple sclerosis: whereas approximately 50% of individuals with MS are known to have cognitive impairment, 21 little is known about those without such deficits. It is also evident that some patients with mild cognitive impairment do not progress to dementia and that patients with neurologic disease often have islands of intact cognition. 22,23 Our field may glean important empirical perspectives from other behavioral research focused on positive outcomes (e.g., long-term maintenance of weight loss; marital satisfaction). Related ideas could be used to derive new research paradigms aiming to comprehensively understand neuropsychiatric patients who show cognitive improvement, stability, or lack of impairment. 6. Normal and above normal cognition Neuropsychology has a rich history of case studies related to cognitive dysfunction, although less is known about normal and impressive cognition. Luria 24 described an early case of an individual with exceptional episodic and working memory who also experienced notable synesthesia. More recently, research examining individuals with ostensibly superior memory functioning has actually clarified what could be considered remarkable executive functioning. 25,26 A better understanding of those with robust cognitive functioning could further inform rehabilitation efforts with tangible strategies and interventions. The study and promotion of cognitive health is a growing area of interest among neuropsychologists and the broader health care community as seen in the neuropsychological literature, organizational efforts, and conference proceedings (including the inaugural SuperBrains positive neuroscience conference hosted earlier this year). Neuropsychologists are well poised to offer meaningful contributions to this area in clinical settings and through novel research paradigms. Clinical Take Home Points: 1. Cognitive and emotional compensatory strategies promote cognitive health. 2. Consistent physical/aerobic, social, and intellectual activity promotes cognitive health across the lifespan. 3. Prevention of cognitive impairment or additional cognitive decline takes many forms, including healthy sleep, dietary, and exercise habits; avoiding smoking; and effectively managing concussion sequelae. 4. Many individuals harbor misconceptions about the brain, cognition, and brain injury/illness, and public education in neuropsychology is critically needed. Related efforts include speaking engagements, social media activity, newspaper articles, and media interviews.

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