Secondary Influences on Neuropsychological Test Performance

Peter Arnett

It has long been appreciated among clinical neuropsychologists that both primary and secondary factors contribute to cognitive dysfunction in neurological patients. Primary influences are the direct result of the extent and location of damage to the brain. Secondary influences stem from something associated with brain injury or disease besides the specific areas of the brain affected. For example, a patient with a neurological disease may develop depression, something which in turn often impacts cognitive functioning. Other secondary factors associated with disease besides depression can also negatively impact cognitive functioning, including anxiety, pain, fatigue, and motor impairments, to name a few. Despite the widespread appreciation of the importance of such secondary factors on cognitive functioning in clinical neuropsychology, there has never been a single source for this...