What is a Neuropsychological Test?


Neuropsychological tests are specifically designed tasks that are used to measure a psychological function known to be linked to a particular brain structure or pathway.

Refer to Neuropsychological Assessment.

Tests are used for research into brain function and in a clinical setting for the diagnosis of deficits. They usually involve the systematic administration of clearly defined procedures in a formal environment. Neuropsychological tests are typically administered to a single person working with an examiner in a quiet office environment, free from distractions. As such, it can be argued that neuropsychological tests at times offer an estimate of a person’s peak level of cognitive performance. Neuropsychological tests are a core component of the process of conducting neuropsychological assessment, along with personal, interpersonal and contextual factors.

Most neuropsychological tests in current use are based on traditional psychometric theory. In this model, a person’s raw score on a test is compared to a large general population normative sample, that should ideally be drawn from a comparable population to the person being examined. Normative studies frequently provide data stratified by age, level of education, and/or ethnicity, where such factors have been shown by research to affect performance on a particular test. This allows for a person’s performance to be compared to a suitable control group, and thus provide a fair assessment of their current cognitive function.

According to Larry J. Seidman, the analysis of the wide range of neuropsychological tests can be broken down into four categories. First is an analysis of overall performance, or how well people do from test to test along with how they perform in comparison to the average score. Second is left-right comparisons: how well a person performs on specific tasks that deal with the left and right side of the body. Third is pathognomic signs, or specific test results that directly relate to a distinct disorder. Finally, the last category is differential patterns, which are typically used to diagnose specific diseases or types of damage.


Most forms of cognition actually involve multiple cognitive functions working in unison, however tests can be organised into broad categories based on the cognitive function which they predominantly assess. Some tests appear under multiple headings as different versions and aspects of tests can be used to assess different functions.


Intelligence testing in a research context is relatively more straightforward than in a clinical context. In research, intelligence is tested and results are generally as obtained, however in a clinical setting intelligence may be impaired so estimates are required for comparison with obtained results. Premorbid estimates can be determined through a number of methods, the most common include: comparison of test results to expected achievement levels based on prior education and occupation and the use of hold tests which are based on cognitive faculties which are generally good indicators of intelligence and thought to be more resistant to cognitive damage, e.g. language.

  • National Adult Reading Test (NART).
  • Wechsler Adult Intelligence Scale (WAIS).
  • Wechsler Intelligence Scale for Children (WISC).
  • Wechsler Preschool and Primary Scale of Intelligence (WPPSI).
  • Wechsler Test of Adult Reading (WTAR).


Memory is a very broad function which includes several distinct abilities, all of which can be selectively impaired and require individual testing. There is disagreement as to the number of memory systems, depending on the psychological perspective taken. From a clinical perspective, a view of five distinct types of memory, is in most cases sufficient. Semantic memory and episodic memory (collectively called declarative memory or explicit memory); procedural memory and priming or perceptual learning (collectively called non-declarative memory or implicit memory) all four of which are long term memory systems; and working memory or short term memory. Semantic memory is memory for facts, episodic memory is autobiographical memory, procedural memory is memory for the performance of skills, priming is memory facilitated by prior exposure to a stimulus and working memory is a form of short term memory for information manipulation.

  • Benton Visual Retention Test.
  • California Verbal Learning Test.
  • Cambridge Prospective Memory Test (CAMPROMPT).
  • Gollin figure test.
  • Memory Assessment Scales (MAS).
  • Rey Auditory Verbal Learning Test.
  • Rivermead Behavioural Memory Test.
  • Test of Memory and Learning (TOMAL).
  • Mental Attributes Profiling System.
  • Wechsler Memory Scale (WMS).


Language functions include speech, reading and writing, all of which can be selectively impaired.

  • Boston Diagnostic Aphasia Examination.
  • Boston Naming Test.
  • Comprehensive Aphasia Test (CAT).
  • Multilingual Aphasia Examination.

Executive Function

Executive functions is an umbrella term for a various cognitive processes and sub-processes. The executive functions include: problem solving, planning, organisational skills, selective attention, inhibitory control and some aspects of short term memory.

  • Behavioural Assessment of Dysexecutive Syndrome (BADS).
  • CNS Vital Signs (Brief Core Battery).
  • Continuous performance task (CPT).
  • Controlled Oral Word Association Test (COWAT).
  • d2 Test of Attention.
  • Delis-Kaplan Executive Function System (D-KEFS).
  • Digit Vigilance Test.
  • Figural Fluency Test.
  • Halstead Category Test.
  • Hayling and Brixton tests.
  • Kaplan Baycrest Neurocognitive Assessment (KBNA).
  • Kaufman Short Neuropsychological Assessment.
  • Paced Auditory Serial Addition Test (PASAT).
  • Rey-Osterrieth Complex Figure.
  • Ruff Figural Fluency Test.
  • Stroop task.
  • Test of Variables of Attention (T.O.V.A.).
  • Tower of London Test.
  • Trail-Making Test (TMT) or Trails A & B.
  • Wisconsin Card Sorting Test (WCST).
  • Symbol Digit Modalities Test.
  • Test of Everyday Attention (TEA).


Neuropsychological tests of visuospatial function should cover the areas of visual perception, visual construction and visual integration. Though not their only functions, these tasks are to a large degree carried out by areas of the parietal lobe.

  • Clock Test.
  • Hooper Visual Organisation Task (VOT).
  • Rey-Osterrieth Complex Figure.

Dementia Specific

Dementia testing is often done by way of testing the cognitive functions that are most often impaired by the disease e.g. memory, orientation, language and problem solving. Tests such as these are by no means conclusive of deficits, but may give a good indication as to the presence or severity of dementia.

  • The Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog).
  • Clinical Dementia Rating.
  • Dementia Rating Scale.

Batteries Assessing Multiple Neuropsychological Functions

There are some test batteries which combine a range of tests to provide an overview of cognitive skills. These are usually good early tests to rule out problems in certain functions and provide an indication of functions which may need to be tested more specifically.

  • Barcelona Neuropsychological Test (BNT).
  • Cambridge Neuropsychological Test Automated Battery (CANTAB).
  • Cognistat (The Neurobehavioral Cognitive Status Examination).
  • Cognitive Assessment Screening Instrument (CASI).
  • Cognitive Function Scanner (CFS).
  • Dean-Woodcock Neuropsychology Assessment System (DWNAS).
  • General Practitioner Assessment Of Cognition (GPCOG).
  • Hooper Visual Organisation Test.
  • Luria-Nebraska Neuropsychological battery.
  • MicroCog.
  • Mini mental state examination (MMSE).
  • NEPSY.
  • Repeatable Battery for the Assessment of Neuropsychological Status.
  • Short Parallel Assessments of Neuropsychological Status (SPANS).
  • CDR Computerised Assessment System.

Automated Computerised Cognitive Tests

Traditional cognitive examinations are mostly paper and pen based. As such most of them are time consuming and require special training to be carried out. Today there is a rapidly growing number of automated computerised cognitive tests emerging, for example Brain on Track, Cogstate, CAMCI, CANTAB. Several of these new tests are shoving promising ability to discriminate between healthy individuals and different cognitive difficulties and/or to monitor cognitive impairment over time. Since these tests are easily administered to large groups of people this is opening up possibilities to, for example, regularly screen portions of the population at risk for cognitive decline and early on give adequate support and treatment.

Benefits of Neuropsychological Testing

The most beneficial factor of neuropsychological assessment is that it provides an accurate diagnosis of the disorder for the patient when it is unclear to the psychologist what exactly the patient has. This allows for accurate treatment later on in the process because treatment is driven by the exact symptoms of the disorder and how a specific patient may react to different treatments. The assessment allows the psychologist and patient to understand the severity of the deficit and to allow better decision-making by both parties. It is also helpful in understanding deteriorating diseases because the patient can be assessed multiple times to see how the disorder is progressing.

What is a Neuropsychological Assessment?


Neuropsychological assessment was traditionally carried out to assess the extent of impairment to a particular skill and to attempt to determine the area of the brain which may have been damaged following brain injury or neurological illness.

With the advent of neuroimaging techniques, location of space-occupying lesions can now be more accurately determined through this method, so the focus has now moved on to the assessment of cognition and behaviour, including examining the effects of any brain injury or neuropathological process that a person may have experienced.

A core part of neuropsychological assessment is the administration of neuropsychological tests for the formal assessment of cognitive function, though neuropsychological testing is more than the administration and scoring of tests and screening tools. It is essential that neuropsychological assessment also include an evaluation of the person’s mental status. This is especially true in assessment of Alzheimer’s disease and other forms of dementia. Aspects of cognitive functioning that are assessed typically include orientation, new-learning/memory, intelligence, language, visuoperception, and executive function. However, clinical neuropsychological assessment is more than this and also focuses on a person’s psychological, personal, interpersonal and wider contextual circumstances.

Assessment may be carried out for a variety of reasons, such as:

  • Clinical evaluation, to understand the pattern of cognitive strengths as well as any difficulties a person may have, and to aid decision making for use in a medical or rehabilitation environment.
  • Scientific investigation, to examine a hypothesis about the structure and function of cognition to be tested, or to provide information that allows experimental testing to be seen in context of a wider cognitive profile.
  • Medico-legal assessment, to be used in a court of law as evidence in a legal claim or criminal investigation.

Miller outlined three broad goals of neuropsychological assessment. Firstly, diagnosis, to determine the nature of the underlying problem. Secondly, to understand the nature of any brain injury or resulting cognitive problem (see neurocognitive deficit) and its impact on the individual, as a means of devising a rehabilitation programme or offering advice as to an individual’s ability to carry out certain tasks (for example, fitness to drive, or returning to work). And lastly, assessments may be undertaken to measure change in functioning over time, such as to determine the consequences of a surgical procedure or the impact of a rehabilitation programme over time.

Diagnosis of a Neuropsychological Disorder

Certain types of damage to the brain will cause behavioural and cognitive difficulties. Psychologists can start screening for these problems by using either one of the following techniques or all of these combined:

History TakingThis includes gathering medical history of the patient and their family, presence or absence of developmental milestones, psychosocial history, and character, severity, and progress of any history of complaints. The psychologist can then gauge how to treat the patient and determine if there are any historical determinants for his or her behaviour.
InterviewingPsychologists use structured interviews in order to determine what kind of neurological problem the patient might be experiencing. There are a number of specific interviews, including the Short Portable Mental Status Questionnaire, Neuropsychological Impairment Scale, Patient’s Assessment of Own Functioning, and Structured Interview for the Diagnosis of Dementia.
Test-TakingScores on standardised tests of adequate predictive validity predictor well current and/or future problems. Standardised tests allow psychologists to compare a person’s results with other people’s because it has the same components and is given in the same way. It is therefore representative of the person’s behaviour and cognition. The results of a standardised test are only part of the jigsaw. Further, multidisciplinary investigations (e.g. neuroimaging, neurological) are typically needed to officially diagnose a brain-injured patient.
Intelligence TestingTesting one’s intelligence can also give a clue to whether there is a problem in the brain-behaviour connection. The Wechsler Scales are the tests most often used to determine level of intelligence. The variety of scales available, the nature of the tasks, as well as a wide gap in verbal and performance scores can give clues to whether there is a learning disability or damage to a certain area of the brain.
Testing Other AreasOther areas are also tested when a patient goes through neuropsychological assessment. These can include sensory perception, motor functions, attention, memory, auditory and visual processing, language, problem solving, planning, organisation, speed of processing, and many others. Neuropsychological assessment can test many areas of cognitive and executive functioning to determine whether a patient’s difficulty in function and behaviour has a neuropsychological basis.

Information Gathered from Assessment

Tsatsanis and Volkmar believe that assessment can provide unique information about the type of disorder a patient has which allows the psychologist to come up with a treatment plan. Neuropsychological assessment can clarify the nature of the disorder and determine the cognitive functioning associated with a disorder. Assessment can also allow the psychologist to understand the developmental progress of the disorder in order to predict future problems and come up with a successful treatment package. Different assessments can also determine if a patient will be at risk for a particular disorder. It is important to remember, however, that assessing a patient at one time is not enough to go ahead and continue treatment because of the changes in behaviour that can occur frequently. A patient must be retested multiple times in order to make sure that the current treatment is still the right treatment. For neuropsychological assessments, researchers discover the different areas of the brain that is damaged based on the cognitive and behavioural aspects of the patient.

Benefits of Assessment

The most beneficial factor of neuropsychological assessment is that is provides an accurate diagnosis of the disorder for the patient when it is unclear to the psychologist what exactly they have. This allows for accurate treatment later on in the process because treatment is driven by the exact symptoms of the disorder and how a specific patient may react to different treatments. The assessment allows the psychologist and patient to understand the severity of the deficit and to allow better decision-making by both parties. It is also helpful in understanding deteriorating diseases because the patient can be assessed multiple times to see how the disorder is progressing.

One area where neuropsychological assessments can be beneficial is in forensic cases where the defendant’s competency is being questioned due to possible brain injury or damage. A neuropsychological assessment may show brain damage when neuroimaging has failed. It can also determine whether the individual is faking a disorder (malingering) in order to attain a lesser sentence.

Most neuropsychological testing can be completed in 6 to 12 hours or less. This time, however, does not include the role of the psychologist interpreting the data, scoring the test, making formulations, and writing a formal report.

Qualifications for Conducting Assessments

Neuropsychological assessments are usually conducted by doctoral-level (Ph.D., Psy.D.) psychologists trained in neuropsychology, known as clinical neuropsychologists. The definition and scope of a clinical neuropsychologist is outlined in the widely accepted Houston Conference Guidelines. They will usually have postdoctoral training in neuropsychology, neuroanatomy, and brain function. Most will be licensed and practicing psychologists in their particular field. Recent developments in the field allow for highly trained individuals such as psychometrists to administer selected instruments, though determinations regarding testing results remain the responsibility of the doctor.

Book: Assessment Procedures for Counsellors and Helping Professionals

Book Title:

Assessment Procedures for Counsellors and Helping Professionals.

Author(s): Carl Sheperis, Robert Drummond, and Karyn Jones.

Year: 2019.

Edition: Ninth (9th).

Publisher: Pearson.

Type(s): Paperback.


A classic textbook for aspiring counsellors, now updated and expanded to improve its usefulness and relevance for practicing counsellors.

Since its first publication in 1988, Assessment Procedures for Counsellors and Helping Professionals has become a classic among assessment textbooks designed specifically for aspiring counsellors. Now in its 9th Edition, the text includes extensive changes to content and updating throughout, while maintaining its popular, easy-to-read format and continuing emphasis on assessment information that is most useful and relevant for school counsellors, marriage and family therapists, mental health counsellors, and other helping professionals. Throughout the text, readers get invaluable information and examples about widely used assessment instruments in order to become familiar with these well-known tests.


Before purchasing, check with your instructor to ensure you select the correct ISBN. Several versions of the MyLab(TM) and Mastering(TM) platforms exist for each title, and registrations are not transferable. To register for and use MyLab or Mastering, you may also need a Course ID, which your instructor will provide.

Used books, rentals, and purchases made outside of Pearson

If purchasing or renting from companies other than Pearson, the access codes for the MyLab or Mastering platform may not be included, may be incorrect, or may be previously redeemed. Check with the seller before completing your purchase.

Book: Assessing Adolescent Psychopathology: MMPI-A / MMPI-A-RF

Book Title:

Assessing Adolescent Psychopathology: MMPI-A / MMPI-A-RF.

Author(s): Robert P. Archer.

Year: 2016.

Edition: Fourth (4th).

Publisher: Routledge.

Type(s): Hardcover and Paperback.


Assessing Adolescent Psychopathology: MMPI-A / MMPI-A-RF, Fourth Edition provides updated recommendations for researchers and clinicians concerning the MMPI-A, the most widely used objective personality test with adolescents, and also introduces the MMPI-A-Restructured Form ( MMPI-A-RF), the newest form of the MMPI for use with adolescents. Further, this fourth edition includes comprehensive information on both MMPI forms for adolescents, including descriptions of the development, structure, and interpretive approaches to the MMPI-A and the MMPI-A-RF. This text provides extensive clinical case examples of the interpretation of both tests, including samples of computer based test package output, and identifies important areas of similarities and differences between these two important tests of adolescent psychopathology.

Book: MMPI-A Assessing Adolescent Psychopathology

Book Title:

MMPI-A Assessing Adolescent Psychopathology.

Author(s): Robert P. Archer.

Year: 2005.

Edition: Third (3ed).

Publisher: Routledge.

Type(s): Hardcover.


This third edition of Robert Archer’s classic step-by-step guide to the MMPI-A continues the tradition of the first two in presenting the essential facts and recommendations for students, clinicians, and researchers interested in understanding and utilising this assessment instrument to its fullest .

Special features of the third edition include:

  • Presentation of appropriate administration criteria;
  • Updated references to document the recent development of an increasingly solid empirical foundation – more than 160 new ones;
  • Extensive review of new MMPI-A scales and subscales including the content component scales and the PSY-5 scales;
  • Expanded variety of clinical examples; and
  • A new chapter on the rapidly expanding forensic uses of the MMPI-A, including those in correctional facilities and in custody or personal injury evaluations.

Is the PROMIS® v2.0 Cognitive Function Scale a Reliable Measure of Subjective Cognitive Functioning?

Research Paper Title

Normative Reference Values, Reliability, and Item-Level Symptom Endorsement for the PROMIS® v2.0 Cognitive Function-Short Forms 4a, 6a and 8a.


Reliable, valid, and precise measures of perceived cognitive functioning are useful in clinical practice and research. The researchers present normative data, internal consistency statistics, item-level symptom endorsement, and the base rates of symptoms endorsed for the PROMIS® v2.0 Cognitive Function-Short Forms.


The four-, six -, and eight-item short form of the PROMIS® v2.0 Cognitive Function scale assess subjective cognitive functioning. The researchers stratified the normative sample from the US general population (n = 1,009; 51.1% women) by gender, education, health status, self-reported history of a depression or anxiety diagnosis, and recent mental health symptoms (i.e. feeling anxious or depressed in the past week) and examined cognitive symptom reporting.


Internal consistency was measured using Cronbach’s alpha and ranged from .85 to .95 for all three forms, across all groups. Mann-Whitney U test comparisons showed that individuals with past or present mental health difficulties scored significantly lower (i.e., worse perceived cognitive functioning) on the self-report questionnaires, particularly the eight-item form (history of depression, men: p < .001, Cohen’s d = 1.07; women: p < .001, d = .99; history of anxiety, men: p < .001, d = 1.06; women: p < .001, d = .98; and current mental health symptoms, men: p < .001, d = 1.38; women: p < .001, d = 1.19).


All three short forms of the PROMIS® v2.0 Cognitive Function scale had strong internal consistency reliability, supporting its use as a reliable measure of subjective cognitive functioning. The subgroup differences in perceived cognitive functioning supported the relationship between emotional and cognitive well-being. This study is the first to present normative values and base rates for several community-dwelling subgroups, allowing for precise interpretation of these measures in clinical practice and research.


Iverson, G.L., Marsh, J.M., Connors, E.J. & Terry, D.P. (2021) Normative Reference Values, Reliability, and Item-Level Symptom Endorsement for the PROMIS® v2.0 Cognitive Function-Short Forms 4a, 6a and 8a. Archives of Clinical Neuropsychology. doi: 10.1093/arclin/acaa128. Online ahead of print.

Clinically Rated Semi-Structured Interviews: An Alternative Gold Standard?

Research Paper Title

Validating mental health assessment in Kenya using an innovative gold standard.


With the growing burden of mental health disorders worldwide, alongside efforts to expand availability of evidence-based interventions, strategies are needed to ensure accurate identification of individuals suffering from mental disorders.

Efforts to locally validate mental health assessments are of particular value, yet gold-standard clinical validation is costly, time-intensive, and reliant on available professionals.

This study aimed to validate assessment items for mental distress in Kenya, using an innovative gold standard and a combination of culturally adapted and locally developed items.


The mixed-method study drew on surveys and semi-structured interviews, conducted by lay interviewers, with 48 caregivers.

Interviews were used to designate mental health “cases” or “non-cases” based on emotional health problems, identified through a collaborative clinical rating process with local input.


Individual mental health survey items were evaluated for their ability to discriminate between cases and non-cases.

Discriminant survey items included 23 items adapted from existing mental health assessment tools, as well as 6 new items developed for the specific cultural context.

When items were combined into a scale, results showed good psychometric properties.


The use of clinically rated semi-structured interviews provides a promising alternative gold standard that can help address the challenges of conducting diagnostic clinical validation in low-resource settings.


Watson, L>K., Kaiser, B.N., Giusto, A.M., Ayuku, D. & Puffer, E.S. (2020) Validating mental health assessment in Kenya using an innovative gold standard. International Journal of Psychology. 55(3), pp.425-434. doi: 10.1002/ijop.12604. Epub 2019 Jun 17.

Can We Use Smartphones in the Assessment & Prediction of Mental Health?

Research Paper Title

Digital phenotyping for assessment and prediction of mental health outcomes: a scoping review protocol.


Rapid advancements in technology and the ubiquity of personal mobile digital devices have brought forth innovative methods of acquiring healthcare data.

Smartphones can capture vast amounts of data both passively through inbuilt sensors or connected devices and actively via user engagement.

This scoping review aims to evaluate evidence to date on the use of passive digital sensing/phenotyping in assessment and prediction of mental health.


The methodological framework proposed by Arksey and O’Malley will be used to conduct the review following the five-step process.

A three-step search strategy will be used:

  1. Initial limited search of online databases namely, MEDLINE for literature on digital phenotyping or sensing for key terms;
  2. Comprehensive literature search using all identified keywords, across all relevant electronic databases: IEEE Xplore, MEDLINE, the Cochrane Database of Systematic Reviews, PubMed, the ACM Digital Library and Web of Science Core Collection (Science Citation Index Expanded and Social Sciences Citation Index), Scopus; and
  3. Snowballing approach using the reference and citing lists of all identified key conceptual papers and primary studies.

Data will be charted and sorted using a thematic analysis approach.


The findings from this systematic scoping review will be reported at scientific meetings and published in a peer-reviewed journal.


Spinazze, P., Rykov, Y., Bottle, A. & Car, J. (2019) Digital phenotyping for assessment and prediction of mental health outcomes: a scoping review protocol. BMJ Open. 9(12):e032255. doi: 10.1136/bmjopen-2019-032255.