Book Review February 15, 2011

The Neuropsychology of Women

Marion Zucker Goldstein, MS, MD

J Clin Psychiatry 2011;72(2):264-265

Article Abstract

From our regular book review column.

The Neuropsychology of Women

edited by Elaine Fletcher-Janzen. In book series: Issues of Diversity in Clinical Neuropsychology. Springer Publishing, New York, NY, 2009, 328 pages, $79.95 (hardcover).

This book is in the avant-garde of bringing "brain-behavior relationships" across women’s entire lifespan from the realm of research into the education of medical students and practice of physicians and other health care workers.

The editor and contributing authors accomplish their goal of creating a valuable, scientific resource by focusing on the diversity of neuroscience research of women and men that has evolved over the past 20 years. This research relates genotype to phenotype as well as sex (genetic/biological determinants) to gender (behavioral, social, psychological, cultural) differences in development, disease states, course, and quality of life of women. The editor considers this rightfully "a small handbook," which this reviewer notes is "small" only because of the relatively tiny print.

Most of the contributing authors are in the field of psychology and education. Their goal is "to begin the codification of sex and gender perspectives of neuropsychology practice" (p9). They address medical issues of differential diagnosis, assessment, research, and treatment of women as these pertain to brain development, traumatic brain injury, chronic illness, dyslexia, epilepsy, eating disorders, and aging, in terms of recent, current, and yet to be undertaken multidisciplinary research.

One chapter is dedicated to neuroimaging in women. In this chapter, the currently available methods are clearly described, followed by uses in childhood, adulthood, and aging as well as hormonal, anatomic, linguistic, emotional, and cognitive variations and conditions.

There has been an incredibly long delay and eventual need for mandatory inclusion of women for nationally funded research and US Food and Drug Administration drug approval. The historical outline from 1977 to 2001 included on page 2 in the introduction is well worth a look. For some pioneers, this outline will elicit "I remember"; for others, it will be an eye opener; still others may ask, "What took so long?" and yet others need yet to be awoken to the realities of gender disparities in research and their insidious effects on the health care of women.

Although this book addresses medical, including many psychiatric, issues, APA in this book stands for American Psychological Association, while the American College of Graduate Medical Education (ACGME) is mentioned only in the appendix. The 89-page appendix is typeset in even more miniscule print than the main body of the book.

A grid listing Women’s Health Care Competencies for medical students was created in 2005 by the Association of Professors of Gynecology and Obstetrics (see http://wheocomp.apgo.org/). Neuropsychologists would like to prepare a similar grid of Women’s Health Care Competencies for themselves, but how can these competencies be acquired and monitored without going to medical school followed by residency training? The authors of this book are a great group for psychiatrists to learn from and to collaborate with as long as we maintain knowledge of and respect for each other’s training, boundaries, and ethics of evidence-based practices. Advancing knowledge, to which these authors have contributed and which leads to improvements of physician-women patient care, is most commendable.

This book is of interest to a diverse and scholarly group of medical practitioners, researchers, and educators in the neurosciences and beyond. The "beyond" includes the attention of American Association of Medical Colleges, ACGME, and Continuing Medical Education (CME) accreditation to mandate inclusion of sex and gender issues in "Competencies" for medical students, residents, and CME accreditation.

Marion Zucker Goldstein, MS, MD

[email protected]

Author affiliation: School of Medicine and Biomedical Sciences, SUNY at Buffalo, New York. Potential conflicts of interest: None reported.