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Professional Ethics in Sports Neuropsychology

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Abstract

There has been unprecedented interest in sport-related concussions from many and varied sources including media, sports leagues, players’ unions, lawyers, legislators, scientists, clinicians, parents, coaches, and the athletes themselves. This interest has been fueled by epidemiologic data which indicate that concussions frequently occur at all ages, at all levels of play, and across a broad range of sports. The ubiquitous nature of the injury has also been coupled with concerns about whether and what type of relationships may exist between sports-related brain injury and the development of later neurodegenerative disease processes. The development of Sports Neuropsychology has largely paralleled the interest in sports concussions, making it a young and rapidly growing area of clinical and research interest. The youth of sports neuropsychology coupled with a focus on a poorly defined injury while being subject to unprecedented media, public, legislative, and legal scrutiny presents unique and important challenges to the ethical practice of sports neuropsychology. This paper explores these challenges by reviewing the brief history of sports neuropsychology, providing a basic review of the APA Code of Ethics, and discussing key ethical constructs such as beneficence, non-maleficence, and autonomy. The role of ethnic/racial cultural considerations in sports neuropsychology is discussed as well as ethical questions related to test use and development, the various roles that sports neuropsychologists play in sports medicine, and several illustrations of the challenges faced by sports neuropsychologists related to confidentiality, competence, role definition, and role boundaries. Although this article does not provide simple answers to complex questions, it does highlight areas in need of thoughtful discourse for clinicians engaged in the dynamic and evolving nature of ethical sports neuropsychology practice.

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References

  • American Educational Research Association, American Psychological Association & National Council on Measurement in Education. (2014). Standards for Educational and Psychological Testing. Washington: Author.

    Google Scholar 

  • American Psychological Association. (2010). Ethical principles of psychologists and code of conduct (as amended). Washington: Author.

    Google Scholar 

  • Ardila, A. (2005). Cultural values underlying psychometric cognitive testing. Neuropsychology Review, 15, 185–195.

    Article  PubMed  Google Scholar 

  • Bailes, J. E., Lovell, M. R., & Maroon, J.C. (1999). Sports-Related Concussion. St. Louis: Quality Medical Publishing.

  • Barth, J., Alves, W., Ryan, T., Macciocchi, S., Rimel R, Jane J, … Nelson, W. (1989). Mild head injury sports; Neuropsychological sequelae and recovery of function. In H. Levin, J. Eisenberg, & B. A., Mild Head Injury (pp. 257–275). New York: Oxford University Press

  • Bauer, R. M., Iverson, G. L., Cernich, A. N., Binder, L. M., Ruff, R.M., & Naugle, R. I. (2012). Computerized neuropsychological assessment devices: Joint Position Paper of the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology. The Clinical Neuropsychologist, 26, 177–196; Archives of Clinical Neuropsychology, 27, 362–373 (joint publication).

  • Chronbach, L. J., & Meehl, P. E. (1955). Construct validity in psychological tests. Psychological Bulletin, 52, 281–302.

    Article  Google Scholar 

  • DeMarco, A., & Barth, J. (2014). Historical perspectives of sport related concussion. In R. Echemendia & G. Iverson (Eds.), The Oxford Handbook of Sports-related Concussion (pp. 1–14). London: Oxford University Press.

    Google Scholar 

  • Echemendia, R. J. (2004). Cultural aspects of neuropsychological evaluation in sports. In M. Lovell, R. Echemendia, J. Barth, & M. Collins (Eds.), Traumatic brain injury in sports: An international neuropsychological perspective (pp. 435–443). Lisse: Swets & Zeitlinger.

    Google Scholar 

  • Echemendia, R. J. (Ed.). (2006). Sports neuropsychology: Assessment and management of traumatic brain injury. New York: Guilford Press.

    Google Scholar 

  • Echemendia, R. J. (2015). Presidential Address. Annual Meeting of the Sports Neuropsychology Society. Atlanta, GA

  • Echemendia, R. J. & Comper, P. (2009). NHL/NHLPA Neuropsychological Testing Program: Challenges and Outcomes. Presented as part of “Issues and Challenges with Rapid Neuropsychological Assessment.” University of Toronto, Toronto, Canada: December

  • Echemendia, R. J., Herring, S., & Bailes, J. (2009). Who should administer and interpret neuropsychological tests? British Journal of Sports Medicine, 43, 32–35.

    Article  Google Scholar 

  • Echemendia, R., Iverson, G., McCRea, M., Broshek, D., Gioia, G., Sautter, S., … Barr, W. (2012). Role of neuropsychologists in the evaluation and management of sport-related concussion: An inter-organization position statement. Archives of Clinical Neuropsychology, 27, 119–122

  • Echemendia, R. J., Iverson, G. L., McCrea, M., Macciocch, S., Gioia, G., Putukian, M., … Comper, P. (2013). Advances in Neuropsychological Assessment. British Journal of Sports Medicine, 47, 294–298

  • Echemendia, R. J., & Parker, E. (1998). Ethical issues in the neuropsychological assessment of athletes. In J. Bailes, M. Lovell, & J. Maroon (Eds.), Sports related concussion and nervous system injuries. St. Louis: Quality Medical Publishers.

    Google Scholar 

  • Gronwall, D., & Wrightson, P. (1974). Delayed recovery of intellectual function after minor head injury. Lancet, 2, 605–609.

    Article  PubMed  Google Scholar 

  • Harris (UPMC) Poll (2015). How knowledgeable are Americans about concussion: Assessing and recalibrating the public’s knowledge. UPMC Harris Poll.

  • Iverson, G. L., & Schatz, P. (2015). Advanced topics in neuropsychological assessment following sport-related concussion. Brain Injury, 29, 263–275.

    Article  PubMed  Google Scholar 

  • Jones, N., Walter, K., Caplinger, R., Wright, D., Rasch, W., & Young, C. (2014). Effect of education and language on baseline concussion screening tests in professional baseball players. Clinical Journal of Sports Medicine, 24(4), 284–288.

    Article  Google Scholar 

  • Kirschen, M. P., Tsou, A., Nelson, S. B., Russell, J. A., & Larriviere, D. (2014). Legal and ethical implications in the evaluation and management of sports-related concussion. Neurology, 83, 352–358.

    Article  PubMed  Google Scholar 

  • Kroshus, E., Baugh, C.M., Daneshvar, D.H., Stamm, J.M., Lauresen, R. M., & Austin, S.B. (2015). Pressure on sports medicine clinicians to prematurely return collegiate athletes to play after concussion. Journal of Athletic Training, 50, 944–951.

  • Langlois, J. A., Rutland-Brown, W., & Wald, M. M. (2006). The epidemiology and impact of traumatic brain injury: A brief overview. The Journal of Head Trauma Rehabilitation, 21(5), 375–378.

    Article  PubMed  Google Scholar 

  • Lovell, M., Echemendia, R., Barth, J., & Collins, M. (Eds.). (2004). Traumatic brain injury in sports: An international neuropsychological perspective. Lisse: Swets & Zeitlinger.

    Google Scholar 

  • Lyall, J. (2015, October 3). Rugby world Cup 2015: Brain Expert Warns of Concussion “Anxiety”. BBC Scotland, pp. 1–2

  • Macciocchi, S. (2009). Doing good: The pitfalls of beneficence. The Journal of Head Trauma Rehabilitation, 24(1), 72–74.

    Article  PubMed  Google Scholar 

  • Manly, J., & Echemendia, R. J. (2007). Race-specific norms: Using the model of hypertension to understand issues of race, culture, and education in neuropsychology. Archives of Clinical Neuropsychology, 22(3), 319–326.

    Article  PubMed  Google Scholar 

  • McCrory, P., Meeuwisse, W., Aubry, M., Cantu, R., Dvorak, J., Echemendia, R., … Tator, C. (2013a). Consensus statement on concussion in sport – the 4th international conference on concussion in sport held in Zurich, November 2012. British Journal of Sports Medicine, 47, 250–258

  • McCrory, P. M., Meeuwisse, W., Echemendia, R., Iverson, G., Dvořák, J., Kutcher, J. (2013b). What is the lowest threshold to make a diagnosis of concussion. 47, 268–271

  • McKee, A. C.-W. (2009). Chronic traumatic encephalopathy in athletes: Progressive tauopathy after repetitive head injury. Journal of Neuropathology Experimental Neurology, 7, 709–735.

    Article  Google Scholar 

  • Parker, E., & Echemendia, R. (2004). Ethical issues in the evaluation of athletes. In M. E. Lovell (Ed.), Traumatic brain injury in sports (pp. 468–477). Lisse: Swets & Zeitlinger.

    Google Scholar 

  • Partridge, B. (2014). Dazed and confused: Sports medicine, conflicts of interest, and concussion management. Bioethical Inquiry, 11, 65–74.

    Article  PubMed  Google Scholar 

  • Sports Neuropsychology Society. (2015). Sports neuropsychology: Definition, qualifications, and training guidelines—An official position statement of the Sports Neuropsychology Society. www.sportsneuropsychologysociety.com

  • Stanford Encyclopedia of Philosophy. (2013). The principle of beneficence in Applied Ethics. http://plato.stanford.edu/entries/principle-beneficence

  • Zillmer, E. A., Schneider, J., Tinker, J., & Kaminaris, C. I. (2006). A history of sports-related concussions: A neuropsychological perspective. In R. J. Echemendia (Ed.), Sports Neuropsychology: Assessment and Management of Traumatic Brain Injury. New York: Guilford Press.

    Google Scholar 

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Authors and Affiliations

  1. Comprehensive Concussion Care, University Orthopedics Center, State College, Altoona, PA, USA

    Ruben J. Echemendia

  2. Department of Psychology, University of Missouri – Kansas City, Kansas City, MO, USA

    Ruben J. Echemendia

  3. Departments of Clinical & Health Psychology and Neurology, Clinical and Translational Science Institute, University of Florida, Gainesville, FL, USA

    Russell M. Bauer

Authors
  1. Ruben J. Echemendia
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  2. Russell M. Bauer
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Correspondence to Ruben J. Echemendia.

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Conflict of Interest

Dr. Echemendia receives financial compensation for consulting services from the National Hockey League, Major League Soccer, the U.S. Soccer Federation, and Princeton University. He has also received financial compensation for services rendered as an expert witness in plaintiff and defense cases related to traumatic brain injury and sports-related concussion. He is a non-paid member of the Medical Advisory Board of BrainScope. He claims no financial conflicts of interest related to the topics discussed in this article. Dr. Bauer receives research support from the Rehabilitation Research and Development Service, Veterans HealthCare Administration (1I21RX001730-01), from the Clinical and Translational Science Institute (UL1TR001427) and from the National Institute on Aging (1P50AG047266-01A1). He claims no financial conflicts of interest related to the topics discussed in this article.

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Echemendia, R.J., Bauer, R.M. Professional Ethics in Sports Neuropsychology. Psychol. Inj. and Law 8, 289–299 (2015). https://doi.org/10.1007/s12207-015-9241-3

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