Emotion matters: A call for systematic assessment of affective and motivational domains in clinical neuropsychology.

Abstract

Objectives: Clinical neuropsychology historically emphasized the assessment of "cold" cognitive functions, whereas emotional and motivational processes remain rarely evaluated. This point-of-view article argues for the inclusion of affective-motivational assessment into neuropsychological practice and outlines the key domains that should be routinely considered.

Methods: Drawing on neuroscience and clinical research, we review four core affective-motivational domains: emotional reactivity, emotion regulation, emotion recognition, and social cognition. For each domain, we summarize self-report instruments and performance-based tasks. Beyond these domains, we discuss emotional-cognitive interference as a cross-cutting modulatory mechanism that may influence overall neuropsychological performance.

Results: Evidence indicates that emotional and motivational processes shape cognitive functioning, predict functional outcomes, and contribute uniquely to diagnosis, rehabilitation adherence, and quality of life. Validated tools are available for assessing each domain, and many clinical conditions present affective and social disturbances that may be more disabling than cognitive deficits. Despite this, surveys consistently show that affective-motivational domains are rarely assessed in practice.

Conclusions: Integrating emotional-motivational assessment is essential for achieving a comprehensive characterization of clinically relevant dimensions of everyday functioning. We propose a modular framework guided by referral questions and emphasize the need to develop a brief affective-motivational screener analogous to cognitive screeners such as the Mini-Mental State Examination or Montreal Cognitive Assessment. Systematic assessment of these domains can enhance diagnostic accuracy, strengthen rehabilitation planning, and more accurately reflect the complexity of everyday functioning.