Do Black lives matter to clinical neuropsychologists? An introduction to a special issue.

Abstract

The racial strife that was exacerbated by the murder of George Floyd in the Spring of 2020 prompted many of us to reflect on race as a social justice issue in clinical neuropsychology. As a specialty in which White Americans have historically been over-represented (Sweet et al., 2021), how much do Black lives really matter to clinical neuropsychology? Of course, the broader Civil Rights movement has been active for decades and the racial inequities in psychological science, training, and practice have existed for even longer (Guthrie, 2004). Importantly, they are inextricably linked and relevant to clinical neuropsychology. Black Americans experience marked health disparities and are over-represented in many of the clinical populations that neuropsychologists serve (e.g. vascular disease, dementia, and infectious disease). And yet, fewer than 1% (n = 75) of the nearly 11,000 articles published in our field’s six major journals since 1985 focus specifically on Black Americans. As seen in Figure 1, the limited emphasis on Black Americans in our neuropsychological research has not improved meaningfully in 35 years, as publication frequencies fall reliably below studies focused on other sociodemographic factors such as age, sex/gender, and education/literacy (ps < .0001). A majority of the neuropsychological articles on Black Americans emphasize race-based test score discrepancies, psychometrics, and norms (e.g. Heverly et al., 1986). Although such psychometric studies have value, they are nevertheless fraught with thorny interpretive issues (e.g. Manly & Echemendia, 2007; Possin et al., 2021) and represent only a small part of the brain health needs of Black Americans. Moreover, race is a social, rather than biological, construct, and the issues associated with race and brain health are tremendously complex and cannot be resolved with an exclusive psychometric focus. Inspired by the Black Lives Matter academic strike (Nature, 2020), this special issue was a call to action for clinical neuropsychologists to use their platform as clinician-scientists to promote the brain health and quality of life of Black Americans. The special issue begins with two systematic reviews examining the representation of Black Americans in neuropsychological studies. Historically, well over half of articles in clinical neuropsychology journals fail to include even basic descriptive data on