Gender and ethnic/racial diversity in clinical neuropsychology: Updates from the AACN, NAN, SCN 2020 practice and "salary survey".

OBJECTIVE: Examination of gender and diversity issues within clinical neuropsychology, using data from the 2020 professional practice and "salary survey." METHODS: Clinical neuropsychologists in the U.S. and Canada were invited to participate in an online survey. The final sample consisted of 1677 doctoral-level practitioners. RESULTS: Approximately, 60% of responding neuropsychologists are women and 53.8% of those women identify as early career psychologists (ECPs). Conversely, a majority of men in the sample are advanced career psychologists (ACPs). Both genders work predominantly in institutions, but more men than women work in private practice. ACP men produce a greater number of peer-reviewed publications and conference presentations. Across all work settings, women earn significantly less than men, and are less satisfied with their incomes. Establishing and maintaining family life is the biggest obstacle to attaining greater income and job satisfaction for both genders. Ethnic/racial minority status was identified in 12.9% of respondents, with 59.2% being ECPs. Job satisfaction and hostility in the workplace vary across ethnic/racial minority groups. Hispanic/Latino(a) and White neuropsychologists report higher incomes, but there were no statistically significant differences between any of the groups. CONCLUSIONS: Income and select practice differences persist between female and male neuropsychologists. There is a slow rate of increased ethnic/racial diversity over time, which is much more apparent among early career practitioners. Trajectories and demographics suggest that the gender income gap is unlikely to be improved by the next survey iteration in 2025, whereas it is very likely that ethnic/racial diversity will continue to increase gradually.

Clinical neuropsychology in Canada: Results from the 2020 AACN, NAN, SCN professional practice and "salary survey".

Objective: The current study summarizes the results of a 2020 survey that solicited information regarding backgrounds, beliefs, practices, and incomes of clinical neuropsychologists who practice in Canada. Methods: Clinical neuropsychologists who practice in Canada were invited to participate in an online survey that was available from 1/17/20 to 4/02/20. Available survey findings were obtained from 111 respondents, which reflects a response rate of 51.3% of the 216 doctoral-level Canadian neuropsychologists identified in at least one major North American or international professional organization membership list (AACN, INS, NAN, or SCN). Results: Most of the current respondents were White/Caucasian women who identified as adult providers and worked full-time in urban institutional settings. Four Canadian provinces (Alberta, British Columbia, Ontario, Quebec) accounted for more than 91% of the current respondent sample. Incomes and career satisfactions were largely encouraging, though some important variations were noted by province, work setting, and professional identity. Incomes were significantly associated with forensic practices and years of clinical experience. Most respondents made use of technician support in their practices, largely to increase productivity and patient volume. Only a small minority of respondents were board-certified and there was generally limited interest in future board certification. Conclusions: While important similarities were observed in the current Canadian sample relative to recent survey findings obtained in a U.S. sample, results also reveal a number of important differences that serve as important areas of future consideration.

Professional practices, beliefs, and incomes of U.S. neuropsychologists: The AACN, NAN, SCN 2020 practice and "salary survey".

OBJECTIVE: This portion of the 2020 survey updates practice information, beliefs, and income data of clinical neuropsychologists who practice within the United States. Methods: Doctoral-level neuropsychology practitioners were invited via numerous methods, with multiple reminders, to participate in a web-based survey from January 17 through April 2, 2020. The useable U.S. sample of 1677 doctoral-level practitioners was 6.2% larger than the comparable group in the prior 2015 practice survey. Results: Whereas women practitioners predominate, which continues a steeply increasing trend across time, increases in overall ethnic/racial diversity continue at a slow pace. Median age has remained very similar over the last 30 years, reflecting a continuous influx of young practitioners. A relatively small minority of neuropsychologists work part time. The proportion of board-certified neuropsychologists continues to show meaningful increase; interest in subspecialization certification is relatively high. Reliance on technicians remains popular, especially for neuropsychologists who work in institutions or are board certified. Although implementation of new CPT codes in 2019 and related payor policies appear to have had more negative than positive effects, psychology-related annual incomes of neuropsychologists have again increased compared to prior surveys. Variables such as specific work setting, state, region, years in practice, forensic practice hours, board certification, and basis for determining income (e.g. hours billed, revenue collected, relative value units) have an impact on income. More than half of practitioners engage in forensic neuropsychology, with the number of related practice hours per week again increasing. There is very high agreement regarding the use of response validity measures in clinical practice and forensic practice. Neurologists remain the number one referral source whether working in an institution, private practice, or a combination of both, and regardless of maintaining a pediatric, adult, or lifespan practice. Career satisfaction ratings for income, job, and work-life balance remain high, with the majority of ratings regarding the future of the specialty in the positive range. Additional data summaries related to a wide range of professional and practice topics are provided. Conclusions: Updating and comparing survey information at five-year intervals continues to provide insights and perspectives regarding relative stabilities and changes in practice activities, beliefs, and incomes of U.S. clinical neuropsychologists. Such information also provides guidance regarding the future of the specialty.

Professional Practices, Beliefs, and Incomes of Postdoctoral Trainees: The AACN, NAN, SCN 2020 Practice and 'Salary Survey'.

OBJECTIVE: Within a portion of the 2020 professional practice and "salary survey," to update key information regarding neuropsychology postdoctoral trainees. METHODS: Postdoctoral trainees were contacted via a variety of membership listings, including the listserv used by the program directors of the Association of Postdoctoral Programs in Clinical Neuropsychology (APPCN). Invitations sent in multiple waves to members of numerous neuropsychological organizations via e-messages and physical postcards included the request that postdoctoral trainees participate. The survey website was opened on January 17, 2020 and closed on April 2, 2020, during which time a total of 178 postdoctoral trainees in the USA and 3 in Canada participated. RESULTS: Response rate was estimated to be 56.4%, which adequately represents the target sample. The modal postdoctoral trainee is a woman whose internship was American Psychological Association (APA)-accredited and whose postdoctoral training is in an APPCN program that adheres to Houston Conference training guidelines. Extensive clinical experiences in neuropsychology in the form of externship practica and during internship were reported by the majority of trainees prior to postdoctoral training. There are few differences between APPCN and non-APPCN trainees and reported training experiences. Job satisfaction is high. Salaries appear to have increased substantially in recent years. There is universal interest in pursuing board certification. Support for the empirical foundations justifying assessment of response validity is high. CONCLUSIONS: Surveys of postdoctoral trainees continue to provide valuable perspectives regarding training background, clinical experiences, practice beliefs, and incomes of individuals who will soon launch their careers in clinical neuropsychology.

The Relationship Between Grandiosity, Psychopathy, and Narcissism in an Offender Sample.

Clinical accounts suggest grandiosity is an important characteristic of both psychopathy and narcissism. This study examined the relationships between grandiosity and each of these personality disorder syndromes, using a novel index, namely the Grandiosity Index. Seventy-five incarcerated males completed clinical interviews of psychopathy and narcissism and a self-report inventory of narcissism and were rated on interpersonal measures of psychopathy and narcissism. Trained research assistants rated participants on the Grandiosity Index. Analyses provided preliminary evidence of construct validity for the index. Scores on the Grandiosity Index were significantly correlated with scores on both clinical and interpersonal measures of psychopathy and narcissism and with self-reported narcissism. Regressions demonstrated that the Grandiosity Index explained substantial unique variance in psychopathy after controlling for scores on narcissism. This study demonstrates that grandiose features are associated uniquely with clinical ratings of psychopathy, though not significantly more with psychopathy than with narcissism.

Clarifying Associations between Psychopathy Facets and Personality Disorders among Offenders.

Purpose: This study examined bivariate, unique, and multivariate associations between psychopathy facets and other Personality Disorders (PDs). Method: 76 incarcerated males were assessed with clinical interviews assessing psychopathy and DSM-5 PDs. Canonical Correlation Analysis (CCA) was used to examine multivariate associations between dimensional scores of psychopathy facets and other PDs. Results: Preliminary analyses of bivariate and partial associations revealed that much of the covariation between psychopathy and PD traits reflected shared variance among psychopathy facets and among PD traits. After controlling for the shared variance, unique relationships were limited to positive relationships between Narcissistic PD and interpersonal facet and between Paranoid PD and antisocial facet ratings. Canonical Correlation Analysis results yielded two pairs of functions that explained the shared variance between psychopathy and PDs. In the first pair of functions, elevations on the interpersonal and antisocial facets were associated with symptoms of Paranoid, Narcissistic, Histrionic, and Antisocial PDs. In the second pair of functions, high levels of the antisocial facet and low levels of the interpersonal facet were related to Borderline PD. Conclusion: Results suggest that associations between psychopathy and DSM-5 PDs go beyond established links with Antisocial and Narcissistic PDs to include associations with Histrionic, Borderline, and Paranoid PDs.