Military Forensic Neuropsychological/Psychological Evaluations
Dr. Fabian has specialized training with active military and veteran populations. He completed postdoctoral fellowship training in clinical neuropsychology at the University of New Mexico School of Medicine Center for Neuropsychological Services and Veteran’s Administration Polytrauma Traumatic Brain Injury and PTSD unit. He has extensive training in both the clinical and forensic assessment of PTSD and traumatic brain injury with military populations. As an expert witness forensic neuropsychologist/psychologist, Dr. Fabian has testified in US Marine Corp and US Air Force court martial and administrative separation hearings. Additionally, Dr. Fabian is on faculty at the Center for Forensic Behavioral Sciences at Walter Reed National Military Medical Center.
Dr. Fabian offers the following forensic examinations for military defendants:
- Neuropsychological assessment of PTSD and traumatic brain injury
- Neuropsychological assessment of the effects of drug abuse on brain functioning
- Neuropsychological/psychological assessment in administrative separation hearings
- Neuropsychological/psychological assessment in Courts-Martial trials
- Fitness for duty neuropsychological and psychological evaluations
- Mitigation at sentencing
- Violence risk assessment for sentencing and military parole hearings
- Psychological assessment in child pornography cases
- Expert consultation in sexual assault and UCMJ Article 120 cases
- Records reviews for Military Discharge Review Boards
Neuropsychological assessment of Veterans
When considering neuropsychological assessment of Veterans, the neuropsychologist will evaluate relevant areas:
- Auditory and visual attention.
- Processing speed.
- Verbal/auditory and visual memory.
- Executive functioning (planning, mental set shifting, problem solving, mental flexibility, Disinhibition)
- Visuospatial constructional abilities and sensory perception.
- Language abilities.
- Emotional intelligence.
- PTSD and psychological functioning.
- Cognitive effort.
The brain behavior functions that are affected in PTSD and TBI are often very similar. When considering neuropsychological testing of TBI, obviously the specific area injured in the brain impacts the area of functional deficit. Severe TBI’s involve considerable forces, often through blasts in war producing widespread cellular death and dysfunction with clear global functional consequences. Traumatic brain injury affects the cognitive, emotional, psychological and physical functioning of an individual. Of particular interest is the observation that the orbital prefrontal cortex and related circuitry are vulnerable to damage associated with TBI which likely account for the prevalence of executive deficits after TBI and contributes to the high rates of behavioral and emotional dysregulation. Neuropsychological testing of TBI often indicates deficits in attention, executive functioning and memory loss. Similarly, there is a growing body of evidence that suggests that cognitive alterations occur in PTSD patients. Individuals with PTSD often perform less proficiently on learning and memory tasksxvi with impairments more frequently found in the verbal memory domain. Attention and executive functioning impairments are often indicated in those with PTSD. PTSD is characterized by impaired executive dyscontrol including increased perseveration and poor inhibition of inappropriate responses. Veterans often perform more poorly on continuous performance tasks that measure sustained visual attention as well as on tasks of working memory.
Violence in Veterans
Veterans returning from deployment are at risk to have a number of risk factors related to psychosocial adjustment and potential future violence:
- Histories of childhood abuse and neglect.
- Lower socioeconomic status.
- Potential lower levels of intelligence.
- Histories and current status of substance abuse and dependence.
- Prevalence of mental health issues including PTSD, depression, suicidal and paranoid thinking.
- History of TBI and other medical problems.
- Frequent history of exposure to and proficiency in weapons.
- Prevalence of social isolation and interpersonal/marital dysfunction when returning from war.
- Unemployment and homelessness.