ABSTRACT
This chapter attempts to deconstruct the meanings of diagnosis in a neuropsychological context and to recognize the multiple meanings of diagnosis and learn to distinguish the appropriate clinical strategy and pitfalls of each approach. It also attempts to guide the student and practitioner into a general clinical approach to patient examination. The greatest risk for neuropsychologists who perform descriptive diagnosis is confirmatory bias—assuming both the validity of the working diagnosis and the imprimatur to "measure" it. Neuropsychological reports that require domain-specific differential diagnosis should outline the factual basis for concluding that a particular pattern of test results and history can be differentially diagnosed. The next layer of neuropsychological diagnostic inference, multidomain neuromedical diagnosis, includes the influence of psychiatric disorder, both active and historical. The final layer of diagnostic consideration differential forensic biopsychosocial diagnosis includes a culture-fair biopsychosocial assessment as to how a particular diagnosis may be shaped by the patient's culture, language facility, societal differences, and attitude toward the examination.
