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Today, I get to have a conversation with clinical neuropsychologist Dr. Alison Buchholz to explore the complex, rapidly evolving landscape of Functional Neurological Disorder. We discuss the critical historical context of FND, moving past outdated psychoanalytic models and confronting the problematic dualism that traditionally separates neurology from psychiatry in brain science. Dr. Buchholz shares clinical insights into identifying the positive diagnostic signs of FND subtypes, navigating the nuances of performance validity testing, and understanding why comprehensive neuropsychological evaluations are so vital. We also delve into practical strategies for delivering therapeutic feedback to patients, implementing multidisciplinary reprogramming treatments, and building robust, collaborative care pathways across various clinical settings.

Key Moments

02:29: The historical evolution of Functional Neurological Disorder and legacy of clinical misunderstandings
05:40: Deconstructing the false dichotomy between neurological and psychiatric frameworks in brain science
12:17: Categorizing the main clinical presentations of FND and navigating symptom heterogeneity
13:32: Evaluating diagnostic criteria discrepancies between the DSM-5-TR and ICD-11
16:55: Differentiating Functional Neurological Disorder from malingering and factitious disorders
21:31: Advanced neuroimaging insights and altered neural network connectivity hubs in the brain
24:47: Identifying positive clinical signs across functional seizure, movement, and cognitive subtypes
41:11: Navigating performance validity testing failures and internal inconsistency during evaluations
54:32: Implementing multidisciplinary reprogramming therapies and evidence-based neurobehavioral protocols
01:03:05: Strategies for program building, care pathways, and accessing professional training resources

Cool Things Mentioned

Craft: the premier membership community for testing psychologists
Crafted Practice: the only in-person business retreat for testing psychologists
Reverb: the premier AI-powered report-writing platform for testing psychologists
Functional Neurological Disorder Society: www.fndsociety.org
FND Hope Patient and Caregiver Resources: https://fndhope.org/resources/
American Academy of Neurology Functional Seizure Management Guidelines: www.aan.com
Taking Control of Your Seizures Workbook: Buy here
American Academy of Clinical Neuropsychology: www.theaacn.org

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About Dr. Alison Buchholz

Alison Buchholz, PhD, is an Assistant Professor at Johns Hopkins University, School of Medicine with appointments in psychiatry and behavioral sciences and neurology. Dr. Buchholz works as a neuropsychologist at Johns Hopkins Hospital in Baltimore, MD, where she leads the adult epilepsy neuropsychology service. She is a founding member of the Functional Neurological Disorder (FND) Society and founded and co-directs the Johns Hopkins FND program.

Get in touch:

Email: abuchho1@jh.edu
Website: https://www.hopkinsmedicine.org/neurology-neurosurgery/specialty-areas/fnd-program

About Dr. Jeremy Sharp

I’m a licensed psychologist and Clinical Director at the Colorado Center for Assessment & Counseling, a private practice that I founded in 2009 and have grown to over 20 clinicians. I earned my undergraduate degree in Experimental Psychology from the University of South Carolina before getting my Master’s and PhD in Counseling Psychology from Colorado State University. These days, I specialize in psychological and neuropsychological evaluation with kids and adolescents.

As the host of the Testing Psychologist Podcast, I provide private practice consulting for psychologists and other mental health professionals who want to start or grow psychological testing services in their practices. I live in Fort Collins, Colorado with my wife (also a therapist) and two young kids.

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