522. Functional Cognitive Disorder w/ Dr. Ryan Van Patten

Would you rather read the transcript? Click here. I had a fascinating conversation with Dr. Ryan Van Patten, board-certified neuropsychologist, podcaster, and researcher, about the increasingly recognized but still misunderstood condition known as Functional Cognitive Disorder (FCD). We unpacked its place within the broader Functional Neurological Disorder (FND) umbrella, explored the core concept of “internal inconsistency” as a positive diagnostic sign, and discussed how clinicians can compassionately assess, diagnose, and treat FCD. We also delved into mechanisms like metacognition, abnormal Bayesian priors, and the nocebo effect. Ryan shared incredibly practical insights for assessment and feedback sessions, along with an honest look at what research and clinical resources are still missing. Topics Covered Why FCD represents the “quintessential neuropsychiatric disorder” The biopsychosocial model and the “Four P’s” of formulation FND vs. malingering: clinical and neurological distinctions Internal inconsistency as a diagnostic hallmark of FCD How to assess FCD using interviews, behavioral observations, and testing Differentiating FCD from MCI and dementia Metacognition, memory perfectionism, and nocebo effects Providing compassionate, validating feedback to clients with FCD Treatment strategies clinicians can use today Research gaps and future directions for the field Resources Mentioned Harriet Ball et al. (2020) – Diagnostic criteria for FCD Navigating Neuropsychology Podcast: FCD w/ Dr. Laura McWhirter – Episode 128 FND w/ Dr. Mark Hallett – Episode 108 Functional Seizures w/ Dr. Curt LaFrance – Episode 112 Persistent Post-Concussive Symptoms w/ Dr. Noah Silverberg – Episode 147 FND Society Education Hub – www.fndsociety.org/fnd-education FND Hope (patient education and advocacy) – www.fndhope.org Functional Neurological Disorder education portal – www.neurosymptoms.org KnowNeuropsych: Functional Neurological Disorders page Reuber et al. (2009) – Biopsychosocial model of FND Teodoro et al. (2023) – Mechanisms of FCD: Metacognition & Expectancy Cabreira et al. (2023) – Systematic review on FCD vs. dementia Cool Things Mentioned The Testing Psychologist mastermind groups and business consulting Featured Resources I am honored to partner with two AMAZING companies to help improve your testing practice! PAR is a long time supporter of the Testing Psychologist podcast, and I will continue to bring you featured items from their catalog! Listen to each episode for specific product recommendations and links. Learn more at www.parinc.com. TherapyNotes is the leading EHR system for mental health practitioners. I’ve used TherapyNotes for over 10 years, and it just keeps getting better. Use this link and the promo code “testing” to get two free months and try it for yourself! www.therapynotes.com/testing The Testing Psychologist podcast is approved for CEU’s!I’ve partnered with At Health to offer CE credits for podcast episodes! Visit this link to access current and past episodes available for CE credit. You can use code “TTP10” for a discount on ALL the course credits you purchase from At Health! About Dr. Ryan Van Patten Ryan Van Patten, PhD is an Assistant Professor at Brown University and a Board Certified Clinical Neuropsychologist at the Providence VA Medical Center in Providence, RI. Ryan is an active researcher, clinician, and educator. As an early career clinical scientist, he has over 60 peer reviewed publications (more than 30 first authored), as well as VA grants, book chapters, and editorial service. His research program focuses on functional neurological disorder, digital neuropsychology, traumatic brain injury, and cognitive rehabilitation. Get in Touch & Resources: E-mail: [email protected] Website: www.navneuro.com 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. Ready to grow your testing services? Click below to schedule a complimentary 30-minute pre-consulting call! Schedule Your Call