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The Clinical Neuropsychologist
ISSN: 1385-4046 (Print) 1744-4144 (Online) Journal homepage: https://www.tandfonline.com/loi/ntcn20
Shift happens: the gender composition in clinical
neuropsychology over five decades
Martin L. Rohling, Rebecca E. Ready, Lindsay Y. Dhanani & Julie A. Suhr
To cite this article: Martin L. Rohling, Rebecca E. Ready, Lindsay Y. Dhanani & Julie A. Suhr
(2020): Shift happens: the gender composition in clinical neuropsychology over five decades, The
Clinical Neuropsychologist, DOI: 10.1080/13854046.2020.1778791
To link to this article: https://doi.org/10.1080/13854046.2020.1778791
Published online: 30 Jun 2020.
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Shift happens: the gender composition in clinical
neuropsychology over five decades
Martin L. Rohlinga
, Rebecca E. Readyb
, Lindsay Y. Dhananic
and Julie A. Suhrc
a
Psychology Department, University of South Alabama, Mobile, Alabama, USA; b
Psychological and
Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA; c
Psychology
Department, Ohio University, Athens, Ohio, USA
ABSTRACT
Objective: The current study utilizes five decades of data to dem-
onstrate cohort differences in gender representation in govern-
ance, speaking at conferences, serving on editorial boards, and in
scholarly productivity in clinical neuropsychology. Broadly examin-
ing gender disparities across domains of professional attainment
helps illuminate the areas in which inequity in clinical neuro-
psychology is most pronounced and in need of ameliora-
tive resources.
Methods: Data from 1967 to 2017 were coded from publicly
available information from the four major professional associa-
tions for clinical neuropsychology in the U.S. (i.e. INS, AACN, NAN,
& SCN). Gender differences were examined in (1) speaking at a
national conference, (2) holding an office in a professional organ-
ization, (3) serving on the editorial team for a journal affiliated
with a professional organization, and (4) scholarly activity as
coded from Google Scholar.
Results: The percentage of men in the field significantly declined
across time, whereas the percentage of women significantly
increased; the number of women exceeded the number of men
in approximately 1992. Gender differences in conference speakers,
editorial board members, and research citations were greater in
the earlier than in more recent cohorts of clinical neuropsycholo-
gists but gender inequity in conference speaking and editorial
activities is evident in the most recent cohorts.
Discussion: Gender differences in conference speakers, editorial
board members, and in earning research citations have dimin-
ished over time, but early career women still face disadvantages
in speaking at conferences and serving on editorial boards. We
provide strategies to increase and sustain women’s participation
in leadership in neuropsychology.
ARTICLE HISTORY
Received 10 March 2020
Accepted 29 May 2020
Published online 30 June
2020
KEYWORDS
Gender; sex; bias;
leadership; neuropsychology
The majority of clinical neuropsychologists are women (Sweet et al., 2015). Likewise, in
the field of psychology, women outnumber men 2:1 with regard to active psycholo-
gists in the workforce (Center for Workforce Studies, 2015). Women gained visibility as
CONTACT Martin L. Rohling mrohling@southalabama.edu Department of Psychology, 1000 UCOM, University
of South Alabama, Mobile, AL 36688, USA
ß 2020 Informa UK Limited, trading as Taylor & Francis Group
THE CLINICAL NEUROPSYCHOLOGIST
https://doi.org/10.1080/13854046.2020.1778791

their representation grew, but women have not reached parity with men in leadership
positions and other indicators of scholarly recognition in psychology (American
Psychological Association, 2006; Gregor & O’Brien, 2015). Although there are compel-
ling data that similar gender inequities exist in clinical neuropsychology (Sachs et al.,
2018; Sweet et al., 2018), there has not yet been a systematic attempt to summarize a
broad range of indicators of gender disparity across the lifetime of the field.
Information about gains across time for women in professional attainment would indi-
cate whether there has been progress toward the amelioration of gender disparities as
well as illuminate the areas in which the field should focus resources to correct the
most egregious gender imbalances.
The aim of the current study is to report five decades of data from clinical neuro-
psychology organizations pertaining to women’s attainment in speaking at conferen-
ces, serving in governance, serving on editorial teams, and research productivity. Data
were gathered from the four major neuropsychological associations in the United
States (i.e. the American Academy of Clinical Neuropsychology [AACN], the
International Neuropsychological Society [INS], National Academy of Neuropsychology
[NAN], and the American Psychology Association’s [APA] Society for Clinical
Neuropsychology/Division 40 [SCN]). Our study builds on recent publications about
persistent and substantive gender differences in wages and appointments to elected
governance positions in the field of neuropsychology (Sachs et al., 2018; Sweet et al.,
2018) by looking at a broader set of indicators of professionals attainment to provide
a more holistic understanding of the barriers women may face in the field.
Women in STEM and academic medicine
Data pertaining to women’s leadership within STEM fields and academic medicine
place the field of clinical neuropsychology in context and help identify which trends
in gender parity in neuropsychology are unique and which reflect broader demo-
graphic patterns in STEM. Although women’s representation has increased over time
across STEM fields, women lag behind men in most disciplines (National Science
Foundation, 2020). As of 2014, women earned 41% of the doctoral degrees awarded
in STEM, but occupied less than 30% of all STEM positions and represented 28% of
tenure-track faculty within STEM. Women comprised roughly 30% of doctoral gradu-
ates in economics, mathematics, and statistics, and 20% or less of doctoral graduates
in computer science and physics. These data confirm that women in STEM remain in
the numeric minority. Qualitative data indicate that women in STEM face barriers to
leadership, including gender bias, lack of social capital, and limited opportunities for
advancement (Amon, 2017).
Data from academic medicine reveal similar trends. Demographic reports from the
Association of American Medical Colleges (AAMC) indicate that from 2006-2019, male
graduates from medical school only slightly outnumbered females (AAMC, 2020a).
Data from AAMC data also indicate that women advance to the highest faculty ranks
at lower rates than men. In 2018, there were fewer female full professors in medical
schools, whereas for instructors, which represents the lowest faculty rank, women out-
numbered men (AAMC, 2020b). Further, female physicians have lower salaries than
2 M. L. ROHLING ET AL.

men, even after controlling for age, specialty, faculty rank, and research productivity
(Jena et al., 2016) and women are proportionately underrepresented on editorial boards
in dentistry (Ioannidou & Rosania, 2015) and medicine (Morton & Sonnad, 2007).
Women in psychology
As noted earlier and counter to trends in other STEM fields, women have seen a dra-
matic rise in representation in psychology. In 1950, only 15% of doctoral degrees in
psychology were earned by women (American Psychological Association, 2006). Since
1984, women have outpaced men in earning doctoral degrees in psychology. By 2017,
approximately 74% of doctoral degrees in psychology were earned by women and
this number is expected to hold firm (American Psychological Association, Committee
on Women in Psychology, 2017). The number of degrees earned by women in clinical
psychology similarly skyrocketed. From 1990 to 2012, female doctorates in clinical
psychology rose by 20%, whereas degrees awarded to men fell by 47%. Indeed, in
2016 women earned nearly 77% of doctorates in clinical psychology.
As women’s representation in psychology increased, women occupied more leadership
positions. The percentage of women editors of journals published by the APA
Publications and Communications Board rose from 4% in 1979 to 28% in 2005 (American
Psychological Association, 2006) and to 50% in 2018 (personal communication from Rose
Sokol-Chaang, APA Council of Editors, January 2018). Although these data are encourag-
ing, data from the 2017 APA Committee on Women in Psychology Task Force Report indi-
cate that women have made inconsistent gains in APA editorial board representation
(American Psychological Association, Committee on Women in Psychology, 2017). More
specifically, declines in the number of women editors-in-chief and action editors began in
2011 and by 2013 they had dropped to nearly the same levels seen in 1995.
There has not been an equitable gender representation in honors or in leadership
positions in psychology (American Psychological Association, 2006; Gregor & O’Brien,
2015). For example, in 1988, 18% of APA fellows were women, which increased to
26% in 2005 (American Psychological Association, 2006) but was only 32% in 2013
(American Psychological Association, Committee on Women in Psychology, 2017). The
percent of women on the APA Council of Representatives in 1975 was 20%, which
increased to only 49% in 2005. Women are also underrepresented in faculty ranks; in
2013, women represented 46% of psychology faculty despite representing a numerical
majority in the field (Center for Workforce Studies, 2015). Further, female psychologists
earn less than their male counterparts. To illustrate, a comparison of psychologists
working in health service settings found that women earn an average of $39,648 less
than men (American Psychological Association, 2014). More positively, the percent of
women on the APA Board of Directors rose from 0% in 1975 to 38% in 2005 to 62.5%
in 2019, representing one of the strongest gains for women over time (American
Psychological Association, 2019).
Women in clinical neuropsychology
The number of female doctoral program graduates who specialize in clinical
neuropsychology is not known, but female neuropsychologists represent 77% of
THE CLINICAL NEUROPSYCHOLOGIST 3

postdoctoral trainee status (Sweet et al., 2015). There was a rise in women’s member-
ship in SCN from 1995 (36%) to 2005 (58%). However, women in neuropsychology
have not gained parity with men in earnings (Sweet et al., 2018). Additionally, in data
from 1997-2015, gender disparities were evident in the proportion of women who
held elected and appointed upper-level leadership positions in neuropsychological
organizations, among fellows of SCN and NAN, and on editorial boards of a broad
range of neuropsychology journals (Sachs et al., 2018). Whereas the number of female
fellows in SCN/Division 40 rose from 1997 (23.2%) to 2015 (30.8%), female fellows in
NAN saw little growth from 2002 (19%) to 2014 (22%). Further, women held approxi-
mately 33% of consulting or associate editor positions for fifteen major neuropsych-
ology journals and were 20% of the editors-in-chief. Sachs et al. (2018) concluded that
these numbers do not reflect the proportional representation of women in clinical
neuropsychology.
Encouragingly, women are gaining ground in some areas of leadership in clinical
neuropsychology. Women are also generally well represented (50%) as training direc-
tors of internship and postdoctoral programs and women in leadership in AACN is
relatively robust (Sweet et al., 2018).
The current study
With some exceptions, there are indications in STEM, academic medicine, psychology,
and clinical neuropsychology that women have not gained parity with men in leader-
ship. Two recent seminal publications in clinical neuropsychology - reviewed above -
analyzed women’s representation in the field, election to boards of directors, editorial
memberships, fellow status, directorships of training programs, board certification
rates (Sachs et al., 2018), and pay disparities (Sweet et al., 2018). The goal of the pre-
sent study was to build on this work. We provide a comprehensive analysis of the
gender composition of leadership in the field of clinical neuropsychology with regard
to four outcomes, two of which have been the focus of previous research [i.e. organ-
izational office holder, editorial board member in Sachs et al. (2018)] and two which
have not (i.e. organizational conference speaker, research citations). Our data also
extend further back into the history of clinical neuropsychology than previous work to
provide a deeper understanding of the trends in gender disparities across time. We
coded and analyzed five decades of historical documents from INS, AACN, NAN, and
SCN - as well as scholarly activity coded from Google Scholar - to obtain data pertain-
ing to the interface of gender and influence in the field. These data, in combination
with past work, will enable the field to take actions to reduce gender disparities in
leadership where they are most needed.
Methods
Sample
The sample included 3,422 unique individuals who were listed as a speaker for any
type of invited or submitted presentation (e.g. presidential addresses, keynote speak-
ers, plenum speakers, workshop leaders, members of a symposium, panel discussions)

at a conference of any of the four organizations during their history; poster presenta-
tions did not qualify. Gender was coded as male or female based on name, personal
acquaintance, search of social media accounts (e.g. Facebook, LinkedIn, Research Gate,
Institutional Website, etc.), and/or consultation with colleagues in the field. These sour-
ces did not reveal any participants who identified as gender nonbinary or third gen-
der, but should we have been made aware of someone with one of these gender
identities, we would have created separate codes for these cases.
The data were coded for a 50-year period ranging from 1967 (i.e. when INS was
founded) to 2017. As each of the other organizations were formed, their data were
added to the database, such that data from NAN were available from 1973 to 2017,
SCN data were coded from 1975 to 2017, and data from AACN spanned 1997 to 2017.
Analyses were conducted by dividing the sample into five 10-year cohorts. Each par-
ticipant is a member of only one cohort and cohort membership is based on the date
of first scholarly activity from the Publish or Perish software, which uses Google
Scholar as its search engine (Harzing, 2007).
Procedure
Historical documents from INS, NAN, SCN, and AACN were reviewed and data were
coded and analyzed by the first author, using methods from existing analytic
approaches for coding historical records (Kornblith, 2002; Napoli, 2014). Data were
coded into four domains that are used to evaluate persons in academia for tenure
and promotion: (1) conference speaker; (2) organizational office holder; (3) editorial
board member; and (4) research citations. Data collection and coding involved fre-
quent consultation with colleagues within the specialty for guidance and recommen-
dations as to how best to address data collection, data analyses, and/or spotting
errors in the data. Data collection required an exhaustive search of published journals,
conference brochures, professional newsletters, minutes of organizational meetings,
historical references in textbooks, and journal articles.
Conference speaker
Each organization holds an annual conference. Speakers may be invited or selected
from a pool of competitive submissions. Three variables were coded for the speaking
domain: (1) the number of times an individual presented (i.e. speaking epochs), (2) the
order of speaking when more than one person was presenting (e.g. speaking order),
and (3) total time presenting. Points were weighted for speaking epochs and speaking
order such that: (a) a solo presenter or leader of a workshop earned 7 points, (b) two
presenters earned 4 points each, (c) for three presenters, the first presenter was
awarded 4 points and the second and third presenters earned 3 points each, and (d)
for four or more presenters, the first presenter was awarded 4 points, the second pre-
senter was awarded 3 points, the third and fourth presenters earned 2 points, and any
subsequent presenters were awarded 1 point each. The coding system was developed
and implemented by the first author based on professional experience and consult-
ation with senior colleagues in the field.

For total time presenting, the time allotted to present was divided proportionally by
the total number of speakers. For example, if a presentation was allotted a 3-hour
time slot and only one person spoke, the presenter was awarded the full 3 hours.
However, if a presentation was allotted a 3-hour time slot and there were three pre-
senters, each was awarded 1 hour of time. The mean correlation between the speaking
measures (i.e. points, time, and frequency) equaled .92. Due to the high correlations
between speaking measures, we report results of analyses using the points system as
the best single measure of influence for a conference speaker.
Office holder
Coding of leadership was primarily based on elected office (i.e. president-elect, president,
past president, treasurer, secretary, members-at-large), with a few appointed positions that
we considered significant (i.e. executive director, director of publications, director of con-
tinuing education, and program chair). Points were awarded as follows: (1) the president
was awarded 7 points for each year of service; (2) past presidents and president-elect
were awarded 5 points for each year of service;1
(3) treasurer and secretary were awarded
4 points for each year of service; (4) members-at-large and the executive director were
awarded 3 points for each year of service; (5) chairs of the continuing education commit-
tee and publication committee were awarded 2 points for each year of service; and, (6)
the conference program chair was awarded 1 point for each year of service. The mean
correlation amongst the four office holder measures (i.e. highest office, number of offices,
years in office, and points for office holding) equaled .95. Due to the high correlations
amongst the four office holder measures, we report results of analyses using the points
system as the best single measure of influence for an office holder.
Editorial board member
Editorial board service was coded for journals associated with each organization. The
official journal for the International Neuropsychological Society (INS) is the Journal of
the International Neuropsychological Society (JINS). The official journal of the National
Academy of Neuropsychology (NAN) is Archives of Clinical Neuropsychology (ACN). The
American Psychological Association, home of SCN, publishes Neuropsychology (NP).
Finally, the official journal for AACN is The Clinical Neuropsychologist (TCN). Points were
awarded for editor-in-chief (7 points), associate editors (4 points for each year of ser-
vice), section editors (e.g. those in charge of book reviews or forensic rounds, 2 points
for each year of service), and members of the editorial board who held no specific
office (1 point for each year of service).
Four metrics were coded for this domain, which included highest editorial office
held, number of unique editorial positions, and total number of years in which a person
held an editorial position. The mean correlation amongst the four office holder meas-
ures equaled .90. Due to the high correlations amongst these four measures, we report
results of analyses using the points system as the best single measure for this domain.
Research citations
To rate scholarly productivity, five metrics were coded from Publish or Perish (PoP)
software, which relies on the search engine Google Scholar: (1) total number of years

of publishing; (2) number of publications listed; (3) number of citations for all publica-
tions located; (4) the h-index; and (5) the g-index. The h-index is used by institutions
of higher education to assist them in evaluating faculty for tenure and promotion; it is
an omnibus measure of scholarly productivity and is defined as “the number of papers
with citation number higher or equal to h” (Hirsch, 2005). The g-index reflects the
overall frequency of citation for all publications of a scholar (Egghe, 2006).
The number of publications, number of citations, the h-index, and the g-index were
correlated an average of .89; the h-index and g-index alone were correlated .98. Thus,
the indices were assumed to be measuring a single construct. We chose the h-index
for analyses of scholarly productivity, due to its familiarity to many readers.
Analyses
To determine the degree to which there is gender bias in leadership and influence in
clinical neuropsychology over a 50-year period, we conducted a series of 2 (gender)
by 5 (cohort) ANOVAs on each of our four leadership and influence metrics. We report
the effect size of gender effects on our outcomes for the entire study period, as well
as by cohort.
Results
Gender distribution in clinical neuropsychology
The percentage of men represented in our database significantly declined across time,
while the percentage of women has significantly increased across time, Chi2
¼ 251.47,
p .0001 (Table 1, Figure 1). The number of women first exceeded the number of
men in approximately 1992. Women’s representation continued to grow and the num-
bers of women in the last 10-year period is 1.94 times the number of men.
Table 1. The number and percentage of men and women in the sample grouped into 10-year
cohort blocks.
Cohort 10-Year Blocks
Men Women
Totals
n %a
n %a
N %b
Years ¼ 1977 354 75.6 114 24.4 468 13.7
Years ¼ 1978 – 1987 382 59.5 260 40.5 642 18.8
Years ¼ 1988 – 1997 408 49.9 410 50.1 818 23.9
Years ¼ 1998 – 2007 332 39.2 516 60.8 848 24.8
Years ¼ 2008 - 2017 220 34.1 426 65.9 646 18.9
Mean – All Years 1,696 49.6 1,726 50.4 3,422 100.0
Notes: Participants were speakers at International Neuropsychological Society (INS), the American Academy of
Clinical Neuropsychology (AACN), the National Academy of Neuropsychology (NAN), and/or the Society of Clinical
Neuropsychology (SCN) from 1967 to 2017. Cohort assignment was made based on year of first scholarly activity.
a
Data in the % columns under the headings Men and Women are the percentage of participants by gender within
a cohort.
b
Data in the % column under the heading Total are marginal means. Thus, the percentages listed for a cohort is
based on the entire sample.

Figure 1. Regression percentage of gender onto time (years divided into 10-year blocks): Panel A
shows results from the entire sample. Panel B presents results separately by gender based on the
sample of men and women from a cohort.
Notes: Participants are placed in a 10-year cohort blocks based on first year of scholarly activity.
The sample was divided by into men and women.

Conference speaker
A two (gender) by five (cohort) ANOVA on speaking points found a main effect for
gender, F(1, 3410) ¼ 14.50, p .001, a main effect of cohort, F(4, 3410) ¼ 25.36, p
.0001, and a significant interaction between gender and cohort, F(4, 3410) ¼ 3.05, p
.05 (Table 2, Figure 2). For the entire sample, a Cohen’s d effect size of -0.26 was
found for gender in a direction that favored men. The interaction reflects less influ-
ence of gender on speaking points across more recent cohorts. We probed this inter-
action further by examining the gender differences for each cohort. Curiously, in the
earliest cohort, there was no evidence of gender bias. In all of the remaining cohorts,
however, men earned more speaking points than women. The magnitude of the male
advantage has notably declined in the most recent two cohorts, reducing from a gen-
der difference of -.31 in the 1998-2007 cohort to a difference of -.17 in the final cohort
(i.e. 2008-2017). When taken together, these findings suggest that gender differences
are waning, but women are still underrepresented among conference speakers.
Office holder
For office holders, a two (gender) by five (cohort) ANOVA revealed a main effect of gen-
der favoring men, F(1, 3411) ¼ 7.75, p .01, and a main effect of cohort, F(4, 3411) ¼
38.72, p .0001 (Table 3, Figure 3). The interaction between gender and cohort was
not significant, F(4, 3411) ¼ 2.15, p ¼ .073. Cohen’s d effect size for gender independent
of cohort was -0.22 and thus reflects a bias toward male representation in office holders.
In the earliest three cohorts, when men outnumbered women and men garnered more
points for holding office. Notably, though the interaction was not significant, the
Cohen’s d for the two most recent cohorts were positive and thus in favor of women.
In a two (gender) by five (cohort) ANOVA, there was a main effect of gender, F(1,
3411) ¼ 17.09, p .0001, a main effect of cohort, F(4, 3411) ¼ 55.94, p .0001, and a
significant interaction between gender and cohort for editorial board membership,
F(4, 3411) ¼ 3.20, p .05 (Table 4, Figure 4). Independent of cohort, Cohen’s d effect
Table 2. Descriptive statistics for participants’ points earned for being a conference speaker,
which were divided by gender and grouped into 10-year cohort blocks.
Men Women Total
n M SD %Ptsa
n M SD %Ptsa
n ES %Ptsb
Years ¼ 1977 354 9.23 26.10 75.9 114 9.08 14.89 24.1 467 -.01 30.6
Years ¼ 1978 – 1987 382 11.52 20.51 71.3 260 6.80 12.61 28.7 642 -.31 33.2
Years ¼ 1988 – 1997 408 8.57 16.41 62.6 410 5.09 9.03 37.4 817 -.29 26.4
Years ¼ 1998 – 2007 332 4.89 7.78 45.4 516 3.78 7.14 54.6 849 -.18 13.6
Years ¼ 2008 – 2017 220 2.67 2.86 38.2 426 2.23 3.28 61.8 647 -.17 5.2
Mean or Total All Yrs 1,696 7.89 17.97 63.2 1,726 4.51 8.90 36.8 3,422 -.26 100.0
Notes: Points were awarded based on the type of conference presentation at the International Neuropsychological
Society (INS), the American Academy of Clinical Neuropsychology (AACN), the National Academy of Neuropsychology
(NAN), and/or the Society of Clinical Neuropsychology (SCN) from 1967 to 2017.
a
Data in the %Pts columns under the headings Men and Women are the percentage of points earned by each gen-
der within a cohort.
b
Data in the %Pts column under the heading Total are marginal means. Thus, the percentages listed for a cohort is
based on the total number of conference speaker points earned by the entire sample.

size for gender equaled -0.31. An examination of the interaction suggests that the
gender differences in editorial board membership have declined across cohorts. The
most pronounced change in gender differences was found for the final cohort, in
which Cohen’s d was -0.03, indicating a smaller effect of gender than for any other
cohort. However, there is evidence of disproportionate under representation of women
in editorial positions. For example, in the first cohort, when men outnumbered
women, men earned more editorial board points than women. In contrast, in the most
Figure 2. ANOVA results bar graph showing the mean of participants’ points earned for conference
speaking divided by gender and grouped into 10-year cohort blocks.
The sample was divided by into males and females.
Table 3. Descriptive statistics for participants’ points earned for being an office holder, which
were divided by gender and grouped into 10-year cohort blocks.
Men Women Total
n M SD %Ptsa
n M SD %Ptsa
n ES %Ptsb
Years ¼ 1977 354 11.56 28.50 82.0 114 7.86 17.41 18.0 467 -.15 49.8
Years ¼ 1978 – 1987 382 5.06 18.05 73.2 260 2.72 10.08 26.8 642 -.17 26.4
Years ¼ 1988 – 1997 408 2.44 9.62 61.0 410 1.55 6.93 39.0 817 -.13 16.3
Years ¼ 1998 – 2007 332 .69 3.59 32.5 516 .92 6.00 67.5 849 .10 7.0
Years ¼ 2008 – 2017 220 .02 .27 7.9 426 .12 1.13 92.1 647 .54 .5
Notes: Points were awarded for elected and select appointed offices for the International Neuropsychological Society
(INS), the American Academy of Clinical Neuropsychology (AACN), the National Academy of Neuropsychology (NAN),
and/or the Society of Clinical Neuropsychology (SCN) from 1967 to 2017.
a
b
Data in the %Pts column under the heading Total are marginal means. Thus, the percentages listed for a cohort
are based on the total number of offices holder points earned by the entire sample.

recent cohort, in which women outnumber men by almost 2:1, the two genders
earned the same average number of editorial membership points.
Research citations
For the ANOVA on research citations, there was a main effect of gender, F(1, 3412) ¼
59.81, p .0001, a main effect of cohort, F(4, 3412) ¼ 267.07, p .0001, and a
Figure 3. ANOVA results bar graph showing the mean of participants’ points earned for organiza-
tional leadership divided by gender and grouped into 10-year cohort blocks.
Table 4. Descriptive statistics for participants’ points earned for being an editorial board member,
which were divided by gender and grouped into 10-year cohort blocks.
Men Women Total
n M SD %Ptsa
n M SD %Ptsa
n ES %Ptsb
Years ¼ 1977 354 10.99 23.04 80.9 114 8.04 17.95 19.1 467 -.14 46.6
Years ¼ 1978 – 1987 382 6.54 16.60 77.3 260 2.82 7.74 22.7 642 -.29 31.4
Years ¼ 1988 – 1997 408 2.47 7.51 61.5 410 1.54 6.18 38.5 817 -.17 15.9
Years ¼ 1998 – 2007 332 .99 4.79 63.9 516 .36 1.96 36.1 849 -.21 5.0
Years ¼ 2008 – 2017 220 .20 1.50 37.8 426 .17 1.17 62.2 647 -.03 1.1
Notes: Editor board members for the Journal of the International Neuropsychological Society (JINS), The Clinical
Neuropsychologist (TCN), the Archives of Clinical Neuropsychology (ACN), and the American Psychological
Association’s journal Neuropsychology (NP) from 1967 to 2017 were awarded points based on position of influence.
a
b
Data in the %Pts column under the heading Total are the marginal means. Thus, the percentages listed for a cohort
are based on the total number of editorial board points earned by the entire sample.

significant gender by cohort interaction, F(4, 3412) ¼ 5.53, p .001 (Table 5,
Figure 5). The Cohen’s d effect size for gender independent of cohort equaled -0.54,
which is in the direction of favoring men and was the largest of the effect sizes across
the four domains. Cohen’s d for the most recent cohort was 0.08, which is in the direc-
tion favoring women. Examining how gender differences changed across cohorts, we
find that gender differences were relatively stable across the first four cohorts, but
showed a small advantage in favor of women in the final cohort.
Figure 4. ANOVA results bar graph showing the mean of participants’ points earned for being edi-
torial board members divided by gender and grouped into 10-year cohort blocks.
Table 5. Descriptive statistics for participants’ points earned for research citations, which were
divided by gender and grouped into 10-year cohort blocks.
Men Women Total
n M SD %Ptsa
n M SD %Ptsa
n ES %Ptsb
Years ¼ 1977 354 44.18 33.05 80.2 114 33.77 26.50 19.8 467 -.31 26.2
Years ¼ 1978 – 1987 382 37.12 28.31 64.5 260 29.98 24.95 35.5 642 -.25 29.6
Years ¼ 1988 – 1997 408 29.04 24.87 58.5 410 20.50 17.67 41.5 817 -.37 27.2
Years ¼ 1998 – 2007 332 15.25 13.72 46.9 516 11.11 12.64 53.1 849 -.34 14.5
Years ¼ 2008 – 2017 220 2.74 4.36 32.0 426 3.01 5.20 68.0 647 .08 2.5
Mean/Total – All Yrs 1,696 27.92 28.00 63.6 1,726 15.67 19.28 36.4 3,422 -.54 100.00
Notes: Results citations – from 1967 to 2017- were represented by the h-index.
a
b
Data in the %Pts column under the heading Total are the marginal means. Thus, the percentages listed for a cohort
are based on the total number of professional publication points earned by the entire sample.

Summary
Our findings show that, overall, men seemed to be advantaged across all four domains
of professional attainment examined in this study. Further, there were significant inter-
actions of gender and cohort for conference speaker, editorial board member, and
research citations, indicating that disparities in gender representations in these three
areas significantly decreased over time. However, in the most recent cohort, women
remain underrepresented in speaking at conferences and in editorial board member-
ship. Conference speaking is the area in which the most recent cohort has the largest
effect size difference in favor of men over women.
Discussion
Five decades of data were analyzed to determine the gender composition of leader-
ship and influence in clinical neuropsychology. Our results add to previous research
about women’s representation in the field that focused on election to board of direc-
tors, editorial memberships, fellow status, directors of training programs, board certifi-
cation rates (Sachs et al., 2018), and pay disparities (Sweet et al., 2018). We extend this
prior work by including previously unexamined indicators of professional attainment,
including research productivity, and speaking at conferences, and utilize data for the
entire lifespan of the professional organizations in clinical neuropsychology. Using
archival data from over five decades, we found that women neuropsychologists
Figure 5. ANOVA results bar graph showing the mean of participants’ points earned for research
citations divided by gender and grouped into 10-year cohort blocks.

outnumbered men since 1992 and that the number of women in the last 10-year
period is almost double the number of men. Our findings pertaining to women’s suc-
cesses as conference speakers, office holders, editorial board members, and in garner-
ing research citations must be considered in light of this gender shift – from male to
female dominated – in later cohorts.
Over the past five decades, women have been under-represented as conference
speakers, office holders, editorial board members, and in earning research citations.
Despite some signs that gender differences have changed over time for some of our
outcomes, women were underrepresented in all four outcomes for the earliest three
to four cohorts. In the most recent cohort, we see more equitable gender representa-
tion in office holders and in editorial board members and an advantage for women in
research citations. These data from the most recent cohort could indicate more gender
equality in influential positions in clinical psychology or they could mean that gender
differences have not had sufficient time to develop. Our cross-sectional data cannot
identify trends over time, but the results offer cautious optimism for the future of clin-
ical neuropsychology with regard to women in leadership. We address the implications
of these data for career advancement of women in neuropsychology and provide
strategies to increase gender equity in leadership within clinical neuropsychology.
Conference speaker
Our data are unique in measuring conference speakers at major neuropsychology con-
ferences for women and men. Conference speaking is vital for networking and career
development (Casadevall, 2015; Johnson et al., 2017). We found evidence of persistent
gender differences that favored men in conference speaking across all five cohorts
although the size of the difference decreased in the most recent cohorts. Thus, despite
women’s sizable gains in representation in the field of clinical neuropsychology, they
have not yet reached parity with men in this domain. Indeed, the largest gender dispar-
ity in favor of men in the most recent cohort across our four outcomes was for confer-
ence speakers. Our findings comport with those from other disciplines because women
were likewise underrepresented as conference speakers in social and personality psych-
ology from 2003-2015 (Johnson et al., 2017) and in primatology from 1992-2012 (Isbell
et al., 2012). Deliberate steps are needed by leaders in clinical neuropsychology to pro-
mote and facilitate more women speakers at conferences; we review strategies to facili-
tate women in leadership below.
Office holders
We found that there was not a significant pattern for women in more recent cohorts
to have different representation in governance than women in earlier cohorts.
However, the gender effect for the two most recent cohorts is trending to favor
women. Thus, women who entered the field in more recent decades have greater
average leadership points in comparison to men who entered the field at the same
time, although the interaction between cohort and gender was not significant. Our
data are somewhat similar to those reported by Sachs et al. (2018), who charted

uneven gains over time for women in governance for INS, SCN, NAN, and AACN.
Continued efforts toward gender parity in leadership and governance are warranted.
We might seek guidance from other organizations who have a strong representation
of women leaders. For example, women currently hold 63% of the seats on the APA
Board of Directors (American Psychological Association, 2019), a sizeable increase from
0% in 1975 and 38% in 2005 (American Psychological Association, 2006).
The gender gap for editorial service was the largest overall effect size difference in the
study. Although gender bias in editorial service decreased from later to more recent
cohorts, there was a slight advantage for men found even in the most recent cohort.
Gender disparities on editorial boards are widespread in our field and in academic medi-
cine. Sachs et al. (2018) found gender disparities in the proportion of women on editor-
ial boards and their study, which included a broader range of neuropsychology journals
but covered a shorter time span. They found that women held approximately 33% of
consulting or associate editor positions and approximately 20% of editor-in-chief posi-
tions across fifteen major neuropsychology journals. Our data also align with findings
from medicine that show underrepresentation of women editors (Ioannidou Rosania,
2015; Morton Sonnad, 2007). For APA journals, women’s representation on APA editor-
ial boards has generally grown over time, but there were notable set-backs in 2011-
2013 (American Psychological Association, Committee on Women in Psychology, 2017).
Research citations
Women in early cohorts of clinical neuropsychology achieved less research productiv-
ity than men. In the most recent cohort, the gender balance slightly favored women,
and indeed, gender representation in scholarly productivity across cohorts was signifi-
cantly different. Though these data may suggest that there is a trend toward gender
equality in the most recent cohort, all previous cohorts evidenced advantages in favor
of men that were relatively stable in magnitude. Thus, it is unclear if the most recent
cohort reflects gains in equality or if gender disparities in research citations may
develop later in people’s careers.
Our data – indicting greater research productivity in men that might be declining -
are similar to some areas of academic medicine. In surgery, men publish more and
have higher h-index scores than women (Mueller et al., 2017) but data for younger
generations of scientists tell a somewhat different story. Gender gaps in publication
rates may be decreasing in the field of psychology (Geraci et al., 2015) and the gender
gap in publications was not significant in a recent sample of scientists from a variety
of disciplines (van Arensbergen et al., 2012). Efforts to increase and sustain research
productivity of women in clinical neuropsychology should be a top priority so that our
field can maintain and benefit from in women’s scholarship. After a review of some
causes of gender disparities in holding positions of influence, we offer strategies to
promote women in all areas of influence below.

Contextualizing the current findings
Findings from the current study and what they suggest about gender equity in clinical
neuropsychology are perhaps best interpreted in the context of extant studies examin-
ing other indicators of gender disparity. As previously reviewed, there have been two
studies that have systematically examined gender differences in career success in the
field (Sachs et al., 2018; Sweet et al., 2015). Our findings both complement and extend
these prior studies. In line with previous findings, we also find evidence of a female
disadvantage in leadership positions and editorial board membership. We also expand
on these findings by offering unique insights into how these gender differences vary
across cohorts of clinical neuropsychologists, suggesting that the most recent cohort
currently show smaller gender differences. Our data cannot clarify what is contributing
to the smaller gender differences among more recent cohorts, but we speculate two
explanations. First, it is possible that efforts to foster more equity in the field are pay-
ing off. Second, it is alternatively possible that gender disparities may accumulate over
one’s career and thus may take more time to become apparent.
We also think it is important to consider our findings in light of the continued evi-
dence of pay and promotion inequities in the field (Sweet et al., 2015). Many of the
outcomes we examined in the current study are used in promotion decisions, at least
within the domain of academia. Yet, despite finding smaller gender differences across
recent cohorts, data suggest persistent gender differences in advancement rates. We
believe this can be reconciled in two ways. First, the greater equity in the most recent
cohort may have not yet had time to matriculate into higher level outcomes such as
being promoted to the highest academic ranks. Second, women may not advance to
higher positions because of decisions to exit the field due to their disproportionate
exposure to mistreatment, hostile climates, or other negative experiences. Indeed, an
examination of people who have chosen to leave academia found that women were
more likely to report harassment and discrimination, family-related issues that pulled
them away from their positions, and fewer retention offers from their universities
(Martinez et al., 2017). Thus, there may be many external factors that affect promotion
and retention outside of performance. Pay gaps may similarly be driven by factors dis-
connected from the outcomes examined in this study. As some examples, pay gaps
can originate from starting salaries and persist regardless of subsequent performance.
Gender differences in initiating salary negotiations and the outcomes of those negotia-
tions can also contribute to long-term salary differences (Stuhlmacher Walters,
1999). We believe that, when taken together, this suggests that we may see improve-
ments in pay and promotion differences if the trends in our data hold, but more
equity may only be realized if we also intervene to change the external factors that
influence women’s advancement.
Causes of gender disparities
Several factors prevent women from entering into leadership roles. Indeed, the path-
ways to leadership are different for men and women. Women must traverse a
“labyrinth” (Eagly Carli, 2007) of challenges inherent in sexism, discrimination, racism,
and the unique demands women experience (Sanchez-Hucles Davis, 2010). Women

face many obstacles that make career advancement more difficult. Women are bur-
dened with greater teaching and service demands than men (American Psychological
Association, Committee on Women in Psychology, 2017), face stereotypes that bar
them from advancing into leadership positions (Eagly Karau, 2002), and are vulner-
able to a lack of institutional support and unrealistic productivity demands (Raj et al.,
2016). Women’s advancement may be similarly limited by obstacles in their non-work
life to a greater degree than men, because women have more household responsibil-
ities, devote more time to child rearing, and prefer flexible work schedules (Jena et al.,
2016; Mccutcheon Morrison, 2016).
Recommendations to promote the careers of women in neuropsychology
Our findings demonstrate gender disparities in clinical neuropsychology, and it is crit-
ical to take actions to foster equity in the field. In the sections below, we offer sugges-
tions for policy change, organizational change, and individual action. These
recommendations should be considered in tandem because a multipronged approach
that includes changes at each of these levels will be most efficacious.
Policy changes
Organizational initiatives and policy changes are the first route through which more
equitable working conditions can be generated. Many of these initiatives have been
undertaken over the last decade, but the predominant focus of these efforts has been
on improving the proportion of women entering into medicine and STEM. However,
increasing women’s representation in a field may not produce meaningful changes in
women’s treatment in the absence of attempts to change the climate into which
women enter (Walton, Logel, Peach, Spencer, Zanna, 2015). Increasing the number
of women in a field or in an organization may not be sufficient in producing meaning-
ful changes to the systematic barriers women experience. Indeed, meta-analytic
reviews show that organizational climate is a much more meaningful predictor of
women’s treatment than representation alone (Willness, Steel, Lee, 2007).
Correspondingly, we recommend that organizations be cautious not to equate
numeric equity with treatment equity and redouble their efforts to enact policies that
ensure women are protected from discrimination, sexual harassment, unfair service
demands, hostile climates, and other institutional disadvantages.
Implicit bias training may also be a fruitful path toward reducing gender biases.
Efforts to combat implicit biases have become increasingly common among university
admissions and hiring committees. Though the positive effects of diversity training
programs have not been unanimous (Legault et al., 2011), implicit bias training
appears to be effective when appropriately implemented (e.g. Devine, Forscher,
Austin, Cox, 2013). Organizations should continue to require implicit bias training for
people making high stakes decisions, such as admitting students and hiring faculty.
The training should also be extended to people serving on tenure committees, grant
panels, editorial boards, boards that appoint people to leadership roles, and other
bodies that make decisions that are critical to career advancement. Organizations may
also consider coupling their training programs with other efforts, such as structured

interviews (Bragger et al., 2002; Levashina et al., 2014) and gender- and race-blind
applications (Noack, 2016) to further reduce the effects of bias.
Participation in workplace interventions to promote gender fair policies can be
effective when at least 25% of a department’s faculty participate (Carnes et al., 2015).
In a pair-matched, single blind, cluster randomized trial, a gender equity intervention
was delivered to medicine, science, and engineering departments. Gender biases were
conceptualized as a habit that was targeted for change. The intervention was a 2.5-
hour interactive workshop, that incorporated principles of adult education and inten-
tional behavioral change. The workshop aimed to increase faculty awareness of gender
bias and promote motivation, self-efficacy, skills, and positive expectations for consist-
ently behaving in ways to support gender equity. The intervention demonstrated
immediate boosts in personal awareness, internal motivation, perception of benefits,
and self-efficacy to engage in behaviors to achieve gender equity, as well as a positive
change in departmental climate.
Recommendations for professional organizations
Professional organizations can make changes to their practices to foster gender equity
in positions of influence. Professional organizations need to do more to include
women as both conference speakers and as members of their boards. Toward this
aim, the field can obtain guidance from successes in other fields. For example, the
Microbiology General Meeting achieved gender equity in speakers by creating aware-
ness of gender representation in the field, increasing the number of women decision
makers, and including explicit instructions to avoid bias against women (American
Psychological Association, 2006). Annual conferences in clinical neuropsychology
should consider offering childcare services to attendees to increase attendance and
participation among working parents. Professional organizations can further take
actions to ensure parity between the gender representation in their general member-
ship and the gender representation among those in leadership. Finally, we advocate
for professional organizations to survey their membership about demographic infor-
mation and the barriers that minority members may be experiencing as a way to take
stock of inequality, increase transparency, and to facilitate future research efforts to
quantify the disparities that may exist, and increase transparency.
Individual actions
Individuals can take steps to close the gap between men’s and women’s career attain-
ment. Our first recommendation is for women to seek mentors and sponsors and for
women to serve as mentors and sponsors. Mentors support the long-term growth and
development of a mentee by serving as a source of wisdom, information, and support
(Re, 2020). Mentorship has long been recognized as an important factor in women’s
career development (Noe, 1988) and empirical evidence supports that mentorship pro-
grams can positively impact mentees, mentors, and the broader organizational envir-
onment (de Vries et al., 2006). Sponsors play a different role than mentors are senior
colleagues that hold formal organizational power and advocate on behalf of more jun-
ior members of the organization (Travis et al., 2013). Sponsors are uniquely suited to
help rising talent gain recognition and empirical evidence has connected sponsorship

to important career successes (Patton et al., 2017). Women are less likely than men to
have sponsors (Patton et al., 2017). Women - in collaboration with formal systems
implemented by organizations - should seek mentors and sponsors, particularly at nas-
cent stages of their career. Further, women should serve as mentors and sponsors
because exposure to female role models can mitigate stereotype threat and improve
performance for women in STEM (Marx et al., 2005; McIntyre et al., 2003). Indeed,
women’s representation in a working environment and in leadership positions has
long been linked to a lower occurrence of negative gender-based behaviors
(Fitzgerald et al., 1997).
Beyond leadership, women should nominate one another and support self-nominating
for editorial boards and leadership positions. Barriers that prevent women from being
invited for such positions may require self-advocating and peer support. Early appoint-
ments can influence the trajectory of one’s career.
Limitations
These data were collected and coded solely by the first author (MLR). Though the
data were spot checked by several leaders in the field not involved in this paper, reli-
ability of the data is unavailable2
. Further, our system for awarding points to activities
and roles was based on our judgment. We created a system to award more points to
persons who had more responsibility (e.g. president of a board, editor in chief) than
to persons who lesser responsibility (e.g. secretary, associate editor). Of central import-
ance, any errors in our coding would apply equally to men and women and thus not
interfere with our aims to compare the influence of men and women on the field in
clinical neuropsychology across cohorts.
These data also offer a necessarily selective review of women in leadership.
Participants were included if they presented at one of four major neuropsychology con-
ferences and thus individuals who are active in leadership (e.g. a training director) but
did not speak at one of these conferences are not included. Further, we did not differ-
entiate between types of conference presentations (e.g. invited speakers versus pro-
posals that were submitted to the conference by the author, plenary speakers, and
presidential addresses). We reviewed editorial positions on four major neuropsychology
journals, but a more comprehensive review is provided by Sachs et al. (2018).
Governance positions that were included in the analyses were elected positions and
major appointed positions; other important appointed positions, such as committee
chairs, were not considered. We also acknowledge that metrics that reflect scholarly
productivity (e.g. the h-index) have well-known limitations (Waltman et al., 2012). There
is a lag between the time that a person enters the field and has the opportunity to
hold positions of influence, such as serving on an editorial board or holding elected
office. This lag would apply primarily to the most recent cohort and it is possible that
this lag would deferentially affect men and women. Our data are cross-sectional and
cannot speak to change over time in gender representation in clinical neuropsychology.
Gender was coded in a binary fashion and gender was not self-reported; thus,
some degree of error in gender classification occurred. However, our data indicating
that women are the clear majority in clinical neuropsychology are consistent with data

from Sweet et al. (2015), which confirm an over representation of women in clinical
neuropsychology because 55.7% of respondents to the 2015 salary survey were
women and 76.6% of postdoctoral trainees were women. Finally, we did not include
ethnic/minority status in our analyses and future work on the intersectionality of gen-
der – more broadly conceived – and ethnic/minority status are needed.
Conclusions
Our data are the first systematic examination of five decades of archival data pertain-
ing to gender and influence in clinical neuropsychology. Women were underrepre-
sented in all areas of leadership and influence, but there were indicates that this
imbalance is significantly shifting over time in conference speakers, editorial board
members, and in research citations. Conference speaking is the area in which the
most recent cohort has the largest gender disparity. There is some hope that gender
differences were smallest and/or reserving for some outcomes in the most recent
cohort, but these individuals are early in their careers. It will be important to docu-
ment for all our outcomes – via longitudinal studies – if these cross-section data por-
tend change that might persist over time. In the meantime, proactive steps to
promote women in neuropsychology should be a priority for all members of our field
and particularly to men and women in mid- and later-career stages who have the
power and influence to address gender inequities by for example, by sponsoring
women and minorities and establishing policy changes. Efforts to increase women’s
engagement in positions of influence will pay dividends in the future.
Notes
1. Whereas points earned for president-elect, past president, and president may be
confounded, not all persons served all three roles for idiosyncratic reasons.
2. We attempted to gather inter-rater reliability data for the sample, but due to the nature of
these data it was not possible. Specifically, the citations used for the research domain were
gathered at a specific point in time. A second coder attempted to replicate these data but
did not begin the work until a year had passed since the first coder gathered the data.
Thus, many subjects included in the database had increases in the number of citations and
the h index. However, we were unable to determine, when differences in coding occurred
whether the differences were the result of errors on the first coders part or due to actual
additional citations to the published research. Such differences were not systematic and
there was no way to easily reconstruct the original data for error checking.
Disclosure statement
No potential conflict of interest was reported by the author(s).
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