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Clinical Neuropsych - Chapter 15 - Concept Formation and Reasoning

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Konstantine Zakzanis

Chapter 15 – Clinical Neuropsychology -Conceptual activities typically involve: 1. Intact system to organize perceptions 2. Well-stocked and readily store of remembered learned material 3. Intact cortical and subcortical interconnections and interaction patterns that underlie thought 4. Capacity to process two or more mental event at a time 5. A response modality sufficiently integrated with central cortical activity to transform conceptual experiences into behaviour 6. Proper functioning feedback system for continuous monitoring and modulation of output -it is not unusual to fund executive and conceptual/reasoning deficits occurring together -concrete thinking is one of the most common signs of impaired conceptual functions -usually appears as an inability to think in useful generalizations, at the level of ideas, or about persons, situations, events not immediately present Concept Formation -some patients do poorly on virtually all tests of abstract thinking, regardless of mode of presentation or channel of response -patients with mild neuropsychological defects may not engage in concrete thinking generally, but may show deficits on test that test specific aspect of concept formation and reasoning -concrete thinking takes different forms with different patients, and varies in its effect on mental efficiency with the type of task Word Usage Tests -call for abstract comparisons between two or more words, and provide a sensitive measure of concrete thinking -word usage is very dependent upon the integrity of the patient’s communication system and level of verbal skills. The patient’s verbal skill level must always be taken into account -difficult items indicate cognitive dysfunction in bright and well educated adults SIMILARITIES -subject must explain what each pair of concepts has in common -concepts range in difficulty from (orange-banana) to (friend-enemy) -abstract generalizations get a score of two points whereas, specific and concrete responses get a score of one point -age related decline beginning at age 70 -Education has a large impact on this test, and account for about 25% of variance in scores between individuals -Sex effects are virtually non-existent - Slight difference between black subjects and white subjects -An excellent test of general mental ability, and general verbal ability -depressed scores on this test are affiliated with left temporal and frontal deficits, and is a good indicator of left hemisphere disease -low scores are also associated with bilateral frontal lesions -vulnerable to dementia, and performance decline is predictive of the development of Alzheimer’s disease M ATRIXR EASONING -26 item measure that presents a series of increasingly difficult visual patter completion and analogy problems; the subject must choose from a multiple-choice array the item that best completes the pattern -no time limit, but can be discontinued if there are 4/5 subsequent failures -involves fluid intelligence, broad visual intelligence, classification and spatial ability, knowledge of part- whole relationships, simultaneous processing, and perceptual organization -age has a large effect on performance -it has been suggested that this measure is sensitive to the decline observed in Alzheimer’s and with impair
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