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PSYC31 Ch 1

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Konstantine Zakzanis

PSYC31 Chapter 1: Theory and Practice of Neuropsychological Assessment Any of 6 purposes will prompt a psychological evaluation:  Diagnosis  Patient Care  Treatment-1: Identifying Treatment Needs  Treatment-2: Evaluating Treatment Efficacy  Research  Forensic Questions Diagnosis  Neuropsychological assessment can be useful in - Discrimination between psychiatric and neurological symptoms - Identifying a possible neuropsychological disorder in a nonpsychiatric patient - Distinguish between different neurological conditions - Providing behavioural data for localizing the site of the lesion  Contributions o Patient care and treatment o Understanding the behaviour phenomena and brain function  Due to the development of noninvasive neurodiagnostic techniques that are highly sensitive and reliable for many diagnostic purposes  Accurate diagnosis (including localization of a lesion) is often achieved by means of the neurologists’s examination and laboratory devices  Laboratory analysis may not be diagnostically helpful  neuropsychological findings are crucial in these cases o Even when the site and extent of a brain lesion have been shown on imaging, the image will not identify the nature of residual behavioural strengths and deficits  Toxic encephalopathies  Alzheimer’s disease and related dementing processes  Mild traumatic brain injury (TBI) o Localized lesions may appear similar on neuroimaging but can have different psychosocial outcomes o Cognitive assessment can document mental abilities that are inconsistent with anatomic findings  A patient’s level of functioning may exceed expectations based on neuroimaging  Neuropsychological assessment can aid in prediction o Outcome of a diagnosed condition o Likelihood that a neuropathological condition will manifest o Practical consequences of a particular kind of brain impairment  Huntington’s diseases, TBI  Screening o Identify persons most likely at risk for some specified condition or in need of further diagnostic study Patient Care and Planning  Precise descriptive information about cognitive and emotional status is essential for careful management of many neurological disorders  Understand the patient’s capabilities and limitations, the kinds of psychological change they are undergoing, and the impact of these changes on their experiences of themselves and on their behaviour  Data from successive neuropsychological examinations repeated at regular intervals can provide reliable indications of whether the underlying neurological condition is changing o Repeated testing is recommended to:  Evaluate performance inconsistencies in patients with attentional deficits  Deterioration on repeated testing can identify a dementing process early in its course  Measure the effects of surgical procedures, medical training, or retraining  Brain impaired patients must have factual information about their functioning to understand themselves and to set realistic goals o Their need for this information is often overlooked  Distrust of their experiences is a problem shared by many brain damaged persons o Feelings of strangeness and confusion  Self-doubt of the brain injured person is referred to as “perplexity” o Perplexity  not knowing if you’re right  Usually distinguishable from neurotic self-doubts about life goals, values, principles, etc  Can be as painful and emotionally crippling  Careful reporting and explanati
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