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Psychology (9,695)
PSYC32H3 (34)
Chapter 1

Chapter 1 - Mitrushina.docx

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Zachariah Campbell

Chapter 1 Introduction Clinical neuropsychology: applied science concerned with the behavioural expression of brain dysfunction Neurologists: neurobehaviour specialists who administer tests and test batteries, tailored for answering specific referral questions. (Ideally) test battery consists of well-validated, reliable, standardized, and normed measures that help identify/quantify behavioural changes that may have resulted from brain injury/other central nervous system disturbances. Cognitive areas typically assessed are: • Language • Attention/concentration • Visuospatial perception and constructional abilities • Frontal systems/executive function • Verbal/nonverbal learning • Memory o Sensory and motor functions + general IQ tests are also usually assessed as well. After administering a test, a neuropsychologist has to make sense of all of the numerical and qualitative data. • Optimal use – neuropsychologist must have understanding of what makes a ‘normal’ performance on the tests before they can locate an individual’s strengths and weaknesses of their capacities. A test is meaningful when it has an empirical frame of reference. • Normative data provides this context • This type of data represents the range of performance on a test of a group of medically/neurologically healthy individuals with relatively homogenous demographic characteristics o ‘Gold standard’ by which an individual’s scores are compared. • Not complete and sole basis for interpretation of test score Tests must take into account qualitative observations and a patient’s history background, present circumstances, motivation, attitudes, and expectations regarding self/examination. • Formal evaluation of the patient’s emotional functioning and personality characteristics is also part of a neuropsychological evaluation 3 main parts for forming a clinical judgement  interpretation  REPORT • Observations: Reporting a score with reporting how it was obtained can be misleading. Did a person get a normal score in a short amount of time or did they get a normal score after working at the test for a long period? Is also important to assess attitude, effort, and motivation – is the patient giving their best performance? • History: along with presenting symptoms, important for understanding test data. Some medical/psychiatric conditions can influence neuropsychological test performance – documenting these risk factors is important so that the neuropsychologist can attribute the contribution of peripheral nervous system/central nervous system, and/or emotional dysfunction to the clinical picture. o History includes: medical; psychiatric; education; vocational; avocational • Raw Data, Norms: More than one test should be administered when assessing performance within a specific functional domain so that the internal consistency of performance findings can be judged before offering an opinion about function. Test-Taking Environment In order to obtain the best possible performance from a patient, a neuropsychologist must develop a rapport with the patient, gain cooperation, and conduct the evaluation in an environment that is as free as possible from distracting influences. • ‘Ideal’ test environment Neuropsychological test norms have been standardized under ideal test environment conditions. Deviation from a standardized test environment should be well documented because it will almost always adversely affect the reliability and validity of the test data  the reliability and validity of the professional opinions derived from that data. Allowing others to observe or record the neuropsychological test can modify a patient’s responses and/or attitude towards the test. • Also alter the standardized examination test environment  this means that the information can be considered invalid Recording equipment can place neuropsychologists in potential conflict with laws regulating the practice of psychology. It can be an issue ethically because psychologists have to maintain the integrity and security of test materials. However, with recordings, once they leave the room, the neuropsychologists have limited control over the materials. • A test can become invalid if it becomes to exposed to the public Test Norms There are relatively few large-scale normative reports in psychology. • They are very expensive and logistically difficult • Researchers are also have not been supported in conducting normative research o These types of studies are descriptive and are not really considered ‘scientific’ because they are not testing a hypothesis Normative data is mostly found in publications of clinical studies = hard to find Researchers have to try to choose the appropriate set of data to use as a normative comparison a
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