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Chapter 15

PSYC 3090 Chapter 15: CHAPTER 15

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PSYC 3090
Krista Trobst

CHAPTER 15 – NEUROPSYCHOLOGICAL ASSESSMENT Neurology: branch of medicine that focuses on the nervous system and its disorders Neuropsychology: branch of psychology that focuses on the relationship between brain functioning and behavior Neuropsychological assessment: the evaluation of brain and nervous system functioning as it relates to behavior Behavioural neurology: the subspecialty area within the medical specialty of neurology that focuses on brain-behaviour relationships Neurotology: branch of medicine that focuses on problems related to hearing, balance and facial nerves The Nervous System and Behaviour -neurons, CNS, PNS -review brain areas + lobes -contralateral control Neurological Damage and the Concept of Organicity Neurological damage: may take form of a lesion in the brain or any other site within the CNS or PNS Lesion: pathological alteration of tissue, such as that which could result from injury or infection -can be physical or chemical -can be focal (one site) or diffuse (scattered) Brain damage: general reference to any physical functional impairment in the CNS that results in sensory, motor, cognitive, emotional or related deficit -organicity derives from post WW1 research of kurt Goldstein, concluded that factors differentiating organically impaired from normal individuals included loss of abstraction ability, reasoning and inflexibility in problem-solving tasks -heinz and strauss wanted to find one thing common to all brain injured people -nonunitary supported by various findings see page 534 Neuropsychological Evaluation When a Neuropsychological Evaluation is Indicated -psychologists more for screening, neuropsychologists more specific + diagnostic -look for signs, refer to someone else -signs can take many forms Hard sign: indicator of definite neurological deficit Soft sign: indicator that is merely suggestive of neurological deficit -neuropsychologist focuses on extent to which is impairment, monitor cognitive changes or find problem when there is no medical basis General Elements of a Neuropsychological Evaluation -objective of typical neuropsychological evaluation is to draw inferences about the structural and functional characteristics of a persons brain by evaluating an individuals behavior in defined stimulus-response situations -common to all examinations are history taking, mental status examination and administration -take history -special attention to presence/absence of certain developmental milestones -variety of structured interviews + rating forms available as well -take note of more neurological related things Physical Examination -sometimes noninvasive procedures -examine skull and scalp for anything unusual, muscles may be examined -reflexes Neuropsychological Tests -test muscle coordination – walking, running skipping, standing still, nose-fingernose, finger wiggle Tests of General Intellectual Ability -Wechsler tests have tools for neuropsychologist Pattern analysis: looking at pattern of test scores as indicators of particular deficits Deterioration quotient (DQ): pattern of subtest scores on a Wechsler test that Wechsler himself viewed as suggestive of neurological deficit -by the book administration not always possible/desirable for testing neurological impairments Tests to Measure the Ability to Abstract -wechsler similarities subtest for verbal abstraction -identify how two subjects are alike -proverbs test -sorting tests Tests of Executive Function Executive function: organizing, planning, cognitive flexibility, inhibition of impulses and related activities associated with the frontal and prefrontal lobes of
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