Are interviews necessary?
Neuropsychological assessment
Concerned with evaluating the functioning of the nervous system as it relates to behavior
Concerned with both central and peripheral nervous system
organicity, a mental disorder is linked to a biological cause (e.g. brain lesion)
Lots of plasticity in brain functioning/recovery and link between organicity and damage are not one-to-one
Conditions prompting evaluation
- Referrals from psychologist, general practitioner, neurologist
- No medical basis for impairment (e.g. headaches)
- Look at cognitive reponse to trauma or chronic conditions
- hard vs. soft signs
Neuropsychological evaluation
purpose - to make inferences about the structural and functional characteristics of the brain by evaluating an individual's behavior in defined stimulus-response situations
May test a myriad of behaviors: visual, auditory, perceptual, problem solving, cognitive processing, sensory
Timing of assessment may be critical to validity
methods - similar as other psychological methods but also including imaging equipment (e.g fMRI)
Imperative to have a strong understanding of biology and neurological functioning
What would it mean if someone was complaining about headaches?
History and case study
- Similar methods to counseling/clinicial psychologist evaluation
- Medical history of patient and their family
- For children, have they reached developmental milestones
- Demographics and psychological history (e.g. intelligence, personality disorders, etc)
- Type, nature, and severity of issues
- Will want to know the onset of behavior and any changes observed
Interview and mental status exam
Unlike counseling/clinicial, interviews here are more structured
Typically involve rating
Formal exam would be used to screen for impairments and/or disease
Would administer a mental status exam for general understanding of the mental state of the examinee
Mental status exam
- Appearance, behavior
- Orientation
- Memory
- State of senses and psychomotor abilites
- State of consciousness, affect, mood, personality
- Thought content & processes
- Intelligence, insight, judgment
- Focus on neuropsychological functioning
What types of tests would we want to use in neuropsychology?
General intelligence tests
Weschler tests very commonly used in neuropathology
Patterns of scores often indicative of a deficit
Focus on interpreting pattern of subtest scores (pattern analysis)
Other scores devised to assess brain damage (e.g. quotients or ratio scores)
Depending on focus of assessment, may deviate from prescribed testing procedure
Abstract thinking
- Inability to think in abstract manner indicative of neuropsychological deficit
- Tests elicit abstract thinking in testee administered
- Weschler similarities test
- Proverbs test
- Sorting tests
- Test frontal lobe functioning - concentration, planning, organization, cognitive flexibility, working memory, inhibition of impulsive behavior
Executive Functioning
Involved in planning, organizing, cognitive flexibility, and inhibition of impulses
Associated with frontal and prefontal lobes
Associated with, but distinct from, intelligence
Believed to be plastic
Children in poverty often have low EF
Perceptual and motor test
- perceptual - measure sensory functioning
- motor - measure motor skills
- includes tests of color, smell, dexterity, speed, ability, etc.
Tests of verbal functioning
verbal fluency may be associated with brain injuries or diseases (e.g. dementia)
- Controlled Word Association Test - examiners says a letter and examinee says as many words as they can
- Has been used with dementia patients (but can not readily identify people with dementia)
Is someone able to express them self with language (aphasia)
Reitan-Aphasia Screening Tests used to detect aphasia - naming common objects and writing familiar words
Unidimensional? Culturally sensitive?
Tests of memory
- Many models of memory
- Memory models include short and long-term memory
- Something perceived may move into short-term memory, back to being aware, back to short-term memory (and so on), and either to long-term memory or could be lost
- Different ways memory is classified in LTM
Types of test
- California Verbal Learning Test-II
- Obtain the most comprehensive and detailed assessment of verbal learning and memory available for older adolescents and adults
- Examinees are read a list of words, selected after careful study of their frequency of use across multiple demographic variables, and asked to recall them across a series of trials
- Wechsler Memory Scale
- An extremely comprehensive memory test
Why might we consider a battery of tests?
Why might be an
issue with this?
fMRI
- Produces images of the brain, non-invasively, that allow us to monitor the flow of blood (i.e. study function)
- Use fMRI to see how our brain responds to different stimuli
- Diverse uses including studies of mindfulness, prevent disabilities, treating disorders and addictions, studying autism, studying criminials, examing racism, decision-making, memory, and much more
Issues with fMRI
Often done with small sample sizes, low statistical power, and lots of statistical testing!
Non-independent statistical tests and corrections are needed, otherwise dead salmon
Be mindful of practical significance and understand how it differs from statistical significance