Clinical neuropsychological applies to:
Humans only
Humans and all primates
Humans and mammals
Humans and chimpanzees
Clinical neuropsychological assessment means interpreting test performance within the context of:
Clinical history
Psychological interview
Behavioural observations
Animal behaviour models
Response to neuropharmacology
Clinical neuropsychology evolved out of which parent disciplines?
Behavioural neurology
Clinical psychology
Socio-cognitive psychology
Behavioural neuropharmacology
Cognitive neuroscience
What can make an assessment neuropsychological?
The questions that prompted it
The main issues
The findings
The inferences
Being assigned to a neuropsychologist
Recommendation from primary physician
What is the opposite of localisation?
Lateralisation
Equipotentialism
Spatiality
Which perspective says that the size of a lesion is important but its location is not?
Localisation
Which perspective says that the location of the lesion is more important than the size?
Who said that brain damage needs to be considered measurable and multi-dimensional?
Lezak (2012)
Farah & Gillihan (2012)
Costa & McCrae (1990)
Lewisham (2016)
Which of the following affects the behavioural consequences of a lesion?
Nature
Extent
Location
Duration
Cause
Strategic Lacunar infarcts can have a bigger impact than large infarcts. Which perspective does this support?
List the most common causes of acquired neuropsychological disorders, from most to least common: 1. ❌ 2. ❌ 3. ❌
Ischaemic = ___________; haemorrhagic= __________
Blockage; bleed
Bleed; blockage
Rupture; constriction
Constriction; rupture
What is true of TBI?
Least common cause of acquired neuropsychological disorders
Happens when a mechanical force meets the head
Causes neurons to stretch/shear
Causes glia to stretch/shear
Rarely due to accidents
Which of the following are causes of acquired neuropsychological disorders?
Substance Abuse
Oxygen Deprivation
Herpes Simplex
HIV/AIDS
Invasive brain tumours
HPV
Non-invasive brain tumours
Schizophrenia
Neuropsychological assessment is the most effective tool for diagnosing:
Mild TBI
Early-onset dementia
Late-onset dementia
Dementia with Lewy Bodies
Ischaemic stroke
Haemorrhagic stroke
Some brain disorders exclusively affect the left or right hemisphere. What is the name of this concept?
Locationalisation
Linearitisation
Which brain disorders commonly lateralise?
Stroke
Focal gunshot wound
Vascular dementia
Damage to the dominant hemisphere means the patient will most likely:
Perform worse in verbal activities than nonverbal activities
Perform worse in nonverbal activities than verbal activities
Perform worse in spatial than non-spatial activities
Perform worse in non-spatial than spatial activities
Currently, what are the purposes of neuropsychological assessment?
Determine cognitive capabilities and deficits
Establish functional capacity
Develop a treatment/rehab plan
Clarify diagnosis
Measure change over time
Diagnose size and shape of lesion
What questions might be asked when establishing functional capacity?
Can they live independently?
Can they drive?
What other services/interventions do they need?
How will they get home from the hospital/rehab?
In cases of acquired brain injury, time should lead to:
improvement
decline
full recovery
stagnation
Over time, dementia usually:
worsens
improves
remains static
What is true of forensic neuropsychological assessment?
Also called "medico-legal" assessment
Commonly done by junior neuropsychologists
Neuropsychologist considered an expert witness
Everything you do has to be defensible in a court of law
Rely on patient having had premorbid neuropsychological assessment
What is a psychological test?
Measuring device
Procedure designed to measure psych-related variables
Tool
Provide comprehensive diagnostic information
What information can neuropsychological assessment take into account?
Test scores
Direct observation
Info provided by family
Objective info from other records
Patient's personal preferences
Which of the following are approaches to neuropsychological assessment?
Process
Composite battery
Fixed battery
Partial battery
Syndrome
Paralegal
Which approach uses the Luria-Nebraska?
What is true of the Fixed Battery Approach?
Gives every test in large batteries
Gives tests pulled from large batteries at the neuropsychologist's discretion
Very common in Australia
Can take 4-5 hours
Covers a broad range of cognitive functions
Follows the hypothesis-testing approach
Usually standardised
Often uses Weschler tests
What are some disadvantages of the Fixed Battery Approach?
Fatigue
Does not administer enough tests
Does not take into account context
Often administered by a psychometrician
No direct observation
What is true of the Composite Battery approach?
Uses the Luria-Nebraska
Does not allow for hypothesis-testing
Administers a small battery of tests
What is true of the Syndrome approach?
Follows the medical model
Most popular approach
Most common in stroke
Most common in TBI
Describe patient's performance in regards to its closeness to an established syndrome
Describe patient's performance in regards to its closeness to normal functioning
What is the name given to a tiny metal object lying on the ground that turns out to be a large object buried deep?
Pymble
Gordon
Turramurra
Killara
Hornsby
What are the characteristics of Balint's syndrome?
Optic ataxia
Gaze dyspraxia
Object ataxia
Simultanagnosia
Prosopagnosia
Apperceptive agnosia
Neglect
What is true of simultanagnosia?
Perceptual version of tunnel vision
Can't process more than 1 piece of visuo-spatial info at a time
Can't process more than 1 piece of visual info at a time
Renders person unable to count the number of objects on the desk without using their hand
Can't voluntarily shift gaze
What do you call it when a person can't voluntarily shift their gaze?
Gaze ataxia
Simultagnosia
Completely missing someone's hand when going in for a handshake may be a sign of:
What is true of the Process approach?
Focuses on binary outcome of test
Focuses on strategies used by patient to arrive at the outcome
More quantitative than qualitative
Greater focus on clinical than statistical methods
What is true of Poreh and Kaplan's work?
Quantified the Process approach
Called Quantified Process Approach
Allows for statistical evaluation of the Process Approach
Quantified the Composite Battery approach
Called Numerical Battery Approach
80% of people in Western countries begin the Bells Test from the:
Top left
Top right
Centre
Anywhere left of centre
Bottom left
Mid-right
What is the mildest form of neglect?
Rightward orienting bias
Partial neglect
Dyspraxia
Ataxia
In the Bells test, what is the criteria for neglect?
3 more bells omitted on one side compared to the other
4 bells omitted overall
At least 1 bell omitted on one side and 0 bells omitted on the other
2 bells omitted on each side
All bells in periphery omitted
What is true of Standard conditions?
Provides a patient's test score in relation to their peers
Expect a poor result in the suspected-impaired area
Adds in unnecessary error
Makes measurement less precise
Allows patient cross-comparison
Helps to elucidate the impaired function
What is true of optimal conditions?
Modifies the test
Allows for use of normative data
Removes all test validity
What is true of norms?
The vast majority of tests are highly correlated with age
Have to at least match your norms to your patient's age group
Verbal tests depend on education
Visuo-spatial tests always vary by education
Australia has large norms on Chinese-Australians
How is premorbid functioning estimated?
Measure cognitive functions that are usually not affected by brain injury
Often measures irregular word reading
Can use Weschler Test of Adult Reading (WTAR)
Often uses WAIS
Can use the Test of Premorbid Functioning
Compare test results to norms
Can also use demographics
When can people be motivated to under-perform?
Compensation claims
Reducing prison sentence
Desire for attention
Escaping conscription
Impress a new boy/girlfriend
What is true of practise effects?
Pretty much plateaus out after 3rd administration
True improvement/decline is outside the CIs for the true score
Can be resolved by using parallel forms
Are less common in memory tests
What is true of the Wisconsin Card Sorting Test?
Requires cognitive flexibility
Especially susceptible to novelty effects
Measures neuroticism
Cannot be done via computer
What are examples of qualitative data?
General attitude to testing
Motor behaviour
Affect/mood
Z scores
Raw scores
Write in numerals: Z score: Mean = , SD= Scaled score: Mean= , SD= Standard score: Mean of , SD= T-score: Mean= , SD=
In a standard scale: 50% of scores are between and 80% of scores are between and 95% of scores are between and Under is intellectual impairment
What is true of Pattern Analysis?
Looks at patterns of impairment
Compares patient's profile against known clinical profiles
Eg dementia will have above-average performance on memory tasks
Flat(ish) profile= significant brain impairment
Can use the Repeatable Battery for the Assessment of Neuropsychological Statis [RBANS]
What is true of clinical signifiance?
= The reliability of the difference between 2 test scores
= How unusual the difference between 2 test scores is in the normal population
Interesting if the difference only occurs in 5-10% of normal population
Clinical groups have similar curves to control groups
What is Veridicality?
How well the cognitive test correlates with real world outcomes
How well the cognitive test mimics real world situations
Correlations between existing tests and functional measures
Unstandardized tests
What is Verisimilitude?
The Trail Making Test Part B correlates highly with the Occupational Therapy Driving Assessment. What is this an example of?
Veridicality
Verisimilitude
Verity
Vermillion
The Tes of Everyday Attention tests ability to perform real world (albeit anachronistic) applications of cognitive functions. What is this an example of?
What is the Vector Approach?
Using all available data
Drawing conclusions about likely diagnosis
Drawing conclusions about likely prognosis
Less holistic
Less ecological validity
Any data inconsistent with the diagnosis must be accounted for
What is true of the BREIF-A?
= Behaviour Rating Inventory of Executive Functioning for Adults
Has poor psychometrics
Gold-standard of self-report executive functioning measures
Has self-report and informant versions
What is true of the Cognitive Failures questionnaires?
Follows peoples' day-to-day cognitive challenges
Can get self-report and informant versions
Gold-standard of self-report executive function measures
More holistic
Answer in numerals to 1dp: Tests tend to have a correlation with real world functioning