PSYC 125 - Neuropsychological Assessment Pt 1

Neuropsychology

Study of brain and behavior relationships.

Modern Neuropsychology

Evolved from lab research to clinical practice since 1970s.

International Neuropsychological Society (INS)

Organization for sharing neuropsychological research and findings.

National Academy of Neuropsychology (NAN)

Focuses on clinical issues, especially for solo practitioners.

Division 40 of the APA

Section of APA dedicated to neuropsychology.

Data Driven

Approach based on empirical evidence and statistics.

Validity

Ensures a test measures what it claims to.

Reliability

Consistency of measurement across different instances.

Standardization

Process of replicating tests in a uniform manner.

Doctoral Training

Advanced education in clinical psychology specialization.

Internship

One-year practical training in clinical settings.

Postdoctoral Fellowship

One to two years of advanced research training.

Neuropsychological Assessment

Evaluation of brain-behavior relationships.

Key Assumptions

Cognition results from combined brain processes.

Modularity

Specific brain areas perform distinct functions.

Equipotentiality

Brain tissue can perform various functions.

Distributed Processing

Multiple brain areas work together for functions.

Interconnected Networks

Brain areas interact to support cognitive functions.

Plasticity

Brain's ability to adapt after injury.

Deficit Measurement

Loss of function indicates brain damage.

Association

Similar measures suggest weak localization evidence.

Disassociation

Different scores in groups indicate functional separation.

Double Dissociation

Reversal of patterns shows strong localization evidence.

Lesion Approach

Study cognitive functions through brain lesion analysis.

Broca's Area

Language processing area in the dominant hemisphere.

H.M. Case

Severe amnesia following epilepsy treatment.

Prosopagnosia

Inability to recognize faces.

Single vs Group Studies

Single cases highlight exceptions; groups validate findings.

Performance Measures

Assessments include behavior and imaging techniques.

WADA Technique

Temporarily anesthetizes one brain hemisphere.

Transcranial Magnetic Stimulation (TMS)

Uses magnetic pulses to study brain functions.

CT Scans

Structural imaging for diagnosing brain conditions.

X-ray beams

Pass through head to detect tissue density differences.

CT scan

Uses X-ray beams for detailed brain imaging.

Iodine contrast

Enhances CT by improving visibility of brain structures.

Calcium deposits

Better visualized with CT than MRI.

Electroencephalography (EEG)

Measures electrical activity of synchronized neurons.

Ictal activity

Seizure activity recorded during an epileptic event.

Event-related potentials (ERPs)

Neural responses time-locked to specific stimuli.

Temporal resolution

Ability to measure changes over short time intervals.

Positron emission tomography (PET)

Uses radioactive tracers to measure brain activity.

Blood glucose

Metabolized more in active brain regions during PET.

Magnetic resonance imaging (MRI)

Aligns hydrogen atoms for high-resolution brain images.

Diffusion tensor imaging (DTI)

Maps axon projections using water diffusion patterns.

Functional MRI (fMRI)

Measures blood flow changes related to brain activity.

Vegetative state

Awake but shows no signs of awareness.

Neuropsychological assessment

Comprehensive evaluation of cognitive and behavioral functions.

Reliability

Consistency of measurement across tests and time.

Validity

Accuracy of a test in measuring intended constructs.

Face validity

Surface-level assessment of what a test measures.

Ecological validity

Test's relevance to real-world scenarios.

Criterion-oriented validity

Effectiveness in detecting issues in individuals.

Concurrent validity

Measures current abilities at the time of testing.

Predictive validity

Forecasts future developments or conditions.

Content validity

Adequacy of sampling across the construct being tested.

Construct validity

Ensures the concept is fully measured.

Convergent

New tests align with existing test conclusions.

Discriminant

Ensures tests do not correlate with unrelated measures.

Standardization

Consistent technique application across all assessments.

Reliability

Consistency of a measure over time and context.

Validity

Accuracy of a measure in assessing what it claims.

Base Rate (BR)

Percentage of population with a specific disorder.

Sensitivity

given that you have the disorder, what is the probability that your test will be positive (.90)--is gonna respond to disorder

Specificity

given that you dont have the disorder, what is the prob if having a negative test–specific, only responds to that disorder

Positive Predictive Value (PPV)

• given you have a positive test, what is the chance you have it (are positive for it)

  • Chances are strong you have it if the value is high

Negative Predictive Value (NPV)

•  given you have a negative test, what is the chance you do not have it (are positive for it)

  • Both PPV and NPV are sensitive to the base rate

  • The more rarer it is, the lower the values (in rare disorders)

Flexible Battery

Tailored tests based on individual patient needs.

Fixed Battery

Standard set of tests for all patients.

Executive System Deficits

Frontal lobe impairments affecting cognitive abilities.

Mini Mental State Exam (MMSE)

Quick test assessing mental status and orientation.

Motor Skills

Assessment of fine and gross motor abilities.

Sensory/Perceptual Function

Evaluates sensory systems affecting test performance.

Language Assessment

Evaluates comprehension, expression, and fluency in speech.

Memory Assessment

Focus on episodic and semantic memory evaluation.

Higher Cognitive Functioning

Includes attention, reasoning, and problem-solving skills.

Minnesota Multiphasic Personality Inventory (MMPI-2)

Standardized test for assessing personality disorders.

Malingering

Faking deficits to appear more impaired.

Practice Effects

Improvement in test scores due to repeated exposure.

Test Order

Sequence of tests to avoid contamination of results.

Follow-Up

Post-assessment feedback and implementation of recommendations.

flexible battery strengths

• Relevance in the patient’s concern

• Focus is on presenting problem–more efficirent in saving time

• Emphasizes why and not whether a task is failed

flexible battery weaknesses

• Confirmation bias

• Subjectivity in interpretation

• Lack of standarization (making up tests)

• Not good for research

fixed battery strengths

• Comprehensive

• Patterns of scores can facilitate diagnosis

• Teaching 

• Good for research

fixed battery weaknesses

• Time consuming

• Omits qualitative observations

• Data limited by original test selection

• Overly rigid and nonadaptive to individuals

my soup lacks many hot peas

motor, sensory/perceptual, language, memory, higher cog function, personality/emotional

The medulla

• Breathing

• Heart rate

  • Damaged nerves can affect breathing

The pons

• sleep/wake, etc

• Autonomic functions

The cerebellum

• Regulates motor movement, balance, and coordination, kinesthetic sense

• Important for shifting attention between auditory and visual stimuli

• Some types of learning

  • Lesions in cerebellum affect classical conditioning

  • Inverse relationship between cortical thickness and frontal in kids w adhd

Wernicke-korsakoff’s syndrome

 vitamin deficiency, where only source of nutrition is alc–very dense amnesia, life-threatening (V1) (diencephalic syndromes)

Afferent (accessing)

 coming into a structure; incoming 

Efferent (outgoing, exiting’)

 sending communication to somewhere else

basal ganglia

Caudate nucleus + putamen +globus pallidus + substantia nigra + subthalamic nucleus [cn,p,gp,sn,stn]

Cingulate gyrus

• on cortex, plays role in social and emotion behaviors (observign other ppl doing things, mimicking other ppl) inhibiting behaviors 

contralateral vision

patient says ring—RVF, left hand holds key; LVF reads ring

Ventricular system

• Structural support

• Cleans up dead cells and proteins that shouldnt be there etc

• To keep it from collapsing

gyrus/gyri

bumps

sulcus/sulci

valleys or grooves between gyri in the brain.

Astereognosis

• inability to identify object by touch

Finger agnosia

cannot identify any kind of fingers or what theyre called

Paresthesia

pins and needles; spinal cord lesions