Summary of all 6 lectures of Neuropsychological Assessment 2024
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Course
Neuropsychological Assessment (PSMNV2)
Institution
Rijksuniversiteit Groningen (RuG)
Providing an extensive summary of the course Neuropsychological Assessment, containing all the information from the slides and lecturers, including images and tables.
Purpose of neuropsychological assessment
1. Diagnosis
Discriminating between psychiatric and neurological disorders
Identifying a possible neurological disorder
Distinguish between different neurological disorders
Neuropsychological assessment cannot localize the site of the lesion. For this you need
neurodiagnostic techniques (neuroimaging).
Neuroimaging will not identify the behavioural strengths and accompanying deficits. For
this you need neuropsychological assessment.
(Xphrenology)
2. Patient care and planning (most often used purpose)
Identifying cognitive strengths and weaknesses
Identifying behavioural alterations
Identifying personality characteristics
Needed for optimal and careful management of many disorders/ job selections
Irrespective of (apart from) a diagnosis
3. Treatment planning and remediation
What is the most appropriate cognitive rehabilitation treatment?
4. Treatment evaluation
Did the treatment have an effect?
5. Research
Examine specific brain disorders and behavioural disabilities
Development, standardization, and evaluation of NPA techniques
6. Forensic neuropsychology
In the context of claims of injury and loss of function
In criminal cases is there reason to suspect brain dysfunction that contributes to
misbehaviour / is the suspect suitable to stand trial?
Diagnostic cycle
N=1, number of steps
, You use hypotheses throughout the cycle. During each step hypotheses can be
formulated, rejected or accepted. By doing this you get a transparent and well-
considered diagnostic process.
If you don’t formulate hypotheses and go through the diagnostic cycle, you will easily
make interpretation errors:
Confirmation bias; seek and value supportive evidence for the hypotheses at the expense
of contrary evidence
Overgeneralizing: if this, then that (similar pattern of scores lead to correlation)
Disregarding base rates of disorders; when a sign occurs more frequently than the
condition it indicates
Psychometric approach: Reitan – Halstead test battery
Standardized assessment and scoring
Quantitative test approach
Normative data and cut-off scores
-Ex; tactual performance test patient is blind-folded and has to place the blocks in their
appropriate space with the dominant hand
-Ex; speech-sounds perception test patient has to underline the syllable he/she hears
-Ex; trail making test (simple instructions, easy to administer test)
Scoring: for each subtest: does the patient score above/below the cut-off?
Summary index of brain damage: impairment index = #impaired test performances/#tests
Consistency of impairment?
, Criticism:
A-theoretical (not based on theories about the brain)
Nonflexible (not adjusted to the individual)
Only focuses on abilities not on dysfunctions (no insight into the nature or cause of
the problem/gives no direction for rehabilitation)
Behavioural neurological approach: Luria’s behavioural
After 2nd WW, large number of patients with brain injury developed test battery based on
his view/theory of the brain:
Functional units attention (brain stem), perception (posterior) and organization &
planning (anterior)
Hierarchy within each unit primary (image), secondary (interpretation) and tertiary
(cross-model integration, combination of senses)
Linking behaviour to neurological regions.
Based on observation
Flexible test battery testing hypotheses
Qualitative assessment gives direction to rehabilitation
The tasks are simple because the goal is to provoke symptoms.
Ex: recreating hand gestures, objects in objects drawings, find figure in figure
Criticism:
Theory is strongly focused in the left and less on the right hemisphere (emotion is not
assessed)
No empirical testing of theory
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