Purpose of neuropsychological assessment:
1. Diagnosis
- Distinguish between different neurological disorders
- Discriminating between psychiatric and neurological disorders
- Identifying a possible neurological disorder
Neuropsychological assessment cannot localize the site of a lesion!
2. Patient care and planning
- Identifying cognitive strengths and weaknesses
- Identifying behavioral alterations
- Identifying personality characteristics (Irrespective of a diagnosis)
The above three are needed for optimal and careful management of many disorders
3. Treatment planning and remediation
- What is the most appropriate cognitive rehabilitation treatment?
4. Treatment evaluation
- Did the treatment have an effect?
5. Research
6. Forensic neuropsychology
- In the context of claims of injury and loss of function
- In criminal cases
o Is there reason to suspect brain dysfunction that contributes to misbehavior?
o Is the defendant’s mental capacity sufficient to stand trial?
,Why Hypotheses?
If you do not formulate hypotheses and go through the diagnostic cycle you will easily make
interpretation errors.
Interpretation errors:
- The tendency to rely strongly on some results and to disregard others
- Disregarding the base rate of disorders
o A neuropsychologist who works a lot with patients with Alzheimer’s disease will
have the tendency to diagnose Alzheimer’s disease more often
- Confirmation bias
o Looking for results that support the hypotheses
- Thinking that subjective complaints are objective disorders
Neuropsychological Assessment: Two Classical Approaches
Psychometric approach; Reitan-Halstead Testbattery
- Standardized assessment and scoring
- Uses normative data and cut-off scores per test and for the total test performance
- Quantitative test approach
- Not based on theories about the brain
- Category Test (Does the picture remind you of a 1, 2, 3 or 4?)
- Tactual Performance Test (Patient is blind-folded and has to place the blocks in their
appropriate space with the dominant hand)
- Speech-Sounds Perception Test (Patient has the underline the syllable he hears)
- Trail Making Test
- For each subtest: Does the patient score above the cut-off?
o Calculate Impairment Index:
- A-theorethical
- Fixed test battery
- Only focuses on ‘abilities’ and not on ‘dysfunctions’
o Impaired performance can have several possible causes
o No insight into the nature of the problem
o Gives no direction for rehabilitation
Behavioral Neurological approach: Luria
- After second world war: A large number of patients with brain injury
- Developed test battery based on his view / theory of the brain:
o Attention – Regulated by the brain stem
, o Perception – Posterior part of the brain
Primary (image)
Secondary (interpretation)
Tertiary (cross-modal integration)
o Organization and planning – Anterior part of
the brain
- Simple tasks
o Goal: to provoke symptoms
- Motor functions
- Higher order visual functions
- No empirical testing of his theory
- No normative data
- No standardization
- Based on observation
- Flexible test battery – adjusted to the individual patient
- Qualitative assessment
- Gives direction to rehabilitation
Criticism on Luria:
- Theory is strongly focused on
the left hemisphere.
- No insight into the severity of disorders
- No standardization, normative data or data about the reliability and validity of the tests
Current Situation: Differential diagnostic thinking
- Listen to complaints of patients in an unjudgmental manner
- Try to cluster syndromes, symptoms and impairments
- Be aware of halo-effect: Assuming that a patient has certain complaints or characteristics
which in reality are not present
Neuropsychological Assessment: Focused on Different Domains
- Intelligence Medical history - Perception
- Orientation - Motor skills
- Attention Anamnesis - Memory ((non)-verbal)
- Speed of information processing - Language
- Executive functions Hetero anamnesis - Social cognition
o Planning - Mood
o Cognitive flexibility Observation - Personality
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller eefkedej. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $4.34. You're not tied to anything after your purchase.
