Advanced Neuropsychology Exam Example Questions
College 1
Question 1
Neuropsychological tasks are meant to elicit behavior in such a way that it helps to
understand possible changes in that behavior. This comes with some pitfalls, one of
which is task impurity.
Explain what is meant with task impurity (2 pt) and provide an example of it (2
pt).
Task impurity refers to the fact that any cognitive task never measures ‘only’ one
concept, is always asks for other function to come up with the good
behavior/response (2 pt). An example is a test for verbal memory. This refers not only
to verbal memory but also to language function (if you have no understanding of the
words you have to remember, this seriously hampers your performance) or any other
example in this line of reasoning (2 pt).
c) A patient comes to your clinic and tells you that nothing is wrong with him.
However, during your interview and examination you can proof the opposite: this
patient has a severe cognitive deficit in visual perceptive functioning.
What could be underlying his own story with respect to his functioning (come
up with 2 explanations)?
This patient can have a disorder in his insight/awareness of his own cognitive
functioning. In its most extreme case this concerns anosognosia (1 pt).
Another explanation is that the patient just doensn’t share it with you because 1. He
hasn’t been confronted with the deficit yet and the testing is the first confrontation, 2.
Afraid to tell you/ashamed to tell you. 3. Afraid of the consequences when the
disorder comes out (e.g. losing his driver’s license).
Question 3
Task impurity seems like a disadvantage, but it is also a good thing. Explain
the advantage?
Task impurity, meaning a task measures more than the intended skill, can be
advantageous because it offers a broader understanding of behavior as a whole.
While it may make results less clear-cut, it provides insights into the interplay of
various cognitive functions in real-life scenarios. For instance, a verbal memory test
may also assess language comprehension, revealing how these skills interact.
College 2
Question 1
Describe the three core executive functions according to Diamond's model
(2013) and provide an example of how impairments in each function could
manifest in daily life.
Diamond's model (2013) proposes that there are three core executive functions:*
1. Working memory: Working memory (WM) temporarily holds and processes
information for tasks such as learning and problem solving. It involves mentally
calculating, rearranging items, or connecting one idea or fact to another. Problems
with working memory can manifest as difficulty remembering information, following
instructions, or multitasking.
2. Cognitive flexibility: Cognitive flexibility is the ability to adapt and switch between
different tasks or mental strategies. This includes being able to think outside the box,
,Advanced Neuropsychology Exam Example Questions
see something from different perspectives, switch quickly between tasks, or change
course flexibly when necessary. Problems with cognitive flexibility can manifest as
rigidity, difficulty adapting to change, or being stuck in certain thought patterns.
3. Inhibitory Control: Inhibitory control is the ability to choose how to respond and
involves suppressing reactions and distractions to focus on relevant information. [8,
9] It involves choosing to follow or reject an impulse. [9] Problems with inhibitory
control can manifest as impulsiveness, difficulty controlling emotions, or being
distracted by irrelevant stimuli.
Question 2
a) Explain how EF is on the top of the cognitive pyramid and b) give an
example according to a disorder?
EF is considered at the top of cognitive pyramid because it encompasses higher
order cognitive processes that enable an individual to manage and regulate other
cognitive functions, enabling goal-directed behavior.
For example, a person diagnosed with ADHD may face challenges with attention and
organization. However, if their EFs are intact, they can develop strategies to manage
these challenges effectively, demonstrating the overarching role of EFs in the
cognitive hierarchy.
Question 3
Explain 2 caveats of EF testing, and give examples?
a) Task Impurity: Many EF tests don't isolate executive functions. They often involve
non-executive processes like attention and memory, making it difficult to interpret
results solely based on EF. For instance, a planning task may require substantial
working memory, confounding the assessment of pure planning abilities.
b) Individual Differences: People vary in their baseline EF abilities and familiarity
with different test types. This variability can affect performance, making it challenging
to compare results across individuals.
Question 4
Working memory and Inhibitory control are related, how are they related?
In the model of Diamond, both are components of the broader executive function
system. They interact closely because effective working memory relies on the ability
to inhibit irrelevant information and distractions. In other words, to use working
memory effectively, you need to control and manage distractions through inhibitory
control. On the other hand, inhibitory control uses the working memory, because the
working memory should actively maintain and hold on to the goal. By maintaining the
goal, inhibitory control knows what he should inhibit and what is relevant for working
memory.
Question 5
Zink et al. (2021) describe two approaches to understanding the neural
organization of executive functions: centralized and distributed control
systems.
a) Describe the main difference between these two systems.
b) Name two main advantages of a distributed control system over a
centralized system. Briefly explain these advantages.
c) Mention key principles of a distributed control system. Briefly explain these
principles
, Advanced Neuropsychology Exam Example Questions
a) The main difference between a centralized and a distributed control system lies in
the way executive functions are organized and controlled.
- Centralized control system: This model suggests that a single brain region,
such as the prefrontal cortex (PFC), acts as the primary coordinator and
directs other brain regions to manage complex cognitive tasks and actions.
- Distributed control system: In this model, multiple brain regions interact and
influence each other, with each region able to both control and be controlled.
Executive functions emerge from the interaction between distributed elements.
b) 2 advantages of a distributed control system over a centralized system are:
Robustness to damage: A distributed system is less vulnerable to damage to a
specific brain area. If one region is damaged, other regions can (partly) take over the
function of the damaged region. This contrasts with a centralized system, where
damage to the central controller can lead to a complete disruption of executive
functions. (because of the self organization through simple rules)
Flexibility and adaptability: A distributed system is more flexible and can adapt better
to changing circumstances. The interaction between different brain areas ensures
greater dynamics and adaptability, allowing the system to respond better to new and
complex situations. A centralized system, on the other hand, can be more rigid and
less responsive to unforeseen circumstances.
c) Multiple answers possible:
- Horizontal information flow: information is derived from neighbours, not from a
central communicator
- Stigmergy: de signalen die gedrag aansturen, komen van de acties zelf.
signals that direct behavior come from the actions itself
- Feedback loops: using feedback to adjust and refine processes
- Self-organization through simple rules: system is based on easy to implement
rules. This makes it:
Robustness and flexible to changes or damage
- Quorum sensing: consensus-based control mechanism wherein a set
threshold or quorum determines the course of action
Question 6
Alex moved from Overvecht to Lombok. After class, he wants to cycle from Utrecht
Science Park to his new home in Lombok. However, he suddenly finds that he has
driven past the turning point and is heading straight to his old house in Overvecht.
a) Explain what happened and what went wrong, according to the model of Tim
Shallice on the Supervisory Attentional System.
- A task schema with a learned/familiar (note: ‘automatic’ is not the same)
sequence of input-output rules was activated, this is the dominant/automatic
route.
- Because Alex has moved, he faced a novel situation.
- In a novel situation the Supervisory Attentional System should have monitored
better, to
prevent the habitual response (OR: inhibit the error/old schema/old
schemata),
and activate (OR: create) a new schema
