Psychass

• Neuropsychology


  The branch of psychology that focuses on the relationship between brain functioning and behavior
• Neuropsychology


  • Formerly a specialty area within clinical psychology, neuropsychology has evolved into a specialty in its own right, with its own training regimens and certifying bodies
• Neuropsychologists


  Study the nervous system as it relates to behavior by using various procedures, including neuropsychological assessment
• Neuropsychological Assessment


  The evaluation of brain and nervous system functioning as it relates to behavior

  
• Subspecialty areas within neuropsychology

  • Pediatric neuropsychology
  • Geriatric neuropsychology
  • Forensic neuropsychology
  • School neuropsychology
• Central nervous system


  Consisting of the brain and the spinal cord
• Peripheral nervous system


  Consisting of the neurons that convey messages to and from the rest of the body
• Cerebrum


  The large, rounded portion of the brain that can be divided into two sections or hemispheres

  
• Each of the two cerebral hemispheres receives sensory information from the opposite side of the body and also controls motor responses on the opposite side of the body—a phenomenon termed contralateral control
• It is due to the brain's contralateral control of the body that an injury to the right side of the brain may result in sensory or motor defects on the left side of the body

  
• Corpus Callosum


  The meeting ground of the two hemispheres although one hemisphere—most frequently the left one—is dominant
• It is because the left hemisphere is most frequently dominant that most people are right-handed
• Dominant Hemisphere


  Leads in such activities as reading, writing, arithmetic, and speech
• Nondominant Hemisphere


  Leads in tasks involving spatial and textural recognition as well as art and music appreciation
• In the normal, neurologically intact individual, one hemisphere complements the other
• Tools used by investigators

  • High-technology imaging equipment
  • Experimentation involving the electrical or chemical stimulation of various human and animal brain sites
  • Experimentation involving surgical alteration of the brains of animal subjects
  • Laboratory testing and field observation of head-trauma victims
  • Autopsies of normal and abnormal human and animal subjects
• Neurological Damage


  May take the form of a lesion in the brain or any other site within the central or peripheral nervous system
• Lesion


  A pathological alteration of tissue, such as that which could result from injury or infection
• Neurological lesions may be physical or chemical in nature, and they are characterized as focal (relatively circumscribed at one site) or diffuse (scattered at various sites)
• Because different sites of the brain control various functions, focal and diffuse lesions at different sites will manifest themselves in varying behavioral deficits

  
• Circumscribed Lesion


  May affect many kinds of behaviors, even variables such as mood, personality, and tolerance to fatigue. It is possible for a diffuse lesion to affect one or more areas of functioning so severely that it masquerades as a focal lesion
• With an awareness of these possibilities, neuropsychologists sometimes "work backward" as they try to determine from outward behavior where neurological lesions, if any, may be
• Neurological Assessment


  May also play a critical role in determining the extent of behavioral impairment that has occurred or can be expected to occur as the result of a neurological disorder or injury
• Brain damage


  Any physical or functional impairment in the central nervous system that results in sensory, motor, cognitive, emotional, or related deficits

  
• Neurological damage


  Covers not only damage to the brain but also damage to the spinal cord and to all the components of the peripheral nervous system

  
• Organicity


  Derives from the post–World War II studies of brain-injured soldiers led by German neurologist Kurt Goldstein, who concluded that the factors differentiating organically impaired from normal individuals included the loss of abstraction ability, deficits in reasoning ability, and inflexibility in problem-solving tasks
• Goldstein and his colleagues developed psychological tests that tapped these factors and were designed to help in the diagnosis of organic brain syndrome, or organicity for short
• The tests included tasks designed to evaluate test-takers' short-term memory and ability to abstract
• Birch and Diller (1959) were already beginning to question the "naïvete of the concept of 'organicity'", noting that "brain damage" and "organicity" are not identities and serve to designate interdependent events
• Hard Sign


  An indicator of a definite neurological deficit, such as abnormal reflex performance or cranial nerve damage as indicated by neuroimaging
• Soft Sign


  An indicator that is merely suggestive of a neurological deficit, such as an apparent inability to accurately copy a stimulus figure or relatively minor sensory or motor deficits
• The objective of the typical neuropsychological evaluation is to draw inferences about the structural and functional characteristics of a person's brain by evaluating an individual's behavior in defined stimulus-response situations

  
• Areas of history taking in a neuropsychological examination


  • Medical history of the patient
  • Medical history of the patient's immediate family and other relatives
  • Presence or absence of certain developmental milestones
  • Psychosocial history
  • Character, severity, and progress of any history of complaints involving various functions
• Beyond the history-taking interview, knowledge of an assessee's history is also developed through existing records, which are valuable resources for determining the level of the patient's functioning and neuropsychological intactness prior to any trauma, disease, or other disabling factors
• Examples of Structured Interviews in Neuropsychological Evaluation

  • Short Portable Mental Status Questionnaire
  • Neuropsychological Impairment Scale
  • Mini-Mental State Exam (MMSE-2)
  • 7 Minute Screen
• Neither the Short Portable Mental Status Questionnaire nor the 7 Minute Screen should be used for the purpose of diagnosis
• Neuropsychological Mental Status Examination


  Overlaps the general examination with respect to questions concerning the assessee's consciousness, emotional state, thought content and clarity, memory, sensory perception, performance of action, language, speech, handwriting, and handedness, but may delve more extensively into specific areas of interest
• Non-invasive procedures performed as part of the neurological examination


  • Observations about the examinee's appearance
  • Physical examination of the scalp and skull
  • Assessment of reflexes

  
• Sample Tests Used to Evaluate Muscle Coordination


  • Walking-running-skipping
  • Standing still (Romberg test)
  • Nose-finger-nose
  • Finger wiggle
• Parkinson's Disease


  A brain disorder that leads to shaking, stiffness, and difficulty with walking, balance, and coordination, caused by the loss of neurons in the substantia nigra that produce the neurotransmitter essential for normal movement