Assessment of "functional" causes" of poor test performance Flashcards
What is one conscious process that might be involved in cognitive problems/ poor cognitive functioning?
Malingering!
What might be the cause for malingering?
Secondary gains:
Direct financial, indirect social and personal (avoid military/criminal charges)
Conscious vs. unconscious production of sx
- Somatic sx disorder/ conversionvs malingering
- Sometimes both conscious and unconscious influences exist
It’s not debated that, at some level, ____interferes with some level of functioning
STRESS!!
Differential diagnosis
- Conscious vs. unconscious production of symptoms
- Both conscious and unconscious influences
- “Functional” and veridical brain damage co-exist
- Brain damage related cognitive impairments with emotional reaction to deficits
From Dr. D: Conversion is limited to motor/sensory
-The DSM doesn’t allow for a psych process to be the cause of neuropsych problem – neuropsychs ignore it. The psych process manifests itself as a cognitive deficit or impairment. Dx criteria only allow with phys/ med, but we know it can be cognitive sx. Neuro eval – do testing first. Do below-avg. tests scores make sense? If the answer is no (they don’t provide pattern), they do not rep. a brain process, yet something else.
that’s all
Evaluation of malingering - pattern of performance in standardly administered tests:
- Inconsistencies in test performance
- poorer recognition than recall memory performance; poor memory test performance with good recall of events in past few months - Bizarre or unusual performance
- unusually poor Digit Span performance; “near miss” of approximate answers
a. one off on Arithmetic answers
b. Anna Thompson was from Maine
c. She worked as a dishwasher - Performance more impaired than that documented for a patient with comparable injury
- Repeat testing
- Comparison of two sets of test results will reveal consistency or lack thereof in test performance
