Lec 62 Neuropsychological Assessment Flashcards
What is purpose of psychological testing? two types?
- formal assessment of emotionality, intellectual abilities, personal characteristics and psychopathology
- objective or projective
What is purpose of projective test?
personality test to let person in open-ended way respond to ambiguous stimuli –> to reveal hidden emotions and internal conflict
- responses assumed based on motivational state, analyzed for meaning
What is the purpose of an objective test?
responses are analyzed according to universal standard (ex. multiple choice exam)
score and statistically analyzed
What is the minnesota multiphasic personality inventory [MMPI]?
objective psychological test
- defines normal personality structures and psychopathology based on 567 T/F
- all self-report
What is the rorschach test?
initially developed as IQ test but later as projective personality test to identify thought disorders and defense mechanisms
theory: underlying psych organization and needs will be projected onto ambiguous stimuli such as ink blots
shown 10 cards and asked to free associate
What is thematic apperception test (TAT)?
projective psychology test
subject asked to tell dramatic story about each of pics represented
responses provide info about unconscious views of self, world, interpersonal relationships
What is the sentence completion test (SCT)?
projective pych test
pt completes sentences started by examiner; identify worries, conflicts, motivations, using verbal associations
What are research tools used for psychopathology?
- hamilton depression rating scale
- montgomery asberg depression rating scale
- young mania rating scale
- BPRS
What is the beck depression inventory [BDI]?
21-Q self-report inventory
used clinically
screening + measuring severity of depression
- symptoms of depression - hopelessness, irritability, cognitions such as guilt, feelings of being punished, physical symptoms
What is the PHQ-9?
clinically used
9-item depression scale
in primary care setting used to diagnose depression and select and monitor treatment
score >= 10 have sensitivity/sepcificty 88% for major depressive disorder
What is the PHQ-2?
2 questions initial screen for depressed mood and anhedonia
if positive –> administer PHQ9
used clinically
What is use of neuropsych testing?
inform about integrity/efficacy of the brain through a comprehensive sampling of its behaviors products
covers: sensory-perceptual, attention + concentration, motor, visuospatial, language, abstract thought, new learning/memory, intellectual, executive functsion
What are goes of neuropsych testing?
- diagnosis
- gain better understanding neurocognitive deficit + its impact on individual function
- change in function over time
–> cannot localize lesion or tell cause of the deficit
What does IQ assessment tell you?
WAIS-R or Stanford-Binet
- intelligence defined as measure of innate potential for learning
What is mental age?
person’s level of intellectual functioning
What is chronological age?
person’s actual age in eyar
What is equation for IQ?
IQ = Mental age / chronological age * 100
What is premorbid IQ?
how a person would be expected to perform if he/she did not have an illness?
Does IQ change with age?
relatively stable throughout life [esp in absence of brain pathology]
What is average IQ?
100
What is cutoff for normal vs mental retardation?
IQ < 70 is abnormal = MR
What is WAIS-R?
wechsler adult intelligence scale = most popular IQ test
- also WISC-R for children and WPPSI for preschool and primary children
What is vineland social maturity scale?
used to evaluate skills for daily living in mental retarded and other intellectually disabled
What is rey osterrieth complex figure test?
evaluates visuospatial abilities, memory, attettion, planning/executive function
What is california learning test?
list of 16 words presented over 5 trails with expected “learning curve” followed by short then long (20 min) delayed recall and recognition
tests ability to acquire, store, retrieve verbal info
What is stroop test?
measures selective attention, cognitive flexibility, problem solving, processing speed
used as a tool in evaluation of executive function
stroop effect –> activate frontal lobe = anterior cingular cortex, dorsolateral prefrontal cortex
What is wisconsin card sorting test?
test of set-shifting
ability to display flexibility in face of changing schedules of reinforcement
sensitive to frontal lobe dysfunction
What is function of neuropsychological testing?
may help localize CNS impairment
can indicate brain dysfunction in absence clear neuro, imaging, or EEG signs
What is mini-mental state exam (MMSE)? normal?
30 point questionnaire to screen for cognitive impairment, estimate severity and follow course of change
= arithmetic, memory, attention, visuospatial function, language, orientation
score range = 0 to 30
25 or higher = normal
How does MMSE change over time in alzheimer’s pt?
declines 3-4 pts per year
What cognitive domains can MMSE not tell you about?
executive functioning
What is the montreal cognitive assessment (MOCA)?
30 q test
assess greater variety cognitive ability than MMSE
includes short term memory, executive function
–> include clock drawing test and trails B for executive function
What do series 7 and world backwards assess?
attention and concentration
What tests do assess orientation?
ask person, place, date
How do you assess language?
ask to name objects, repeat sentence, follow commands, write a sentence
How do you assess memory?
ask to register then recal 3 words at 5 min
How do you assess visuospatial function?
copy pentagons or cube and bisect a line
How do you assess executive/frontal lobe function?
draw clock
perform trail B [connect letters to numbers in seq]
