lecture 8- clinical neuropsychological assessment

Question 1

case study: Mrs Y: referred to social services

Answer 1

• Goldstein & McNeill, Chapter 1, p10.
• Head injury 25 years previously
• Distractible during testing
• WAIS FSIQ = 98. Estimated premorbid IQ =
  115.
• Memory OK but learning poor
• Performance on planning and sequencing
  poor
• Concluded historic head injury caused lasting executive dysfunction

Question 2

clinical neuropsychological assessment

Answer 2

suspected to have a brain illness or injury or known to have

Question 2

uses of clinical neuropsychological assessment

Answer 2

• patients with suspected brain illness/injury
• Case formulation: understand nature of
  psychological problems
• Patient care, prognosis, planning of
  interventions
• Legal assessment

-Research

Main aim = understand
nature of problems and how
best to support functioning
in everyday life

Question 3

procedures of assessment

Answer 3

• Medical assessment
• Including neuroimaging, history, medication
• Personal & family history, demographics
• Structured clinical interview
• Assess symptoms and awareness
• Assess mental state
• Observations
• Tests
• Questionnaires/informant ratings

Question 4

test selection: issues to consider when choosing tests

Answer 4

• What are the main aims of the assessment?
• Screening, diagnosis, case formulation, progress over time
• Assessment of care needs or functional potential
• Developing or measuring rehabilitation/treatment package
• Validity and reliability of tests
• Normative data
• Global or specific deficits?
• Patient characteristics

Harvey (2012)

Question 5

reporting scores

Answer 5

• Standard scores: e.g. IQ
• Percentiles: percentage of the population
  who achieve less than a given score
• IQ of 70 = 2nd percentile.
• How decide cut-off point for ‘impairment’?

Question 6

factors to consider when interpretating test scores

Answer 6

• Consider test scores in context of:
• Medical history, behaviour, self-reports, and personal information
• Litigation and malingering
• Multiple testing sessions, over time
• Inconsistencies in performance?
• Trajectory of scores
• Concentration, motivation and emotions
• Distractibility & fatigue
• Emotions: Flat affect, anxiety, depression and frustration

Question 8

sensitivity