Single Case Studies

Question 1

patient HM

Answer 1

bilateral medial temporal resection
- profound forgetfulness (anterograde and retrograde)
- absence of intellectual problems

Question 2

patient RB

Answer 2

highly localized stroke
- can’t form new memories
- part of hippocampus destroyed
- area called CA1
- procedural intact

Question 3

hippocampal damage - what kind of memory tasks are impaired

Answer 3

recognition and recall equally

Question 4

what can we learn from HM

Answer 4

• memory isn’t unitary
• memory regions not involved in intellectual functions
• immediate memory and maintenance separate
• permanent memory stored elsewhere (than hippocampus)

Question 5

Prof John Crawford (statistical man)

Answer 5

dissociation essential in addition to group studies
methodological rigour!

Question 6

why single case research

Answer 6

• only way of measurement for some constructs
• collection of norms time consuming
• norms may not be applicable
• intra individual comparison problematic
  SO: use modestly sized matched control sample

Question 7

Crawford alternative for single case comparisons

Answer 7

no comparison with general population
but comparison with matched control sample –> does client come from control pop (H0) or do they not (H1)

Question 8

adding dissociation to single case comparison

Answer 8

Test X < Test Y
Test X < controls
Test Y = controls

Question 9

t test

Answer 9

t= difference between two quantities / standard error of difference

Question 10

patient NC (female)

Answer 10

Susac’s syndrome
- rare microangiopathy: encephalopathy, hearing loss, retical occlusions
- white matter lesions mostly right and corpus callosum

Question 11

spatial relations, hemispheric divide

Answer 11

LH: categorical (rocking chair left of couch)
RH: coordinate ( rocking chair is closer to the dining chair than to the couch)

Question 12

NC neuropsychological impairment

Answer 12

mixed pattern if impaired performance
- important to take into account observations
- important to look at relative performance
NC appears biased to small scope of attention with less global attention in Line with her right hemisphere damage

Question 13

what can we learn from NC

Answer 13

spatial relation processing linked to attention
existing model (left right divide of categorical and coordinate) too simple
- actually more interconnected with frontal and visual cortex affecting Both left and right parietal but in different ways
visual gives info large to right and small to left
frontal gives info coordinate to right and categorical to left
both sides together make decision

Question 14

patient IS

Answer 14

unable to create mental representations of spatial situations
- gets lost often
- since childhood
- no memory complaints or cognitive difficulties besides
- no brain damage malformation or condition

Question 15

assessing change over time - uses

Answer 15

track recovery
evaluate intervention
disease progression
forensic evaluation
pathological aging

Question 16

assessing change

Answer 16

actual change +ERROR (different ways)

Question 17

error - Patient variables

Answer 17

demographic variables (imrpvoement expected for age group)
clinical condition ( may vary at differing timepoints)
prior experiences (exposed to related activities affecting performance)

Question 18

error - Testing situation

Answer 18

retest interval (reliability decreases with longer intervals)
regression to mean (drift towards population mean)

Question 19

error - Test variables

Answer 19

reliability
practice effects
novelty
floor or ceiling effects

Question 20

error assesment

Answer 20

• simple discrepancy score
  Performance Time 2 - Performance Time 1
  (easy, less precise estimate, doesn’t control for factors affecting repeated assessment)

Question 21

error assesment - Standard deviation index

Answer 21

simple discrepancy score/ SD of performance at Time 1

(widely used, easy, more precise, no control for variables affecting repeated assessment)

Question 22

error assesment - reliable change index

Answer 22

simple discrepancy score/ SED
(standard error of difference, estimates standard error of differences not score itself like in prior one)
(more precise estimate for change, controls for reliability of test, doesnt control for practice effects)