Week 5 Flashcards

1
Q

Neuropsychology

A

Study of the relationship between behaviour, emotion and cognition on one hand and brain function on the other hand

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2
Q

Clinical neuropsychology

A

Assessing and cognitive, emotional and behavioural function after suspecting brain damage for diagnosis and potential treatment
=> diagnosis and treatment
Imperfect index of brain function

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3
Q

Different diagnosis

A

Brain damage after trauma, vascular accidents, tumors, toxicity, infections (also neurodegenerative diseases or just aging)

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4
Q

Physical differences brain

A

No brains are the same.
Brain plasticity can be affected by specialised SKILL acquisition, Enrichment, deprivation.
Cultural: education, stress, health
Correlates on differing cognitive mechanisms
Experience more generally

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5
Q

Cultural neuroscience

A

Field with focus on factors that affect biological and psychological processes that reciprocally shape beliefs and norms shared by groups of individuals

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6
Q

Physical differences: GENETICS

A

Core of nature/nurture interactions.
- heredity: passing on characteristics from parents to children based on genetic material.
- although 99% is fixed, 1% differ across individuals
- genes can have effects that depend on external variables
(cat with darker spots due to different heat patterns)

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7
Q

Epigenetics

A

Environmental factors cause genes to switch on or off without modification of the dna sequence.
- chemical tags can control genes in specific cells
- epigenetic tags can result from lifestyle choices or specific experiences
- some epigenetic tags are hereditary

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8
Q

Different approaches physical differences

A

1) how can thr same physiological characteristics lead to different outcomes depending on one’s culture?
2) how can the same culture lead to different outcomes depending on one’s physiological characteristics?

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9
Q

Relationship between biology and behavior

A

May depend on the cultural meanings of behaviour, rather than on the actual behaviour

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10
Q

Normative data (NP Assessment)

A

Is based on very limited subsample (WEIRD patients!)
=> partial and biased

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11
Q

Cultural affect on NP Assessment

A

1) values and meaning
- no general agreement on verdiensten van reacties. =>Attitude speelt hierin een rol
2) modes of knowing
- individuele taak vs collectivistisch streven
=> why would it matter what i know if i am part if a collective?
3) conventions of communication
- interaction: one way questions, authority
- type of questions: both in content and way of asking

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12
Q

Patterns of abilities

A

Culture prescribes what should be learned at what age and by what genders.
Results in culture- specific clusters.
Tests need to be appropriate for subjects learning opportunities and contextual experiences.

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13
Q

Cultural values

A

Culture dictates what is or is not situationally relevant and significant or even appropriate.

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14
Q

Specific testing (cultural values)

A

Vb. 1 op 1 testing relationship with stranger
=> best performace: why try to get a high score?
=> background authority: why follow orders?
=> isolated environment: unusual social situations
=> specific type of communication: unusual language
=> speed: why trade off speed for accuracy?
=> private embarrassing or subjective issues
=> specific materials and strategies

Based on values that are not necessarily shared!

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15
Q

Familiarity (during testing)

A

1) testing situation (part of school culture)
2) attitudes that facilitate good performance (motivation and purpose)
3) elements (vb. objects, situations, stories, animals, plants, foods)
4) strategies needed to solve task (vb. spelling met het alfabet en windrichtingen)

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16
Q

Whorfian hypothesis

A

Language influences thoughts

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17
Q

Language

A

The use and meaning differs with cultural and subcultural background. Correlates with educational level, testing language often formal.

Make sure test instructions are understandable and appropriate

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18
Q

Education

A

Accounts for 50% of variance in IQ tests, 38% in NP tests.
Schooling increases test performance, smaller increases with each year of schooling

19
Q

Double role for education

A

1) increases knowledge of the test content
2) increases familiarity with testing setting and strstegies

20
Q

Illiteracy

A

Not being able to read or write.
2/3 of illeterates are women
Literacy is closely tied to poverty in Europe, North America and Australia

21
Q

Functional iliteracy

A

Reading and writing is inadequate “to manage daily living and employment tasks that require reading skills beyond a basic level”
Can be high in specific groups.
Vb. document reading, reading a book from a to z. This is associated with poorer health (difficulty navigate the health care system)

22
Q

Illiteracy and cognition

A

Learning to read reinforces certain cognitive abilities, such as verbal memory, phonological awareness, and visuospatial discrimination.

23
Q

Illiterate individuals shows lower scores on:

A

Naming tasks, verbal fluency, verbal memory, visuo-perceptual abilities, conceptual functions, numerical abilities.

More difficulty with copying nonsense figures or words -> concrete real life situations much easier to process.

24
Q

Minorities within a culture

A

Different ethnic groups in one country, after migration (especially first generation), groups with no country.
These groups have more difficulties with fitting in the health care system and test system.

25
Distinguish minorities within a culture
1) nationality and legaly 2) relative culture distance to majority culture 3) relative language distance to majority language 4) normality: how strange is the minority culture perceived by the majority? 5) reference group: how big is the minority group? 6) social image: positive or negative attitudes towards a minority group
26
Necessarity for specific tests and norms
Not clear how specific relative scores are needed. Fir each laguages? Cultural region? Educational level? SES level? Age group? => DEPENDS ON COGNITIVE FUNCTION! Understanding the underlying variables is as important as the specific norms
27
Aging
Cognitive functions decline with age (Not all: memory and executive functions > vocabulary and world knowledge) Risk of mild cognitive impairment and dementia increases with age
28
Mild cognitive impairment
Cognitive changed that are serious enough to be noticed, not severe to interfere with daily life of independent functions => memory impairment most common subtype => progression to dementia in 10-15% of afflicted persons per year
29
Dementia
Umbrella term for symptoms caused by neural disorders, especially cognitive symptoms
30
Most common causes of dementia
Alzheimer (550-80%) Vascular dementia (20%) Dementia with lewy bodies (15%) Frontotemporal dementia (5%) This data is from western sample!
31
Screening for dementia
Mini mentak screening exam (Folstein) - orientation to time and place - naming - registration - attending and calculation - recall - repetition - complex command Max score= 30, dementia is < 24 !!! Screening not diagnosis
32
Prevalence MCI and Dementia
MCI: 3-19% with risk of developing dementia 11-33% within 2 years. Dementia prevalence: 5.6-4.6% (> 60 years)
33
Dementia and poverty
More dementia in poorer countries
34
Migrant groups in the Netherlands
25% of population consist om migrants => tuks, marokkaans, surinaams 65% hiervan First generation non-western immigrants are aging 9% of older population in 1990, 15% in 2029, 26% expected in 2050. Native dutch older groups grows a bit less fast. Older immigrants in the us show higher prevalence of risk factors for dementia (and other diseases)
35
Care experts
64% thinks its more challenging to assess dementia in patients from ethic minorities. Language, presentation of symptoms, educational level, lacking assessment tools, lacking cultural knowledge.
36
Over and under diagnosis
Accurate: high sensitivity (good true detection) and high specificity (low false detection) Denmark beliefs - dementia is under diagnosed in migrant groups - finding: in general health care, immigrants show different rates of disgnosis - finding: age effects -> overdiagnosis younger people and underdiagnosis of older groups
37
Reasons age effects in diagnosis
Differences in health seeking behaviour - stigma on illness, especially dementia - more inclined to solve problems within the family - insufficient knowledge of dementia Difficulty with health care system - language barrier - literacy skills Assessment and diagnosis - Language and literacy - Test wiseness
38
Culture fair testing
Need to account for cultural values, familiarity, language, different education levels, interpretation of norms
39
Cross cultural dementia screening
Developed in Amsterdam - instructions in own language - culture free/ fair items - nonverbal as much as possible Domains: memory, mental speed, executive functions
40
Cross cultural dementia tasks
Memory Object test: remember objects among destractors (household items shown in coloured pictures-> immediate and delayed recognition) Mental speed and divided attention Dots test: connect objects in order of increasing numbers (adjusted trail marking test looks like dominos, using black and white domino’s instead of numbers als letters) Mental speed and inhibition test Sun-moon test: cross name pictures in own language (adjusted stroop task using only pictures, takes speed and accuracy into account)
41
Interpreters
No longer covered by dutch insurance since 2012. 6 languages. Interpreters that are not family are preferred, shamefull for patient, covering up by interpreter Native testers are ideal!
42
CCD evaluation
Total battery Sensitivity (true detection of dementia 85%) Specificity (true detection of no dementia 89%) Mmse: sensitivity 76%, specificity 83% All subtests showed good individual sensitivity and specificity, strongest predictors: object test B (delayed) and sun moon test B (interference)
43
Symbol study
SYstematic Memory testing Beholding OLder MIgrants. Aim: assess prevalence MCI and dementia in migrants > 55 jaar and map their and their care givers health care use and care needs (cross sectional) Hypothesis: prevalence in MCI and dementia for older immigrants = 2x prevalence in native Dutch. Results: Dutch lowest group with dementia compared to migrants Conclusion: 3-4x more prevalent in majority of non western immigrant groups compared to Dutch
44
Implications symbol studies
- Differences are important for planning and improving health care facilities. - Broad use of culture fair diagnostic tools (more focus necessary on reliability of existing tools) - Adjustments in care homes (food, activities, languages) - increasing awareness among migrant groups (sigmas) - with growing group of elderly migrants, this issue will become increasingly important