Time to get rid of the ‘Modular’ in neuropsychology: A unified theory of anosognosia as aberrant predictive coding

Cognitive neuroscience, being more inclusive and ambitious in scope than cognitive neuropsychology, seems to have taken the place of the latter within the modern neurosciences. Nevertheless, recent advances in the neurosciences afford neuropsychology with epistemic possibilities that simply did not exist even 15 years ago. Human lesion studies still have an important role to play in shaping such possibilities, particularly when combined with other methods of enquiry. I first outline theoretical and methodological advances within the neurosciences that can inform and shape the rebirth of a dynamic, non‐modular neuropsychology. I then use an influential computational theory of brain function, the free energy principle, to suggest an unified account of anosognosia for hemiplegia as a research example of the potential for transition from a modular, cognitive neuropsychology to a dynamic, computational and even restorative neuropsychology. These and many other adjectives that can flexibly, take the place of ‘cognitive’ next to ‘neuropsychology’ will hopefully designate the much needed rebirth and demarcation of a field, neuropsychology itself, that has somehow lost its place within the modern neurosciences and yet seems to have a unique and important role to play in the future understanding of the brain.     

认知神经心理学简介

认知神经心理学是认知心理学的一个分支。它的目的是探讨当人们执行认知活动的时候,心理信息加工过程是怎样的,所采用的手段是研究这些认知功能受损的病人。它与认知神经科学的不同在于：认知神经心理学关注的是心理（mind）,而认知神经科学关注的是大脑（特别是关注与认知有关的大脑机制）。研究认知神经心理学的方法也可以用于研究发展性认知障碍,如阅读障碍,或者特殊的语言损伤,这就是发展性认知神经心理学。这些方法还可以用于高级认知发面的研究,如信念形成和心理理论。这些高级认知方面的障碍是精神病学的范畴,因此这类研究错觉、幻想或虚构等的认知神经心理学叫做认知神经精神病学。认知神经心理学的典型特征有：1）研究症状,而不是并发症;2）采用个案研究,而不是群体研究;3）主要数据来源是症状间的双分离;4）致力于模块化认知模型的建立。     

Contribution de la neuropsychologie développementale à l'étude des sujets à haut potentiel : une revue de questions

Developmental neuropsychology studies cognitive development in relation with brain maturation and cerebral plasticity. Some authors have reported physiological correlates of intellectual precocity with the purpose of demonstrating neural basis of intelligence. A part of the literature also reports various cognitive profile and specific talents in information processing in the clinical population of gifted children. Thus, the study of exceptional performances may contribute to our knowledge of functional brain organization taking into consideration individual differences.     

Neuropsychological Measures in the Arab World: A Systematic Review

Although Arabic is one of the most widely used languages in the world, little is known on the availability of standardized neuropsychological tests in Arabic. We review the literature published before 2016, using the keywords Arab*, cogniti*, and neuropsycholo*, as well as keywords for each Arab country. PubMed, PsycINFO, Education Source, Academic Search Complete, Education Resources Information Center, Shamaa, and Arabpsynet databases were searched, in addition to a selected number of Arabic medical and educational journals. After excluding case reports, studies conducted on Arab groups residing outside the Arab world or Israel, and studies that employed intelligence scales or cognitive screens without standardization, 384 studies were eventually reviewed. Tests with most extensive use, adaptation, validation and norming were identified. The Raven Matrices, with its variants, was the most normed cognitive test for Arab individuals (normed in 16 countries). The rate of neuropsychology publications from the Arab countries combined, per year, was less than half of that of each American journal (top 10 journals pertaining to cognition). Nonetheless, the rate in Arab countries has increased after 2010. Publications were mostly from Egypt and Saudi Arabia, but the ratio of test adaptation-to-publication was the largest in Jordan and Lebanon. Approximately half of these publications did not employ cognitive tests that were developed, translated, adapted, or standardized according to international guidelines of psychological measurement. We provide recommendations on improving clinical neuropsychology to better serve Arab patients.     

词汇表征和加工理论及其认知神经心理学证据

认知神经心理学为探讨语言心理表征和加工理论提供了新途径 ,使得人们对心理词典结构的认识不断深入细化。研究表明词汇不同性质的信息在表征上相互独立 ,词典系统至少包括语义系统、语音输入词典与语音输出词典、字形输入词典与字形输出词典等模块。本文着重介绍了这一词典系统及其认知神经心理学证据     

Cognitive modifiability as a function of mother–child mediated learning strategies,mothers' acceptance–rejection,and children's personality

This study investigated (a) the effects of mediated learning experience (MLE) in mother–child interactions on cognitive modifiability as measured by dynamic assessment, (b) the effects of mothers' acceptance–rejection towards their children and the children's personality on the mothers' MLE strategies, (c) the combined effects of the mothers' acceptance–rejection, children's personality, and MLE strategies on children's cognitive modifiability, and (d) the prediction of cognitive modifiability by MLE interactions in two distinct conditions: free-play and structured. Fifty-four mother–child dyads (26 boys and 28 girls) in grade 2 were videotaped interacting in two situations: free-play and structured. The interactions were analysed with observation of mediation instrument using five criteria: intentionality and reciprocity, transcendence, meaning, feelings of competence, and regulation of behaviour. The children were administered the parent acceptance–rejection questionnaire, the personality assessment questionnaire, and the children's inferential thinking modifiability test. A distal–proximal factors of cognitive modifiability model was used to explain causal paths among mothers' acceptance–rejection and children's personality (distal) on MLE (proximal), and of both on children's cognitive modifiability. A structural equation model analysis revealed that (a) all MLE criteria were predicted by the distal factors of mothers' acceptance–rejection and children's personality, (b) none of the mothers' attitudes or children's personality factors explained the children's cognitive factors, (c) MLE criteria of transcendence and regulation of behaviour explained the children's CITM-post-teaching score but not the CITM-pre-teaching score. The results are discussed in relation to Feuerstein's MLE theory and Tzuriel's previous results with preschool children. © 1998 John Wiley & Sons, Ltd.     

TENI: A comprehensive battery for cognitive assessment based on games and technology

TENI (Test de Evaluación Neuropsicológica Infantil) is an instrument developed to assess cognitive abilities in children between 3 and 9 years of age. It is based on a model that incorporates games and technology as tools to improve the assessment of children’s capacities. The test was standardized with two Chilean samples of 524 and 82 children living in urban zones. Evidence of reliability and validity based on current standards is presented. Data show good levels of reliability for all subtests. Some evidence of validity in terms of content, test structure, and association with other variables is presented. This instrument represents a novel approach and a new frontier in cognitive assessment. Further studies with clinical, rural, and cross-cultural populations are required.     

That Burning Bush Again: the psychometric assessment of stages in religious thinking

The influence of Dr Ronald Goldman's work on RE in the 1960s is not disputed. However, questions still remain about what was actually measured by his questionnaire. This article describes an attempt to define the constructs inherent in Goldman's work, to examine what his instrument was actually assessing, and to what extent his instrument can be shown to measure unidimensional factors. It is shown by this study that the statements made by children of different ages and quoted by Goldman as representing different levels of thinking do not cohere well. Nonetheless it is possible to identify a number of these statements which do cohere well. However, even these purified cores of statements do not function as Goldman predicted, that is, as a measure of cognitive development related to age. No correlation can be shown between the so‐called levels of thinking and age. However, an highly significant correlation emerges between ‘level’ of thinking and church attendance. This leads to the suggestion that Goldman's interview‐based test was not measuring a stage in cognitive development but rather a style of thinking related to religiosity.     

Russian Neuropsychology After Luria

It is now more than 20 years after Luria's death in 1977. His collaborators, disciples, and followers both in Russia and abroad continue to further develop his work. The development of Russian neuropsychology reflects the universal tendency to replace static neuropsychology, which relates individuals' behavior to fixed cerebral lesions, with dynamic neuropsychology, which analyzes the dynamics of brain-behavior interaction. Three types of Russian studies illustrate the latter approach: (1) neuropsychological follow-up of different nosological groups of patients in the process of medical or psychological treatment, (2) studies of cognitive evolution (developmental neuropsychology), and (3) studies of cognitive involution (neurogeriatrics). All studies focus on cortico-subcortical and interhemispheric relationships. Another change in modern Russian neuropsychology consists of combining the qualitative approach with the quantitative one, but the system of rating is based, following Luria's tradition, on the psychological evaluation of each task's structure and the qualitative analysis of the patients' performance and possibilities for its correction. Hence, Luria's creative and comprehensive approach stimulates the further development of neuropsychology in Russia.     

Cognitive Neuropsychology and Developmental Disorders: Uncomfortable Bedfellows

Cognitive neuropsychology provides a theoretical framework and methods that can be of value in the study of developmental disorders, but the "dissociation" logic at the centre of this approach is not well suited to the developmental context. This is illustrated with examples from specific language impairment. Within the developing language system there is ample evidence for interaction between levels of representation, with modularity emerging in the course of development. This means that one typically is seeking to explain a complex pattern of associated impairments, rather than highly selective deficits. For instance, a selective impairment in auditory processing can have repercussions through the language system and may lead to distinctive syntactic deficits that are seen in written as well as spoken language. Changes in the nature of representations and in the relationships between components of a developing system mean that cross-sectional data at a single point in development may be misleading indicators of the primary deficit. Furthermore, traditional cognitive neuropsychology places a disproportionate emphasis on representational (competence) deficits, with processing (performance) deficits being relatively neglected. Methods for distinguishing these two kinds of impairment are discussed, as well as other approaches for elucidating the underlying nature of developmental disorders.     

An Introduction to Neuropsychological Assessment

Since its inception in the 1940s, clinical neuropsychology has evolved into a field encompassing a diverse and sometimes bewildering array of theoretical points of view and technical approaches. The purpose of this article is to acquaint counselors with the primary historical developments, current perspectives, and clinical applications of neuropsychology so that they can make optimal use of this valuable diagnostic approach. Neuropsychological assessments are significant for counselors in evaluation, remediation, and ongoing counseling of clients and their families. These assessments allow the identification of patients whose cognitive deficits have been underestimated or overestimated by other diagnostic procedures and provide clinically relevant information about potential for and specific means to promote recovery. Advocacy for clients, as broadly conceived, is also an important role for counselors.     

Brain Activity and Cognitive Transition during Childhood: A Longitudinal Event-Related Brain Potential Study

This study examined the relation between brain activation and cognitive development using event-related brain potentials (ERPs) and a longitudinal design. Five-year-old girls performed a visual recognition (‘oddball’) task and an experimental analogue of the Piagetian conservation of liquid quantity task at three experimental sessions, with one year between consecutive sessions. The data revealed age-related changes in neurocognitive mechanisms common to both tasks. In comparing children before and after a Piagetian transition on a traditional clinical conservation test the data revealed a major shift in performance and ERPs to the experimental analogue of the liquid quantity task. These findings are consistent with a previously performed cross-sectional study and provide strong support for the hypothesis that cognitive transition is related to new neurocognitive mechanisms emerging during childhood. Possible implications of these findings for child neuropsychology are discussed.     

One hundred years of neuropsychology in Japan: Retrospect and prospect

The development of neuropsychology in Japan since the end of the 19th century will be outlined, including a number of pioneering works that gave a scientific basis to contemporary Japanese neuropsychology. The activities of societies/associations of related disciplines as well as the educational systems of clinical and experimental neuropsychology, which represents in Japan an interdisciplinary field, will be described. After national and international activities are mentioned, a review of significant Japanese contributions to main topics in neuropsychology will be given in some detail: dementia, memory disorders, frontal lobe syndromes, aphasia-alexia-agraphia, callosal syndromes, and specific right hemisphere syndromes. The issues of these interdisciplinary scientific investigations have found application in language and cognitive disabilities of brain-damaged patients, as well as evaluation of medical treatments and comedical rehabilitational efforts, care, and counseling. Finally, some comments will be presented on possible and desirable developments of Japanese neuropsychology in the future.     

Neuropsychological predictors of conversion to probable Alzheimer disease in elderly with mild cognitive impairment

In the field of neuropsychology, it is essential to determine which neuropsychological tests predict Alzheimer's disease (AD) in people with mild cognitive impairment (MCI) and which cut‐off points should be used to identify people at greater risk for converting to dementia. The aim of the present study was to analyse the predictive value of the cognitive tests included in a neuropsychological battery for conversion to AD among MCI participants and to analyse the influence of some sociodemographic variables – sex, age, schooling – and others, such as follow‐up time and emotional state. A total of 105 participants were assessed with a neuropsychological battery at baseline and during a 3‐year follow‐up period. For the present study, the data were analysed at baseline. During the follow‐up period, 24 participants (22.85%) converted to dementia (2.79 ± 1.14 years) and 81 (77.14%) remained as MCI. The logistic regression analysis determined that the long delay cued recall and the performance time of the Rey figure test were the best predictive tests of conversion to dementia after an MCI diagnosis. Concerning the sociodemographic factors, sex had the highest predictive power. The results reveal the relevance of the neuropsychological data obtained in the first assessment. Specifically, the data obtained in the episodic verbal memory tests and tests that assess visuospatial and executive components may help to identify people with MCI who may develop AD in an interval not longer than 4 years, with the masculine gender being an added risk factor.     

Discourse analysis in neuropsychology: comment on Chapman and Ulatowska.

This paper discusses a recent article by Chapman and Ulatowska (1989, Brain and Language, 36, 651-658) on discourse analysis in aphasia. As such, the research in this area is interdisciplinary drawing from neuropsychology, as well as cognitive psychology, and, in part, aging. We illustrate problems that can arise when theoretical constructs and methodological considerations in this interdisciplinary approach are not rigorously observed. It is argued that definitive conclusions regarding the functional organization of the brain and discourse can be offered only when discourse analysis uses the state of the art from neuropsychology and cognitive psychology.     

神经心理学手段及其在行为遗传学研究中的应用

神经心理学的检测手段包括神经心理学测验和仪器检查。行为遗传学是一门在多学科基础上发展形成的的交叉学科。近年来,应用神经心理学手段进行行为遗传学研究,已经取得了一些可喜的进展。     

The relationship between cerebral lateralization and cognitive ability: suggested criteria for empirical tests

Many recent investigations in cognitive neuropsychology have been devoted to a fundamental question: are individual differences in cerebral lateralization reliably associated with differences in cognitive ability? The results have been highly inconsistent and inconclusive, with some studies showing a relationship, others not. We propose that research on this question has been hampered by inadequate clarification of the criteria required for a proper test. We suggest what these criteria should be, and, for purposes of illustration, we evaluate representative tests of the lateralization--cognition hypothesis in light of these criteria. We conclude that studies that meet our criteria lend at least a modest measure of support for the hypothesis.     

The new object‐spatial‐verbal cognitive style model: Theory and measurement

The current study challenges traditional approaches to Visual‐Verbal cognitive style as a unitary bipolar dimension, and instead suggests a new three‐dimensional cognitive style model developed on the basis of modern cognitive science theories that distinguish between object imagery, spatial imagery and verbal dimensions. The results of the confirmatory factor analysis demonstrated that the overall fit to the data of the new three‐dimensional model of cognitive style was significantly better than that of a traditional model. Furthermore, based on the new theoretical model, we designed and validated a new self‐report instrument assessing the individual differences in object imagery, spatial imagery and verbal cognitive styles, the Object‐Spatial Imagery and Verbal Questionnaire (OSIVQ). Across a series of studies, the OSIVQ demonstrated acceptable internal reliability as well as construct, criterion and ecological validity. The current study supports the validity of an object‐spatial‐verbal cognitive style dimension and related measures when developed on the basis of modern cognitive science theories. Copyright © 2008 John Wiley & Sons, Ltd.     

Investigating medical decision‐making capacity in patients with cognitive impairment using a protocol based on linguistic features

A critical question is whether cognitively impaired patients have the competence for autonomous decisions regarding participation in clinical trials. The present study aimed to investigate medical decision‐making capacity by use of a Swedish linguistic instrument for medical decision‐making (LIMD) in hypothetical clinical trials in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Three comparable groups (age, education) participated in the study: AD (n = 20; MMSE: 24.1 ± 3.3) and MCI (n = 22; MMSE: 26.7 ± 2.4) patients and healthy controls (n = 37; MMSE: 29.1 ± 1.0). Medical decision‐making capacity was operationalized as answers to questions regarding participation in three hypothetical clinical trials. Answers were scored regarding comprehension, evaluation and intelligibility of decisions, and a total LIMD score was used as the measure of medical decision‐making ability. Groups differed significantly in LIMD with AD patients performing worst and MCI poorer than the control group. A strong association was found between all LIMD scores and diagnosis which supported the assertion that LIMD as it is designed is a one‐dimensional instrument of medical decision‐making capacity (MDMC). The results indicate that a fundamental communicative ability has an impact on the competence for autonomous decisions in cognitive impairment.