Extending neuropsychological assessments into the primary mental ability space

A battery of 17 neuropsychological tests (including the CERAD battery) and 17 psychometric ability tests were administered to a sample of 499 participants of the Seattle Longitudinal study who had been given the psychometric ability tests seven and 14 years earlier. The neuropsychological tests were projected into a 5-factor psychometric ability space by means of extension analysis. The concurrent regressions of the neuropsychology tests on the psychometric ability tests were then used to estimate neuropsychology test scores from the psychometric ability tests administered in 1984, 1991 and 1998. Neuropsychologists then rated the study participants as either normal, suspect or cognitively impaired in 1998. Changes in estimated test scores were computed over seven and fourteen years. Significant odds ratios between normal and cognitively impaired groups were found for all neuropsychological tests over the proximal period and for most tests over the 14-year period. Similar findings occurred for the odds ratios between the normal and suspect groups for the most proximal 7-year changes.     

Using three-dimensional graphics in neuropsychological hypothesis testing

This paper presents the application of an overlapping sampling technique used with a fast Fourier transform on electroencephalographic data. The use of this sampling and analysis technique is demonstrated on data in which steady state, rate of change, and critical event hypotheses are tested. The benefit of applying computer-generated three-dimensional graphics to the results of using this innovative sampling and analysis technique is emphasized.     

Virtual reality technology in neuropsychological testing: A systematic review

Neuropsychological testing aims to measure individuals' cognitive abilities (e.g. memory, attention), analysing their performance on specific behavioural tasks. Most neuropsychological tests are administered in the so-called ‘paper-and-pencil’ modality or via computerised protocols. The adequacy of these procedures has been recently questioned, with more specific concerns about their ecological validity, i.e. the relation between test scores observed in the laboratory setting and the actual everyday cognitive functioning. In developing more ecological tasks, researchers started to implement virtual reality (VR) technology as an administration technique focused on exposing individuals to simulated but realistic stimuli and environments, maintaining at the same time a controlled laboratory setting and collecting advanced measures of cognitive functioning. This systematic review aims to present how VR procedures for neuropsychological testing have been implemented in the last years. We initially explain the rationale for supporting VR as an advanced assessment tool, but we also discuss the challenges and risks that can limit the widespread implementation of this technology. Then, we systematised the large body of studies adopting VR for neuropsychological testing, describing the VR tools' distribution amongst different cognitive functions through a PRISMA-guided systematic review. The systematic review highlighted that only very few instruments are ready for clinical use, reporting psychometric proprieties (e.g. validity) and providing normative data. Most of the tools still need to be standardised on large cohorts of participants, having published only limited data on small samples up to now. Finally, we discussed the possible future directions of the VR neuropsychological test development linked to technological advances.     

Comprehensive driving assessment: neuropsychological testing and on-road evaluation of brain injured patients

The study investigates the correspondence between neuropsychological test results and on-road driving performance among 55 patients with a CT-verified brain damage or documented neurological disorder (cerebrovascular accident: 43, traumatic brain injury: 5, multiple sclerosis: 4, other: 3). 5 patients showed unimpaired test profiles and passed the on-road evaluation. 18 patients showed severe neuropsychological deficits contrary to driving and were not recommended for on-road evaluation. Of the remaining 32 patients with some neuropsychological deficits, all 100% in the minor impaired group (n = 8) passed the driving evaluation, compared to 69% in the mildly impaired (n = 16) and 38% in the moderately impaired group (n = 8). Measures of reduced visuoconstructive ability, reaction time, visual attention, and awareness of cognitive impairments, were found to discriminate between groups. It is concluded that neuropsychological assessment of targeted functions provide an ecological valid prediction of driving skill after brain damage, but that on-road evaluation is needed as supplement in cases with ambiguous test findings.     

From recognition to decisions: Extending and testing recognition-based models for multialternative inference

The recognition heuristic is a noncompensatory strategy for inferring which of two alternatives, one recognized and the other not, scores higher on a criterion. According to it, such inferences are based solely on recognition. We generalize this heuristic to tasks with multiple alternatives, proposing a model of how people identify the consideration sets from which they make their final decisions. In doing so, we address concerns about the heuristic’s adequacy as a model of behavior: Past experiments have led several authors to conclude that there is no evidence for a noncompensatory use of recognition but clear evidence that recognition is integrated with other information. Surprisingly, however, in no study was this competing hypothesis—the compensatory integration of recognition—formally specified as a computational model. In four studies, we specify five competing models, conducting eight model comparisons. In these model comparisons, the recognition heuristic emerges as the best predictor of people’s inferences.     

Cognitive deficits related to major organ failure: The potential role of neuropsychological testing

Until recently, little attention has been paid to the possibility of cognitive deficits in patients with disease or failure of major organs such as the liver, kidney, or heart. However, there is a growing awareness that major organ failure often has neuropsychological sequelae. These sequelae may at times be quite subtle and not detectable under gross. examination. Nevertheless, even subtle deficits may have a major impact on adherence to medical regimens, psychosocial adjustment, and quality of life of patients. Neuropsychological assessment has a potentially valuable role to play both in research and in clinical work. It can be useful in adding to our knowledge of the cognitive effects of various types, severity and duration of major organ disease, as well as sequelae associated with treatment. It also is a potentially valuable clinical tool for identifying cognitive deficits that will affect the quality of life and probability of survival for organ failure patients.     

Anomalous dominance in sibling stutterers: Evidence from CT scan asymmetries, dichotic listening, neuropsychological testing, and handedness

Two left-handed siblings with developmental stuttering are comprehensively described. The methods of study included speech and language evaluation, neurological and neuropsychological examinations, dichotic listening, auditory evoked responses, electroencephalogram, and CT scan asymmetry measurements. The data from each sibling showed evidence of anomalous cerebral dominance on many of the variables investigated. The CT scan measurements showed atypical asymmetries, especially in the occipital regions. These findings support the theory that stuttering may be related to anomalous cerebral dominance, both on functional as well as structural bases. Implications of anomalous dominance and the resultant effect of hemispheric rivalry on speech fluency are discussed.     

Extending fields of work

The aim of this paper is to describe some acute responses to the suicide of a parent, through the account of the analytic psychotherapy of a latency child who found the body of his dead father. The acute traumatic responses of the child show that the perceptual apparatus, time and space are subverted, while the functioning of the contact barrier is deeply damaged. The importance of the environment in facilitating the first stages of the mourning process is stressed as well as the pre-traumatic personality structure. Both the Bionian model of preconception and the post-Jungian notion of archetype, revisited in terms of an unsaturated predisposition, are considered from a theoretical point of view. Preconceptions and archetypal dispositions to survive traumatic events are very important to the therapeutic outcome, along with the opportunity to start the treatment as early as possible after the traumatic event. This is particularly relevant in relation to the latency period, in terms of the capacity to contemplate the effects of the drives. The importance of allowing the child to work through all the stages of mourning is also considered, particularly rage, protest and hostile fantasies towards the lost object. The clinical material is structured as a narrative in an attempt to evoke the emotional climate experienced during the sessions as well as the state of mind of the child. The narrative is a secondary elaborated account with condensation and displacement at its core, like in dream work. Events, filtered through the analyst's state of self, are reported by lending the first person to the child in the narrative reconstruction.     

Extending Everything with Nothing

Philosophia - In this paper we offer a new solution to the old paradox of nothingness. This new solution develops in two steps. The first step consists in showing how to resolve the contradiction...     

Extending Perceptions-Contributions to Theory

No abstract available for this article.     

Desirable features in neuropsychological tests

Seven desirable features are presented as guidelines for the design and evaluation of neuropsychological tests. Such features are not systematically present in most commonly used testing procedures because the field's methods have been borrowed from disciplines whose theories and measurement goals are quite different from those of modern neuropsychology. In the course of the presentation, three meanings of the term deficit are differentiated.     

The classification of neuropsychological deficit

The study involves classification of neuropsychiatric patients on the basis of neuropsychological and intelligence test performance. One hundred twenty-five hospitalized male neuropsychiatric patients with various diagnoses were administered the Halstead-Reitan and Luria-Nebraska neuropsychological test batteries, as well as the Wechsler Adult Intelligence Scale. A cluster analysis was performed for each of those three procedures utilizing Ward's method. It was found in all cases that clusters were determined on the basis of level rather than pattern of performance. Relationships were found between cluster membership and age, education, and presence or absence of structural brain damage but were not found for diagnoses of schizophrenia or alcoholism. Schizophrenic and alcoholic patients were found in all clusters in the case of all three test procedures. Differences in clustering among the three test procedures were noted, with the WAIS being relatively more sensitive to educational differences while the Halstead-Reitan was more sensitive to age differences. The clinical utility of classifying patients on the basis of neuropsychological and cognitive test performance was discussed.Acknowledgement is made to the Veterans Administration for support of this research.     

The neuropsychological assessment of dementia

It has become standard practice to base the diagnosis of dementia on the combination of neuropsychological and non-behavioral findings. The present article provides a short, clinically oriented synopsis of the targets, investigational procedures, and difficulties of the modern neuropsychological approach to the diagnosis of dementia. Over the years, neuropsychology has developed assessment tools to evaluate the cognitive and behavioral abnormalities of many dementias. Validated tests of memory, language, executive, and other cognitive functions are used to screen for dementia and identifying certain dementia profiles. Behavioral assessment procedures are available for non-cognitive neurodegenerative alterations. At present, problems arise mainly with the behavioral heterogeneity of certain dementia syndromes. Especially problematic are discrimination of age-associated or mild cognitive impairments from incipient dementia and the impact of psychiatric symptoms on cognitive functions. It is concluded that neuropsychology offers a valuable contribution to the diagnosis and differential diagnosis of dementia.     

Behavioral approaches to neuropsychological rehabilitation

Behavioral approaches have been applied to a wide variety of behavioral and cognitive disturbances resulting from brain damage or disease. This article provides a comprehensive and critical review of the literature concerned with behavioral interventions in neuropsychological rehabilitation. The article examines six categories of target behavior: inappropriate social behavior, attention and motivation, unawareness of deficits, memory, language and speech, and motor disturbance. The efficacy of behavioral approaches for treatment of the neurologically impaired and implications for the future role of behavioral approaches in neuropsychological rehabilitation are discussed.     

Patient classification in neuropsychological research

In a number of papers we have been concerned with the type of inferences that are legitimate in "experiments of nature" where the experimenter does not and cannot control the modifications to the cognitive system that are introduced by brain damage. We have argued that in such cases very restrictive conditions must be met in order to be able to draw valid inferences about the structure of normal cognitive mechanisms. Two consequences of these conditions are (1) patient classification into syndrome types (e.g., phonological dysgraphia, agrammatism, and so forth) can play no useful role in research concerned with issues about the structure of normal cognitive functioning or its dissolution under conditions of brain damage; and (2) only single-patient studies allow valid inferences about the structure of cognitive mechanisms from the analysis of impaired performance. Zurif, Gardner, and Brownell (1989, Brain and Cognition, 10, 237-255) have taken exception to our conclusions and propose to show the limitations of our arguments. In this paper we respond to their criticisms.     

A long-term follow-up case study of crossed aphasia assessed by single-photon emission tomography (SPECT), language, and neuropsychological testing

A 65-year-old man with well-defined crossed aphasia secondary to right cerebral infarction 10 years previously was studied for current language and cognitive abilities and regional cerebral blood flow (rCBF) during cognitive activation measured by single-photon emission tomography (SPECT). Reversed hemispheric lateralization was demonstrated by qualitative aspects of the patient's constructional deficits, dominant parietal lobe signs, and absence of the neglect syndrome. Language activation procedures during SPECT produced focal increases in rCBF to both frontal lobes with a phoneme detection task and to right temporal and parietal lobes with a math task. The authors stress the complexities of assessing brain/language mechanisms in vivo and demonstrate variabilities in rCBF during language activation dependent on task selection.     

Connectionist models of neuropsychological disorders

Artificial neural networks ('connectionist models') embody aspects of real neuronal systems. But does studying the breakdown of performance in such models help us to understand cognitive impairments in humans following brain damage? Here we review recent attempts to capture different neuropsychological disorders using connectionist models with simulated lesions. We show how such lesion studies can be used to evaluate some of the standard assumptions made in neuropsychological research, concerning both double dissociations and associations between patterns of impairment. We also illustrate how lesioned models, like humans, can sometimes be more impaired on the easier of two tasks and demonstrate that connectionist models can incorporate forms of internal structure. Finally we discuss the utility of the models for understanding and predicting the effectiveness of different rehabilitation strategies. Future questions concern the role and possible development of internal structure within these models, whether the models can be generalized to larger-scale simulations, and whether they can accommodate higher-order linguistic disorders.