ch 2: neuropsychological assessment

Question 1

What are the primary purposes of clinical assessment?

Answer 1

To conduct a differential diagnosis, describe behavior, predict risks and outcomes, monitor treatment responses, and guide interventions.

Question 2

What is differential diagnosis in clinical assessment?

Answer 2

Determining whether symptoms are due to different possible causes, such as a dementing process issue vs. substance use issue.

Question 3

Why is describing behavior important in clinical assessment?

Answer 3

To understand the effects of specific conditions (e.g., head injury) on executive, language, or motor functions.

Question 4

How does clinical assessment help predict risks and outcomes?

Answer 4

It assesses whether an individual can return to work or resume previous activities.

Question 5

How does clinical assessment monitor treatment responses?

Answer 5

By evaluating the effectiveness of treatment and determining whether modifications are needed.

Question 6

What is neuropsychological testing?

Answer 6

An objective, comprehensive assessment of cognitive and behavioral functioning.

Question 7

What types of information should be gathered about the patient?

Answer 7

Medical, social, academic, and other contextual information.

Question 8

What are the key concepts in assessment?

Answer 8

Reliability, validity, and standardization.

Question 9

What is reliability?

Answer 9

Consistency in measurement (e.g., test-retest, split-half, internal consistency).

Question 10

What is validity?

Answer 10

Measuring what the test is intended to measure (e.g., face validity, ecological validity, criterion-oriented validity).

Question 11

What is standardization?

Answer 11

Consistent use of a technique or device, ensuring questions are asked the same way for all individuals.

Question 12

What is test-retest reliability?

Answer 12

Comparing scores of a test taken at two different times.

Question 13

What is split-half reliability?

Answer 13

Administering one test, splitting it into two parts, and correlating the scores to avoid practice effects.

Question 14

What is inter-rater reliability?

Answer 14

Ensuring consistency when multiple individuals rate or judge a phenomenon using the same rubric.

Question 15

What is face validity?

Answer 15

The test appears to measure what it is supposed to measure (e.g., asking about recent depression).

Question 16

What is ecological validity?

Answer 16

The extent to which test results mimic real-world functioning.

Question 17

What is criterion-oriented validity?

Answer 17

How well scores differentiate between people with and without a specific condition (e.g., concurrent or predictive validity).

Question 18

concurrent validity

Answer 18

currently possess the ability to do the task that is asked; e.g., blood test comes back positive for a disease

Question 19

predictive validity

Answer 19

• score will determine that you will have it
• Does the test correlate with future abilities/behavior?

Question 20

What is construct validity?

Answer 20

Whether the test measures the concept it claims to measure.

Question 21

How is construct validity established?

Answer 21

Through convergent validity (correlation with gold standard tests) and discriminant validity (no correlation with unrelated constructs).

Question 22

What are the outcomes in signal detection for diagnosis

Answer 22

hit, false positive, false negative, correct rejection

Question 23

hit

Answer 23

disease present, test positive

Question 24

false alarm (type 1 error)

Answer 24

disease absent, test positive

Question 25

miss (type 2 error)

Answer 25

disease present, test negative

Question 26

correct rejection

Answer 26

disease absent, test negative

Question 27

What influences predictive value in testing?

Answer 27

The base rate, or percentage of people in the population with the condition

Question 28

Why do rarer disorders have poorer predictive value?

Answer 28

Because the base rate is lower, reducing the accuracy of positive tests.

Question 29

positive predictive value (PPV)

Answer 29

percent of positive tests that were accurate

Question 30

negative predictive value (NPV)

Answer 30

percent of negative tests that were accurate

Question 31

sensitivity

Answer 31

percent of people with the disorder who were correctly identified

Question 32

specificity

Answer 32

percent of people without the disorder who were correctly identified

Question 33

What are the 2 primary approaches to a neuropsychological assessment?

Answer 33

flexible battery and fixed battery

Question 34

flexible battery

Answer 34

a large range of tests available and we pick and choose the ones we believe are most helpful for the research question/patient we are evaluating

Question 35

What are the strengths of the flexible battery approach?

Answer 35

Lack of redundant testing, lower costs, individualized focus, and emphasis on why tasks are failed.

Question 36

What are the weaknesses of the flexible battery approach?

Answer 36

Confirmation biases, subjectivity, lack of standardization, and reduced usefulness for research.

Question 37

fixed battery

Answer 37

A predetermined set of tests used for every patient

Question 38

What are the strengths of the fixed battery approach?

Answer 38

Comprehensive, standardized, good for research, and useful for teaching.

Question 39

What are the weaknesses of the fixed battery approach?

Answer 39

Time-consuming, lacks qualitative observations, and is rigid.

Question 40

What are the main steps in neuropsychological assessment?

Answer 40

Reviewing background, conducting interviews and mental status exams, testing, writing reports, providing feedback, and follow-ups.

Question 41

What are the domains of an assessment? (My Soup Lacks Many Hot Peas)

Answer 41

- motor - sensory - language - memory - higher cognitive functioning - personality/emotional

Question 42

What do motor skills tests test for?

Answer 42

- Fine and gross manual motor speed/dexterity - Graphomotor skills (drawing tasks) and motor apraxia (ability to carry out motor sequences)

Question 43

What do sensation and perception tests test for?

Answer 43

- sensory/perceptual systems' functioning - tests like HRNB sensory/perceptual exam - visuospatial functioning

Question 44

stereognosis

Answer 44

identifying objects by touch

Question 45

anosmia

Answer 45

loss of smell

Question 46

visuospatial functioning

Answer 46

higher-level skills (clock drawing, map reading, facial recognition)

Question 47

What do language tests test for?

Answer 47

- receptive/comprehension - expressive speech - fluency - reading, writing, spelling

Question 48

What do memory tests test for?

Answer 48

- episodic memory (explicit events) - semantic memory (basic facts) - retrograde vs. anterograde memories - acquisition, recall, recognition

Question 49

What do higher cognitive function tests test for?

Answer 49

- attention/concentration - executive function - personality/mood

Question 50

What are some procedural considerations for neuropsychological assessment?

Answer 50

- test order - motivation - testing of limits - practice effects - use of technicians - special populations