Manual Clinical Neuropsychology: A Pocket Handbook for Assessment, Second Edition

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The task consists of a series of twenty second trials in which the individual is performing a visual search and cancellation task. The task is to detect and eliminate various target 2s and 7s, which are intermingled within a row of distractor symbols e. The test is scored by totaling the speed and accuracy of target detection. Concept Formation, Abstraction, and Reasoning. Cognitive rigidity often occurs in association with concrete thinking, and can appear as the inability to shift and adapt perceptual organization, train of thought, or ongoing behavior to current environmental situations.

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The Category Test. This test is mainly a test of concept formation ability as well as a highly complex monitor of abstract thinking and logical analysis. The projection apparatus has an answer panel below the screen with four levers numbered 1 to 4, which are used by the examinee to select an answer; when answered correctly, a bell sounds, and incorrect answers receive a loud buzzer.

Examinees are instructed to determine principles that relate stimulus subsets by observing sets of stimulus figures that vary in shape, size, number, intensity, color, and location, and are grouped by abstract principles. Individuals are required to solve simple and complex math problems without the use of pencil and paper and under the pressure of time. This test measures functional cognitive properties involved in problem solving such at fluid reasoning ability, working memory, attention, concentration, planning, and mathematical ability, however this is not a test of mathematical potential such as seen in tests of academic achievement , but of quantitative reasoning skills and practical thought processes Golden, Motor function.

Neuropsychological tests that measure manual motor functioning have been useful in the detection of lateralized brain dysfunction Berg et al. The HRNB identifies lateralized cerebral damage by comparing performances of the same type i. Assessments comparing motor performance between the two sides of the body has been said to permit inferences about functional efficiency of the hemispheres Henninger, Finger Tapping Test. This test is a measure of finger agility and tapping speed.

It consists of a tapping key with a device for recording the number of taps. Performance is measured by averaging amount of taps for five trials, for each hand, and performance levels are expected to be affected by age and sex Berg et al. The presence of cortical damage tends to result in a slowing in the rate of finger tapping at any age, and lateralized lesions may show a marked decrease in tapping rate for the hand contralateral to the lesion Berg et al. The Finger Tapping test has been demonstrated as quite sensitive to damages of frontal regions of the brain on both sides Reitan, , except when the deficits are limited to prefrontal regions alone Golden, Block Design.

Tests of block designs have been demonstrated to be some of the best indicators of brain damage, especially that of the right hemisphere McFie, , but it also can be sensitive to lesions associated with the left hemisphere, especially when they are involving the parietal lobe McFie, Individuals are required to produce designs with six-sided blocks while looking at a model picture located in the stimulus book. Object Assembly. This task requires the assembly of ambiguous jigsaw puzzle-like pieces to form commonly seen objects within a given time limit.

This test involves visual- perceptual organization and processing, but is less sensitive to it than the Block Design subtest is Golden, Other functions involved include perception of meaningful stimuli, motor activity, motivation, and persistence. Emotion is an observable, public event that represents an interaction between the individual expressing the emotion and the relevant environmental situation or their cognitive representation of the environmental situation. Their functional role is to signal the presence of a personally relevant event in the environment and to prepare the individual for a specific action in response to salient stimuli Starratt, According to Newman and Sweet , there three major areas of impairment that seem to be associated with clinical depression: 1 psychomotor speed, 2 motivation and attention sustained effort and concentration , and 3 memory and learning.

The primary symptoms of depression involve a lack of energy and motivation, negative self- assessment, and poor attention particularly sustained attention and concentration, and have been suggested to significantly affect performance on neuropsychological assessment.

Their viewpoint on depression is that because depressed individuals perform worse on tasks of sustained effort and concentration, they will perform better on tasks with minimal demand. Beck Depression Inventory-II.

Clinical Neuropsychology: A Pocket Handbook for Assessment

Scores ranging between 0 and 13 demonstrate minimal depression; 14 to 19 as mild depression; 20 to 28 as moderate depression; and 29 to 63 as severe depression. A study by Beck et al. Academic Achievement and Aptitude. One of the common ways of doing this is through tests of academic skills or achievement and aptitude. Jastak as a supplement to the Wechsler-Bellevue Scales Wechsler, The WRAT4 was standardized on a representative national sample according to age, sex, level of education, geographic region, and socioeconomic status.

This assessment of academic skill monitors educational achievement in reading, arithmetic, and spelling and provides a measure of the basic academic skills necessary for effective learning, communication, and thinking. Word Reading provides a measure of ability to decode letters and words through tasks involving the identification of letters and recognition of words.

Sentence Comprehension involves the use of a modified cloze shortened form of closure technique, where individuals are required to fill in missing words from sentences Figure 8. Spelling assess the ability to encode auditory information into written format through a task that requires the individual to write out words and letters that are orally stated by the testing technician. Math Computation measures basic mathematical skills and ability to perform computations through counting, identifying numbers, solving simple oral problems, and calculating written mathematics problems.

The test-taker is required to answer questions regarding history, geography, time, and science, and the results reflect his or her educational knowledge through measurements of fundamental information and long-term memory capacity for factual information Hernandez, This kind of general knowledge tends to remain as stable in brain injury as vocabulary Golden, Also, those who were not involved in litigation had better not necessarily statistically significant means on every retest. Litigants not only performed worse on tests that are shown to reflect brain function i. CAT , but also on those that are not closely related to brain function i.

This finding suggests that individuals involved in litigation are more likely to exert less effort in testing than those who are not involved in litigation. In a study assessing performance on neuropsychological tests and its relationship with personality, criminality and violence by Rasmussen, Almvik, and Levander criminal versatility and violence were significantly related to deficits in verbal ability as well as dysfunction in attentional ability and executive function, which were manifested in childhood and persistent ADHD.

Spellacy conducted a study involving violent and non-violent males from a penitentiary population and found that violent prisoners performed worse on assessments for language, perceptual, and psychomotor abilities, which he attributed to cognitive dysfunction as causing an inability to control aggression.

However, the most vigorous findings about mental function have been made concerning verbal and attentional deficits among delinquents Rassmussen et al. In , Hare conducted a study of dichotic listening DL and determined that psychopaths had a small right-ear-advantage in verbal DL when compared to non-psychopaths. Fischer, Barkley, Edlebrock, and Smallish conducted a longitudinal study with children exhibiting symptoms of ADHD and concluded that they remained chronically impaired in academic achievement, inattention, and behavioral disinhibition well into late adolescence.

Hanlon, Rubin, Jensen, and Daoust conducted a study concerning the crime-related neuropsychological features of indigent murder defendants and death row inmates. The authors explain that murder defendants tend to manifest a larger frequency of neurological impairment, involving attentional disturbance, language dysfunction and intellectual impairment, and executive dysfunction, as well as differences in neuropsychological status as opposed to nonhomicidal, less violent criminals involving language, memory, and psychomotor speed.

Studies involving the use of positron emission tomography PET scan have demonstrated reduced activity in lateral and medial prefrontal cortex, as well as hemispheric laterality effects involving increased activity in subcortical measures of the right hemisphere i. History of head trauma has also been associated with aggression and criminal behavior Hanlon et al. Based on the literature concerning the structure and function of behavior within these cases, the largest performance deficits should be demonstrated in the death penalty subjects, and should include at least measures of executive functioning, verbal ability, decreased intellectual functioning, and attentional deficits.

This will most likely occur due to the fact that all death penalty inmates were on trial in order to determine if they were competent for execution based on the fact that they were mentally retarded i. Overall, personal injury litigations are hypothesized to perform better on most tasks than the other cases, due to the fact that they are least likely to have severe impairment in any specific area of premorbid functioning since they make up a better representation of the general population than any other case, all of which exhibit bias in some characteristic.

Method Participants A total of participants males, 55 females were selected from an archived database of individuals who presented at University Neuropsychology, a clinical neuropsychology practice in Wilmington, North Carolina. Puente, Ph. Normative data were derived from Mitrushina, et al. Any scores above or below three standard deviations from the mean were not included in analyses in order to dismiss outliers and to assume equal variances.

Descriptive statistics were initially calculated for the entire sample, however because of the large percentage of Hispanic participants included in the Death Penalty case, a second set of descriptive statistics was calculated for only those involved in civil litigations PI, SS, and WC in order to control for possible ethnic influence on the result interpretation. Two one-way analyses of variance ANOVAs were calculated to determine differences, first between the individual test scores among those only in the civil litigation cases, and a second for those between all four cases.

Descriptive statistic calculations were performed to determine the percentage of Good and Suspect Effort subjects there were for each group. This was done in order to determine if any significant differences were due to type of case, ethnicity, or an interaction between the two. Refer to Table 4 for psychometric properties.

Descriptive statistics were performed for frequency of malingers in each case. No other significant main effects or interactions were found for case or ethnicity when civil litigations were analyzed alone. Refer to Table 5 for between-subjects effects of case and ethnicity. Discussion The criminal mind is something that has been of interest to psychologists for as long as the field has been in existence. However, the field of forensic neuropsychology may be able to provide insight into the minds, or brains, of not only criminals, but of others involved in civil legal issues as well.

However, personal injury was hypothesized to be likely to malinger because they probably represent the highest functioning group in the study, but need to prove impairment on assessments in order to receive the desired compensation from liability. The results of all groups for malingering are based on very small ns and should not be considered as statistically valid. Our data analyses determined that our sample of death penalty inmates, regardless of being of majorly different ethnicity, performed significantly worse than the civil case groups on measures of general intelligence, memory and learning involving verbal intelligence, overall language and verbal ability, executive functioning involving verbal concept formation, abstraction and reasoning abilities, motor function, and abilities to focus and sustain attention.

These results support the initial hypothesis of this study that the criminal offenders would have the largest neuropsychological test performance deficits in mainly executive functioning, verbal ability, intellectual functioning, and attention. Although our data did not involve collection of information concerning whether or not subjects had specific disorders, we may suspect, with good reason, the possibility that our death penalty sample included a significant amount of individuals with ADHD; this assumption is based on the results in literature that associate our findings of deficits in executive function, verbal memory, and impaired Stroop performance with the presence of ADHD Siedmen et al.

Hanlon et al. Unfortunately, access to specific and objective measures of neurological activity was unavailable in this study, however localization of function through neuropsychological measures seems to indicate that prefrontal regions are involved due to poor performance on tasks of executive functioning, attention, and interference, as seen, for example, on the Stroop.

The finding that Hispanics scored significantly lower on skills of academic achievements involving word and sentence comprehension than both Caucasians and African Americans makes logical sense, for those who do not speak English, or speak it as a second language, will obviously be at a disadvantage in these areas. This is supportive of our hypothesis that overall, the personal injury group was a better representation of the general population, which are adequately functioning in these areas, especially relative to those who are disabled to the extent that they cannot work. They both typically remained at a status of performing worse than the personal injury litigators, but better than the individuals on trial for the death penalty.

It is always important to question the validity behind results of neuropsychological assessment for someone involved with litigation or compensation in any sense. Malingerers are able to fake their responses and actions on tests, but abilities in cognition are much more difficult to consciously manipulate.

Social security also seemed to score worse on assessments of cognitive functioning, however there are slightly more significantly lower scores associated with Social Security applicants, and those are moderately involved in sensorimotor performance, such as the tasks that make up the WMI and the PIQ. Overall, this study provided generally supportable and expected results across the four categories of forensic cases evaluated.

Clinical Neuropsychology A Pocket Handbook For Assessment

This is good news for a study involving as many variables as were involved in this present study, for too many variables can often be of a limiting nature. In order to further extend this study, more specific information regarding individual differences between subjects, such as neurological or neuropsychological disorders e. Also, an important limitation to this study is the fact that educational data was not collected for the sample from the archived database, but was collected from a sample of currently active patients within the same cases.

Most importantly, it is important to mention the skewed distribution of ethnicities between and within the four conditions, and the possibility of ethnic bias in our sample. Although we did our best to control for this, it still may have had some influence in our findings.

Neuropsychological functioning in late-life depression

In the future this data set will be extended to include these variables for the actual sample involved. With a more detailed and informative data set, a closer look at the differences between the most common forensic neuropsychological foci can occur, and will shed more light on a deep understanding of the underlying correlates of brain, behavior, and the law. M Effect of age on performance of the Trail Making Test. Perceptual and Motor Skills, 36, Boone, K.

Bowen v. Yuckert, U. McCaffrey, A. Is this book recommended for lay-people that have done a former reading and have done a few psychology classes? I'm getting to the point of reading popular science books and not getting any new info because all material has been covered.


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I'd like to get more sophisticated information. How is this book compared to Lezak's Neuropsychological Assesment? See 1 question about Clinical Neuropsychology…. Lists with This Book. This book is not yet featured on Listopia. Community Reviews. Showing Average rating 4. Rating details. More filters.

Sort order. Aug 30, Chrissy rated it really liked it Shelves: neuroscience , textbooks , psychology , read-for-school. Some of the chapters were much better than others each was written by a different group of experts in the appropriate field , and the editors could have done a better job of removing overlap and matching formatting across chapters But these are common enough issues with textbooks of this sort, and it was quite informative and thorough overall.

I found it to be a fantastic read compared to so many neuro texts, as it cuts out the fat and delivers exactly what you need to know clinical present Some of the chapters were much better than others each was written by a different group of experts in the appropriate field , and the editors could have done a better job of removing overlap and matching formatting across chapters I found it to be a fantastic read compared to so many neuro texts, as it cuts out the fat and delivers exactly what you need to know clinical presentation, diagnostic criteria and tests, neurological correlates in a clear an concise manner.

It also contains extremely handy charts, tables, and visualizations to help you organize differential diagnoses in your mind. May 05, Abnoos rated it really liked it Recommends it for: neuropsychologists, psychiatrists, psychologists. This was the first manual I used for neuropsychological assessment course and it turned out to be a great help!

Perfect for creating assessment charts, finding necessary and relevant assessment tests, evaluating the results. With extra information about each condition. May 29, Nikki added it. I coauthored Chapter 1 of the first edition of this book under my maiden name. I'll have to check out the second edition to see if the editors kept my chapter. Feb 29, Erin rated it it was amazing Shelves: medical , mental-illness , non-fiction , psychology , i-own , grad-classes , science.

An incredibly helpful resource! May 05, Abnoos rated it really liked it Recommends it for: neuropsychologists, psychiatrists, psychologists. This was the first manual I used for neuropsychological assessment course and it turned out to be a great help! Perfect for creating assessment charts, finding necessary and relevant assessment tests, evaluating the results. With extra information about each condition. May 29, Nikki added it. I coauthored Chapter 1 of the first edition of this book under my maiden name. I'll have to check out the second edition to see if the editors kept my chapter.

Feb 29, Erin rated it it was amazing Shelves: medical , mental-illness , non-fiction , psychology , i-own , grad-classes , science. An incredibly helpful resource! Andrew Gardner rated it really liked it Jun 09, Stanley C. Ferneyhough rated it it was amazing Aug 15, Nancy rated it really liked it Nov 09, Louise rated it it was amazing Mar 09, Laura Adams rated it it was amazing Feb 11, Rochelle Day rated it it was amazing May 08, Ali rated it really liked it Nov 12, Ada Mullett rated it it was amazing Feb 19, Susan rated it really liked it Jun 11, Jeremy Roper rated it it was amazing Dec 13, Wish rated it really liked it May 30, Jenna rated it liked it Aug 17, Jovany Agathe rated it liked it Feb 19, Mark and Sonya rated it really liked it Aug 11, Mia rated it it was amazing Oct 05, George Pappas rated it it was ok Jun 04, Aoife Menton rated it it was amazing Feb 15, Katie rated it really liked it Sep 27,