Methodology in Neuropsychological Assessment: An Interpretative Approach to Guide Clinical Practice

Description

Methodology in Neuropsychological Assessment: An Interpretative Approach to Guide Clinical Practice provides practical and methodological guidance for neuropsychologists working with people with brain lesions or brain dysfunctions. The textbook underlines the principles that can be used to guide clinicians in recognizing and interpreting signs and symptoms while enabling a complete neuropsychological assessment through a series of well-defined steps. The text provides a detailed methodological approach towards neuropsychological tools, with guidance on how to select the right test and how to interpret the outcome, which can act as a primer for a clinician through every step of the assessment in a coherent and reasoned way. The textbook presents an exhaustive discussion of the varied tools that a clinician can employ to complete a rigorous and consistent neuropsychological assessment. It guides the reader from the first step of collecting the personal history of the examinee – the anamnesis – to the selection of suitable psychometric tests and scoring, which is accordingly integrated to formulate the neuropsychological diagnosis and write up the neuropsychological report. Chapters also include coverage of the neuropsychological interview with the examinee and their family and the probability of identifying a disorder with a neuropsychological assessment. The authors have further included a series of detailed and explanatory clinical cases from their experience to expand upon the evaluation process. The textbook is valuable reading for students in clinical neuropsychology who are learning to carry out neuropsychological evaluations as well as clinicians who are seeking to develop a more comprehensive approach towards performing a thorough neuropsychological assessment. Cover Half Title Title Page Copyright Page Contents An introduction to methodology in neuropsychology 1. Principles, objectives and settings 1.1. Rationale of this book: an Interpretative Approach to neuropsychological assessment 1.2. Objectives of a neuropsychological assessment 1.2.1. Contribution to medical diagnosis 1.2.2. Distinction between partially overlapping pathologies 1.2.3. Assessment of an examinee’s independence in day-to-day activities 1.2.4. Planning a rehabilitative intervention 1.2.5. Certifying the cognitive status for legal or insurance-related reasons 1.3. The neuropsychological setting 1.3.1. Traditional in-person setting (Setting A) 1.3.2. Remote setting with neuropsychologist (Setting B) 1.3.3. Remote setting with self-administered psychometric tests (Setting C) 1.4. The timeline and the main tools of the neuropsychological assessment 2. Anamnesis and semeiotics 2.1. Before meeting the examinee: anamnestic information about the examinee (neuropsychological anamnesis) 2.1.1. Medical history 2.1.2. Psychological history 2.1.3. Cognitive history 2.2. Meeting the examinee: information gathered directly from the examinee (neuropsychological semeiotics) 2.2.1. How signs and symptoms can be detected 2.2.2. Examples of the main signs typically associated with disorders of specific cognitive functions 2.3. At the end of the meeting: preliminary diagnosis and feedback to the examinee 3. The neuropsychological interview 3.1. Theoretical features of the neuropsychological interview 3.1.1. Reformulating and mirroring techniques 3.1.2. Goals of the neuropsychological interview 3.2. Practical features of the neuropsychological interview 3.3. Examples of a communicative exchange during interview 3.3.1. Example 1. Introducing the idea of a neuropsychological assessment (using Setting A) 3.3.2. Example 2. Introducing the idea of a neuropsychological assessment for an examinee who suffered a brain injury and needs to be cognitively assessed (using Setting A) 3.3.3. Example 3. Persuading a reluctant and uncooperative examinee (using Setting A) 3.3.4. Example 4. Engaging with an examinee with a depressive attitude (using Setting B, over the phone) 3.3.5. Recommendations for remote testing with self-administered modality (using Setting C) 4. Psychometric assessment and neuropsychological tests 4.1. The psychometric assessment and the neuropsychological tests 4.2. A definition of a neuropsychological test 4.2.1. Digital (computerised) neuropsychological tests 4.3. Measurement in neuropsychology and test development 4.4. Constructs investigated in the neuropsychological assessment 4.5. The main properties of a test: validity and reliability 4.5.1. Validity 4.5.2. Content validity 4.5.3. Convergent-divergent validity 4.5.4. Criterion validity 4.5.5. Reliability 4.5.6. The relationship between reliability and validity 4.5.7. Cognitive fluctuations and reliability 4.5.8. Validity and reliability information during the assessment 4.5.9. When is a neuropsychological test good enough to be used? 4.6. The selection of tests 4.7. The issue of multiple testing in neuropsychological assessment 5. Test scores 5.1. Normative data 5.1.1. The rationale for using normative data 5.2. Collection of normative data 5.3. The meaning of cut-offs 5.4. The most common methods for calculating normality cut-offs 5.5. The difference between sample and population in the use of normative data. 5.6. Fundamental aspects of normative data 5.6.1. Considering demographic variables in normative data 5.6.2. Normative data from very large groups are not necessarily better 5.6.3. The importance of using up-to-date normative data 5.6.4. The importance of using country-specific standards 5.7. Other uses of tests 5.7.1. Assessing change over time using neuropsychological tests 5.7.2. Comparing the results of different neuropsychological tests 6. Test scores: attribution and interpretation 6.1. Test scoring 6.2. The interpretation of tests 6.2.1. The validity of a test for a specific measurement 6.2.2. Interpreting tests below the cut-off as a sign of a specific cognitive deficit 6.2.3. Interpreting test results at different levels 6.2.4. Estimating impairments in daily life from neuropsychological tests 6.3. The integration of information for interpreting tests 6.3.1. Interpreting ambiguous results 6.3.2. Results close to cut-offs 6.3.3. Age or education between two different bins 7. The probability of identifying a pathology in neuropsychological assessment 7.1. The concept of ‘condition of interest’ 7.1.1. A priori division of groups and gold standards 7.2. Sensitivity and specificity of a test 7.2.1. Why do only a few neuropsychological tests have sensitivity and specificity? 7.3. The probability of drawing correct or incorrect conclusions in the neuropsychological assessment 7.4. The importance of Bayes’ theorem for the clinical neuropsychologist 8. Neuropsychological diagnosis, feedback and report 8.1. Diagnostic reasoning and final diagnosis 8.1.1. Descriptive diagnosis (Level 1) 8.1.2. Diagnosis of compatibility with an aetiology (Level 2) 8.1.3. Functional diagnosis (Level 3) 8.2. Errors made by neuropsychologists in formulating a diagnosis 8.3. Feedback to the examinee 8.3.1. Feedback during the assessment 8.3.2. Feedback at the end of the assessment (on the preliminary analysis of the results) 8.3.3. Examples of feedback to the examinee 8.4. Feedback to the family 8.4.1. Examples of feedback to the family 8.5. Neuropsychological report 8.5.1. Content of the report 8.5.2. Style of the report 8.5.3. Tips on how to write a report 8.5.4. Ethical considerations 8.6. Conclusions 9. Examples of clinical cases and reports 9.1. A case of head trauma: in-person setting with paper-and-pencil tests (Setting A) 9.1.1. Information used by the neuropsychologist for the diagnosis 9.1.2. Chronological step-by-step diagnostic procedure 9.1.3. Report of the neuropsychological assessment 9.2. A case of initial cognitive decline: in-person setting with paper-and-pencil and digital tests (Setting A) 9.2.1. Information used by the neuropsychologist for the diagnosis 9.2.2. Chronological step-by-step diagnostic procedure 9.2.3. Reports of the three neuropsychological assessments 9.3. A follow up assessment after brain surgery: remote setting with paper and pencil tests (Setting B) 9.3.1. Information used by the neuropsychologist for the assessment 9.3.2. Chronological step-by-step diagnostic procedure 9.3.3. Report of the follow-up neuropsychological assessment 9.4. The case of a healthy older woman: remote setting with self-administered tests (Setting C) 9.4.1. Case description 9.4.2. Neuropsychological step-by-step procedure Appendix 1: Form used by the neuropsychologist to collect signs and symptoms during an assessment Appendix 2: The Cognitive Reserve Index Questionnaire (CRIq) Appendix 3: Implicit inferences in the report Glossary Bibliography Index