Neuro-psychology: Definition and Nature

Neuro-psychology.

Neuro-psychology is a field that combines neurology and psychology and studies the relationship between brain and behavior. It studies the cognitive processes. It tries to understand which part of the brain associates with which type of cognitive processes etc. Neuro-psychology aims to understand how the structure and function of the brain relates to specific psychological processes.

Neuropsychology is a structured, objective, and scientific discipline which delves into the brain and tries to associate various behaviors of the individuals to the changes that come about in the brain. The ultimate aim is to understand the individual mind and brain.

Neuropsychology compares the performance among persons with known differences in their biological brain structures and attempts to find out the various sources that cause the variations in the brain which all produce differences in individual behaviors. These sources include the following:

1. 1. Biological factors (e.g., genetic, diseases, and injuries)
   2. Psychological factors (e.g., learned behaviors and personality) and
   3. Social factors (e.g., economics, family structure, and cultural values).

Neuro-psychology is that branch of psychology which deals with the relationship between the nervous system, especially the brain, and the cerebral or mental functions such as language, memory, and perception. Moreover, neuro-psychology as a science is concerned with the integration of psychological observations on behavior with neurological observations on the central nervous system (CNS), including the brain.

It is the study of (and the assessment, understanding, and modification of) brain-behavior relationships. Neuropsychology also seeks to understand how the brain, through structure and neural networks, produces and controls behavior and mental processes. Moreover, it includes emotions, personality, thinking, learning and remembering, problem solving, and consciousness.

Neuro-psychology and Other Disciplines.

If we presume that the brain is the starting point for why and how we process all mental information and not just cognitive, but interpersonal communications, self-concept, emotional reactivity, personality, learned responses, etc., then in some aspect, all psychology is neuropsychology.

Neuro-psychology is the basic scientific discipline that studies the structure as well as function of the brain related to specific psychological processes and overt also behaviors.

• Neuropsychology is scientific in its approach.
• It is closely related to cognitive psychology in that it also considers the mind as information processing system
• Closely related to cognitive science.
• It is considered eclectic.
• Neuropsychology overlaps with some areas of neuroscience.
• It is also closely associated to philosophy of mind.
• It of course associates closely with neurology.
• However, psychiatry draws a lot from neurology.
• By using artificial neural networks it is considered close to computer science also.

Functions of Neuro-psychologists.

Neuropsychologists are not medical doctors. But doctors of psychology whose field of study is concentrates on the brain and its functions. Neuropsychological testing designed to determine the brain’s capacity with respect to short and long term memory, abstract reasoning, attention, concentration, executive functioning, motor skills and also other cognitive and psychological factors.

By comparing the pattern of these results, against the patients pre-morbid capabilities, and correlating these results with the nature of the trauma suffered by the patient, neuropsychologists can, to a reasonable degree of certainty, opine that individuals without an acute diagnosis of brain injury, have permanent deficits as a result of brain trauma.

Moreover, neuropsychologists use batteries of tests to triangulate the brain’s functioning and through that triangulation, determine whether the brain is functioning as it should.

Major Domains of Neuropsychological Functioning.

Neuropsychological examination is useful in measuring many categories of functioning, including the following:

• Intellectual functioning
• Academic achievement
• Language processing
• Visuospatial processing
• Attention/concentration
• Verbal learning and memory
• Visual learning and memory
• Executive functions
• Speed of processing
• Sensory-perceptual functions
• Motor speed and strength
• Motivation/symptom validity
• Personality assessment

Referrals to Neuropsychologists for Neuropsychological Examination:

Neuropsychological testing provides diagnostic clarification and grading of clinical severity for patients with obvious or supposed cognitive deficits. Often these include patients with a history of any of the following problems:

• Head injury
• Failure to achieve developmental milestones
• Learning or attention deficits
• Exposure to drugs, alcohol, or maternal illness in utero
• Exposure to chemicals, toxins, or heavy metals
• Parkinson’s disease
• Seizure disorders
• Substance abuse
• Strokes
• Dementia
• Psychiatric Disorders

Applications of Examinations- Neuro-psychology

• Differential diagnosis of organic and functional pathologies
• Determination of the presence of epilepsy versus somatoform disorder (that is, nonepileptic seizures or pseudoseizures)
• Assessment for dementia versus pseudodementia.
• Determination of the presence of traumatic brain injury (TBI) versus malingering or
  – unconscious highlighting.
• Guidance for rehabilitation programs as well as monitor patient progress
• Guidance for referring to specialists
• Providing of data to guide decisions about the patient’s condition, such as
  the following:
  • – Competency to manage legal and financial affairs
    – Capacity to participate in medical and legal decision making
    – Ability to live independently or with supervision
    – Ability to return to work and school affairs
    – Candidacy for transplants
• Providing data to guide the following assessments and procedures:
  • – Evaluation of the cognitive effects of various medical disorders and associated interventions
    – Assessment of tests for diabetes mellitus, chronic obstructive pulmonary disease (COPD), hypertension, human immunodeficiency virus (HIV) infection, coronary artery bypass graft (CABG), and clinical drug trials
    – Assessment of CNS lesions and/or seizure disorders before and after surgical interventions, including corpus callosotomy, focal resection (e.g., topectomy, lobectomy), and multiple subpial transection
• Monitoring the effects of pharmacologic interventions
• Documentation of the cognitive effects of exposure to neurotoxins
• Documentation of the adverse effects of whole brain irradiation in children
• Issuance of Standard protocols for assessment of specific disorders, such as dementia (e.g. Alzhimer Disease).

Test Selection: Neuro-psychology.

1. Reliability, Validity, Sensitivity and Specificity.

• Generally, findings suggest that performance on tests of motor functioning, speed of cognitive processing, cognitive flexibility, complex attention, and memory are related positively to real-world success.
• The amount of variance accounted for by cognitive factors alone, however, is typically quite small.
• Exceptions occur when comparisons made between results of formal Neuropsychological examination and real world criteria are limited to very simple, very circumscribed, and very well defined functions.
• Consequently, situational assessment is seen as a critical adjunct to neuropsychological assessment, especially at higher levels of cognitive functioning.
• Many tests have proven to be good predictors of future behavior and, therefore, have demonstrated ecologic validity.
• However, a qualitative process approach may improve the ecologic validity of the neuropsychological test battery.
• For example, testing the limits with measures of memory and executive functioning allows the examiner to understand better what a person can do under relatively ideal circumstances.
• The test itself may have little demonstrable ecologic validity, but an accurate analysis and insightful interpretation of findings can be highly valid from an ecologic perspective.

2. Sensitivity and Specificity.

• Sensitivity refers to a test’s ability to detect the slightest abnormalities in CNS function and is a reflection of the test’s true positive rate, that is, its ability to identify persons with a disorder.
• Whereas, Specificity refers to the ability to differentiate patients with a certain abnormality from those with other abnormalities or with no abnormality, as indicated by the true negative rate.
• A score on any test can be a true positive, false positive, true negative, or false negative.
• True positive means it requires high sensitivity to dysfunction, also allowing dysfunctions to be detected.
• False positive means it indicates sensitivity to dysfunction, though lacks specificity to a particular dysfunction.
• True negative refers to the high specificity, allowing negative to be distinguished from others.
• False negative on the other hand refers to the lack of sensitivity, without regard to specificity of the test.
• Therefore for any evaluation, it is important to understand the rates of each of the above aspects in the results.

References,

•  Anderson, J. R. (2015). Cognitive psychology and its implications. New York: Worth Publishers
• Galloti, K. M. (2004). Cognitive psychology in and out of the laboratory. USA: Thomson Wadsworth.
• Matlin, M. (1994). Cognition. Bangalore: Harcourt Brace Pub.
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