DA Fast Guide to Neuropsychology - Depression Alliance

DA Fast Guide to Neuropsychology

Neuropsychology

The human brain is amazing. It is arguably the most important organ in the human body because it controls all the other organs. For example, it tells the heart to pump blood, tells the lungs when to inhale and exhale, aids digestion and controls the nervous system. The brain is also in charge of our cognitive functions such as learning, verbal fluency, attention, and memory. Injury or damage to the brain can cause the body to malfunction, and give way to unusual thoughts and behaviors. Neuropsychology is the field of psychology focused on understanding the brain. In this article, we explore what neuropsychology is and what it entails.

Neuropsychology: What Is It?

Neuropsychology is a branch of psychology aimed at understanding how the brain and the rest of the nervous system influence a person’s behavior and cognition. More importantly, how brain injuries or illnesses affect behavior and cognitive functions. Neuropsychologists apply this knowledge in assessing, diagnosing and treating individuals’ neurological disorders.

Neuropsychology Theory

Neuropsychology merges neurology and psychology in a bid to fully understand the relationship between the ‘brain’ and the ‘mind’. It helps doctors understand how brain malfunctions occur and the results of these malfunctions. Throughout history, scholars, physicians and philosophers such as Hippocrates, Imhotep, and Rene Descartes have posited that the brain influences psychological states.

Modern neuropsychology emerged in the late 19th century. The first neuropsychologists studied animals and humans with brain and nervous system injuries. They made great progress in understanding the relationship between the brain and the mind. In the 20th century, the field of neuropsychology experienced great advancement after World War 2 when doctors needed to treat war veterans with head injuries. In the 1960s, the autonomous field of scientific inquiry known as Neuropsychology was formally established when the international scientific journal called Neuropsychologia was launched.

How Does Neuropsychology Suggest That The Mind Works?

Certain parts of the brain control specific bodily functions. Chemicals such as hormones and neurotransmitters can influence the way signals are sent from the brain to other areas of the body, and within the brain. Neuropsychologists believe that there is a strong link between the brain and the mind, and illnesses injuries and diseases in the brain can affect the way a person feels, thinks, and behaves.

How Do Neuropsychology Interventions Cause Change?

After evaluating patients in order to get a clear picture of the patient’s brain health, neuropsychologists create a treatment plan based on an understanding of how the patient’s brain functions and how that relates to the patient’s behavior. Neuropsychology helps the patient:

  • Gain a better understanding of their brain’s strengths and weaknesses.
  • Know how to navigate day-to-day living in ways that aid their recovery.
  • Get information that will help them succeed at school or work or live independently.
  • Assist the rehabilitation team to come up with the best treatment plan that addresses current difficulties.
  • Provide relevant information to their family in order to help recovery.

What Happens In A Neuropsychology Session?

Neuropsychologists look at how the health of your brain affects your thinking skills and behavior. The first session is typically a conversation where you tell the neuropsychologist about your concerns and explain how you feel. The psychologist will ask you questions about your behavior, how you feel, your general mood and your thinking. You might also get asked about your medical history, family background, your education, and occupation. Sometimes tests are administered in this first session. At the end of the session, the neuropsychologist will advise you on whether further assessment will be helpful. Subsequent sessions may include neuropsychological evaluation and brain scans such as MRI scans. After the diagnosis has been made, treatment plans may include cognitive rehabilitation therapy, medication or surgery.

Techniques Used In Neuropsychology

There are various techniques that Neuropsychologists use in assessing the health of the brain in order to be able to make a diagnosis. They include the following:

Neuropsychological Testing

Neuropsychological testing is a part of the neuropsychological evaluation process which includes:

  • A review of medical records
  • An interview with the patient and another person who knows the patient well
  • Administration of tests that measure abilities and general brain health

Neuropsychologists use the information gotten from these sources to provide the patient with a comprehensive report that summarizes the evaluation results, and recommendations for the future.

Neuropsychological tests are designed in a way that allows performance on the test to be linked to specific neurocognitive processes. This simply means that the tests assess how your brain functions. The tests typically include questions that will help identify how well you perform daily tasks, any issues you might have with your memory and mental health concerns. There’ll also be questions about your symptoms and medical history. The aim of the tests is to measure how your brain functions in different areas such as:

  • Memory
  • Cognitive ability
  • Problem-solving
  • Reasoning
  • Personality
  • Emotions
  • Attention
  • Motor Function
  • Perception
  • Verbal ability

Note that the tests may focus more on some areas more than others depending on the injury.

Here are some examples of the kind of tests that may be administered.

  • Memory test: The patient may be presented with a list of words and asked to repeat the items on the list after the list has been taken away.
  • Cognition test- The patient may be asked to explain the relationship between two things. For instance, if a picture of an apple and orange is shown, the patient is expected to say that they’re both fruits.
  • Verbal tests- The patient may be asked to spell and pronounce words or to list words starting with a specific letter.

The tests usually last between 3-6 hours. It varies from individual to individual and is usually based on how fast the patient and technician can get through the questions. Breaks are given during the sessions, however, sometimes, multiple sessions are necessary to complete the tests.

A technician known as a psychometrist usually administers the test. A psychometrist is trained to give and score these tests. Sometimes, the tests may be administered by a Doctoral student studying psychology.

After the tests, the neuropsychologist will review the results and write a comprehensive report. This report is very confidential and is usually only given to the patient and the professional who referred the patient for neuropsychological testing. The report typically consists of: A summary of the tests that were administered, important medical and personal history, current problems being experienced, test results, comparison of results with other people in the patient’s age group and recommendations for the patient.

We recommend that you go through the report carefully, note any questions that you might have and review them with your neuropsychologist. You can ask your neuropsychologist for a feedback session where you can go over your questions and concerns.

Neuropsychology

Brain Scans: MRI, fMRI, EEG, and PET Scans

The technical term for brain scans is Neuroimaging and it involves the use of various techniques such as MRI, EEG, and PET to image the structure, current state, and function of the brain. Neuroimaging falls into two broad categories:

  • Structural imaging- Has to do with the structure of the brain and diagnosis of large-scale brain diseases or injury (e.g tumor)
  • Functional imaging- Used to diagnose metabolic diseases and lesions which may not be so obvious. It’s also used for neuropsychology and cognitive psychology research. One way functional imaging works is to enable the way the brain processes information to be directly visualized.

The following are the brain imaging techniques popularly used in Neuropsychology:

MRI- This stands for Magnetic resonance imaging. MRI uses radio waves and magnetic fields to produce high definition two or three-dimensional images of brain structures without using X rays. MRI provides a great physical picture of the brain and is able to point out injuries such as inflammation. However, it usually fails to provide information about how the brain is functioning. This is where functional MRI imaging, fMRI comes in.

fMRI- This means Functional magnetic resonance imaging. It uses the paramagnetic properties of oxygenated/deoxygenated hemoglobin to see images of changing blood flow in the brain associated with neural activity.  This generates images that show which brain structures are activated during the performance of different tasks. fMRI can be used to reveal brain processes associated with perception, thought, and action.

EEG- Electroencephalography is used to measure the electric fields in the brain. It offers a very direct and accurate measurement of neural electrical activity.

PET-  Positron emission tomography show blood flow, metabolism, and oxygen in the brain tissues. It shows the amount of activity in different parts of the brain and serves as a guide to learn more about how the brain works. PET scanning is useful for diagnosing brain diseases.

Do Neuropsychological Interventions Work? Neuropsychology can help the diagnosis of a cognitive, behavioral or neurological condition. It leads to a deeper understanding of the condition and proposes a clear path to treatment. It also helps the patient make smarter decisions. Neuropsychology is very useful and effective.

What Kinds Of Concerns Are Neuropsychology Interventions Best For?

Neuropsychology is primarily concerned with assessing conditions that affect brain health such as memory and learning difficulties. However, it addresses a wide range of concerns.  Here are some conditions neuropsychology is used to evaluate and treat:

  • Stroke
  • Parkinson’s disease
  • Alzheimer’s disease
  • Dementia
  • ADHD
  • Dyslexia

How Are Neuropsychologists Trained?

A neuropsychologist is a trained psychologist who provides assessment and treatment services to patients based on theories of neuropsychology. Training in neuropsychology usually comprises a background in clinical psychology and specialized training in neuropsychology. Neuropsychologists are required to have a doctoral degree in psychology from an accredited university, an internship in a relevant area of professional psychology and additional specialized training in neuropsychology. They also need a license to practice neuropsychology. A board certification is usually the clearest evidence that a practitioner has met the necessary criteria.

Concerns/ Limitations Of Neuropsychology

The major criticism of neuropsychology is that most neuropsychological tests weren’t designed to predict how patients are likely to function in the real world, post diagnosis. They’re only designed to identify impairments that stem from brain injury or disease. No neuropsychological test is able to predict how an individual who has suffered from brain injury or disease will function in everyday settings. The proposed solution to this is that, predictions made will be more accurate if the tasks used during testing closely match the patient’s individual vocational and life demands. For example, tests administered to a professional driver should involve cars.

Important Practitioners In Neuropsychology

Here are some of the people whose work has greatly influenced Modern neuropsychology:

Thomas Willis- Thomas Willis studied at Oxford University and took a psychological approach to the brain. He is credited for coining the terms ‘hemisphere’ and ‘lobe’ and was one of the first people to use the words ‘neurology’ and ‘psychology’. Willis’ theories provided a foundation for the in-depth study of the brain and human behavior, especially in areas of disorders and dysfunctions of the brain.

Franz Joseph Gall- Franz was a neuroanatomist and physiologist. He theorized that personality was directly linked to the workings of the brain, He also invented phrenology, which regarded the brain as an organ of the mind, where the shape of the skull could determine one’s intelligence and personality. Though many of his theories were proven wrong and viewed as controversial, his work helped to advance the field of neuropsychology.

Karl Spencer Lashley- Lashley did very important work in neuropsychology and tutored people who reached even greater heights in the field. Lashley is credited for discovering the spectacular ability that the brain has to take over the functions of specific areas if those areas fail or are removed.

How To Find A Therapist

If you’re looking for a neuropsychologist, you can get a referral from another physician or healthcare provider. Neuropsychologists usually work closely with neurologists, neurosurgeons, and psychiatrists. Speaking with one of these professionals is another option for finding a neuropsychologist. Also, most large hospitals have neuropsychologists on staff. You can find a list of neuropsychologists, certified by the American Board of Clinical Neuropsychology, on the AACN website in the member directory. You can also do a quick online search that should bring up names and websites of neuropsychologists.

What Should I Be Looking For In An LMHP?

You should be looking for a trained clinical neuropsychologist with proof of certification and a license to practice. You should also check to see how much experience the neuropsychologist has.

Questions To Ask A Potential Therapist

  • How long have you been practicing neuropsychology?
  • What form of treatment will be most appropriate for me?
  • How much experience do you have in this field?
  • Do you consider yourself an expert in neuropsychology?
  • How much do sessions cost and will this be covered by my insurance?
  • What is your cancellation policy?

If you’re having trouble remembering things, concentrating or making decisions, you might need to see a neuropsychologist. The evaluation done by the therapist will chart the course for treatment and give you tips to live your life in the best way possible. Neuropsychology is a very useful tool for assessing your brain’s health and the impact it has on your feelings and behavior.

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