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Ganser’s syndrome
Published in David Enoch, Basant K. Puri, Hadrian Ball, Uncommon Psychiatric Syndromes, 2020
David Enoch, Basant K. Puri, Hadrian Ball
A wide variety of ridiculous and approximate answers may be given. Colours may be incorrectly named. One of our patients, when given a block design test, insisted that the red areas on the blocks were white and the white areas were red. Asked how many legs a dog had, he arrived at the correct answer only after considerable deliberation and counting on his fingers. Attention must be given not only to the absurdity of the answers but also to the manner in which they are given. Inconsistency is a hallmark of the performance; the tendency to give approximate answers may alter dramatically during an examination and can be radically influenced by the responses and attitude of the interviewer. As the suspicions of the examiner are aroused and questions pressed more ardently, “I don’t know” responses tend to become more frequent, the degree of dissociation tends to increase and the subject may show increasing lack of interest in the proceedings or lapse into sullen silence.
Contribution of the neuropsychological evaluation to traumatic brain injury rehabilitation
Published in Mark J. Ashley, David A. Hovda, Traumatic Brain Injury, 2017
As noted earlier, several neuropsychological tests judge the accuracy and speed of information processing. Individuals without brain injury are usually capable of completing tasks both accurately and within a reasonable period of time. After TBI, one or both aspects of information processing may be impaired. The Wechsler Adult Intelligence Scale–Fourth Edition contains four indices that are analytically derived from the subtests of the test. The Verbal Comprehension, Perceptual Organization, and Working Memory Indexes require accurate responses, and the patient is penalized less for time of completion. An exception to this is the Block Design test in which the correct response is recorded, but more points are awarded with a more rapid correct response. The Processing Speed Index provides a measure of information processing efficiency. Speed of information processing for response inhibition, as measured by the Stroop Color–Word Test and motor output speed on the Purdue Pegboard, has been shown to be associated with general functional outcomes (operationalized by the Glasgow Outcome Scale) in patients with moderate-to-severe TBI.41 The analysis of speed versus accuracy is also obtainable on tests such as the Ruff 2 and 7 Selective Attention test on which selective attention accuracy (errors of omission and commission) and amount of information processed (accurate target detection speed) are measured. The relative mix of accuracy and speed can be calculated from a subset of items from Form I of the LNNB termed the Power and Speed Indexes. As with most neuropsychological tests, there are few that purely measure a single construct. For example, the Delis-Kaplan Executive Function System Color–Word Interference Test measures information processing speed and response inhibition as well as shift set maintenance. There is considerable overlap between attention abilities and information processing speed. Table 31.6 includes measures of information processing speed.
An investigation into the relationship between Quality of pantomime gestures and visuospatial skills
Published in Augmentative and Alternative Communication, 2020
Ellen Rombouts, Bea Maes, Inge Zink
To assess visuospatial skills, the Perceptual Organization Index from the WISC-III-NL was used. This Index is a composite score of four subtests: (a) picture completion, (b) picture arrangement, (c) block design, and (d) object assembly. While researchers have previously employed the block-design test (Wray et al., 2017) and the Raven’s colored progressive matrices (Botting et al., 2010; Wray et al., 2016), a factor score such as the Perceptual Organization Index score is a more reliable measure than a single subtest score. In addition, individuals with Williams syndrome have considerable difficulty completing the block-design test (Farran et al., 2001; Farran & Jarrold, 2003), so that using only this subtest as a measure of visuospatial skills might have conflated the results. Because scores were lower than the scores provided in the manual’s age equivalent table, the lower scores were calculated using the extrapolation method from Toffalini, Buono, Zagaria, Calcagnì, and Cornoldi (2019; see Appendix A for details). Table 1 shows that the visuospatial age equivalents of the participants with developmental language disorder were on average 26.2 months (SD = 5.53) less advanced than the participants with typical development, t(48) = 4.74, p < .001. As expected, the visuospatial skills of the participants with Williams syndrome were on average 19.7 months (SD = 5.39) less advanced than the skills of the participants with developmental language disorder, t(37) = .29, p = .001.
Neurocognitive function in paediatric obsessive-compulsive disorder
Published in The World Journal of Biological Psychiatry, 2018
Daniel A. Geller, Amitai Abramovitch, Andrew Mittelman, Abigail Stark, Kesley Ramsey, Allison Cooperman, Lee Baer, S. Evelyn Stewart
Our results suggest that youths with OCD demonstrate reduced neuropsychological test performance on tests measuring processing speed as well as on tasks of VSA and WM. While youths with OCD underperformed compared to the control group on the Block Design subtest assessing VSA, they did not underperform on a test of VSA in which time does not count toward scoring (i.e., RCFT copy). Thus, given that the Block Design test also assesses motor ability, and more importantly is a timed test, their slower processing speed may have contributed to reduced performance. Similarly, in the WM domain, youths with OCD underperformed compared to the control group on the Arithmetic subtest, but did not differ on the Digit Span subtest. Whereas the latter is an untimed test, the former is a timed test that requires manipulating information in WM. Therefore, this may also point to reduced performance associated with processing speed in youths with OCD when compared to controls. These results imply that processing speed may be a central point of weakness in youths with OCD that underlies underperformance on tests assessing other domains. This notion has been suggested by others (Burdick et al. 2008; Bedard et al. 2009), arguing that processing speed deficits may underlie underperformance in tests of executive function in adult OCD, but to our knowledge this is the first study to demonstrate this effect in youth with OCD. Notably, we did not find performance differences in the domain of NVM and EF between youth with OCD and controls.
Neuropsychological performance in patients with substance use disorder with and without mood disorders
Published in Nordic Journal of Psychiatry, 2020
Irma Höijer, Tuula Ilonen, Eliisa Löyttyniemi, Raimo K. R. Salokangas
Patients with substance abuse and mood disorders seem to have more deficits in speed processing and perceptual reasoning than substance abuse patients without mood disorders. These processing speed difficulties and perceptual problems may impact prognosis and treatment. The Digit Symbol test and the Block Design test are a fast and sensitive ways to examine treatment effectiveness and monitor treatment progress. For the first neuropsychological assessment, it is useful to use a wider set of tests; the follow-up studies can focus more on these tests, which measure co-occurring alcohol misuse, substance use, and mood disorders. Extensive test batteries are not needed for a retest.