DiagnosticsLectures - LeidenUniversity Lecture1→Introduction ●Bas...

DiagnosticsLectures October-December2024 ClinicalNeuropsychology LeidenUniversity 1 / 4

Lecture1→Introduction 2 / 4

●BasicprinciplesofdiagnosticsinCNP ○Cognition,emotion,behaviorinrelationtothedysfunctioning ofthebrain ○Referral&researchquestion(empiricalcycle) ○Neuropsychologistasascientistpractitioner ○Taxonomy ■Recognition/diagnosis→whataretheproblems,whatisintact/impaired?■Explanation→whydotheproblemsoccur,howaretheymaintained?■Prediction→inwhatwaywilltheproblemsofthepatientdevelopinthe future?■Indication→howcantheproblemsbetreated?■Evaluation→aretheproblemssufficientlyaddressedbythetreatment?○Thediagnosticprocessisdynamic→hypothesiscanbegene ,tested, updatedatmultiplestagesintheempiricalcycle ○Anamnesis ■Semistructuredconversation ■Focusontype,course,severityofcomplaints ■Focusonpredictionsbasedon“first”hypotheses ●Hypothesesbasedonbrain-behaviorrelationships ■Askforlimitationsindailylife ■Alwaysaskforspecificexamplestoavoidmisunderstandings ●Memorycomplaints ●Longterm&shorttermmemory 3 / 4

■Duringanamnesis→observation!○Symptomsvssyndromes ■Symptomsarenotsyndromes ■Orderingcomplaintsofthepatients ■Recognitionofsyndromes&patternsofimpairment ■Donotonlysearchforconfirmation,askforsymptomsthatwouldfitother hypothesestorejectincorrectones ■Takebaserateinformationintoaccount ○Heteroanamnesis ■Informationfromsomeoneclose,otherwisehealthcareprofessional ■Informedconsent ■Additionalsourceofinformationtoincreasereliability ■Insight&awarenessofdisease ■Attentionforinconsistencies ■Opportunitytoobserve ○Determiningwhichhypothesestotest ■Operationalization→howshouldwetestthepremisesofthehypotheses ○Choosinginstrumentstomeasurecognitivefunctions ■Preferablyatleast2percognitivedomain ■Relationshipsbetweenattention,memory,executivefunction ■Impossibilitiesofthepatient(physicalimpairments) ■Qualityoftheinstruments ●Validity→extenttowhichatestaccuratelymeasureswhatitis supposedtomeasure ●Reliability→smallmeasurement errorandhightest-retestreliability ●Norms→availabilityofan appropriatenormgroupbasedon age,gender,education ●COTANreviewsthequalityof commontests&questionnairesin NL

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