1. What is Clinical Neuropsychology?.docx

CRITICAL READING: CORNELL NOTES What is Clinical Neuropsychology? Name: Date: 19 August 2023 Section: Lecture 1 Period: Questions/Main Ideas/Vocabulary Notes/Answers/Definitions/Examples/Sentences Neuropsychology Relationship between brain and behaviour. Alternative terms: Biopsych...

CRITICAL READING: CORNELL NOTES What is Clinical Neuropsychology? Name: Date: 19 August 2023 Section: Lecture 1 Period: Questions/Main Ideas/Vocabulary Notes/Answers/Definitions/Examples/Sentences Neuropsychology Relationship between brain and behaviour. Alternative terms: Biopsychology Biological psychology Physiological psychology Focus: normal/healthy brain structure and function. Examines: Gross anatomy of the brain. Electrical processes (nerve impulses). Chemical processes (neurotransmitters). Brain development and ageing. Refers to the study of normal brain development, structure and function, and how it influences/controls: Perception Cognition Movements Emotions Behaviour Normal/healthy brain functioning when: No problems during development (before, during and after birth). No birth trauma. No brain trauma (during childhood or as an adult). No disease or neurodegeneration. Clinical Psychology Assessment and diagnosis of: Mental/psychological illnesses (schizophrenia, personality disorders, PTSD). Disabilities (intellectual disability, learning disorders). Other psychological problems (anxiety, depression, social phobia, OCD). In both children and adults. Treatment (uses evidence-based techniques) to: Treat the aforementioned psychological problems/issues. Provide psychoeducation to people who are receiving mental health services. Improve coping strategies, adjustment and quality of life. Assist family members. Clinical Neuropsychology Essentially does what clinical psychologists do, but with different clients. Clients: Have some form of brain damage or dysfunction. Brain damage can be congenital – resulting from problems that occur during the brain’s development (foetal development). Damage can be acquired at any stage of life – during infancy, childhood, adolescence or in adult years through trauma or disease. Brain damage may be: Known to have occurred because there are clear symptoms and damage is visible on a brain scan. Suspected (small amount of damage not detectable on brain scans, early stages of a neurodegenerative disease). Brain damage can cause a wide range of problems, including perceptual, cognitive, motor emotional and behavioural problems. Functions affected by brain damage: Perceptual skills Motor skills Cognitive abilities Mood/emotional functioning Behaviour All of which affect psychosocial functioning: Ability to live independently Self-care Work/study Maintain friendships Manage finances Resume driving Cognitive psychology: Developed models of cognitive functions. Perception. Attention. Memory. Language. Models are only valid if they can explain cognitive functioning of a person with brain damage. Problems Arising from Brain Damage Range from: Very specific problems such as a specific memory problem or problem with perceiving faces. Widespread problems affecting many or most areas of a person’s life. Can vary in severity: Mild problem with limited impact. Severely disabling, rendering a person dependent on others. All levels in between. Main Roles Assessment and diagnosis of neurological/brain-based disorders: Assessing changes to cognition, mood and behaviour. Estimating a person’s previous (pre-morbid) functioning. Identifying a person’s strengths and weaknesses. Assisting with identifying the underlying cause of problems, if it is not known. Treatment, rehabilitation, psychoeducation, counselling: Educating clients and their families, counselling them, therapeutic recommendations. Where do Clinical Neuropsychologists Work? Hospitals (adult, paediatric, rehabilitation, psychiatric). Community-based services (memory clinics, educational or forensic settings, rehabilitation services). Private practice. Research. Clinical Neuropsychology in Australia Education: Post-graduate degree in clinical neuropsychology. Two years of supervised practice. Registration: Australian Health Practitioner Regulation Agency (APHRA). Endorsement in clinical neuropsychology. Can choose to be a member of the APS College of Clinical Neuropsychologists. Healthy Neurons Neurons: Comprise cell bodies and axons. In the CNS, axons are surrounded by glial cells which form an insulating sheath (myelin). Electrical events: Information is transmitted along axons via electrical events (action potentials). Action potentials move between gaps in myeline, leading to faster transmission. Chemical events: Information is transferred between neurons via chemical events. Neurotransmitters are released at the synapse, enabling messages to be transferred from 1 neuron to the next. Neurotransmitters: DA, serotonin, acetylcholine. Brain Damage Involves death of cells and/or disruption to their functioning. Variety of causes: Lack of blood, oxygen, glucose. Disease or physical injury. Disruptions to neuronal functioning, including: Electrical transmission (MS – affects myelin). Neurotransmitters (Parkinson’s disease – substantia nigra reduced DA). Neuronal functioning. Damage differs in a number of ways: Diffuse vs. focal. ‘Static’ vs. progressive. Diffuse Damage Not concentrated in any specific region. Includes: Diffuse axonal damage (DAI) – affects axons/white matter. Diffuse vascular damage – affects blood vessels. Causing diffuse widespread bleeding in small blood vessels. General term: Diffuse brain damage (DBD). Amount of diffuse damage can vary. Small amount may be difficult to detect on brain scans. Leads to general/wide-reaching cognitive problems: Slower responses, less efficient information processing. Focal Damage Concentrated in specific areas. Damage/’lesions’ often more visible and more easily detected using brain scans. Varies in size/amount. Usually leads to more specific cognitive problems, which vary according to the location of the damage. Static/Single/One-Off Events Acute event. For example, traumatic brain injuries like motor vehicle accidents, stroke, carbon monoxide poisoning. Most damage occurs around the time of the injury/event; in the acute/early stages. Condition stabilises, improvement/recovery can occur. Degenerative Processes Chronic condition, for example: Alzheimer’s disease Parkinson’s disease Huntington’s disease Gradual/progressive deterioration, affecting more functions. Underlying disease process. Exact time of onset often unclear. Rate of deterioration can vary between: Disorders People with the same disorders Brain Basics Has a jelly-like texture. Protective layers: Skull Meninges (dura, arachnoid layer [subarachnoid space, cerebrospinal fluid], pia matter). Subarachnoid space, cerebrospinal fluid (CSF). Main Causes of Brain Damage Vascular: Strokes Vascular dementia Cancer – brain tumours Traumatic brain injuries Degenerative diseases: Alzheimer’s disease Parkinson’s disease Huntington’s disease Autoimmune disorders MS Infections: Bacterial Fungal Viral Toxins: Lead poisoning Chronic alcohol abuse Substance abuse Carbon monoxide poisoning. Many others.