Neuropsychological assessment lezak 5th edition pdf download

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Neuropsychologicalassessment/MurielD.Lezak…[etal.].—5thed.

p.cm. Includesbibliographicalreferencesandindex.

1.Neuropsychologicaltests.I.Lezak,MurielDeutsch.

Dedicatedingratitudeforthelovingsupportfromourspouses,JohnHowieson,JanBigler,and

NatalieDenburg;andinmemoryofSidneyLezakwhoseloveandencouragementmadethiswork

Directobservationofthefullyintegratedfunctioningoflivinghumanbrainswillprobablyalwaysbeimpossible.

Whatdidweknowofpossibilities,justalittlemorethanaquarterofacenturyago?The“blackbox”of

classicalpsychologyisnolongerimpenetrableascreativeneuroscientistswithevermorerevealing

neuroimagingtechniquesaredevisingnewandpowerfulwaysoffindingwindowsintotheblackbox.In

neuroimagingwecannowtraceneuralpathways,relatecorticalareastoaspectsofthinkingandfeeling—

even“see”freeassociationinthe“default”state—andarediscoveringhowallthisisactivatedand

integratedincomplex,reactive,andinteractiveneuralsystems.Wemayyetuncoverthenatureof(self-

andother-)consciousnessandhowsynapticinterconnections,thejuicesthatflowfromthem,andthe

myriadotherongoinginteractiveneuralprocessesgettranslatedintotheexperienceofexperiencing.We

canneveragainsay“never”inneuroscience.

Yet,asentrancingandevenastonishingasarethefindingsthenewtechnologiesbringtoneuroscience,

itisimportanttobemindfuloftheirrootsinhumanobservations.Asthesetechnologicallyenhanced

observationsofthebrainatworkopenthewayfornewinsightsaboutbrainfunctionanditsbehavioral

correlatestheyalsoconfirm,overandoveragain,thefoundationalhypothesesofneuropsychology—

hypothesesgeneratedfromdirectobservationsbyneuropsychologistsandneurologistswhostudiedand

comparedthebehaviorofbothnormalandbrainimpairedpersons.Thesefoundationalhypothesesguide

practitionersintheclinicalneurosciencestoday,whetherobservationscomefromaclinician’seyesand

ears or a machine. In the clinic, observations of brain function by technological devices enhance understandingofbehavioral data and sometimes aid inprediction, butcannotsubstitute for clinical observations. Whentheearliestneuroimagingtechniquesbecameavailable,somethoughtthatneuropsychologists wouldnolongerbeneededasithadbecomeunnecessarytoimprovetheoddsofguessingalesionsite,a onceimportanttaskforneuropsychologists.Today’sadvancedneuroimagingtechniquesmakeitpossible topredictwithareasonabledegreeofaccuracyremarkablysubtlemanifestations,suchasthedifferences betweensociallyisolatedbraininjuredpatientswhowillhavedifficultyinsocialinteractionsalthough activelyseekingthem,versusthosewhomaybesociallyskilledbutlackincentivetosocialize.Yetthis newlevelofprediction,ratherthansubstitutingforhumanobservationandhumanintervention,onlyraises morequestionsforexperiencedclinicalneuroscientists:e.g.,whatcircumstancesexacerbateoralleviate theproblem?whatcompensatoryabilitiesareavailabletothepatient?isthepatientawareoftheproblem and,ifso,canthisawarenessbeusedconstructively?isthisaproblemthataffectsemployabilityand,if so,how?andsoon.Datageneratedbynewneurotechnologiesmayhelpidentifypotentialproblemareas:

neuropsychologistscanfindouthowtheseproblemsmayplayoutinreallife,inhumanterms,andwhat

Thus,inthefifthincarnationofNeuropsychologicalAssessment,wehavetriedtoprovideawide-

rangingreportonneuropsychologyasscienceandasaclinicalspecialtythatisasrelevanttodayasitwas

whenitfirstappeared35yearsago.Certainlywhatisrelevantin2012issomewhatdifferentfrom1976

asthescopeofactivitiesandresponsibilitiesofneuropsychologistshasenlargedandtheknowledgebase

necessaryforclinicalpracticeaswellasforresearchhasexpandedexponentially. ThreemajoradditionsdistinguishthefirstandthefiftheditionsofNeuropsychologicalAssessment. Mostobvioustotheexperiencedneuropsychologististheproliferationoftestsandthewealthofreadily availablesubstantiatingdata.Second,abooksuchasthismustprovidepracticallyusefulinformationfor neuropsychologists about the generations—yes, generations—of neuroimaging techniques that have

evolvedinthepast30years.Further,especiallyexcitingandsatisfyingisconfirmationofwhatoncewas

suspectedabouttheneuralorganizationunderlyingbrainfunctionsthankstothemarriageofsensitive, focused,clinicalobservationswithsensitive,focused,neuroimagingdata.Inthiseditionweconveywhat isknownabouttheenormityofinterwoven,interactive,andinterdependentcomplexitiesofneuronal processingasthebraingoesaboutitsbusinessandhowthisrelatestoourhumanstrengthsandfrailties.

Whatremainsthesamein2012asitwasin1976istheresponsibilityofclinicianstotreattheir

patientsasindividuals,tovaluetheirindividuality,andtorespectthem.Ultimately,ourunderstandings

abouthumanbehavioranditsneuralunderpinningscomefromthoughtfulandrespectfulobservationsof

ourpatients,knowledgeoftheirhistories,andinformationabouthowtheyarelivingtheirlives.

Onceagainwewanttohonorourneuropsychologistfriends,colleagues,andmentorswhohavediedin

thepastfewyears.Mostofwhatiswritteninthistextandmuchofcontemporaryneuropsychologyas

science or clinical profession,relies ontheir contributions to neuropsychology,whether directly, or indirectlythroughtheirstudentsandcolleagues.Wearedeeplygratefulfortheinsightful,innovative, integrative,andhelpfullypracticalworkofWilliamW.Beatty,EdithF.Kaplan,JohnC.Marshall,Paul Satz,EstherStrauss,andTomTombaugh.TheauthorsgratefullyacknowledgeTracyAbildskovincreating thevariousneuroimagingillustrations,JoAnnPetrie’sediting,andAubreyScott’sartwork. Manyof David WLoring’s important contributions to the fourtheditionof Neuropsychological Assessmentenrichthiseditionaswell.Wemisshishandinthiseditionbutaregratefultohavewhathe gaveus.Andthanks,too,toJuliaHannayforsomeinvaluablechaptersectionsretainedfromthefourth edition.SpecialthanksgotoKennethManzellforhisaidinpreparingthemanuscriptandillustrations.We arefortunatetohavemanycolleaguesandfriendsinneuropsychologywho—atworkorinmeetings— havestimulatedourthinkingandmadeavailabletheirwork,theirknowledge,andtheirexpertise.The

ongoing2ndWedns.NeuropsychologyCaseConferenceinPortlandcontinuestobeanopen-doorfree-

for-allandyouareinvited. Ithasbeenapleasuretoworkwithourneweditor,JoanBossert,whohasnotonlybeenencouraging andsupportive,buthashelpedusthroughsometechnicalhoopsandtaughtusaboute-publishing.Tracy O’Hara,DevelopmentEditor,hasdonetheheroictaskoforganizingtheproductionidiosyncrasiesoffour writers into a cohesive manuscript while helping with some much needed data acquisition. Book productionhasbeencarefullytimedandmanagedbySr.ProductionEditorSusanLeewhomakeshouse calls.Thanks,OUPteam,formakingthisbookpossible.Lasttogetinvolvedbutfarfromleast,our gratitudegoesouttoEugeniaCooperPotter,bestknownasGenia,whosethoroughscouringandpolishing oftextandreferencesgreatlyhelpedbringthisbooktolife.

ITHEORYANDPRACTICEOFNEUROPSYCHOLOGICAL

1.ThePracticeofNeuropsychologicalAssessment

Themultipurposeexamination

TheValidityofNeuropsychologicalAssessment

WhatCanWeExpectofNeuropsychologicalAssessmentinthe21stCentury?

LaboratoryTechniquesforAssessingBrainFunction

Neuropsychology’sConceptualEvolution

NeuropsychologyandtheConceptofIntelligence:BrainFunctionIsTooComplexToBe

CommunicatedinaSingleScore

ClassesofCognitiveFunctions

Personality/EmotionalityVariables

3.TheBehavioralGeographyoftheBrain

BrainPathologyandPsychologicalFunction

TheForebrain:DiencephalicStructures

TheCerebralCortexandBehavior

FunctionalOrganizationofthePosteriorCortex

TheOccipitalLobesandTheirDisorders

ThePosteriorAssociationCorticesandTheirDisorders

TheTemporalLobesandTheirDisorders

FunctionalOrganizationoftheAnteriorCortex

ClinicalLimitationsofFunctionalLocalization

4.TheRationaleofDeficitMeasurement

ComparisonStandardsforDeficitMeasurement

NormativeComparisonStandards

IndividualComparisonStandards