Many patients with neurological diseases exhibit behavioral abnormalities, which technical language refers to as adjustment disorders. Clinical neuropsychology is concerned with the psychological and physical experience of stress in affected individuals.
What is clinical neuropsychology?
Clinical neuropsychology is concerned with the psychological and physical stress experience of people affected by adjustment disorders. Clinical neuropsychology is a subdiscipline of psychology. Psychologists are concerned with the question of why people exhibit certain behaviors and patterns of behavior and trace them back to individual experiences. In addition to “behavioral research”, psychology also gets to the bottom of such important questions as how feelings arise, how they affect human action, the learning process, mental state and intelligence. It asks the all-important question of how psychosomatic illnesses arise and how they can be remedied. Neuropsychology starts from this point and subjects this problem to a special analysis. It tries to find answers as to whether the previously mentioned psychological processes are connected with characteristics or parts of the brain.
Treatments and therapies
Clinical neuropsychology is a subfield of neuropsychology and studies the causal links and relationships between behavioral abnormalities, which are considered to have disease value, and central nervous system dysfunctions, which are closely related to brain activity. These dysfunctions can be traced to motor function, perception, attention, memory, and higher cognitive functions and abilities. This sub-discipline does not view the mental-emotional disorder and its underlying physiological disorders and/or complaints separately, but creates a unified picture on which the subsequent treatment concept is based. Clinical neuropsychology recognizes three basic forms of therapy.
- 1) Functional therapy, also known as restitution, focuses on improving or optimizing behavioral abnormalities based on specific neuropsychological treatment methods.
- 2) Compensatory therapy builds the coping skills of the affected individual and enables him to deal objectively with his disorder during this therapy. This form of therapy is always used when functional therapy does not bring the desired results.
- 3) Neuropsychologists combine therapy approaches with integrative treatment methods. This involves combining the methods of other psychological treatment principles and procedures from the field of behavioral therapy with their own therapeutic approaches.
Three main components of attention deficit disorder appear conspicuously: processing capacity, selectivity and alertness (alertness, activation). The processing capacity is limited and requires the undisturbed course of processing speed of information, which must be both divided and parallel, when conscious attention. Another variant is controlled and automated processing. The processing speed represents the basic variable of a large number of cognitive processes, which entails a complex stimulus and reaction procedure. Divided and parallel processing is more complicated, as several tasks must be performed at the same time. These processing procedures may entail different intensities of differentiation of incoming information. Controlled intake of information occurs on an automated basis and at a slower processing speed. With selective perception, a person is able to consciously and unconsciously differentiate the flood of incoming information to which he is exposed on a daily basis according to importance and unimportance. He concentrates on the essential and neglects secondary and irrelevant information. In colloquial language, the term concentration ability is used instead of alertness. It is the maintenance of certain attentional performances over a longer period of time, usually in a controlled manner.Phasic attention focuses on the reception of a short-term incoming information, the goal being to process this new and unexpected stimulus as well as possible. The syndrome-like disorder of neglect entails tactile, visual, and auditory complaints. Patients exhibit unilateral neglect of the extremities (hemiacinesis), misattribute stimuli locally (allesthesia), and neglect one half of space. Their insight into disease (anosognosia) is absent. In particular, they suffer from impaired visual perception, auditory perception disorders, motor disorders, loss of control, hallucinations, thought disorders, apraxias, aphasias, amusias, amnesias, and various types of dementia. Affected individuals are unable to properly process colors, sizes, consistencies, tonality, sounds, speech, music, speed, and other complex stimuli. They may have visual field impairment, poor sense of direction, limited intelligence, learning disabilities, reading, writing and math difficulties, and memory loss (traumatic brain injury).
Diagnosis and examination methods
Headaches and migraines may be the first signs. The brain, more than any other organ, depends on an undisturbed blood and oxygen supply. Vascular diseases (circulatory disorders) are a possible indication of an impending stroke, cerebral hemorrhage and stroke give. Infectious diseases of the nervous system in the form of viruses and bacteria form the preliminary stage of meningitis. If not only the meninges but also the brain is directly affected, encephalitis is present. Multiple sclerosis is an inflammatory disease of the spinal cord and brain, which is due to a dysregulation of the immune system. Affected individuals suffer from cognitive perception disorders and muscle atrophy, which in the chronic stage causes permanent damage and disability (secondary chronic progressive multiple sclerosis). Further suspicious factors in the diagnosis are brain tumors, muscle diseases (muscle atrophy, muscle weakness), diseases of the peripheral nervous system and neurodegenerative diseases (chronic brain diseases without inflammation and circulatory disturbance). The first step on the way to therapy is anamnesis, which is done by interviewing the patient. Laboratory examination of blood and cerebrospinal fluid (nerve and brain water) follows neurological diagnostics. In this way, all types of pathogens, inflammatory parameters and the previously mentioned diseases can be detected. Other examinations include ultrasound of the vessels supplying the brain, electrophysiological diagnostics in the form of derivation of brain waves (EEG), measurement of nerve conduction in the peripheral nervous system (electroneurography), derivation of electrical muscle activity (electromyography), measurement of nerve conduction in the spinal cord and brain (evoked potentials), registration of eye movement (electrooculography), and functional diagnostics of blood pressure and heart activity. Indispensable for neurological findings is diagnostic imaging: regular X-ray procedures, myelography, computed tomography (CT), angiography and magnetic resonance imaging (MRI). In the case of inflammatory brain diseases and brain tumors, tissue sampling (tumor and brain biopsy) is performed. In the case of muscle diseases, a muscle biopsy is performed. Various drug therapies are now available for multiple sclerosis, which have a favorable effect not only on the symptoms but also on the overall course. Improved treatment procedures have significantly improved the prognosis for brain tumors. Special departments in the hospitals (stroke units) provide expert care for patients with strokes, cerebral apoplexies and cerebral hemorrhages. Neuroleptics are administered for migraine, myasthenia and Parkinson’s disease. A prerequisite for successful therapy is coordinated collaboration between neurologists, psychologists, neurosurgeons, cardiac surgeons and radiologists.
