PSY3010 ASSESSMENT OF BEHAVIOUR – S1, 2004
ASSIGNMENT 2
CASE STUDY
TRAUMATIC BRAIN INJURY
Mr. Stephen Gould
is a 28-year-old white male who was involved in a motor vehicle accident on the
highway between Brisbane and Toowoomba. The driver of the other vehicle had
fallen asleep at the wheel and had crossed over into the oncoming lane of
traffic colliding with Mr. Gould’s motorcycle. Mr. Gould was thrown from his
motorcycle into the bush along side the highway. Passersby reportedly stopped
and, finding Mr. Gould unconscious, immediately called for emergency services.
An ambulance arrived within 25 minutes and found his Glasgow Coma Scale to be
7/15. After stabilizing Mr. Gould, he was transported to the nearest Base
Hospital.
The last thing
Mr. Gould remembers before his accident is driving onto the bypass. This
location is approximately 10 minutes away from the site of the accident. His
first memory after the accident is waking up to see his concerned girlfriend
sitting at his bedside in the hospital, approximately three days after the
accident. He was unconscious for a period of 28 hours and was noted to have
emerged from the period of post-traumatic amnesia by his third day in
hospital. A CT scan revealed no intracranial
pathology and remarkably he sustained no other injuries in the accident save
for lacerations, bruises, and abrasions on his legs and arms. He was discharged
from the hospital five days after the accident into the loving care of his
girlfriend.
Mr. Gould was about to begin the final year of a
Bachelor of Science in Biology at the local university. Your first assessment
of him was conducted three months after his accident just prior to his return
to his university studies. He reported persistent headaches, and difficulties
with his concentration and memory, particularly with remembering the right
word. He noted that since the injury his friends have told him that he “takes
forever” to say anything and very often uses incorrect words in his sentences.
He also noted that he can’t drink as much as he used to because he finds that
he gets drunk on virtually just one “stubbie”. Mr. Gould was cooperative and
appeared highly motivated to perform well. He particularly enjoyed the
Information subtest of the WAIS-III saying “this is right up my alley, I know
all this stuff” but became concerned and agitated during the Matrix Reasoning
and Similarities subtests repeatedly saying “I used to be able to do this kind
of thing”. He became quite distressed during the administration of the WMS-III
saying “see this is what I’ve lost - my memory’s completely screwed now”.
Over the academic
year, Mr. Gould struggled with his academic studies and received support and
accommodations with regard to assignments and examinations. While formerly an
A/HD student, his grades in the next two semesters dropped into the C range
with some B’s in his final semester. The second assessment was conducted eleven
months later following the completion of his degree at a point where he is
considering pursuing graduate studies.
Presented below are data from two psychological test batteries – the third editions of the Wechsler Adult Intelligence Scale and Wechsler Memory Scale along with the results from the Wechsler Test of Adult Reading. In a comprehensive assessment many more than these two batteries would be administered but the data presented will be sufficient for you to address the questions in this assignment and give you a taste of how psychological test data is analysed and interpreted in order to test clinical hypotheses. To complete the assignment you will need to analyse the test data provided, including making a number of statistical comparisons in order to address the most likely hypotheses in the case. These analyses and the supporting documentation are sufficient to answer the questions posed.
Results of Initial
Psychological Testing - TBI
Wechsler Adult Intelligence
Scale-Third Edition (WAIS-III)
Vocabulary 13 84 Picture
Completion 13 84
Arithmetic 11 63 Block
Design 12 75
Digit Span 9
37 Matrix Reasoning 10 50
Information 16 98 Picture
Arrangement 11 63
Comprehension 12 75 Symbol
Search 6 9
Lett.-Num. Seq. 8
25
Test – 90%CI
Retest – 90%CI
Verbal 111 77 107 115 105 117
Performance 104 61 98 109 95 112
Full Scale 108 70 104 111 103 113
Test – 90%CI
Retest – 90%CI
POI 109 73 102 114 99 117
WMI 95 37 90 101 87 104
PSI 81 10 76
91 72 95
Full Scale 108 112 -4
7.4 25-49%
Verbal Comprehension 116 111 5 8.7 75-90%
Perceptual Organisation 109 109 0
8.4 50-74%
Processing Speed 81 104 -23 11.0 1%
Test – 90%CI
Retest – 90%CI
Auditory Immediate 94 34 88 100 85 103
Visual Immediate 88 21 82 99 76 104
Immediate Memory 89 23 83 97 80 100
Auditory Delayed 80 9 75 90 70 95
Visual Delayed 75 5 71 88 66 93
Aud. Rec. Delayed 90 25 83 102 76 109
General Memory 77 6 72 86 69 89
Working Memory 91 27 84 100 80 105
Immediate Memory 89 102 -13 9.0 10-24%
General Memory 77 104 -27 9.0 2-4%
Working Memory 91 108 -17 11.5
5-9%
Vocabulary 13 84 Picture
Completion 13 84
Arithmetic 11 63 Block
Design 12 75
Digit Span 10 50 Matrix
Reasoning 14 91
Information 16 98 Picture
Arrangement 11 63
Comprehension 12 75 Symbol
Search 8
25
Lett.-Num. Seq. 9
37
Verbal 115 84 Auditory
Immediate 99 47
Full Scale 113 81 Immediate Memory 98 45
POI 118 88 Visual Delayed
88 21
WMI 99 47 Aud. Rec. Delayed 100
50
PSI 88 21 General Memory 91 27
Working
Memory 96 39
ASSIGNMENT 2 – PSY3010 – S1 2004
Answer each of the following questions on a separate page. Your answers will be marked not only on whether or not your answer is correct but also on the quality and reasoning of your argument. This means that a well reasoned incorrect answer could receive more marks than an inadequately explained correct answer.
Question 1: Describe Mr. Gould’s initial test results in terms of the cognitive constructs they are designed to measure., i.e. verbal abilities, visual processing abilities, attention/working memory, processing speed, immediate memory, delayed recall. (5 Marks)
Question 2: Describe the relationship between Mr. Gould’s initial test results and what would be expected of this gentleman based upon his age, education, gender and reading ability. (5 Marks)
Question 3: Discuss the value or contribution of the IQ scores (VIQ, PIQ, and FSIQ) in this assessment (5 Marks)
Question 4: Describe Mr. Gould’s retest results in terms of the cognitive constructs they are designed to measure., i.e. verbal abilities, visual processing abilities, attention/working memory, processing speed, immediate memory, delayed recall. (5 Marks)
Question 5: How do the retest results differ from the initial test results? In your answer explain what information you used to support your interpretation. (5 Marks)
Question 6: What feedback would you give Mr. Gould following the first testing? What feedback would you give Mr. Gould following the second evaluation? (5 Marks)