PSY3010
ASSESSMENT OF BEHAVIOUR – S1, 2005
ASSIGNMENT
2
CASE
STUDY
RIGHT
HEMISPHERE STROKE
Mr. Douglas Adams
is a 56-year-old white male who is a senior partner in an architecture firm.
Along with the responsibilities and pressures of being a successful
architect, Mr. Adams has fallen
prey to a high-stress, often sedentary lifestyle. He has been taking medication
for his high-blood pressure and high cholesterol for the last 16 years. Four
months ago, Mr. Adams suffered a stroke which disrupted blood flow to his brain
in the distribution of the right middle cerebral artery. He initially
experienced loss of movement in his left arm and leg but has found that, except
for some weakness in his left limbs, his motor control has returned. He still
complains of “pins and needles” in his left arm.
Mr. Adams has
attempted to return to work in his practice and the other partners have grown
concerned at the frequent mistakes he seems to be making. Difficulties have
been noted particularly with his memory and his attempts to draw designs which
are often incorrect in proportion and placement. Mr. Adams’ physician has
recommended a neuropsychological evaluation in order to examine his current
cognitive strengths and weaknesses in the hopes of identifying duties that he
would be able to perform without limitation.
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 – Right CVA
Wechsler
Adult Intelligence Scale-Third Edition (WAIS-III)
Vocabulary 12 75 Picture
Completion 8
25
Arithmetic 13 84 Block
Design 7
16
Digit Span 11 63 Matrix
Reasoning 13 84
Information 14 91 Picture
Arrangement 9
37
Comprehension 14 91 Symbol
Search 7
16
Lett.-Num. Seq. 8
25
Test – 90%CI Retest
– 90%CI
Verbal 115 84 110 119 109 121
Performance 94 34 89 100 86 103
Full
Scale 106 66 102 109 101 111
Test – 90%CI Retest
– 90%CI
POI 95 37 89 101 86 104
WMI 104 61 98 109 95 112
PSI 88 21 82 97 78 101
Full Scale 106 116 -10
6.9 5-9%
Verbal Comprehension 112 115 -3 7.9 25-49%
Perceptual Organisation
95 111 -16
7.9 2-4%
Processing Speed 88 107 -19 9.9
5-9%
Test – 90%CI
Retest – 90%CI
Auditory Immediate 108 70 102 113 98 116
Visual Immediate
84 14 78 95 73 101
Immediate Memory 96 39 90 103 86 107
Auditory Delayed 105 63 97 112 92 116
Visual Delayed 78 7 73 90 68 95
Aud. Rec. Delayed 115 84 102 120 95 128
General Memory
96 39 90 103 86 107
Working Memory
79 8 74 90 69 94
Letter-Number
Seq. 8 25
Spatial Span 4 2
Immediate Memory
96 104 -8 10.1 10-24%
General Memory 96 106 -10 9.5 10-24%
Working Memory
79 110 -31 11.2
<1%
Vocabulary 13 84 Picture
Completion 11 63
Arithmetic 13 84 Block
Design 9
37
Digit Span 11 63 Matrix
Reasoning 13 84
Information 14 91 Picture
Arrangement 11 63
Comprehension 14 91 Symbol
Search 9
37
Lett.-Num. Seq. 10
50
Verbal 117 87 Auditory
Immediate 111 77
Full Scale 112 79 Immediate Memory 100 50
POI 105 63 Visual
Delayed 88 21
WMI 108 70 Aud. Rec. Delayed 120 91
PSI 96 39 General Memory 104 6
Working
Memory 96 39
Letter-Number
Sequencing 10 50
Spatial
Span 9 37
ASSIGNMENT 2 – PSY3010 – S1 2005
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. Adam’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. Adam’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: Explain the reason for the difference between the
Working Memory indices of the WAIS-III (WMI = 104) and WMS-III (WMI = 79) (5
Marks)
Question 4: Describe Mr. Adam’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: The Immediate Memory and General Memory indices of the
WMS-III do not differ significantly following Mr. Adams’ first (IM = 96, GM =
96) or second testing (IM = 100, GM = 104). Does this mean that Mr. Adams does
not have problems with memory? Describe the evidence from the first testing to
support the presence or absence of a memory problem? Based upon the second
testing do any of his difficulties persist? (indicate
what information was used in determining your answer) (5 Marks)