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Neuropsychological diagnostics and rehabilitation of patients with thinking disorders with brain lesions of various etiologies

Neuropsychological diagnostics and rehabilitation of patients with thinking disorders with brain lesions of various etiologies

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Recieved: 06/03/2020

Accepted: 06/12/2020

Published: 10/06/2020

Keywords: clinical psychology; neuropsychology; neuropsychological disorders of mental activity; neuropsychological rehabilitation

p.: 75-84

DOI: 10.11621/npj.2020.0207

Available online: 06.10.2020

To cite this article:

Baulina Maria E., Varako Nataliya A., Maria S. Kovyazina, Yury. P. Zinchenko , Mikadze Yuri V., Anatolii A. Skvortsov, Fufaeva Ekaterina V.. Neuropsychological diagnostics and rehabilitation of patients with thinking disorders with brain lesions of various etiologies. // National Psychological Journal 2020. 2. p.75-84. doi: 10.11621/npj.2020.0207

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Issue 2, 2020

Baulina Maria E. Moscow Institute of Psychoanalysis

Varako Nataliya A. Lomonosov Moscow State University, Research Center of Neurology, Moscow, Russia

Maria S. Kovyazina Lomonosov Moscow State University, Research Center of Neurology, Moscow, Russia, Russian Academy of Education

Yury. P. Zinchenko Lomonosov Moscow State University

Mikadze Yuri V. Lomonosov Moscow State University, Federal Center for Brain and Neurotechnologies, Moscow, Russia, Pirogov Russian National Research Medical University

Anatolii A. Skvortsov Lomonosov Moscow State University

Fufaeva Ekaterina V. Clinical and Research Institute of Emergency Pediatric Surgery and Trauma (CRIEPST), Moscow, Russia

Abstract

Background. Neuropsychological diagnosis and rehabilitation are among the fundamental practical tasks facing a clinical psychologist in accordance with applicable legal documents. The modern rehabilitation system is a partnership between patients with brain injuries, their families and various specialists involved in the rehabilitation process. Sick patients and their family continue living in the society of other people, and they have to solve issues of social interaction in a new status and with new limited opportunities. Cognitive and emotional, psychological and behavioural problems are interconnected, and neuropsychological rehabilitation should be appeal to all these problems.

The Objectives of the paper are: analysing and generalization of diagnostic and rehabilitation experience accumulated in neuropsychological rehabilitation; identifying of quality criteria for neuropsychological diagnosis and rehabilitation of patients with impaired cognitive functions in brain injuries, which should be followed by a practicing clinical psychologist in the process of rehabilitation work.

Results. Based on the analysis of applied research and practical guidelines, the recommended diagnostic tools for identifying thinking disorders are presented, the main directions and methods of rehabilitation work with thinking disorders that have been shown to be effective, including the organization of the dynamics of thought processes, the organization of the operational side of thinking, the organization of the regulatory side of thinking.

Conclusion. The findings can sustain practical work of a clinical psychologist with patients with disturbed thinking and brain damage. The findings outline the main directions of diagnostic and rehabilitation work for the practicing psychologist.

Fig. 1. Algorithms for patient management.

Overall neuropsychological examination

Needs a comprehensive neuropsychological examination?

Comprehensive neuropsychological examination

Symptomatic Syndrome Analysis

Is there a disturbance in thinking?

Assessment of rehabilitation potential and the need for rehabilitation

Does the patient need rehabilitation?

Preparation of a rehabilitation program (60 minutes)

Does not need a comprehensive neuropsychological examination

Are there violations in the HMF (higher mental functions) and mental activity in general?

Syndrome analysis of other identified symptoms and development of a rehabilitation plan

Neuropsychological rehabilitation is not carried out

Correction of the rehabilitation program (once in 10 days)

Assessment of the effectiveness of rehabilitation work (60 minutes)

Making recommendations for hospital discharge

Yes

No

Table 1. Table of methods and tests for diagnosing thinking disorders in brain injuries and correspondence with the International Classification of Functioning, Diasability and Health (ICF), 2001.

Test & Probes

Estimated Parameters

ICF Code

Understanding plot pictures

Estimates the level of generalization, the assessment of various options for completing a task

b1645

 

Understanding paintings with conflicting meanings

Assesses the ability to identify and analyze, finding contradictions

b1645

b1646

Understanding the figurative meaning of metaphors, proverbs

Assesses the level of generalization, the ability to abstract

b1640

d310

 

Definingconcepts

Assesses the level of generalization, the ability to abstract

b1640

 

Comparison of concepts

Assesses the level of generalization, the ability to abstract, assesses various options for completing a task

b1640

b1645

Establishing correspondence

Assesses the ability to identify and analyze, to solve problems

b1645

b1646

Verbal analogies

Assesses the level of generalization, the ability to abstract and make judgments, calculates various options for completing the task

b1640

b1645

b1646

Triads methods

Assesses the level of generalization, the ability to abstract

b1640

 

Search for essential features

Assesses the ability to solve problems, search for information, analyze, assesses the level of generalization

b1640

b1645

b1646

Problem solving

Assesses the ability to take bearings in the problem, establish a sequence of actions for a solution, analyze conditions and search for information to carry a solution

b1640

b1645

b1646

Raven Standard Progressive Matrices

Assesses the ability to analyze, calculates various options for solving a problem, identification, finding a solution, abstracting

b1640

b1645

b1646

Continuation Sequence Test

Assesses the ability to abstract

b1640

 

Subtest ‘Picture Arrangement’ from Wechsler Adult Intelligence Scale (WAIS)

Assesses the ability to manage time, analysis, task orientation, anticipation

b1645

b1646

Subtest ‘Similarities’ from Wechsler Adult Intelligence Scale (WAIS)

Assesses the ability to abstract

b1640

 

Subtest ‘Mosaic’ from Wechsler Adult Intelligence Scale (WAIS)

Assesses the ability to analyze information, calculates various options for solving the problem

b1645

b1646

Wisconsin Card Sorting Test

Assesses the ability to strategic planning, targeted search, the use of feedback from the environment and the change in cognitive attitudes, and changes in behaviour in relation to achieving the goal and modulating impulsive reactions

b1640

b1645

b1646

Table 2. Rating scheme for assessing accuracy level (Eccles et al., 1996).

Accuracy Level

Description

 

 

I

Meta-analyzes, systematic reviews, well-designed randomized controlled trials

II

Well-designed controlled non-randomized trials (cohort, case-control)

III

Uncontrolled research and collaborative efforts

Table 3. Rating scheme for assessing credibility of recommendations (Eccles et al., 1996). 

Credibility Level

 

 

Description

 

 

А

Directly based on Accuracy Level I

В

Directly based on Accuracy Level II or extrapolated from Accuracy Level I

С

Directly based on Accuracy Level III or extrapolated from Accuracy Level II

Fig. 2. ‘Solar chart’

How

Who

Why

What

Subject

When

Where


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To cite this article:

Baulina Maria E., Varako Nataliya A., Maria S. Kovyazina, Yury. P. Zinchenko , Mikadze Yuri V., Anatolii A. Skvortsov, Fufaeva Ekaterina V.. Neuropsychological diagnostics and rehabilitation of patients with thinking disorders with brain lesions of various etiologies. // National Psychological Journal 2020. 2. p.75-84. doi: 10.11621/npj.2020.0207

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