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.
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Keywords: clinical psychology; neuropsychology; neuropsychological disorders of mental activity; neuropsychological rehabilitation
Available Online 06.10.2020
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
Baulina M.E., Varako N.A., Kovyazina M.S., Zinchenko., Mikadze Yu.V., Skvortsov A.A., Fufaeva E.V. (2020). Neuropsychological diagnostics and rehabilitation of patients with thinking disorders with brain lesions of various etiologies. National Psychological Journal, [Natsional’nyy psikhologicheskiy zhurnal], (13)2, 75-84.