LSP Neuropsychological Assessment 5 — Questions and Answers
Question 1: Which neuropsychological profile pattern is most characteristic of semantic dementia (temporal variant frontotemporal dementia)?
- Severely impaired naming and single-word comprehension with spared episodic memory and visuospatial skills (Correct answer)
- Severely impaired episodic memory with intact naming and language
- Prominent executive dysfunction with relatively spared memory and language
- Impaired visuospatial processing with intact memory and language
Correct answer: Severely impaired naming and single-word comprehension with spared episodic memory and visuospatial skills
Semantic dementia is characterized by progressive loss of conceptual knowledge, causing profound anomia and impaired single-word comprehension, while day-to-day episodic memory and visuospatial functions are relatively preserved early on.
Question 2: A TBI patient completes the Paced Auditory Serial Addition Test (PASAT) with markedly reduced accuracy. This test most directly assesses:
- Divided attention and rapid information processing (Correct answer)
- Verbal learning across trials
- Phonemic fluency under time pressure
- Sustained visual vigilance
Correct answer: Divided attention and rapid information processing
The PASAT requires adding serially presented numbers while continuously tracking the running sum, heavily demanding divided attention, working memory, and processing speed simultaneously.
Question 3: In evaluating effort and symptom validity, the 'floor effect' concern refers to:
- Legitimate impairment can produce low scores indistinguishable from invalid performance on very easy tests (Correct answer)
- Tests with very high ceilings fail to differentiate high-functioning patients
- Normative floors set too low inflate false-positive rates
- Patients with floor-level IQ are automatically invalid responders
Correct answer: Legitimate impairment can produce low scores indistinguishable from invalid performance on very easy tests
When tests are too easy for healthy people but a truly impaired patient also scores very low, it becomes difficult to determine whether low performance reflects genuine deficit or feigned failure.
Question 4: The Rey 15-Item Test is classified as a measure of:
- Symptom validity / effort assessment (Correct answer)
- Verbal learning rate
- Visuoconstructional ability
- Immediate visual memory span
Correct answer: Symptom validity / effort assessment
The Rey 15-Item Test is a symptom validity test; its items are deceptively easy for cognitively intact individuals, so very low recall suggests poor effort rather than genuine memory impairment.
Question 5: A neuropsychologist performing serial assessments on a patient with multiple sclerosis observes score improvements at re-evaluation. The most important statistical concept to apply before attributing improvement to treatment is:
- Reliable Change Index (RCI) (Correct answer)
- Cohen's d effect size
- Base rate of impairment
- Confidence interval width
Correct answer: Reliable Change Index (RCI)
The Reliable Change Index quantifies whether score change exceeds what is expected from measurement error and practice effects, allowing the clinician to determine whether change is statistically meaningful.
Question 6: Constructional apraxia following a right hemisphere parietal lesion typically produces copy drawings that are most characterized by:
- Closure difficulty, fragmented right-sided details, and left-side clustering (Correct answer)
- Correct overall gestalt with internal detail errors only
- Preserved spatial relationships with perseverative line additions
- Severe motor tremor with intact spatial planning
Correct answer: Closure difficulty, fragmented right-sided details, and left-side clustering
Right parietal constructional apraxia tends to produce fragmented drawings with closure failures, loss of global configuration, and clustering of details on the left side near the model.
Question 7: The Delis-Kaplan Executive Function System (D-KEFS) Tower Test was designed to assess which executive function compared to traditional tower tasks?
- Planning and problem solving with psychometrically robust normative data across the lifespan (Correct answer)
- Verbal reasoning and abstract concept formation
- Sustained attention and vigilance
- Working memory updating and phonological storage
Correct answer: Planning and problem solving with psychometrically robust normative data across the lifespan
The D-KEFS Tower Test provides standardized, lifespan-normed assessment of spatial planning and rule-governed problem solving, with improved psychometric properties over older tower paradigms.
LSP Neuropsychological Assessment 5
Which neuropsychological profile pattern is most characteristic of semantic dementia (temporal variant frontotemporal dementia)?