Clinical psychology essay part 2
Clinical psychology essay part 1
Neuropsychological Testing in the Diagnosis of Dementia.
- According to the article, neuropsychological tests that focus on the domain of memory impairment are well established with recognized predictive value for dementia diagnoses. What other neuropsychological domains does the author feel are important in dementia diagnoses despite the existence of only a limited number of tools to assess them?
Neuropsychological testing proved to be effective for the diagnosis of dementia at its early stage, as it is especially important to recognize the first signs of the disease. The most common diagnosis of dementia is Alzheimer’s disease that is characterized by memory impairment. Neuropsychological tests are effective for assessing this domain and detecting the memory deficit at an early stage of the dementia development. However, other neuropsychological domains are harder to assess as there are fewer tools for their observation.
Among other neuropsychological domains mentioned in the article by Mary Sano are executive function and pathophysiological deficits. In order to assess these domains, new technologies and better tools are required. Thus, among the new technologies functional imaging can be mentioned. Improved tools for assessing special cognitive domains might help in identifying a wider range of various cognitive deficits at early stages of the dementia development. However, the author of the article made it clear that neuropsychological testing is an effective tool of detecting cognitive deficits in elderly people and patients who suffer from dementia. Such method proved to be an effective clinical utility, even though there is a need for better assessment tools when investigating other domains such as executive function.
In such a way, neuropsychological testing cannot be applied when assessing domains other than memory impairment. And it is up to neuropsychologists to find better means of assessing other domains, mainly executive function and various pathophysiological impairments. Still, neuropsychological testing is undoubtedly a fruitful way of dementia diagnosing at an early stage of the disease development.
- What weaknesses does the author identify in the current criteria for dementia diagnoses?
Although neuropsychological testing proved to be an effective instrument of diagnosing patients who suffer from dementia, it cannot be called efficient in evaluating executive function and other important domains. It is all due to the lack of normative data and unavailability of necessary tools that would help in assessing the domains other than cognitive impairment. This is the first and major weakness of neuropsychological testing.
In addition, there is one more limitation as for the current diagnostic criteria. It includes the fact that neuropsychological testing ignores cognitive complaint as it is mostly focused on cognitive impairment. It is probably due to the low correlation between the neuropsychological diagnosing and cognitive complaint. However, it is true that cognitive complaint is distressing and thus, it should be included into the criteria for dementia diagnosing.
One more weakness of the current criteria is the lack of appropriate methodology to assess the impairment in occupational and social functioning to full extent. In this regard, it is worth saying that the neuropsychological testing lacks tools for evaluating cognitive impairment as they are not fully developed and cannot predict decline. As for executive function, planning and sequencing seem to be more predictive of the functional loss. Thus, to improve the current criteria for dementia diagnosing, there need to be stronger tools, methodology and other instruments of evaluating the cases of dementia at its early stage. However, the current criteria lack many important instruments that would help achieve this goal.
In this regard, neuropsychological testing has many weaknesses that should be dealt with in order to provide a fully developed investigation of dementia. Nevertheless, neuropsychological testing undoubtedly has a number of strong sides as well and can be regarded as an effective method of diagnosing patients with dementia.
Article 3
Psychodynamic Psychotherapy: An Effectiveness Study.
- This article examined the effectiveness of psychodynamic psychotherapy. What experimental design was employed in the study (i.e., between-subjects or within-subjects, longitudinal or cross-sectional)?
The article under discussion investigates the effectiveness of psychodynamic psychotherapy. The researchers employed a single-group, within-subjects, longitudinal experimental design. The participants of the psychodynamic psychotherapy were all adults. The study provides important and valuable information in the area of the moderating outcome variables that underwent certain limitations in the previous studies related to psychodynamic psychotherapy. This was carried out within a longitudinal context by using the empirical measure. Furthermore, the results of the study indicated the significance of the first three months of treatment. The research has shown considerable effectiveness of the psychodynamic psychotherapy in the above-mentioned context. It is a significant break-through as the previous researches on the matter of psychodynamic treatment have been severely criticized for lacking the longitudinal component, insufficient attention to moderating variables and deficit of the empirical measure. All this makes it clear that the current effectiveness study of the psychodynamic psychotherapy proved to be effective in many ways. It is presumably due to the fact that the authors of the research employed the effective experimental design that is characterized as single-group, longitudinal and within-subjects. This gives an understanding that such experimental design is one of the most efficient ones in evaluating the effectiveness of psychodynamic psychotherapy and is advised to be employed in further investigations on this matter. On the whole, the study has given enough evidence of high efficiency of the psychodynamic psychotherapy used for treating various psychological and psychiatric disorders such as depression, anxiety and many other psychological disorders. Finally, it needs to be admitted that the current study proved to be more efficient than all of the previous ones.
- According to the study, was psychodynamic psychotherapy effective? If so, what was the effect size of the change produced?
Findings of the study suggest that the psychodynamic psychotherapy is effective over time. The analysis given in the article makes it clear that such treatment produces a moderate effect over time and it is particularly important to employ psychodynamic psychotherapy during the first three months of treatment. Findings show a general course of recovery with certain between-group variability. Thus, the study proved to be quite effective for treating various psychological disorders, mainly depression and anxiety. The psychodynamic psychotherapy has shown moderate effectiveness within different groups of patients. Although the overall effect size of such treatment is moderate, the therapy should be considered effective for treating a number of personality disorders.
According to the results of the study, the symptom distress subscale had an effect size of .38, which is the highest among all of the three subscales ranging from .28 to .38. However, the OQ total score managed to produce a significantly stronger effect size comprising .41. It should be admitted, that in all of the cases, most of the changes took place during the first three months of employing the psychodynamic psychotherapy. The first three months of treatment are considered to be the most important period leading to the stronger effect size.
However, the actual treatment effect was lower than it was anticipated. The average effect size in the current study comprised .33, which is less than the effect size described in the existing literature on this matter. On the whole, it is to be admitted that according to the current study, psychodynamic psychotherapy appears to be moderately effective for treating different psychological and personality disorders. However, in most cases, the effectiveness of such therapy becomes especially evident only after the first three months of treatment.
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