Neuropsychological evaluations are used to evaluation the relationship between brain function and behavior. Applications of neuropsychological evaluations include individuals who have the following history:
- Traumatic brain injury (TBI) and concussions. These can occur during incidents where there is a blow or traumatic injury to the head as a result of falls, sports, sports accidents, motor vehicle accidents, military activity and assaults.
- Medical diseases can cause decreased mental functioning. Infections such as meningitis, encephalitis and septicemia can impact mental functioning as can breathing conditions (hypoxia, hypercapnia), cardiovascular difficulties (strokes, brain injury due to high blood pressure, or dementia due to many small strokes). In addition, degenerative disorders including Parkinson’s disease, multiple sclerosis, Huntington’s disease, and Alzheimer’s disease, asthma and diabetes can lead to loss of cognitive functioning.
- Substance abuse. Chemical agents such as heroin, cocaine, alcohol, marijuana, hallucinogens, synthetic drugs and prescribed medications can damage brain functioning.
- ADD/ADHD: Attentional problems can be intertwined with cognitive problems.
- Learning disabilities. Neuropsychological testing can ascertain the presence of a specific learning disability, and distinguish between a learning disability, ADD/ADHD, and cognitive and emotional disturbances. Presence of a specific disability may help an individual qualify for accommodations during school, or when taking college entrance exams.
- Treatment resistant clients. Neuropsychological testing may be beneficial for individuals who have received treatment and have not seen improvement. Testing may reveal an underlying neurological issue that may be impeding the therapeutic progress.
A psychological evaluation is necessary to diagnose a number of emotional and behavioral disorders. Testing provides information about cognitive abilities, social/emotional traits, personality and coping. Indications for a psychological evaluation include:
- Individuals who have trauma related personality issues. Personality issues are characterized by rigid patterns of thought and behavior. Such patterns cause impairment in functioning and quality of life.
- Complicated treatment issues. Often individuals can have compounding factors in their history that present as therapeutically complicated. Psychological testing can help elucidate the effects of complicated treatment issues, such as, dysfunctional family environments, difficult living situations, history of trauma and abuse, and how these events have impacted the individual.
- Dual diagnosis. Dual diagnosis is used to describe a comorbid condition where an individual has a mental health issue and a substance abuse problem concurrently. It can be difficult to discern with emotional and behavioral problems are related to an underlying psychological disorder or due primarily to chemical dependency or drug related changes in the brain.
- Medication issues. Psychological evaluation can be helpful for individuals who are not being helped by their psychiatric medication. Testing can assist psychiatrists in finding more effective combinations of medication to maximize effectiveness.
- Evaluation of psychosis. Psychiatric evaluation can help diagnose any underlying psychosis.
Attention Deficit Testing (ADD, ADHD)
Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) are often misdiagnosed and over-diagnosed disorders that mental health professionals encounter. ADHD has become a go-to diagnosis for physicians, whose first line of treatment is Adderall, Ritalin, Strattera, methamphetamine or another stimulant. Diagnoses are often determined using a brief examination or an elementary questionnaire, the answers to which are relative and rely on a patient’s transparency rather than psychological clarification.
At PCH Treatment Center, we view ADHD as a rule-out diagnosis. Many of our young clients come to us with a diagnosis of ADHD. Our psychological testing reveals that the majority of them are not suffering from attentional problems. As a superficial diagnosis, ADHD describes certain behavioral factors. However, depression, anxiety, trauma or emotional dysregulation can produce behavioral issues that mimic ADHD. Casual prescribing of stimulants is irresponsible: they are highly addictive drugs with significant side effects. These drugs do increase focus and attention whether or not you have ADHD. However, stimulants produce severe side effects including paranoia, anxiety, rapid heartbeat, increases in blood pressure, tremors, restlessness, hallucinations, and muscle twitches. They also have long-term effects which are undesirable.
When a client reports symptoms of Attention Deficit Disorder, we approach the test evaluations very carefully. The behavioral symptoms of inattention may be linked to many disorders and etiologies. Brief office evaluations or cursory psychological assessments have the capacity to diagnose a condition such as ADHD, but they lack the specificity to understand what is causing the symptoms. At PCH Treatment Center, we offer different ways to evaluate attentional problems.
- Focused Assessment for Stimulant Prescribing
- Psychological Assessment
- Neuropsychological Assessment
Our focused assessment is a combination clinical evaluation and limited testing battery, to assess the appropriateness of stimulant prescribing. Many student health centers and prescribers request a focused evaluation to determine the appropriateness of medical treatment of ADHD and ADD.
Psychological testing is capable of identifying psychological conditions that may produce or worsen attentional problems and complicate management. Neuropsychological assessments deeply examine cognitive functioning. An ADHD patient with a borderline IQ score, a memory problem, or a specific learning disability will necessarily require a more comprehensive treatment program. Our neuropsychological testing battery assesses cognitive domains including: Intellectual, Achievement, Attention and Working Memory, Language Functioning, Visual-Spatial functioning, Executive Functioning, and Personality Development. Evaluation of this last area is important because cognitive disorders affect a person’s self-confidence which can lead to anxiety, depression, drug-use, etc. Knowing that there is a developmental antecedent to internalized or externalized symptoms is life-changing feedback for a client that struggles with depression or addiction related attentional problems.
- Establish or clarify a diagnosis and assist in differential diagnosis
- Identify weakness in a specific area
- Establish a baseline and compare to changes as a result of therapeutic interventions.
- Testing can be used for treatment planning and assist the multidisciplinary team in managing care.