Tests of cognitive and neuropsychological functioning General ability and intelligence

A very useful broad screening test, especially when it is suspected that mental functions are severely compromised, is the Mini-Mental State Examination. (5,6,) It is brief, to the point, and can be repeated over time to gauge change. It measures general orientation in time and place, basic naming, language and memory functions, and basic non-verbal skills, and has good norms for a middle age range, especially the elderly, with appropriate adjustment for age. The maximum score is 30, and a score of 24 or less raises the possibility of dementia in older persons, especially if they have had 9 or more years of education (a score of 24 is at about the 10th percentile for people aged 65 and older).

However, the Mini-Mental State Examination is only a screening test and the presence or nature of cognitive impairment cannot be diagnosed on the basis of this test alone. A detailed cognitive assessment is provided by the Wechsler scales, i.e. the Wechsler Adult Intelligence Scale-Third Edition UK Version ( WAIS-IIIUK),(2) the Wechsler Intelligence Scale for Children-III UK Version ( WISC-IIIUK),(7) or the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-III).(8) Outlines of the WAIS-IIIuk and WISC-IIIUK are given in Tabled,.

Table 5 Outline of the WAIS-IIIUK and WISC-IIIUK

IQ scores themselves are very broad measures, drawing upon a wide range of functions. This means that the scores are very stable (reliable), but also that the IQ score is relatively insensitive to anything except quite gross brain damage. Rather, a careful analysis of subtest scores is needed, always bearing in mind the concepts of reliability and abnormality of difference scores. For example, it takes a subtest range of 11 to 12 points to be considered abnormal (i.e. found in less than 5 per cent of people) on the WAIS-III UK, the earlier WAIS-R,(4) and the WISC-IIIUK (7.)

Sometimes the patient may have a language disorder or English may not be his or her first language. In such circumstances Raven's Progressive Matrices Test, (9) which is a non-verbal test of inductive reasoning (non-verbal in the sense that it requires no verbal instructions and no verbal or written answers), can be used. The present author avoids the new norms because they were not collected in the normal fashion (i.e. not in a formal test session under the direct supervision of a psychologist), but the old norms are good. The Matrices Test has the additional advantage of having an advanced version for people in the highest range of ability. (10) No non-English versions of the WAIS-IIIUK or the WISC-IIIUK are available, but the non-verbal scores can be used with caution as there may be unexpected cross-cultural effects.

Break Free From Passive Aggression

Break Free From Passive Aggression

This guide is meant to be of use for anyone who is keen on developing a better understanding of PAB, to help/support concerned people to discover various methods for helping others, also, to serve passive aggressive people as a tool for self-help.

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