- Impaired memory: patient forgets events, espe-
cially recent ones, sometimes confabulates or
invents memories to fill the gaps, and may
show impaired ability to learn and retain new
information. - Impaired intellectual functions: comprehension,
speech production, calculation, and general
knowledge may be affected (e.g., cannot define
simple words, name the U.S. president, or add
figures). - Impaired judgment: patient has trouble with
decisions (e.g., cannot decide about lunch,
when to go to bed, etc.). - Shallow and labile affect: person laughs or weeps
too easily and often inappropriately; shifts from
joy to tears to anger, for example, very rapidly. - Loss of emotional and mental resilience: patient may
function reasonably well under normal cir-
cumstances, but stress (e.g., fatigue, mental
demands, emotional upset) may result in dete-
rioration of judgment, emotional reactions, and
similar problems. - Frontal lobe syndrome: a group of personality
characteristics often follow the destruction of
frontal lobe tissue through surgery, tumor, or
injury. Typical symptoms are impaired impulse
control, poor social judgment and planning
ability, lack of concern over the consequences
of one’s actions, apathy and indifference, some
suspiciousness, and temper tantrums.
Box 18-2 illustrates the personality changes that
can follow such injuries.Brain–Behavior Relationships
Before describing specific assessment techniques, we
should review at least briefly some basic ways of
looking at brain–behavior relationships.
We observed earlier that in the second half of
the 19th century, localization of function became a
popular view. The idea that specific areas of the
brain control specific behaviors is still an important
operating principle among neuropsychologists.
Such a principle means that in assessing brain dam-
age, a chief concern is where the injury is located in
the brain. Extent of an injury is important only to
the degree that larger injuries tend to involve more
areas of the brain (Golden, 1984). Indeed, some
tumors may produce intracranial pressure that
impairs areas located far from the tumor itself.
The basic idea, however, is that same-sized lesions
in different regions of the brain will produce differ-
ent behavior deficits (Krech, 1962).F I G U R E 18-2 Brain structures affected by chronic alcohol abuse
SOURCE: Courtesy of the U.S. Department of Health and Human Services. (1997).The Ninth Special Report to the U.S. Congress on Alcohol and Health,p. 150.
NEUROPSYCHOLOGY 521