Qualitative Neuropsychological Assessment: Kurt Goldstein Revisited

Abstract

The value of neuropsychological testing has changed over the past 15 years. In the clinical situation, neuropsychological testing was used to differentiate the organic from the psychiatric patient, localize a lesion, differentiate between tumors and toxic responses, etc. In my opinion, these goals are at best minimal in the clinical situation. Over this time period, many more anatomically and physiologically direct techniques have been developed to meet the above needs. The CAT scanner has been invented and updated, and complementary imaging is done with NMR techniques; evoked potentials have come into their own as a means of assessing change in CNS function; the diagnosis of endogenous or exogenous toxic states has progressed rapidly with the development of complex blood chemistry techniques. I believe the main use of neuropsychological testing in the clinical situation, at the present time, is for purposes of rehabilitation. The goal of that rehabilitation may be as simple as increasing self-care abilities or as complex as aiding the patient to recover to a point where reemployment can be achieved.