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Lab Report No 1
Directional terms in Neuroanatomy
Planes of reference
Directional terms in Neuroanatomy
Planes of reference
Lateral view
Lateral means away from the midline of the body of a vertebrate, toward the
body's lateral surfaces.
Anterior view
Anterior means toward the nose end of a vertebrate. Or with respect to the central
nervous system, located near or toward the head.
Posterior view
Posterior means toward the tail end of a vertebrate or toward the back of head.
Medial view
Medial means toward the midline of the body of a vertebrate.
Dorsal view
Dorsal means toward the surface of the back or toward the top of the head.
Ventral view
Ventral means toward the surface of the chest or the bottom of the head.
Rostral view
Rostral means toward the beak; with respect to the central nervous system, in a
direction along the neuroaxis toward the front of the face.
Caudal view
Caudal means toward the back; with respect to the central nervous system, in a
direction along the neuraxis away from the front of the face.
Ipsilateral view
Ipsilateral means located on the same side of the body (left or right)
Contralateral view
Contralateral means located on the opposite side of the body (left or right)
Sagittal view
Any slices of brain tissue cut in a plane that is parallel to the side of the brain.
Midsagittal view
The plane through the neuraaxis perpendicular to the ground; divides the brain
into two symmetrical halves.
Horizontal section
Any slice of brain tissue cut in a plane that is parallel to the top of the brain.
Coronal section
A plane that shows brain structures as they would be seen from the front.
References
Carlson, N.R.(Foundations of physiologicalpsychology. (4th ed.). London: Allyn and
Bacon.Kalet, J.W. (1998). Biological psychology. (6th ed.).USA: Brooks Cole.
Lab Report No 2
Neurophysiological and Neuropsychological Assessment
Neurophysiological and Neuropsychological Assessment
Neurophysiological Assessment
Definition
The measurement of one or more physiological processes that reflects autonomic nervous
activity (heart rate, brain electrical activity, body temperature”
Introduction
Neuropsychological assessment is an evaluation of cognition, mood, personality and
behavior that I conducted by licensed clinical neurophysiologists (clinical psychologists who are
specialists in brain-behavior relationships). Such an evaluation usually included a formal
interview, a review of medical and/or educational /vocational records, interviews of significant
others (as necessary), and neuropsychological testing using standardized neuropsychological
instruments. “Particularly unique to this process is that it quantifies a patient’s higher cortical
functioning that may include various aspects of attention, memory, speed of information
processing, language, visuospatial ability, sensory processing, motor ability, higher order
executive functioning, and intelligence.
Purposes of conducting Neurophysiologic Assessment
Neurophysiological Assessment will aid in the proper and accurate diagnosis of the
patient’s illness and/or the etiology of symptoms. This has obvious implication for proper
medical care neuropsychological assessment I very often one of the most critical pieces of
evidence in forensic settings when the existence or extent of brain injury is relevant to the facts
or disposition of a case. This can be especially critical in case of traumatic brain injury in which
neuroimaging fails to show brain damage but the neuropsychological assessment reveals
significant impairments. Conversely, such assessment may reveal that an individual in litigation
is malingering (faking brain impairment) for external gain. This type of diagnosis is made
possible by the use of validated assessment instruments and specific patterns of test results that
have been found to suggest malingering.
Types of Neuropsychological Assessment
1. Computerized Axial Tomography
A computerized axial tomography scan is an x-ray procedure that combines many x-ray
images with the aid of a computer to generate cross –sectional views and, if needed, three-
dimensional images of the internal organs and structures of the body Computerized axial
tomography is more commonly known by its abbreviated names. CT scan or CAT scan ACT
scan is used to define normal and abnormal structures in the body and or assist in procedures by
helping to accurately guide the placement of instruments or treatments.
2. Magnetic Resonance Imaging
Magnetic resonance imaging (MRI), or nuclear magnetic resonance imaging (NMIR), is
primarily a medical imaging technique most commonly used in radiology to visualize detailed
internal structure and limited function of the body. MRI provides much greater contrast between
the different soft tissues of the body than computed tomography (CT) does, making it especially
useful in neurological(brain), musculoskeletal, cardiovascular, and ontological (cancer) imaging
Unlike CT, it uses no ionizing radiation, but uses a powerful magnetic field to align the nuclear
magnetization of (usually)hydrogen atoms in water in the body. Radio frequency (RF) field are
used to systematically alter the alignment of this magnetization, causing the hydrogen nuclei to
produce at rotating magnetic field detectable by the scanner. This signal can be manipulated by
additional magnetic fields to build up enough information to constrict an image of the body.
3. Functional MRI
Functional MRI or Functional magnetic Resonance Imaging(FMRI) is a type of specialized
MRI scan it measures the homodynamic (change in blood flow) related to neural activity in the
brain or spinal cord of humans or other animals. It I one of the most recently developed forms of
neuroimaging. Since the early 1990, FMRI has come to dominate the brain mapping field due
to it relatively low invasiveness, absence of radiation exposure, and relatively wide availability.
4. Positron Emission Tomography (PET) Scan
Positron emission tomography (PET) is a nuclear medicine imaging technique which
produces a three dimensional image or picture of functional process in the body. The system
detects pairs of gamma rays emitted indirectly by a positron-emitting radionuclide(tracer),
which is introduced into the body on a biologically active molecule images of tracer
concentration in 3-dimensional or 4-dimensional space (the 4th dimension being time)within the
body are then reconstructed by computer analysis in modern scanners, this reconstruction is often
accomplished with the aid of a CT X-Ray scan performed on the patient during the same
session, in the same machine.
5. X-Rays
X-radiation (composed of X-rays) is a form of electromagnetic radiation. X-Rays have a
wavelength in the range of 10 to 0.01 manometers, corresponding to frequencies in the range 30
petahertz to 30 exahertz (3x 1018 Hz to 3 x 10 14 HZ) and energies in the range 12 eV to 120
keV They are shorter in wavelength than UV rays. In many languages, X-Radiation is called
Roentgen radiation, after Wilhelm Conrad Roentgen, who is generally credited as their
discover, and who had named them X-rays to signify an unknown type of radiation X-rays from
about 0.12 to 12 keV (100 to 0.10 mm wavelength) as “hard” X-rays, due to their penetrating
abilities.
6. Staining
Staining is an auxiliary technique used in microscopy to enhance contrast in the
microscopic image Stains and dyes are frequently used in biology and medicine to highlight
structures in biological tissues for viewing, often with the aid of different microscopes. Stains
may be used to define and examine bulk tissues (lighting for example), or organelles within
individual cells.
7. MRI
The Division of Magnetic Resonance Imaging (MRI) consists of two sub-divisions.
Body MRI and Neuro MRI Body MRI is magnetic Resonance Imaging (MRI) of the structure
and function of all organs and body systems except for the central nervous system. This
encompasses the Cardiovascular System, Musculoskeletal System, Respiratory System including
the brain, spine, he, and neck.
Neurophysiologic Assessment and Emerging Trends
An important development in the field of neuropsychological assessment is the
quantification of the process by which individuals solve common neuropsychological tasks. The
present article outlines the history leading to this development the Quantified Process Approach,
and suggests that this line of applied research bridges the gap between the clinical and statistical
approaches to neuropsychological assessment. It I argued that the enterprise of quantifying the
process approach proceeds via three major methodologies.
1. The “Satellite” Testing Paradigm an approach by which new tasks ate developed to
complement existing tests so as to clarify a given test performance.
2. The Composition paradigm an approach by which data on a given test that have been
largely overlooked are compiled and subsequently analyzed, resulting in new indices
that are believed to reflect underlying constructs accounting for test performance,
and.
3. The Decomposition Paradigm an approach which investigates the relationship
between test items of a given measure according to underlying facets, resulting in the
development of new sub scores.
Neuropsychological Assessment
Definition
Neuropsychological tests are specifically designed tasks used to measure a psychological
function known to be linked to a particular brain structure or pathway. They usually involve the
systematic administration of clearly defined procedures in a formal environment.
Purpose of Neuropsychological Assessment
Assessment may be carried for a variety of reasons, such as Clinical evaluation to
understand the pattern of cognitive strengths as well as any difficulties a person may have, and to
aid decision making for use in a medical or rehabilitation environment. Scientific investigation,
to examine an hypothesis about the structure and function of cognition to be tested, or to provide
information that allows experimental testing to be seen in context of wider cognitive profile.
Types of neuropsychological Tests
Ammons Quick Test
This test has been used for many years to help assess premorbid intelligence. It
is a passive response picture-vocabulary test.
Aphasia Test (various)
Several aphasia and language tests examine level of competency in receptive and
expressive language skills (e.g. Reitan-Indiana Aphasia Screening Test.
Beck Depression or Anxiety Scales
These scales provide quick assessment of subjective experience of symptoms
related to depression or anxiety.
Bender Visual Motor Gestalt Test
This test evaluates visual-perceptual and visual-motor functioning, yielding
possible signs of brain dysfunction, emotional problems, and developmental maturity.
Boston Diagnostic Aphasia Examination
Broad diagnosis of language impairment in adults
Boston Naming Test
Assessing the ability to name pictures of objects through spontaneous responses
and need for various types of cueing inferences can be drawn regarding language facility
and possible localization of cerebral damage
California Verbal learning Test
This procedure examines several aspects of verbal learning, organization, and
memory forms for adults and children
Cognitive Symptom Checklists
Self-evaluation of areas of cognitive impairment for adolescents and adults.
Continuous performance Test
Test that require intense attention to a visual-motor task are used in assessing sustained
attention and freedom from distractibility(e.g. vigil, Connors Continuous performance
Test)
Controlled Oral Word Association Test
Different forms of this procedure exist most frequently used for assessing verbal
fluency and the ease with which a person and think f words that begin with a specific
letter.
Cognistat (The neurobehavioral Cognitive Status Examination)
This screening test examines language, memory, arithmetic, attention, judgment,
and reasoning. It is typically used in screening individuals who cannot tolerate more
complicated or lengthier neuropsychological tests.
Delis-Kaplan Executive Function System
Assesses key areas of executive function (problem-solving, thinking flexibility,
fluency, planning, and deductive reasoning in both spatial and verbal modalities, norm
for ages 8.89 Dementia Rating Seale: Provides measurement of attention, initiation,
construction, conceptualization, and memory to assess cognitive status in older adults
with cortical impairment.
Digit Vigilance Test
A commonly used test of attention, alertness and mental processing capacity,
using a rapid visual tracking task.
Figural Fluency Test: Different forms of this procedure exist, evaluating nonverbal
mental flexibility, often compared with tests of verbal fluency.
Rorschach Projective Technique
This familiar inkblot test is used to evaluate complex psychological dynamics.
Persons with brain injury have been shown to produce certain kinds of response that can
complement other test and help to understand personality changes associated with brain
injury.
Test of Memory and Learning (TOMAL)
This test for children and adolescents measures numerous aspects of memory,
assessing learning, attention and recall.
Thematic Apperception Test
This projective test is most commonly used to examine personality
characteristics that may aid in understanding psychological or emotional adjustment to
brain injury.
Wechsler Test of Adult Reading
|Provides estimate of pre-morbid intellectual functioning in persons 18-19 ,
normed with the WAIS –III and WMS –III
Word Memory Test
A validity procedure designed to detect response bias that might indicate
exaggeration of impairment or symptom feigning.
Test Batteries
The Test Battery serves as a screening device for CPS case managers to help determine
the need for additional services and assist in decision making regarding their clients The Test
Battery consists of several paper and pencil tests suitable for adults and adolescents with at least
a 6th grade reading level. They are Minnesota multi-phasic Personality inventory 2 (MPI-2) or
MACL (adolescent), Substance Abuse Subtle Screening inventory (SASSI) Adult or Adolescent
Questionnaire (contains sentence completion, questions regarding parenting knowledge and
skills and family back ground).
Advantages of Neurophysiological Assessment
1. Neuropsychological biomarker approaches test highly specific cognitive process that
have been linked to pacific regional brain function and transmitter system
2. In large multisided trials such as ease of use, portability established reliability and
normative data, availability of psychologists experienced with such testing low cot
and few technology requirements.
3. Neurophysiologic assessments are important because of the urgent need for
informative and efficient assessment of neurocognitive outcomes in clinical trials.
4. Neurophysiological approach is the foundation in animal models linking discrete
cognitive processes to specific brain region and receptor systems.
Drawbacks of Neurophysiological Assessment
The Positron Emission Tomography(PET) scan involves the injections of a substance
with radioactivity that can cause safety problems
The X-rays can damage our cells
In Functional |MRI the images produced must be interpreted carefully since correlation
does not imply causation and brain process are complex and often non-localized.
Some people may be concerned about the amount of radiation they receive during a CT
scan. It is true that the radiation exposure for a CT scan can be higher than from a regular
x-ray. However, not having the procedure can be more risky than having it, especially if
cancer is suspected. People considering CT must weigh the risks and benefits.
Advantages of Neuropsychological Tests
It can clarify the reasons for the difficulties and will help in providing a foundation
for an effective treatment plan. It is important to keep in mind that psychological
testing is only one part of a complete assessment process which may include
information provided by physicians, teachers, parents and counselors.
Testing may also be helpful when there is ongoing discrepancy between parents and
the school regarding the reason for a child’s difficulties and behavior Testing an
provide a new understanding about why a child is experiencing difficulties in school.
One of the main advantages of standardized testing is that the results can be
empirically documented therefore the test cores can be shown to have a relative
degree of validity and reliability, as well as results which are generalize and
replicable. This is often contrasted with grades on a school transcript which are
assigned by individual teachers. It may be difficult to account for differences in
educational culture across schools, difficulty of a given teachers curriculum
differences in teaching style, and techniques and biases that affect grading. This
makes standardized tests useful for admissions purpose in higher education, where
school is trying to compare students for across the national or across the world.
Psychosis’s, counselors and therapists use psychologies assessment as a supplement
to clinical interviews. Through testing, a lot of information is gathered in a relatively
short period of time.
Psychological testing allows the evaluator not only to corroborate interview data and
clinical impressions, but also to go beyond the interview and collect information of
broader psychotically complexity Information obtained from assessment has scientific
basis as it compares the individual against normative data. It allows the evaluator to
determine how similar or dissimilar this person is to others. While individuals may
attempt to “look good” or look bad in interview depending on the case at hand, most
test instruments contain validity scales on which to assess whether the individual is
providing honest answers and the level of symptom immunization or distortion, if
any.
Neuropsychological testing may be indicated in persons with epilepsy or
hydrocephalus.
Neuropsychological testing is also used to assess post-surgical changes in cognitive
functioning to guide further treatment services.
Disadvantages of Neuropsychological Tests
Lack of correct training is also a significant danger in the use of psychometric testing or
neuropsychological assessment.
Another important danger with neuropsychological testing is the use of questionna ires
that try to assess person’s ability or skills in a particular area
It is difficult to accurately estimate the percentage of clinicians who employ each of these
assessments approaches in a fixed versus flexible manner.
References
Allan, C., (2010). Computer Tomography. Retrieved on March 17, 2010 from
http://www.medterms.com/script/main/art.asp?articlekey=10353
Arnall, P., (2010). Retrieved on March 17, 2010 from
http://www.rad.jhmi.edu/MRI/MRI_Info_SubDivisions.htm
Deutsh, M. L. (1995). Neuropsychological Assessment (3rd ed.). New York: Oxford
University Press, 1995.
Horowitz, T., Schatz, P., & Chute, D.L (2007). Trends in Neuropsychological Test Usage
Los Angeles: Loyola Marymount University Press.
Michael, E. M. ( 2009). Advantages of Neuropsychological Assessment. Loyola
Marymount University. Los Angeles. Retrieved May 26, 2010,from
http://www.drmillslmu.com/Testing/spr2004/subcommittee.html.
Miller, E. (1992). Some Basic Principles of Neuropsychological Assessment. Hove: Laurence
Erlbaum Associates. Retrieved May 26, 2010, from
http://en.wikipedia.org/wiki/Neuropsychological_assessment
Reston, V., (2010). X- Ray Retrieved on March 17, 2010 from ssss
http://www.petscaninfo.com/zportal/portals/pat/basic
Vorvick, L., (2008) x ray. Retrieved on March 17, 2010 from
http://www.nlm.nih.gov/medlineplus/ency/article/003337.htm
LAB REPORT NO 3
Dissection of Ruminant Brain
Abstract
The major aim of the brain dissection is to develop a conceptual image of brain and
identification of anatomy related with various types of behaviors. For this purpose ruminant
brain of a buffalo was selected. After fixating it the formalin and denaturing it, the buffalo
brain was dissected into different actions with the help of the guidelines for plains of
reference and from brain atlas. Different areas of the brain were selected and exposed. They
were thoroughly studied for their locations and for their structural differentiation. It was
observed from the current study that ruminant brain is simpler in structure yet it is quite
similar to human brain.
Introduction
Neuroanatomy
Neuroanatomy is the study of the anatomy of nervous tissue and neural structures
of the nervous system. In vertebrate the routes that the myriad nerves take for the brain
to the rest of the body (or periphery), and the internal structure of the brain in particular,
are both extremely elaborate. As a result, the study of microanatomy has developed into
a discipline in itself, although it also represents a specialization within neuroscience. The
delineation of distinct structures and regions of the brain has figured centrally in
instigating how it works. For example much of what neuroscientists have learned comes
from observing how damage or “lesions” to specific brain areas affects behavior or other
neural function.
Divisions of Nervous System
The nervous system is an organ system containing a network of specialized cells
called neurons that coordinate the actions of an animal and transit signals between
different parts of its body. In most animals the nervous system consists of two parts,
central and peripheral. The central nervous system contains the brain and spinal cord.
The peripheral nervous system consists of sensory neurons, clusters of neurons called
ganglia and nerves connecting them to each other and to the central nervous system.
These regions are all interconnected by means of complex neural pathways. The enteric
nervous system, a subsystem of the peripheral nervous system, has the capacity, even
when severed for the rest of the nervous system through its primary connection by the
vagus nerve, to function independently in contorting the gastrointestinal system.
Neurons send signals to other cells as electrochemical waves traveling along thin fibers
called axons, which cause chemicals called neurotransmitters to be released at junctions
called synapses. A cell that receives a synaptic signal may be excited, inhibited, or
otherwise modulated. Sensory neurons are activated by physical stimuli impinging on
them, and send signals that inform the central nervous system of the state of the body and
the external environment. Motor neurons situated either in the central nervous system or
in peripheral ganglia, connect the nervous system to muscles or other effectors organs.
Central neurons which in vertebrates greatly outnumber the other types make all of their
input output connections with other neurons.
The interactions of these types of neurons form neural circuits that generate an
organism’s perception of the word and determine its behavior. Along with neurons the
nervous system contains other specialized cells called glial cells (or simply glia), which
provide structural and metabolic support.
Central Nervous System
The central nervous system (CNS) is the part of the nervous system that coordinates the
activity of all parts of the bodies of bilateral animals-that is a multicellular animals except
sponges and racially symmetric animals such as jellyfish. In vertebrates, the central nervous
system is enclosed in the meanings it contains the majority of the nervous system and
consists of the brain and the spinal cord. Together with the peripheral nervous system it has a
fundamental roe in the control of behavior. The CNS is contained within the dorsal cavity
with the brain in the cranial cavity and the spinal cord in the spinal cavity. The brain is
protected by the skull while the spinal cord is protected by the vertebrae.
Peripheral Nervous System
The Peripheral Nervous System (PNS) resides or extends outside the central nervous
system(CNS), which consist of the brain and spinal cord(1). The main function of the PNS is to
connect the CNS to the limbs and organs. Unlike the central nervous system, the PNS is not
protected by bone or by the blood-brain barrier, leaving it exposed to toxins and mechanical
injuries. The peripheral nervous system is divided into the somatic nervous system and the
autonomic nervous system.
Autonomic Nervous System
The autonomic nervous system (ANS or visceral nervous system)is the part of the
peripheral nervous system that acts as control system functioning largely below the level of level
of consciousness, and controls visceral functions the ANS affects heart rate, digestion,
respiration rate, salivation, perspiration, diameter of the pupils, micturition (urination), and
sexual arousal. Whereas most of its actions are involuntary, some such as breathing work in
tandem with the conscious mind. It is classically divided into two subsystems, the
parasympathetic nervous system and sympathetic nervous system. Sympathetic and
parasympathetic division as the accelerator and the parasympathetic division as the brake. The
sympathetic division typically functions in actions requiring quick responses. The
parasympathetic division functions with actions that do not require immediate reaction.
Consider sympathetic as “fight or flight|” and parasympathetic as “rest and digest”
Somatic Nervous System
The somatic nervous system enervates all sensory organs, including the eyes, ears,
tongue, and skin, as well as all the skeletal muscles, and the muscles attached to the bone and
used for voluntary movement. In movement, the SNS carries impulses from the brain to the
muscle to be moved, while in its sensory capacity, the SNS carried impulses from the sensory
organ to the brain. There are therefore two portions, or limbs, of the somatic nervous system the
afferent and the efferent. The afferent, or sensory, neurons carry impulses from sense organs into
the central nervous system, while the efferent or motor neurons carry impulses from the central
nervous system to the muscles. Neurons in the SNS project directly from the brain or spinal cord
to the muscle or sense organ. The cell body is located in the central nerves system, and the axon,
along which electrochemical impulses travel to or from the cell body, terminates in the muscle,
skin or sense organ. There are no intermediate cells or synapses, points where one neuron
communicates with another across a tiny gap. The autonomic nervous system differs structurally
from the somatic nervous system in that there are two neurons connecting the central nervous
system to the target organ, rather than only one.
Structural Classification of Brain
A brain is divided into three major divisions:
1. Hind Brain
The hind brain includes cerebellum and two structures found in the lowest part of the
brain stem, the medulla a Pons. Medulla is the base of the brain stem and I attached to the spinal
cord and form the relationship between brain and spinal cord, Pons means bridge. It includes
budges of fibers that connect a brain stem with a cerebellum which lies adjacent to it. Cerebrum
literally means little bran. It influence learning and memory but the most obvious function in
muscle control and order from cortex the cerebellum ordinates involuntary muscles.
2. The Mid Brain
The midbrain is the smallest region of the brain that acts as a sort of relay station for
auditory and visual information. The midbrain controls many important function such as the
visual and auditory systems as well as eye movement Portions of the midbrain called the red
nucleus and the substantial nigra are involved in the control of body movement. The darkly
pigmented substantial nigra contains a large number of dopamine-producing neurons are located.
The degeneration of neurons in the substantial nigra is associated with Parkinson’s. Sometimes
referred to as the “little brain”, the cerebellum lies on top of the Pons, behind the brain stem.
The cerebellum is comprised of small lobes and receives information from the balance system of
the inner ear, sensory nerves, and the auditory and visual systems. It is involved in the
coordination of motor movements as well as basic facets of memory and learning.
3. The Fore Brain
The forebrain is the largest part of the brain. It consists of cerebrum which is the main
portion of the brain, made up of two cerebral hemisphere united by the corpus callosum,
forming the largest part of the central nervous system in man. Each hemisphere is made up of the
cerebral cortex and the basal nuclear, which together control al cognitive and motor function.
The thalamus has numerous functions, the most important being to relay sensory information to
the cerebral cortex, an area of the forebrain which lies beneath the thalamus. It secretes
corticotrophin releasing hormone, which helps to control the body’s metabolism by exerting an
influence on the pituitary gland and vasopressin, which is involved in the regulation of the sleep
and wake states. The limbic system underlies the corpus callosum and is a collective term
referring to several brain parts, including the hippocampus and the amygdala. The limbic
structures are important in the regulation of visceral motor activity and emotional expression.
Functional Subdivision of Brain
A neuron, also known as a neuron or nerve cell is an electrically excitable cell that
processes and transmits information by electrochemical signaling, via connections with other
cells called synapses. Neurons are the core components of the nervous system, which include
the brain, spinal cord, and peripheral ganglia A number of specialized types of neurons exist
sensory neurons respond to touch, sound, light and numerous other stimuli affecting cells of the
sensory organs that then send signals to the spinal cord and brain. Motor neurons receive signals
from the brain and spinal cord and cause muscle contractions and affect gland. Interneurons
connect neurons to other neurons within the same region of the brain or spinal cord a typical
neuron possesses a cell body (often called soma), dendrites and an axon. Dendrites are filaments
of protoplasm that extrude from the cell body, often extending for hundreds of microns and
branching multiple times, giving rise to a complex : dendrite tree: An axon is a special
protoplasmic filament that arises for the cell body at a site called the axon hillock and travels
through the body, often for a great distance. The cell body of a neuron frequently gives rise to
multiple dendrites, but never to than one axon, although the axon may branch hundreds of time
before it terminates. At the majority of synapses, signals are sent from the axon of one neuron to
a dendrite of another. There are, however many exceptions to these rules: neurons that lack
dendrites, neurons that have no axon, synapses that connect an axon to another axon or a dendrite
to another dendrite etc. All neurons are electrically excitable, maintaining voltage gradients
across their membranes by means of metabolically driven ion pups which combine with ion
channels embedded in the members to generate intracellular-versus-extra cellular concentration
differences of ions such as sodium, potassium chloride and calcium. Changes in the cross-
membrane voltage can alter the function of voltage-dependent ion channels. If the voltage
change by a large enough amount, an al-or none electrochemical pulse called an action potential
is generated, which travels rapidly along the cell axon, and activates synaptic connections with
other ells when it arrives. Neurons do not undergo el division and usually cannot be replaced
after being lost although there are few known exceptions. In most cases they are generated by
pencil types of stem cells, although astrocytes (a type of glial cell) have been observed to turn
into neurons as they are sometimes pluripotent.
Methodology
Apparatus
Dissection box
Brain
Boric powder
Surgical Gloves
Water in a container
Procedure
In order to explore various dimensions of human brain, the dissection was performed on a
ruminant brain. The ruminant brain or the buffalo’s brain mimics the dimensional clarity of
human brain and this had easy availability, due to which it was selected for study. Immediately
after getting it, it was dipped in formalin solution of a deep bottom jar. For the sack of denaturing
and fixation it was kept like this for minimum duration of 15 days.
It was dissected and after the removal of meninges a yellow texture appeared and the mid
sagittal section was dissected. This provided us about the exact positioning of ventricle, corpus
callosum, pones, medulla, leaf like structure of cerebellum, whitish inside layer of cerebrum, the
mid line areas of brain stem and mammillary body. After this, its ventricle cut was made, that
helped us to gain inside of various tissues were prepared and this was observed under an electron
microscope in order to learn about its deeper region. From the lab experiment an in-depth inside
was gain indicate about the location of various regions of human being.
References
Structure of Brain. Retrieved March 15, 2010
from http://www.brainexplorer.org/glossary/forebrain.shtml
Classification of brain. Retrieved March 15, 2010
http://www.brainexplorer.org/brain_atlas/Brainatlas_Hindbrain.shtml
Anonymous (2009). Autonomic nervous system. Retrieved March 17, 2010 from
http://www.pharmainfo.net/introduction-autonomic-nervous-system/classification.
Nagappa, A. (2008). Nervous system. Retrieved March 17, 2010 from
http://www.besthealth.com/besthealth/bodyguide/nerv_sys_fin.html.
LAB REPORT NO 4
Introduction of Bender Gestalt Test
Bender Gestalt Test
Introduction
The Bender Gestalt Test, or the Bender Visual Motor Gestalt Test, is a psychological
assessment instrument used to evaluate visual-motor functioning and visual perception skills in
both children and adults. Scores on the test are used to identify possible organic brain damage
and the degree maturation of the nervous system. The Bender Gestalt was developed by
psychiatrist Lauretta Bender in the late nineteenth century.
Population
Ages 4 and over can be included in the test.
Time
The test is untimed, although standard administration time is typically 10-15 minutes.
Author
Lauretta Bender
Publisher
The American Orthopsychiatric Association, Inc.
Purpose
The objectives of Bender Gestalt Test are to asses and evaluate visual motor
functioning and visual perception skills. The Bender Gestalt Test is used to evaluate
visual maturity, visual motor integration skills, style of responding, and reaction to
frustration, ability to correct mistakes, planning and organizational skills, and motivation.
Copying figures requires fine motor skills, the ability to discriminate between visual
stimuli, the capacity to integrate visual skills with motor skills, and the ability to shift
attention from the original design to what is being drawn. This test also identifies
neurobehavioral functioning. This is an effective tool to indicate regional brain damage.
This test is also identifies neurological impairment, emotional disturbances in children
from age 3 and older.
History
The Bender Visual Motor Gestalt Test (Bender-Gestalt) is the most frequently
administered and thoroughly researched of all of the drawing (copying) tests. It consists of nine
geometric designs (numbered A and 1-8). Each design is presented sequentially to the subject
whose task is to reproduce them on a blank sheet of paper, originally developed by Wertheimer
to demonstrate the perceptual tendencies to organize visual stimuli into configurable wholes
(Gestalten).
Lauretta Bender selected from Wertheimer designs in the corporate these into a test for
clinical use the results of her studies with the nine designs are presented by her in a monograph.
A visual Motor Gestalt test and its clinical use were published in 1930 since last
publication of her monographic bender’s Test has come in to widespread use as clinical
instrument. It has been used to ultimate maturation, intelligence, psychological disturbances and
effects of injury to cortex, and tom allow the effects of convulsive therapy.
Description
The Bender Gestalt Test is an individually administered pencil and paper test used to
make a diagnosis of brain injury. There are nine geometric figures drawn in black. These figures
are presented to the examinee one at a time; then, the examinee is asked to copy the figure on a
blank sheet of paper. Examinees are allowed to erase, but cannot use any mechanical aids (such
as rulers). The popularity of this test among clinicians is most likely the short amount of time it
takes to administer and score. The average amount of time to complete the test is five to ten
minutes.
The Bender Gestalt Test lends itself to several variations in administration. One method
requires that the examinee view each card for five seconds, after which the card is removed. The
examinee draws the figure from memory. Another variation involves having the examinee draw
the figures by following the standard procedure. The examinee is then given a clean sheet of
paper and asked to draw as many figures as he or she can recall. Last, the test is given to a group,
rather than to an individual (i.e., standard administration). It should be noted that these variations
were not part of the original test.
Administration
The test is administered to each subject individually in a room free from detracting
stimuli. The subject is seated at a table given a blank white sheet of paper a sharp pencil with an
eraser the subject is told that he is to copy nine designs it is important to tell him the number of
designs he is to copy so that he may plan the size and arrangement of the design. Subjects should
also be told to not to sketch the design but make a single line drawing.
During the administration of the test it is important to note the direction in which the
paper is held. Orientations of the design on the page, as well as the deviations are scored. Most
subjects keep drawing at the top of the page some fit according to the drawing and some rotate
the cards or without rotating the cards invert their drawings. This fact is noted.
Scoring
Scoring is usually relatively easy and rapid, rarely requiring more than three or four
minutes, regardless of whether a formalized or intuitive scoring system is employed. The scoring
System is simple each design is inspected to determine whether or not scorable deviation occur.
The deviation to be scored is given the scoring sheet with their assigned weights and it is
assumed that the abnormal people show more deviation in their scores than normal ones.
Psychometric properties
Reliability
The results involving the Bender with young children reveal inters corer reliability to be
very high with correlations of .90 and above. Test-retest reliability coefficients with children
range from a low of about .50 with kindergarten children measured 8 months apart to .90 with
the same age group measured two weeks apart. More than 20 different reliability studies reported
by Koppitz reveal correlation coefficients in the .80+ range and suggest that normal elementary
school children show relatively stable patterns of Bender-Gestalt scores from one administration
to the next.
Validity
With respect to the validity of the Bender with children, Koppitz reported
correlation coefficients from about .50 to as high as .80 between the Bender-Gestalt and
intelligence as measured by the Stanford-Binet or Wechsler Intelligence Scale for Children up to
about the age of 10. Beyond this age the correlations drop to essentially zero as most older
children obtain nearly perfect scores. She also reported relatively high correlations between
Bender scores and subsequent educational achievement of first-grade children. Koppitz also
reported a relatively high correlation between the Bender and intellectual and academic
performance for retarded children as well. With children diagnosed as having minimal brain
damage, she reported that the Bender is a valuable diagnostic tool but cautioned that it should not
be used alone but in combination with other psychological tests and any background information
available.
Norms
Norms for a wide variety of clinical groups, including mentally retarded, organically
brain-damaged, psychotic, and normal adults are included in Bender’s classic research
monograph.
Precautions
The Bender Gestalt Test should not be administered to an individual with severe visual
impairment unless his or her vision has been adequately corrected with eyeglasses.
Additionally, the test should not be given to an examinee with a severe motor impairment, as the
impairment would affect his or her ability to draw the geometric figures correctly. The test scores
might thereby be distorted.
When making a diagnosis, results from the Bender Gestalt Test should be used in
conjunction with other medical, developmental, educational, psychological, and
neuropsychological information. The Bender Visual Motor Gestalt Test should be administered
and interpreted by a trained psychologist or psychiatrist.
Results
A scoring system does not have to be used to interpret performance on the Bender Gestalt
Test; however, there are several reliable and valid scoring systems available. Many of the
available scoring systems focus on specific difficulties experienced by the test taker. These
difficulties may indicate poor visual-motor abilities that include:
Angular difficulty This includes increasing, decreasing, distorting, or omitting an angle
in a figure.
Bizarre doodling This involves adding peculiar components to the drawing that have no
relationship to the original Bender Gestalt figure.
Closure difficulty This occurs when the examinee has difficulty closing open spaces on
a figure, or connecting various parts of the figure. This results in a gap in the copied
figure.
Cohesion This involves drawing a part of a figure larger or smaller than shown on the
original figure and out of proportion with the rest of the figure. This error may also
include drawing a figure or part of a figure significantly out of proportion with other
figures that have been drawn.
Collision This involves crowding the designs or allowing the end of one design to
overlap or touch a part of another design.
Contamination This occurs when a previous figure, or part of a figure, influences the
examinee in adequate completion of the current figure. For example, an examinee may
combine two different Bender Gestalt figures.
Fragmentation This involves destroying part of the figure by not completing or breaking
up the figures in ways that entirely lose the original design.
Impotence This occurs when the examinee draws a figure inaccurately and seems to
recognize the error, then, he or she makes several unsuccessful attempts to improve the
drawing.
Irregular line quality or lack of motor coordination This involves drawing rough
lines, particularly when the examinee shows a tremor motion, during the drawing of the
figure.
Line extension This involves adding or extending a part of the copied figure that was not
on the original figure.
Omission This involves failing to adequately connect the parts of a figure or reproducing
only parts of a figure.
Overlapping difficulty This includes problems in drawing portions of the figures that
overlap, simplifying the drawing at the point that it overlaps, sketching or redrawing the
overlapping portions, or otherwise distorting the figure at the point at which it overlaps.
Perseveration This includes increasing, prolonging, or continuing the number of units in
a figure. For example, an examinee may draw significantly more dots or circles than
shown on the original figure.
Retrogression This involves substituting more primitive figures for the original design—
for example, substituting solid lines or loops for circles, dashes for dots, dots for circles,
circles for dots, or filling in circles. There must be evidence that the examinee is capable
of drawing more mature figures.
Rotation This involves rotating a figure or part of a figure by 45° or more. This error is
also scored when the examinee rotates the stimulus card that is being copied.
Scribbling This involves drawing primitive lines that have no relationship to the original
Bender Gestalt figure.
Simplification This involves replacing a part of the figure with a more simplified figure.
This error is not due to maturation. Drawings that are primitive in terms of maturation
would be categorized under "Retrogression."
Superimposition of design This involves drawing one or more of the figures on top of
each other.
Work over This involves reinforcing, increased pressure, or overworking a line or lines
in a whole or part of a figure.
Lab Report No 5
Administration, scoring and interpretation of Bender Gestalt
Test on a person with normal functioning
Bio Data of Normal Person
Name: S.A
Age: 23 years
Gender: Male
Education: M.Sc
No. of siblings: 5
Marital Status: Unmarried
Mother Tongue: Punjabi
Background Information
S.A was a 23 years old boy. He belonged to middle class and he had done his B.S.C. His
father was a primary school teacher. His mother was a house lady. His family lived in a small
house just have three rooms. His aim was to become doctor but he could not achieve his goal
because of shortage of money. His father’s salary was not enough to pay his fee in medical
college. After doing his B.S.C he had to work for his family because his father’s income was not
enough. He had 1 brother and 3 sisters. His brother was also younger from him so had also work
to pay his younger brother’s fee. His birth order was 1st and he was unmarried. He lived in
nuclear family system. His mother tongue was Punjabi and religion was Islam.
Test Administration
The Bender Gestalt Test was administered on the normal person at his hostel. The
environment of the room was moderate. He was seated comfortably and he was not looking
tensed rather he was relaxed.
Instructions
The normal person was given several instructions. He was asked to sit normally and be
relaxed. He was instructed to draw the diagram as it is but if he deviated from the actual design
he was not instructed to correct it. Firstly, he was instructed to draw diagrams by seeing it and
then he was asked to make second unseen attempt.
General observation
During the practical, the person’s general behavior was also observed. He looked calm
and relaxed. When given instructions he had few questions in mind that he asked. After clearing
the questions, he drew the entire diagram easily and also in one attempt he made seven diagrams
correctly.
Quantitative Analysis
Sr. No Designs Errors
1 1 0
2 2 0
3 3 0
4 4 0
5 5 0
6 6 3
7 7 3
8 8 0
9 Configuration 0
Quantitative scoring continue
Raw Scores: 06
Cut off scores: 60-80
Standard Scores: 42
Qualitative Analysis
The qualitative analysis of the a person with normal functioning Mr. S.A on Bender
Gestalt Test reveal that he has scored within stipulated range as provided by the manual. The
participant’s z score is 42 and his obtained raw score is 6. Dimensional analysis of the subject on
performance indicates that neural functioning of the participant is normal. Because the
participant’s score is less than cut-off points.
Lab Report No 6
Administration, scoring and interpretation of Bender Gestalt
Test on a patient with depression
DEPRESSION
Definition and description
Generally depression is a term in which you will be aware of is that it is far more than,
just feeling down. In fact, it not only affects how we feel, but how we think, our energy levels,
our concentration, our sleep. So depression has an effect on many aspects of our lives. It effects
on person’s motivation level, emotions and thinking thoughts in which we think about ourselves
our future and the world. Depression is probably the most common psychiatric complaint and
has been described by physicians since before the time of Hippocrates, who called it
melancholia. The course of the disorder is extremely variable from person to person; it may be
mild or severe, acute or chronic. The typical age of onset is in the 20s, but it may occur at any
age.
Types of depression
Depression comes in many shapes and forms. The different types of depression have unique
symptoms, causes, and effects. Following are the types of depression:
Major depression
Major depression, or clinical depression, is characterized by the inability to enjoy life and
experience pleasure. The symptoms are constant, ranging from moderate to severe. Left
untreated, major depression typically lasts for about six months. Some people experience just a
single depressive episode in their lifetime, but more commonly, major depression is a recurring
disorder.
Atypical Depression
Atypical depression is a common subtype of major depression. It features a specific symptom
pattern, including a temporary mood lift in response to positive events. You may feel better after
receiving good news. However, this boost in mood is brief. Other symptoms of atypical
depression include weight gain, increased appetite, sleeping excessively.
Dysthymia
Dysthymia is a type of chronic “low-grade” depression. More days than not, you feel
mildly or moderately depressed, although you may have brief periods of normal mood. The
symptoms of dysthymia are not as strong as the symptoms of major depression, but they last a
long time (at least two years).
Seasonal affective disorder (SAD)
Some people get depressed in the fall or winter, when overcast days are frequent and sunlight
is limited. This type of depression is called seasonal affective disorder (SAD). Like depression,
seasonal affective disorder is treatable. Light therapy, a treatment that involves exposure to
bright artificial light, often helps relieve symptoms.
Unspecified Depression
It includes people with a serious depression, but not quite severe enough to have a diagnosis
of a major depression. It also includes people with chronic, moderate depression, which has not
been present long enough for a diagnosis of a Dysthymia disorder.
Adjustment Disorder
With Depression - This category describes depression that occurs in response to a major life
stressor or crisis.
Bipolar Depression
This type includes both high and low mood swings, as well as a variety of other significant
symptoms not present in other depressions.
Manic Depression
Manic depression can be defined as an emotional disorder characterized by changing mood
shifts from depression to mania which can sometimes be quite rapid. People who suffer from
manic depression have an extremely high rate of suicide.
Causes
Depression can have many causes.
Unfavorable life events can increase a person’s vulnerability to depression or trigger a
depressive episode.
Negative thoughts about oneself and the world are also important in producing and
maintaining depressive symptoms.
Both psychosocial and biochemical mechanisms seem to be important causes; the chief
biochemical cause appears to be the defective regulation of the release of one or more
naturally occurring neurotransmitters in the brain, particularly norepinephrine and
serotonin. Reduced quantities or reduced activity of these chemicals in the brain is
thought to cause the depressed mood in some sufferers.
Bio Data of Depressed Person
Name: A.A
Age: 47 years
Gender: Male
Education: Matric
No. of siblings: 7
Marital Status: Married
Mother Tongue: Urdu
Background Information
Mr. A.A was a 47 years old male. His father was a business man. But his father made
separation from his mother when he was only 5 year old. His mother was a primary school
teacher but she did not continue her job because of her poor health condition. His father shifted
all his business in a foreign country. The participant could not continue his education career
because of poor economic conditions. After doing his matric he had to work at a restaurant as a
table man. He had two brothers and seven sisters. He is married man and had four children also.
He lived in joint family system. Her mother tongue was Punjabi and his religion was Islam.
Test Administration
The Bender Gestalt Test was administered on the patient with depression in Mayo
Hospital Lahore. The environment of the room was moderate and there were no obstruction
during the practical. He was not seated comfortably and was hyperactive. This was also his lunch
time and he was asking again and again about the lunch as he was hungry. When I was
convincing him to cooperate with me, the man entered the room taking his lunch. At that time he
ignored the test and said please came after I have done with lunch.
Instructions
The patient with depression was given several instructions. He was asked to sit normally
and be relaxed. He was instructed to draw the diagram as it is but if he deviated from the actual
design he was not instructed to correct it. Firstly, he was instructed to draw diagrams by seeing it
and then he was asked to make and second unseen attempt.
General observation
During the practical, the person’s general behavior was also observed. He looked
hyperactive but was not relaxed. When given instructions he had few questions in mind that he
asked. After clearing the questions, he drew the entire diagram.
Quantitative Scoring
Sr. No Designs Errors
1 1 0
2 2 14
3 3 36
4 4 51
5 5 21
6 6 34
7 7 22
8 8 34
9 Configuration 16
Raw Score: 228
Cut off score: 60-80
Standard score: 190
Qualitative Analysis
The qualitative analysis of a patient with depression Mr. A.A on Bender Gestalt Test
reveal that he has scored very highly above average as provided by the manual. The subject’s z
score is 190 and his obtained raw score is 228. Dimensional analysis of the subject on
performance indicates that neural functioning of the participant is very poorer. Because the
participant’s score is highly above the cut-off points. He missed the minor figure many times
which shows his major memory deficits.
Lab Report No 7
Administration, scoring and interpretation of Bender Gestalt
Test on a patient with schizophrenia
SCHIZOPHRENIA
Introduction
A psychiatric diagnosis describes a mental disorder characterized by abnormalities in the
perception or expression of reality. Distortions in perception may affect all five senses, but most
commonly manifest as auditory hallucinations, paranoid or bizarre delusions, or disorganized
speech and thinking with significant social or occupational dysfunction.
Diagnostic Criteria
Characteristic symptoms
Two or more of the following, each present for a significant portion of time during a
one-month period.
delusions
hallucinations
disorganized speech (eg, frequent derailment or incoherence)
grossly disorganized or catatonic behavior
negative symptoms (ie, affective flattening, alogia, or avolition)
2. Social/occupational dysfunction
Since the onset of the disturbance, one or more major areas of functioning, such as work,
interpersonal relations, or self-care, are markedly below the level previously achieved
3. Duration
Continuous signs of the disturbance persist for at least six months. This six-month period
must include at least one month of symptoms (or less if successfully treated) that meet Criterion
4. Exclusion
Exclusion of schizoaffective disorder and mood disorder with psychotic features
5. Substance/general medical condition exclusion
The disturbance is not due to the direct physiological effects of a substance (eg, a drug of
abuse, a medication) or a general medical condition
6. Relationship to a pervasive developmental disorder: If there is a history of autistic disorder
or another pervasive development disorder, the diagnosis of schizophrenia is made only if
prominent delusions or hallucinations are also present for at least a month (or less if successfully
treated)
TYPES
Paranoid-type schizophrenia
It is characterized by delusions and auditory hallucinations but relatively normal intellectual
functioning and expression of affect. The delusions can often be about being persecuted unfairly or
being some other person who is famous. People with paranoid-type schizophrenia can exhibit anger,
aloofness, anxiety, and argumentativeness.
Isorganized-type schizophrenia
It is characterized by speech and behavior that are disorganized or difficult to understand,
and flattening or inappropriate emotions. People with disorganized-type schizophrenia may laugh at
the changing color of a traffic. Their disorganized behavior may disrupt normal activities.
Catatonic-type schizophrenia
It is characterized by disturbances of movement. People with catatonic-type schizophrenia may
keep themselves completely immobile or move all over the place. They may not say anything for
hours, or they may repeat anything you say or do senselessly.
Undifferentiated-type schizophrenia
It is characterized by some symptoms seen in all of the above types but not enough of any one of
them to define it as another particular type of schizophrenia.
Residual-type schizophrenia is characterized by a past history of at least one episode of
schizophrenia, but the person currently has no positive symptoms (delusions, hallucinations,
disorganized speech or behavior). It may represent a transition between a full-blown episode and
complete remission, or it may continue for years without any further psychotic episodes.
Bio Data
Name: Muhammad Bashir
Age: 30 Years
Gender: Male
Education: Graduation
No. of siblings: 8
Marital Status: Unmarried
Mother Tongue: Punjabi
Socioeconomic Status: Middle
Background Information
He was a 30 year old man. He was unmarried. He belonged to lower middle class family.
His father was a shopkeeper. He had worked with his father at shop after coming from school. In
this way he could not give proper time to his studies. He did his graduation under very tough
economic conditions. He had one brother but two sisters. His all other siblings were younger to
him. In the age of 25 he had a problem with his brother in law as they reported that he became
hyperactive mostly. He belonged to a Muslim family.
Test Administration
The Bender Gestalt Test was administered on a patient with schizophrenia in Mayo
Hospital Lahore. The environment of the room was moderate and there were no obstruction
during the practical. He was seated comfortably on his bed but he was looking tensed. He started
the test very well but in the middle he was very confused and started forgetting the size and angle
of the designs.
Instructions
The patient with schizophrenia was given several instructions. He was asked to sit
normally and be relaxed. He was instructed to draw the diagram as it is but if he deviated from
the actual design, he was not instructed to correct it. Firstly, he was instructed to draw diagrams
by seeing it and then he was asked to make and second unseen attempt.
General observation
During the practical, the participant’s general behavior was also observed. He looked
little confused and was not relaxed. When given instructions he had few questions in mind that
he asked. After clearing the questions, he drew the entire diagram and also in second attempts he
made four diagrams correctly.
Quantitative Analysis
Design Scores
Raw score of client 70
Z score of the client 113
Raw Score: 70
Standard Score: 113
Cut off Score: 60-80
Qualitative Analysis
The qualitative analysis of a patient with schizophrenia Mr. M.B on Bender Gestalt Test
reveal that he has scored above average range as provided by the manual. The subject’s z score
is 113 and his obtained raw score is 70. Dimensional analysis of the subject on performance
indicates that neural functioning of the participant is not good. Because the participant’s score is
above the cut-off points. His major problem was the size of the design. Sometimes he made very
little and sometimes he made very large designs. This shows his visual memory is mainly
disturbed. By making large figure he is over generalizing the things and magnifying little things
or problems as big, and with the small size the fact is vice-versa.
Lab Report No 8
Administration, scoring and interpretation of Bender Gestalt Test on a
patient with Addiction
Administration of Bender Gestalt Test on a Patient with Addiction
Bio Data
Name: Akhtar
Age: 35
Gender: Male
Education: Matric
No of siblings: 6
Marital status: Married
Children: 3
Mother tongue: Punjabi
Religion: Islam
Socioeconomic Status: Low
Test Administration
The Bender Gestalt test was administered on the patient with drug addiction at Mayo
Hospital Lahore. The environment of the room was moderate and there were no obstruction
during the practical. He was seated comfortably and he was not looking tensed rather he was
relaxed.
Instructions
The patient with drug addiction was given several instructions. He was asked to sit
normally and be relaxed. He was instructed to draw the diagram as it is but if he deviated from
the actual design he was not instructed to correct it. Firstly he was instructed to draw diagrams
by seeing it and then he was asked to make and second unseen attempt.
General observation
During the practical the person’s general behavior was also observed. He looked little
confused and was not relaxed. He fined these figures difficult to draw accurately. When given
instructions he had few questions in mind that he asked. After clearing the questions he drew the
entire diagram, generally was not happy.
Scoring
Qualitative Analysis:
Design Scores
Raw score of client 219
Cut off score
Z score of the client 190
Qualitative Analysis
The qualitative analysis of a patient with drug addiction Mr. A on Bender Gestalt Test
reveal that he has scored highly above average range as provided by the manual. The subject’s z
score is 190 and his obtained raw score is 219. Dimensional analysis of the subject on
performance indicates that neural functioning of the participant is not efficient. Because the
participant’s score is highly above the cut-off points. His major problem was also the size of the
design. Sometimes he made very little and sometimes he made very large designs. This shows
his visual memory is mainly disturbed. By making large figure he is over generalizing the things
and magnifying little things or problems as big, and with the small size the fact is vice-versa. He
also rotated some designs which showed his poor judgment and poor perceptual ability.
References
http://depression.about.com/od/diagnosis/tp/depsymptoms.htm
http://www.britannica.com/EBchecked/topic/158349/depression
http://www.helpguide.org/mental/depression_signs_types_diagnosis_treatment.htm
http://www.psychologyinfo.com/depression/depression_types.html