Melbourne School of Psychological Sciences - Theses
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ItemEarly neuropsychological change in possible dementia of the Alzheimer type( 1996)Early detection of dementia of the Alzheimer type (DAT) is vital in understanding the natural course of the disease, which in turn guides the development of potential pharmacological treatment and management strategies. However, early detection of DAT has traditionally proved difficult. The study described in this thesis comprehensively examined neuropsychological function over a 24 month period in patients with early dementia, using as comparison groups individuals with isolated memory complaints (questionable dementia, QD), and normal controls. The neuropsychological battery utilised included standard measures of cognition, such as the WAIS-R and WMS-R, and experimentally-derived computerised tests of memory. The same pattern of neuropsychological change was exhibited by patients with early DAT and by QD subjects who later fulfilled standard criteria for the disease. In both groups pronounced impairment of recent memory preceded deficits in language and visuospatial function. The progression of cognitive deterioration observed in DAT is likely to reflect the spread of neuropathology throughout the cortex. In view of these findings, the selection of appropriate neuropsychological measures for the detection and staging of early DAT is discussed. One computerised measure, the paired associate learning test, was found to be particularly efficacious in the prediction and early detection of DAT. The QD group performed at a similar level to normal controls when first assessed using the paired associate learning subtest. However, over the course of the study, 43% of the QD subjects exhibited significant deterioration in scores on this measure. All subjects who deteriorated on the computerised paired associate learning task met standard criteria for DAT at the conclusion of the study. Diagnosis of probable DAT was not predicted by any other demographic or psychometric variable. These findings are discussed in terms of the special sensitivity of the associate learning paradigm to the neuropathology of Alzheimer's disease.
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ItemAn exploration of the cerebral lateralisation of musical function( 1996)The aim of the thesis was to conduct a detailed examination of the evidence pertaining to the cerebral lateralisation of musical function. Theoretical models from the neuropsychological and cognitive psychology fields were employed, with emphasis placed on the way the models interrelate to gain a more coherent account of music cognition and its relationship to cerebral lateralisation. (For complete abstract open document.)
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ItemThe cognitive and affective correlates of the memory complaint in temporal lobe epilepsy( 1996)An impression which has dominated both the clinical setting and research literature is that patients with temporal lobe epilepsy (TLE) not infrequently issue "bitter" complaints about their memory function. This observation has rarely been subjected to investigation, based as it is, on the implicit assumption that TLE subjects are "entitled" to a memory disturbance given the involvement of a critical memory structure (i.e, hippocampus) in the pathogenesis of the disorder. While it is almost axiomatic that clinicians become aware of memory difficulties because of the subjective complaints issued by patients, there is growing awareness that the relationship between complaint and objective memory disturbance is a complex and often counterintuitive one. This is particularly true of many patients with TLE who while complaining about their memory function often do so in the presence of objectively normal interictal memory function. This thesis addressed the question: Why do patients with TLE complain about their memory? It was premised on the notion that memory self-report is not a unidimensional construct explicable in terms of an underlying memory dysfunction alone, but the perception and expression of memory may arise from seemingly disparate sources. The principal objective of the thesis was to systematically and comprehensively investigate the complaint in TLE, and to derive an understanding of the variables which contribute to the perception and expression of poor memory in members of this population. The variables selected for investigation emerged from a detailed review of the literature and can be grouped into five broad conceptual domains: demographic, epileptological, psychological, cognitive, and metacognitive. (For complete abstract open document)