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Neuropsychological Models of Childhood Obsessive-Compulsive Disorder
OBSESSIVE-COMPULSIVE DISORDER
1056--4993/99 $8.00 + .00
NEUROPSYCHOLOGICAL MODELS OF CHILDHOOD OBSESSIVE-COMPULSIVE DISORDER Robert T. Schultz, PhD, David W. Evans, PhD, and Monica Wolff, PhD
NEUROPSYCHOLOGICAL ASSESSMENT AS A TOOL FOR THEORY BUILDING
Neuropsychological assessment of psychiatric disorders enables both the description of phenomenologic features of a specific disorder as well as the testing of neurofunctional models of pathology. Given the rich body of literature on many neuropsychological instruments and their known neurophysiological correlates, findings of deficit in one or more measures in a disorder often suggest specific hypotheses about brain processes that underlie the pathobiology of the disorder. Multiple variables need to be considered, however, when interpreting neuropsychological profiles of performance. For example, perturbed function may be part of the primary symptom presentation and therefore of great value for the development of neurofunctional models; alternatively, altered function might be a secondary consequence, such as impaired executive function in the context of stress and anxiety (ArnstenSa ), or the secondary memory impairment found in posttraumatic stress disorder (Bremner et al.,!7a, 17b), presumably related to the toxic effects on the hippocampus of high levels of circulating stress-related glucocorticoids (Sapolsky91a). In the absence of other data it can be difficult to pinpoint From Yale Child Study Center, Yale University, New Haven, Connecticut (RTS); the Department of Psychology, Bucknell University, Lewisburg, Pennsylvania (DWE); and Clinical Research Division, Mexican Institute of Psychiatry, Mexico City, Mexico (MW)
CHILD AND ADOLESCENT PSYCHIATRIC CLINICS OF NORTH AMERICA VOLUME 8 • NUMBER 3 • JULY 1999
513
1056--4993/99 $8.00 + .00
NEUROPSYCHOLOGICAL MODELS OF CHILDHOOD OBSESSIVE-COMPULSIVE DISORDER Robert T. Schultz, PhD, David W. Evans, PhD, and Monica Wolff, PhD
NEUROPSYCHOLOGICAL ASSESSMENT AS A TOOL FOR THEORY BUILDING
Neuropsychological assessment of psychiatric disorders enables both the description of phenomenologic features of a specific disorder as well as the testing of neurofunctional models of pathology. Given the rich body of literature on many neuropsychological instruments and their known neurophysiological correlates, findings of deficit in one or more measures in a disorder often suggest specific hypotheses about brain processes that underlie the pathobiology of the disorder. Multiple variables need to be considered, however, when interpreting neuropsychological profiles of performance. For example, perturbed function may be part of the primary symptom presentation and therefore of great value for the development of neurofunctional models; alternatively, altered function might be a secondary consequence, such as impaired executive function in the context of stress and anxiety (ArnstenSa ), or the secondary memory impairment found in posttraumatic stress disorder (Bremner et al.,!7a, 17b), presumably related to the toxic effects on the hippocampus of high levels of circulating stress-related glucocorticoids (Sapolsky91a). In the absence of other data it can be difficult to pinpoint From Yale Child Study Center, Yale University, New Haven, Connecticut (RTS); the Department of Psychology, Bucknell University, Lewisburg, Pennsylvania (DWE); and Clinical Research Division, Mexican Institute of Psychiatry, Mexico City, Mexico (MW)
CHILD AND ADOLESCENT PSYCHIATRIC CLINICS OF NORTH AMERICA VOLUME 8 • NUMBER 3 • JULY 1999
513