Descriptive Psychopathology: The Signs and Symptoms of ...

320 Section 3: Examination domainsFigure 13.2 Clock drawing in a manic-depressive patient who developed dementiaClock drawing: Asking the patient to draw the face of a clock from memory tapsrecall and perceptual–motor coordination and is sensitive to temporal–parietaldysfunction, an early feature of Alzheimer’s disease. In some versions the clock’sshape (a circle) is provided. The patient is asked to place the clock’s hands at 2:45to also assess for spatial neglect, with such patients often neglecting the left side ofspace (see Figure 13.2). Asking the patient to judge the quality of his effortassesses frontal lobe executive function. Some patients place all the left-sidenumbers on the right side of the clock (see Figure 13.3). 24The patient’s inability to draw the face of the clock correctly on the first trysuggests poor planning consistent with frontal circuitry dysfunction. His improvementon the second try suggests that he has no spatial deficit (Figure 13.2).Copying and recalling shapes: Copying shapes and then recalling them tapsperceptual–motor coordination and visual memory. Almost any five simpleshapes are acceptable. Figure 13.4 shows some examples. After the effort to copythe shapes, the patient is asked to immediately reproduce them from memory.After this effort the five figures are reviewed and followed by a delayed recalleffort toward the end of the testing session.Similarities and their recall: The understanding of the most fundamentalcommon denominator between two things assesses abstract thinking and is asubtest of the WAIS. Recall of the word pairs assesses verbal memory. Almost anyfive pairs of increasing difficulty can be used such as orange–banana, North–West,