Descriptive Psychopathology: The Signs and Symptoms of ...

321 Chapter 13: Testing and psychopathology of cognitive dysfunctionFigure 13.3 Clock drawing indicating left-sided spatial neglectFigure 13.4 Shapes to copyAfter: Mesulam, M-M. (1985). Principles of Behavioral Neurology. Philadelphia: FA Davis.airplane–bicycle, axe–saw, fly–tree. Errors range from recognizing a commonattribute of the items rather than their common category (e.g. “they have wheels”for airplane–bicycle) to being unable to offer an answer. Three of the five pairsshould be recalled after a 10minute delay. Cuing can be used to distinguish patientswho can acquire new information but have difficulty recalling it from those whocannot acquire the information. Cuing statements for the pairs are their similarity.For the items above, the patient is cued with: fruit, directions, transport, tools, andliving things.Verbal absurdities: Understanding verbal absurdities requires reasoning. Thepatient is asked to consider if there is anything wrong with the followingstatement, and if so what that might be:“A man had the flu twice. The first time he died, but the second time he recovered.”“The railroad company discovered that in train accidents the first and the last cars of thetrain are usually the most damaged. So, to save money they are now going to send trains out ofthe station without the first and last cars.”These statements seem ridiculously obvious to the novice examiner, but experiencedclinicians know the poignancy of watching a PhD or CEO offer a concreteanswer such as “Well, you don’t need the last car, but you need the first one topull the train.”