Foundations of Psychology

CHAPTER
Biological and neuropsychology

Loraine Townsend, Kirston Greenop & Mark Solms
7
CHAPTER OBJECTIVES
After studying this chapter you should be able to: • describe the action and dysfunction of neurotransmitters
• describe the organisation of the nervous system • explain why the hormones sent out by the endocrine system
• explain the structure and function of the different areas of the affect the body more slowly than the nerve impulses sent out
hindbrain, the midbrain and the forebrain by the nervous system
• apply knowledge about the cerebrum when trying to under- • identify and describe the origins and basic assumptions of
stand brain damage neuropsychology
• explain what happens in a split-brain patient • discuss the role of neuropsychology in South Africa
• compare the processes of the sympathetic and parasympa- • identify and describe the various methods used in modern
thetic divisions of the peripheral nervous system neuropsychology, and describe the circumstances under
• describe the structure of neurons and synapses which they are used.
• explain communication within neurons and between neurons
CASE STUDY
Melinda became aware of the effects of brain damage when her had resulted in what is known as unilateral neglect, where patients
granny had a stroke. Melinda’s granny was 66 years old and had generally do not pay attention to the left side of their bodies.
had problems with her high blood pressure medications. A neigh- Being a neuropsychologist was not something that Melinda had
bour had found her granny unconscious on the floor at home and ever contemplated as a career choice. Like most people she hadn’t
rushed her to hospital. When Melinda asked her granny if she really known such a profession existed or what it was that neu-
recalled what had happened, she could only remember feeling ropsychologists might do. She knew that there were medical spe-
dizzy while making tea. cialists called neurosurgeons who operated on the brain, but she
Melinda often went to visit her granny in hospital, but noticed hadn’t really thought about how a psychologist might be involved
that her behaviour had changed. Melinda’s granny would only in working with people who had experienced some kind of neu-
notice her and talk to her if she was on the right-hand side of her rological problem. But as Melinda discovered how important the
bed and ignored anyone standing on the left side of the bed. She brain was for all our human experiences, she found herself grow-
also had trouble dressing and washing herself, as she seemed to ing increasingly fascinated with this relatively new but rapidly
ignore the left side of her body. She only washed the right side of growing area in psychology.
her face and dressed the right side of her body and the nurse had People often spoke about the centre of themselves being their
to do the rest. A CT scan (a type of X-ray) revealed that her granny heart, but Melinda began to realise that it was more likely your
had had a stroke in the right occipital-parietal region at the back of brain that made you who you were. A brain injury could change
her brain. From her studies in neuropsychology, Melinda could everything about you, who you felt you were and how you ex
understand why her granny acted in this strange manner. The injury perienced the world.
chapter deals with the brain, the way messages are com
Introduction municated through the body via the nervous system, and
In the case study, Melinda witnessed the effects of an it also touches on the endocrine system.
injury to the brain. To understand what happened to Psychologists could be involved in diagnosing different
Melinda’s granny we have to understand the psychobiol kinds of damage to the brain and helping people with the
ogy of the brain, which is a part of the nervous system. effects of these. Understanding more about this amazing
However, the brain is also affected by the rest of the nerv organ might make it possible not only to help people who
ous system and by the endocrine system. Therefore this have suffered brain disease or injury, but also to
9780190422349_Foundations_of_Psychology.indb 161 29-10-2015 11:02:58AM

Part 4 Brain and behaviour
understand the complex processes that occur in the (the second part). The neurons in the white matter are
minds of normal people. Understanding these better more insulated than those in the grey matter. Pairs of spi
might help with all sorts of psychological problems. The nal nerves are attached to the spinal cord at 31 points on
psychologists who specialise in this area are called the spine. These nerves pass signals from the environ
neuropsychologists. ment to the spinal cord and then transmit the response
Neuropsychology links knowledge from two disciplines: from the spinal cord to the body. When the spinal cord is
neurology and psychology. A neurologist is a medical damaged, there is no way for the body to communicate
doctor who specialises in brain and nervous system disor with these nerves. At the top of the spinal cord a bulge
ders, while a neuropsychologist looks for the relation starts to form which is the start of the brain (the medulla
ships between the mind and the brain. This has often been oblongata).
called the mind–body or mind–brain problem and has The brain is about the size of a large grapefruit, looks
been studied and debated for centuries. like a wrinkly walnut and has the consistency of por
Neuropsychology can be divided into two major divi ridge. Because of its important functions and soft con
sions: research neuropsychology and clinical neuropsy- sistency, it is the most well-protected organ in the body.
chology. The two overlap considerably. However, in Carlson (2005) notes that this protection takes the form
general, research neuropsychologists are interested in how of cerebrospinal fluid, meninges and the skull. The brain
mental functions are organised in the brain, and what the floats in cerebrospinal fluid, which both nourishes it
study of the brain (both when healthy and when diseased) and protects it from bumps and knocks. The meninges
can reveal about the organisation of the mind. Clinical are the membranes that surround the brain, protecting
neuropsychologists, on the other hand, are more con it and storing the cerebrospinal fluid. Surrounding these
cerned with the practical application of this knowledge: is the skull, which forms a solid box that protects the
the diagnosis and management of the mental aspects of brain. The major structures of the brain are shown in
neurological disease. These aspects will be described in Figure 7.1.
more detail later in the chapter.
Hypothalamus
The nervous system Cerebral
cortex Parietal
The nervous system is made up of over 100 billion cells lobe
Frontal
called neurons. In a later section, we will describe the lobe Occipital
Corpus lobe
structure and functioning of neurons. The nervous system callosum Thalamus
is responsible for collecting information from the envi
ronment, sending this information to the right places in Pituitary Midbrain
the body and then enabling the body to respond to this gland
Pons Cerebellum
information. The nervous system can be divided into the Medulla
central nervous system and the peripheral nervous Spinal Central canal
cord of the spinal
system. cord
Figure 7.1 The major structures of the brain (adapted from Kalat,
The central nervous system 2001, p. 97)
The central nervous system is made up of the spinal cord
and the brain. The spinal cord is found in the spinal col We can take two approaches to describing the brain: (1) by
umn that runs down the middle of the back. It commu looking at the regions of the brain in the order in which
nicates with all the muscles and sense organs of the body they developed during evolution, and (2) based on how it
below the head. If you were to cut the spinal cord in half, appears to be divided into two sides called hemispheres.
you would see that it has two parts. The inner part looks We shall start by discussing the former, which divides the
like an H and is grey in colour. It is called grey matter. brain into the hindbrain, the midbrain and the forebrain
It is surrounded by lighter tissue, called white matter (see Figure 7.2).
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Chapter 7 Biological and neuropsychology
7.1 THE CASE OF HM
Source: Wortman, Loftus and Weaver (1999) and Ogden
Forebrain and Corkin (1991)
HM was a young man who suffered from debilitating epilepsy,
Midbrain often suffering up to 10 seizures a day. His epilepsy became
worse and the drugs used to treat it were not working. As a
Hindbrain
result, relationships between the members of his family
became strained. As surgery at that time was very popular and
no other treatments were working, his doctors suggested psy-
chosurgery in 1953. The surgeons decided to operate on HM’s
Figure 7.2 The brain can be divided into the forebrain, midbrain brain and they used a silver straw to remove the parts of the
and hindbrain brain (the amygdala and hippocampus) that were causing the
seizures. Although subsequent studies of the regions that
were removed did not locate the precise site of his epilepsy,
• The central nervous system consists of the spinal cord HM’s seizures grew less and were not as intense. But the side
SUMMARY
and the brain. effects of the surgery were extreme: HM could no longer
• The spinal cord: remember things, his long-term memory was impaired and
»» is in the spinal column he could no longer form new memories. He could remember
»» communicates with all the muscles and sense organs things from before the surgery, but nothing afterwards. He
of the body below the head would complete the same crossword puzzle over and over
»» consists of grey matter surrounded by white matter because he forgot that he had seen it before and he ‘met’ his
(which provides insulation). doctors for the first time every day.
• Pairs of spinal nerves pass signals from the environment
to the spinal cord and from the spinal cord to the body.
The hindbrain
• The medulla oblongata at the top of the spinal cord is the
The hindbrain is made up of the medulla oblongata, the
start of the brain.
pons, the cerebellum and portions of the reticular forma
• The brain:
tion (which is discussed as part of the midbrain).
»» is protected by cerebrospinal fluid, the meninges, and
The medulla oblongata is the first structure in the tran
the skull
sition from the spinal cord to the brain. The medulla is
»» can be described in terms of regions or in terms of its
responsible for breathing, circulation, the functioning of
hemispheres.
the heart, and other involuntary behaviours such as vom
iting, coughing, sneezing, hiccupping and blinking if
The hindbrain, midbrain and forebrain something flies towards your eye. From this description
We can describe the different parts of the brain by looking you can see that any damage to the medulla could result
at the regions of the brain in the order in which they in death, as breathing or the functioning of the heart would
developed during evolution. From this point of view, you be affected (Holt et al., 2012).
will see that the earliest parts of our brain to evolve are the The pons (which means ‘bridge’ in Latin) is directly
ones responsible for our most important survival func above the medulla oblongata. The pons acts like a relay
tions. Only later in evolution did humans develop the station, sending signals from the spine to the brain and
skills of complex thinking such as planning and organis from the brain to the spine. Holt et al. (2012) note that the
ing their worlds. The following categorisation of the brain pons also plays a role in sleeping and waking. Narcolepsy
into the hindbrain, midbrain and forebrain refers to when is a disorder in which a person may fall asleep anywhere
the regions of the brain evolved as well as to their location and at any time, and people suffering from this have been
in the head. The hindbrain is at the bottom near the back, shown to have unusual neural activity in the pons.
the midbrain is near the centre of the brain, and the fore The cerebellum (or small brain) is located at the back of
brain is at the top and front of the brain. the brain. It is responsible for coordinated movement,
163

alance and posture. This structure is affected when you

b The limbic system is not a single structure, but is made
are drunk. When the police test people who are drunk, up of a few structures to create a system (see Figure 7.3). It
they are determining the extent to which the cerebellum is involved in emotion, memory, learning and motivation.
has been affected by alcohol, thus indicating the amount The most important parts are the amygdala and the hip
of alcohol they have had. pocampus. The amygdala is involved in experiencing many
As an example, put your arm out sideways at shoulder emotions, learning and memory for emotional events. Most
height and face forward; then bend your arm and, using importantly, the amygdala is responsible for recognising
your index finger, touch your nose. People who are drunk fear in other people and feeling fear. The hippocampus is
cannot touch their noses and often miss or do it very responsible for certain kinds of memory (see Box 7.1).
slowly because they have to concentrate very hard.
The midbrain Thalamus

The reticular formation is a structure that begins in the
hindbrain and continues through to the midbrain. It is made Mamillary body
up of many neurons that connect to all the areas of the brain.
The reticular formation is responsible for arousal and Olfactory bulb
sleep/wake consciousness. Brain arousal is the state of read
iness for activity and varies in intensity. For example, you Amygdala
would want a heightened state of arousal when you wrote
Hippocampus
an examination, but would need less arousal to watch tele
vision. If the reticular formation is damaged, a permanent Figure 7.3 The limbic system (adapted from Peterson, 1997)
state of sleep or coma (Holt et al., 2012) can result.
The basal ganglia are involved in movement. When these
The forebrain structures are damaged, changes in posture, muscle tone and
The forebrain was the last area of the brain to develop in normal movements can occur (Chakravarty, Joseph & Bapi,
the course of evolution and is involved in complex cogni 2010). When a person has Parkinson’s disease, the dopamine
tive functions, sensory processes and emotions. The neurons start to die. These neurons are meant to project out
forebrain comprises the thalamus, the hypothalamus, to the basal ganglia and, if they no longer exist, those areas
the limbic system, the basal ganglia and the cerebrum. The in the basal ganglia that received them also die. The basal
cerebrum is part of the cortex or outer layer of the brain, ganglia have also been implicated in mood and memory.
but the thalamus, hypothalamus, and limbic system are all The cerebrum makes up the largest section of the fore
subcortical structures as they are below the cortex. brain and is the most complex. It is covered by the cere-
The thalamus is the first structure to process incoming bral cortex which consists of a layer of grey matter a bit
sensory information before relaying it to the appropriate more than 0.5 cm thick. The cortex is wrinkled like a crum
area of the brain for further processing. This is similar to pled piece of paper and so contains a relatively large sur
the information desk in a shopping centre – when you walk face area (about the size of a pillowcase if it was smoothed
into a new shopping centre, you could go to the informa out). The cerebral cortex represents the furthest develop
tion desk to find out where you would find a specific shop. ment in brain evolution. Fish do not have a cerebral cortex,
The thalamus is also active in emphasising certain mes whereas in humans, it forms 80 per cent of brain tissue.
sages over others. The cerebrum comprises four lobes: the frontal, temporal,
The hypothalamus is a very small structure that is found parietal and occipital lobes (see Figure 7.4). In these lobes
below the thalamus. It is involved in many different there are primary areas and association areas. The primary
activities. The hypothalamus controls the pituitary gland, areas are those areas of the cerebrum that process primary
which is the main gland affecting all the other glands in the or raw sensory information. Information is received by the
body. This is the link between the nervous system and the sensory receptors through the thalamus and is directed to the
endocrine (gland and hormone) system. The hypothalamus primary areas. These neurons are more specific (e.g. to vision
is involved in emotions, regulating body rhythms for sleep, or taste) than ones in the association areas. The association
sexual activity, temperature regulation, hunger and thirst. areas are involved in the more complex mental functions.
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Motor area (voluntary movement) Somatosensory cortex (sensation)
Frontal lobe
Parietal lobe
Wernicke’s area (speech hearing)

Auditory area (understanding)
Occipital lobe
Visual area (sight)
Broca’s area (speech formation) Temporal lobe
Figure 7.4 The frontal, parietal, temporal and occipital lobes
To illustrate the difference between the primary areas and A specific area found in the left frontal lobes (in most
the association areas, imagine that you see a bicycle. The people) is involved with language. This is Broca’s area,
sensory information about shape, lines, colour and move named after the man who isolated it. This area is respon
ment would come from the eye, through the thalamus, to sible for the expression of speech or the motor activities
the occipital lobe of the cerebrum. The neurons in the pri that comprise speech. People with Broca’s aphasia may not
mary areas in the occipital lobe are sensitive to noting be able to talk, but they can usually still understand speech
specific lines, colours and movement, and are therefore (Davey, 2004).
stimulated by this information. The visual association area The cerebrum’s temporal lobes are on the sides of the
then receives this information and makes meaning from brain and are mainly responsible for hearing and lan
it, determining that it is a ‘bicycle’. Knowing that those guage. The primary areas receive the frequency, amplitude
lines, shapes and colours represent a bicycle is a result of and pitch of the sounds and the association areas combine
learning what a bicycle looks like. these into words that we recognise. Language is also rep
The cerebrum’s frontal lobes are located in the front of the resented in this cortex and Wernicke’s area is located in
brain and are responsible for many abilities ranging from the left temporal lobe (in most people). This area is respon
movement to higher cognitive functioning. The frontal lobes sible for understanding speech. If you had Wernicke’s
can also be divided into sub-areas. The motor cortex is aphasia, you would still be able to speak, but you would
located at the back of the frontal lobes and is responsible for not make any sense and you would not understand what
movement. This area receives information from the spinal others were trying to say.
cord, the cerebellum and the basal ganglia, and is involved Although hearing and language are emphasised as the
in voluntary movements such as walking, jumping, running main functions of the temporal lobes, they are also
and threading a needle. The motor cortex has different areas involved in visual association. After information from the
dedicated to different parts of the body. For example, one visual system has been processed in the primary areas in
area is dedicated to the mouth and another to the hands. the occipital lobes, the visual association areas in the tem
However, each body part has a different-sized area dedicated poral lobes identify what an object is.
to it. Parts of the body that are sensitive, complex and used The cerebrum’s parietal lobes are located at the top of
frequently, such as the hands, have larger areas dedicated to the brain and contain the somatosensory cortex. This is
them than parts that are not as skillful, such as the thighs. a band of brain area that mirrors the motor cortex and
The association areas in the frontal lobes are involved in which receives sensory information from the body. The
personality and in higher-order thinking such as planning, parietal lobes are also responsible for locating the position
organisation, abstract thought, coordinating skilled move of objects, the sense of touch, detection of movement and
ments and memory. If the frontal lobes are damaged, a spatial orientation (how one’s body is located in space).
person may experience difficulties with these aspects, for Damage to this area could result in the syndrome called
example losing the ability to think abstractly, to plan and unilateral neglect, where patients do not pay attention to
organise behaviour and activities, to adjust socially, or to one side of their bodies.
behave appropriately.
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The cerebrum’s occipital lobes are located at the back other by a thick band of tissue called the corpus callosum,
of the brain and are responsible for vision. If someone hits which allows communication between the two.
you on the back of the head and you see stars, this is It seems that each hemisphere is responsible for, or dom
because the primary visual areas in the occipital lobes inant over, some specific functions. This division of tasks
have been affected. Damage to the primary visual area can between the hemispheres is referred to as lateralisation
result in partial or complete blindness. The association because the functions differ depending on the side of the
areas in the occipital lobes extend to other areas of the brain where located. Thus, when some ability is lateralised,
cortex and are responsible for organising the information it is understood to be located in either the left or the right
from the primary areas into more complex pictures of the hemisphere.
features of objects. In many people, the left hemisphere has been implicated
in speech and language, and the right hemisphere has
been implicated in spatial functions (Holt at al., 2012). One
7.2 CONSCIOUSNESS source that supports the idea of lateralisation is the records
A topic that has puzzled brain researchers for a long time is doctors have made regarding ‘split brain’ patients (Holt
consciousness. What is consciousness? What parts of the brain et al., 2012). Split-brain patients are people who have had
or brain activity are necessary for consciousness? their corpus callosum severed by a surgeon to stop debil
Consciousness mainly means being aware, alert and attentive, itating epileptic seizures. In many cases these patients
and also includes inner self-knowledge. From this definition experience changes in their behaviour and functioning
you can see that consciousness is a very subjective experience following surgery.
and measuring it has proven to be very difficult. In terms of
brain anatomy, researchers have not found one specific area Left visual field Right visual field
of the brain related to consciousness (not least because it is Fixation point
such a hard concept to define).
The main area of research into brain anatomy and con-
sciousness is the problem of binding – that is, the way in
which the brain takes many different aspects of information
from all over the brain and binds them together to form a
subjective experience. This implies that different brain regions
are involved, depending on what part of consciousness you
are studying.
One important area of research into consciousness involves
the frontal lobes. In this research the focus is on executive func-
tioning in terms of self-reference and self-evaluation. But it is
clear that research on consciousness is determined by the defi-
nition of consciousness and the aspects of consciousness being
focused on. In general, every area in the brain has been shown
to link to the study of consciousness (Zillmer & Spiers, 2001).
The left hemisphere and the right hemisphere

of the brain
While the brain can be viewed as being made up of the hind
brain, the midbrain and the forebrain, it can also be viewed
as being formed by two hemispheres, left and right. Thus, the
hindbrain, midbrain and forebrain each have two parts, one Severed
corpus callosum
that falls in the left hemisphere and one that falls in the right
hemisphere. For example, you would have a left forebrain Figure 7.5 The visual pathway in the brain (adapted from Holt
and a right forebrain. These hemispheres are linked to each et al., 2012)
166

Figure 7.5 illustrates the normal visual pathway in the

brain. Information from the left visual field goes to the »» The basal ganglia are involved in movement, mood
right hemisphere and information from the right visual and memory.
field goes to the left hemisphere. The information crosses »» The cerebrum makes up the largest section of the
over at the optic chiasma. However, if the corpus callosum forebrain and is the most complex. The cerebrum
were severed, the information would not be able to be is covered by the cerebral cortex and comprises
communicated between the hemispheres. four lobes (frontal, temporal, parietal and
According to Figure 7.5, if you showed a split-brain occipital lobes); in these lobes there are primary
patient an ice-cream in their left visual field, this informa areas (for processing sensory information) and
tion would travel to the right hemisphere, but the right association areas (for more complex mental
hemisphere could not tell the left hemisphere what it saw functions):
because language is controlled in the left hemisphere. The »» The frontal lobes contain the motor cortex which is
patient would therefore not be able to tell you what responsible for movement.
he/she saw. »» Broca’s area in the left frontal lobes is involved with
However, if you showed the same patient a flower in the language.
right visual field, which was then transmitted to the left »» The temporal lobes are on the sides of the brain
hemisphere, he/she would be able to tell you what was and are mainly responsible for hearing and lan-
seen because language is controlled in the left guage; Wernicke’s area in the left temporal lobe is
hemisphere. responsible for understanding speech.
»» The parietal lobes are located at the top of the
brain; they contain the somatosensory cortex
• The brain can be categorised into hindbrain, midbrain and which receives sensory information from the
body.
SUMMARY
forebrain; in evolutionary terms, the hindbrain developed

earliest. »» The occipital lobes are located at the back of the
• The hindbrain is made up of the medulla oblongata, the brain and are responsible for vision.
pons, the cerebellum, and portions of the reticular • The brain can also be viewed as having a left hemisphere
formation: and a right hemisphere. Thus, the hindbrain, midbrain and
»» The medulla is responsible for breathing, circulation, forebrain each have two parts, one in the left hemisphere
the functioning of the heart and other involuntary and one in the right hemisphere.
behaviours. • The hemispheres are joined by a thick band of tissue, the
»» The pons acts like a relay station, sending signals from corpus callosum.
the spine to the brain and from the brain to the spine. • Certain functions are dominant in one or other hemi-
»» The cerebellum is responsible for coordinated move- sphere; this is called lateralisation. Generally, the left
ment, balance and posture. hemisphere is associated with speech and language, and
• The midbrain consists of the reticular formation; this is the right hemisphere with spatial functions.
responsible for arousal and sleep/wake consciousness. • In terms of the visual pathway, information from the visual
• The forebrain consists of the thalamus, the hypothalamus, fields crosses over to the opposite hemisphere at the optic
the limbic system, the basal ganglia and the cerebrum: chiasma.
»» The thalamus processes incoming sensory information
before relaying it to other areas of the brain for further
processing. The peripheral nervous system
»» The hypothalamus is involved in many different
activities; it controls the pituitary gland and links with The peripheral nervous system consists of all the nerve
the endocrine system. structures that lie outside the brain and spinal cord. It con
»» The limbic system is made up of several parts (most stantly communicates with the central nervous system
importantly, the amygdala and hippocampus); it is through two sets of nerve pathways. The first receives
involved in emotion, memory, learning and motivation. information from the environment through the sensory
receptors and sends this information to the central
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Nervous system
Central nervous system Peripheral nervous system
Brain Spinal cord

Afferent Efferent
system system
Forebrain Midbrain Hindbrain
Somatic system Automatic system

(voluntary muscle (controls smooth
Thalamus Hypothalamus
activation) muscle, cardiac muscle
and glands ; basically
involuntary)
Cerebrum Limbic Corpus Cerebellum Pons Medulla

(cerebral cortex) system callosum Sympathetic Parasympathetic
Reticular formation (generally activates) (generally inhibits)
(begins at the level of the
medulla and runs up through the
brain to the level of the midbrain)
Figure 7.6 The organisation of the nervous system (Holt et al., 2012)
nervous system. The second takes information from the systems are involved in the body’s reaction to stress: the
central nervous system to the muscles and glands, giving fight-or-flight response. The two systems work together to
them directions on how and when to act or move. The maintain homeostasis (a balanced internal state). The
peripheral nervous system has two main parts: the somatic sympathetic nervous system is used to get the body ready
and a utonomic nervous systems. for action (whether this is fighting or preparing for an
injury). This involves:
The somatic nervous system • dilating or widening the pupils to take in as much light
The somatic nervous system carries messages from the as possible to see the stressor
sensory receptors to the brain and spinal cord and also • relaxing the bronchi in the lungs, allowing large
carries messages from these central nervous system struc amounts of air to come into the lungs
tures to all of the muscles attached to bones in the body. • increasing the heart rate so that more oxygen is
These muscles control voluntary movement and they pumped around the body
allow you, for instance, to jump, walk, bend – or scratch • closing down the digestive system slightly to make
your head. energy available to other areas of the body
• constricting the blood vessels so that blood pressure is
The autonomic nervous system increased.
The autonomic nervous system controls all the other
muscles, which are attached to your internal organs and Once the body has reacted to the stress by either fighting
glands in the body. The muscles attached to the autonomic or running away, the parasympathetic system inhibits the
division control mainly involuntary actions, such as the action and relaxes the body. This is done by:
secretion of hormones or the beating of the heart. • contracting the pupils to normal size
However, this latter process is not completely involuntary, • contracting the bronchi
as people can often affect their heartbeat by using relaxa • slowing the heart rate so that you do not constantly
tion techniques. have a racing heart
The autonomic nervous system is divided into the sym • reactivating the digestive system
pathetic and parasympathetic nervous systems. These two • dilating the blood vessels once again.
168

• The peripheral nervous system consists of all the nerve thereby controlling mainly involuntary actions. The
SUMMARY
structures that lie outside the brain and spinal cord. ANS contains two systems (sympathetic and parasympa-
• The PNS constantly communicates with the CNS, sending thetic) which work together to keep a balanced interna
information from the sensory receptors to the CNS and from state:
the CNS to the muscles and glands. »» The sympathetic nervous system gets the body ready for
• The PNS has two main parts, namely the somatic and auto- action (fight or flight).
nomic nervous systems. »» Once the stress is past, the parasympathetic system relaxes
• The somatic nervous system controls voluntary movement. the body.
• The autonomic nervous system (ANS) controls all the other
muscles attached to internal organs and glands in the body,
body, and the axon, which carries electrical impulses to

Neurons and neural other neurons, or muscles and glands.
transmission The electric impulse or message travels down the neuron
and passes across to the next neuron. The message starts
The nervous system is made up of billions of intercon at the dendrites which receive the message from other
nected cells that are constantly communicating with one neurons. Because the dendrites have so many branches,
another. A neuron is a type of cell found in both the central they can receive messages from 1 000 or more adjacent
and peripheral nervous systems; it is specialised to receive neurons (Davey, 2004). This message then travels through
and transmit electrochemical signals in the body. These the cell body of the neuron (the soma), where the mes
signals use both electricity and chemicals to make sure sages from the dendrites are processed. The message then
that their message is transmitted. travels down the axon of the neuron, which transmits the
message to other neurons. The message arrives at the axon
terminals (the end of the neuron) from where it is passed
The structure of neurons on to other neurons.
Neurons can vary widely in shape and size, and many dif The neuron axon may be covered with a myelin sheath,
ferent types of neurons have already been identified which serves to insulate the axon and make the message
(Davey, 2004). Figure 7.7 shows the structure of a typical stronger and travel faster. Similarly, myelinated axons
neuron. Each neuron has three main parts: the soma (or transmit messages faster and more efficiently than
cell body), the dendrites, which emerge from the cell non-myelinated axons. The myelin sheath develops in the
Soma (cell body) Nucleus

Axon terminals
Dendrites Myelin sheath
Axon
Axon hillock
direction of impulse
Figure 7.7 The components of a neuron
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early stages of human development. Multiple sclerosis is The transmission of nerve impulses
a disease that breaks down the myelin sheath and uncov
Neurons are cells that have an electrical charge inside
ers parts of the axon. This affects the transmission of mes
them. The electrical charge inside the neuron is main
sages that travel from the brain to the muscles, causing an
tained at about −70 millivolts (one thousandth of a volt).
interruption in the message and an effect on movement,
The message that travels down the neuron does so as a
for example (Feldman, 2014).
wave of electrical activity. But how does this actually work?
Some substances travel in the opposite direction, from
Atoms are the basic unit of matter. When an atom has all
the axon terminal buttons to the cell body, so that food and
the electrons it is meant to have, it does not have an electrical
nourishment reach the cell body. Certain diseases (e.g. Lou
charge. But when it has lost one or more electrons, or gained
Gehrig’s disease or amyotrophic lateral sclerosis) affect
one or more electrons, it does have an electrical charge, and
this reverse movement so that the neuron eventually dies
it is then called an ion. An atom that has lost one or more
from starvation. Other diseases, such as rabies, travel in a
electrons is a positively charged ion, and an atom that gained
reverse direction up the neuron (Feldman, 2014).
one or more electrons is a negatively charged ion. The
Action potential
Resting potential
Axon Na+ Na+
– – – – – + + + + +
Ion
channels + + + + – – – – –
– – – – – + + + + +
Na+ Na+
Na+
Action potential
+ + + + + – – – – –
– K+ – – K+ – – + + + + +
K+ K+
+ + + + + – – – – –
Axon repolarises
Figure 7.8 The action potential in the neuron (sodium ions travel into the cell and a small number of potassium ions travel out) (Coon
& Mitterer, 2013, p. 42)
170

Action potential
neuron’s cell membrane is like a sieve, allowing some ions to
pass through ion channels but stopping or limiting others. +40 Potassium
A neuron contains ion-filled fluid with protein mole ions
cules (negatively charged ‘anions’) and potassium ions flow out
Voltage (millivolts)
(positively charged). The neuron is surrounded by a 0
slightly different ion-filled fluid containing chloride ions Resting
(with a negative charge) and sodium ions (with a positive membrane Retum to
potential resting
charge). When the neuron is in a resting state, the inside
membrane
of the neuron is mainly negatively charged and the outside Sodium
potential
ions
is mainly positively charged. This state of tension between flow in
the ions is called the resting potential. When in this rest –70
ing state, we say the neuron is polarised.
As with all things with electrical charges, like charges
repel each other and opposite charges attract each other. 1 2 3 4 5
As the inside of the neuron is negatively charged, chloride, Time (milliseconds)
which is also negatively charged, is repelled by the neuron
Figure 7.9 The process of an action potential (Holt et al., 2012,
and therefore stays outside the neuron. As the outside of
p. 102)
the neuron is positively charged, potassium, which is also
positively charged, is repelled by the outside fluid and
3. As the cell returns to its resting potential (−70 mv), the
therefore stays inside the neuron.
potassium channels close. The cell returns to its normal
Sodium is also positively charged, and is therefore
state and waits for the next depolarisation incident.
attracted to the inside of the cell, which is predominantly
4. This sequence is repeated along the axon as the mes
negative, and repelled by the outside of the cell, which is
sage is passed down the cell.
predominantly positive. Overall, the neuron’s semi-
permeable membrane is not very permeable to sodium. The electrical impulse that travels down the neuron follows
This means that even though sodium is attracted to the an all-or-none law. This law states that the electrical
inside of the cell, it cannot cross the membrane. impulse will either be passed down the cell or not. Feldman
When a nerve impulse comes along, the interior voltage (2014) compares this to a gun: you either pull the trigger
in the neuron changes from −70 mv to +40 mv. This takes and the gun fires, or you do not pull the trigger and the gun
about one millisecond and is called the action potential. does not fire – there is no in-between.
The action potential is an electrochemical process as the Some neurons fire at different rates to others. For exam
neural message is electrical and the ions in the surround ple, some can fire at 200 times per second while others can
ing fluid are chemical (see Figure 7.8). fire far fewer times in the same period. The intensity of the
The graph in Figure 7.9 illustrates the different stages of stimulus (e.g. a loud noise versus a whisper) determines
an action potential. The straight line at −70mv is the cell in the rate of firing. Researchers can also measure the rate of
the resting potential. According to Carlson (2005), when firing to determine how intense our reactions are to
an action potential is realised, certain stages occur. various stimuli (Feldman, 2014).
1. When the threshold of excitation is reached, the perme Synaptic transmission

ability of the cell membrane changes, causing sodium When the electrical impulse reaches the end of the neuron
ions to rush into the cell. This stage is called depolarisa- it needs to pass the message onto another neuron. The
tion. The cell becomes positively charged (up to +40 mv). difficulty is that the terminal buttons from the first neuron
2. As the cell becomes more positively charged, the and the dendrites of the second neuron do not actually
potassium channels open and the potassium ions start meet. Between the two neurons is a space called the
to leave the cell. The sodium channels are now closed synaptic gap. The electrical impulse has to pass over this
and no more sodium ions can flow into the cell. This gap to make sure that the message continues in the next
is known as the refractory period (the cell cannot neuron. The process of synaptic transmission is a chemical
pass another message in this recovery state). process, and is illustrated in Figure 7.10.
171

Nerve
impulse
Vesicles without
neurotransmitters
travelling back to Transmitter does
cell body not fit receptor
Neurotransmitter
Axon terminal molecules
Synaptic gap
Receptor site
Transmitter
Dendrite of fits receptor
receiving neuron (a) (b)
Figure 7.10 The synaptic gap (a) and the process of transmission (b) (adapted from Peterson, 1997)
The structure and action of a synapse neurotransmitters and their action. Box 7.3 illustrates how
A synapse is the region where two neurons meet. The ter Ecstasy, an illegal drug, affects neurotransmitters and their
minal buttons of the first neuron sit close to the dendrites action.
of the second neuron. The gap in between the terminals
and the dendrites is the synaptic gap. There are small sacs
called vesicles in the first neuron that contain neurotrans 7.3 THE EFFECTS OF ECSTASY
mitters. When a nerve impulse reaches the terminal Source: Burgess, O’Donohue and Gill (2000)
buttons, it stimulates the vesicles to release the neurotrans Ecstasy, often called E, is an illegal drug that many people
mitters into the synaptic gap. The receptor sites on the consider to be a safe party drug. Its chemical name is MDMA
second neuron then pick up the neurotransmitters. (3, 4-methyl-enedioxymethamphetamine) and it is usually
However, receptor sites are specialised and will only receive taken in pill form and has effects lasting two to six hours. The
the neurotransmitters for which they were designed. For immediate effects include feelings of euphoria, empathy
example, in Figure 7.10 you can see that the circular recep towards others and a heightened sense of touch. Negative
tor sites can only receive circular neurotransmitters and not effects can include jaw clenching, jumpiness, mental prob-
triangular ones. This is similar to a lock-and-key mecha lems such as confusion, anxiety, sleep disruption and poor
nism: only one key can fit a lock and open it. judgement, headaches and nausea, as well as increased heart
Once the receptor site has accepted the neurotransmit rate and blood pressure. After a few days, people report feel-
ter, it starts or inhibits an action potential in the second ing sad, despondent and irritable. Prolonged use of Ecstasy
neuron, depending on the function of the neurotransmit results in the degradation of terminal buttons that secrete
ter. Excitatory neurotransmitters start an action potential serotonin (a mood neurotransmitter). When these buttons are
in the following neuron while inhibitory neurotransmit- affected, people may develop depression, anxiety and sleep
ters stop the next action potential. problems.
Once the neurotransmitters have been released into the The way that Ecstasy works is that when extra neurotrans-
synaptic gap and all receptor sites have received neuro mitters are taken back into the first cell, Ecstasy replaces
transmitters, there are likely to be extra neurotransmitters serotonin, dopamine and norepinephrine. Since serotonin,
left in the gap. These extra neurotransmitters are either dopamine and norepinephrine stay in the synaptic gap, they
broken down by enzymes or taken back up into the first continue to stimulate the receptor sites. However, because
neuron’s terminal buttons. the serotonin axons are then overstimulated they die off. Once
Chapter 24 on psychopharmacology outlines the neuro this happens, they cannot be replaced.
transmitter process and explains how drugs can affect
172

Types of neurotransmitters that the mood neurotransmitters have a better chance to

work at the synaptic gap.
Over 50 different neurotransmitters have been identified.
This section will concentrate on a few of the most well-
Serotonin
known and well-researched neurotransmitters (also see
Serotonin is one of the most well-known neurotransmit
Table 7.1).
ters and is involved in mood, sleep, eating and arousal.
Low levels of serotonin result in depression. The drug
Dopamine
Prozac is a selective serotonin re-uptake inhibitor (SSRI).
Dopamine is found in the brain, especially in the limbic
This means that it stops serotonin from being taken back
system, the cerebellum and the basal ganglia. It is involved
up into the first neuron, causing it to stay in the synaptic
in thought disorders such as schizophrenia (too much
gap and stimulate the next neuron for longer.
dopamine) and movement disorders such as Parkinson’s
disease (too little dopamine). Parkinson’s disease is a dis Acetylcholine
order of movement and causes people to have problems Acetylcholine or ACh is involved at the level of muscle
coordinating movement and to experience tremors when movement as well as learning and memory. An absence
at rest. The drug L-Dopa provides temporary relief as it of ACh is associated with paralysis while on oversupply
mimics or pretends to be dopamine. Drugs used to block may lead to severe muscle contractions and convulsions
dopamine may alleviate schizophrenia; however, one must (Holt et al., 2012). People with Alzheimer’s disease have
be careful with these drugs because they may cause lower levels of ACh than others. Alzheimer’s disease
Parkinson’s-like symptoms when they are taken in large involves a gradual degeneration in terms of memory and
doses. cognition.
Norepinephrine Gamma amino butyric acid (GABA)

Norepinephrine is derived from epinephrine (adrena Gamma amino butyric acid (GABA) is an inhibitory neu
line). It is involved with mood, sleep, eating and arousal. rotransmitter and is involved in emotion, anxiety, arousal
When their levels of norepinephrine are too low, people and sleep. Parrott, Morinan, Moss and Scholey (2004)
experience depression (Holt et al., 2012). Anti- note that many benzodiazepines (such as Valium, Xanax
depressants, the drugs used to treat depression, work by and Librium) act by increasing the effect of GABA. As
either pretending to be a neurotransmitter involved in GABA is inhibitory, increasing its effects will lower
mood, or by blocking the uptake of neurotransmitters so anxiety.
Table 7.1 Examples of some neurotransmitters, their locations, their functions, and what happens when they are disordered
(Feldman, 2014)
Neurotransmitter Location Function Dysfunction

Dopamine The brain (especially the basal Movement, mood, learning, Muscle disorders, mental
ganglia, the cerebellum and the memory disorders, Parkinson’s disease
limbic system)
Norepinephrine The brain (especially the cortex Eating, sleep, arousal, emotion Depression
and the limbic system), and the
spinal cord
Serotonin The brain (especially the thalamus Sleep, arousal Depression
and the brain stem)
Acetylcholine (ACh) The brain, spinal cord and peripheral Muscle movement, cognitive Alzheimer’s disease
nervous system function including memory
Gamma amino butyric The brain and spinal cord Eating, aggression, sleep, arousal Anxiety, sleep disturbances,
acid (GABA) arousal difficulties
173

• The nervous system is made up of billions of • The action potential is an electrochemical process (the neural
SUMMARY
interconnected cells. message is electrical and the ions are chemical).
• Neurons are cells found in both the CNS and the PNS. • The stages of transmission include depolarisation, action
• Neurons receive and transmit signals in the body using both potential and the refractory period.
electricity and chemicals. • The electrical impulse will either be passed down the cell
• Neurons vary widely in shape and size; they consist of a soma, or not.
dendrites and an axon. • Some neurons fire at different rates to others.
• Messages travel from the dendrites to the soma and on to the • The electrical impulse needs to pass from one neuron to the
axon and axon terminals. next, but there is a gap (the synaptic gap) between the
• Some axons are insulated by a myelin sheath which speeds terminal buttons from the first neuron and the dendrites of
the message; damage to the myelin sheath can disrupt the second neuron.
messages, as can disease in which the direction of message • Small vesicles in the first neuron contain neurotrans
travel is reversed. mitters; the nerve impulse stimulates the vesicles to
• Neurons have an electrical charge inside them; the message release the neurotransmitters into the synaptic gap. The
that travels down the neuron does so as a wave of electrical receptor sites on the second neuron then pick up
activity – ions (either positively or negatively charged elec- the neurotransmitters.
trons) move in or out of the cell. • Receptor sites are specialised and will only receive the neuro-
• When the neuron is in a resting state (polarised), there is a transmitters for which they were designed.
state of tension between the inside and the outside of the cell. • Once the receptor site has accepted the neurotransmitter, it
• Chloride (negative), sodium (positive) and potassium (positive) starts (excitatory) or inhibits (inhibitory) an action potential in
ions are involved in the transmission of messages; like charges the second neuron.
repel each other, and opposite charges attract each other. • Leftover neurotransmitters are either broken down by
• When a nerve impulse comes along, the interior voltage in enzymes or taken back up into the first neuron’s terminal
the neuron changes from −70 mv to +40 mv. This takes about buttons.
one millisecond and is called the action potential. • There are more than 50 types of neurotransmitters.
The endocrine system Hypothalamus

This chapter has dealt primarily with the nervous system, Pituitary gland
but there are other biological systems that have an effect
on our psychology. One such system is the endocrine sys Thyroid
tem, to which we referred in the discussion about the
hypothalamus. The endocrine system is the system of hor
mones and glands in the body (see Figure 7.11). Hormones
are chemicals that are secreted by the glands. They travel Adrenal cortex
through the bloodstream (making them a lot slower than Adrenal medulla
nerve impulses and also longer lasting) and they influence Pancreas
the organ to which they were sent.
The pituitary gland is known as the master gland as it
regulates and controls all the other glands in the body. It Ovaries (female)
is close to, and connects with, the hypothalamus in the
Testes (male)
brain. This link between the nervous system and the endo
crine system allows the two to work in harmony. The
pituitary gland is also responsible for growth and regulates
salt and water metabolism.
The thyroid gland in the throat is responsible for the Figure 7.11 The endocrine system is made up of the glands in
body’s metabolism. If one has an under-active thyroid your body (Holt et al., 2014)
174

gland, one is likely to be apathetic and sluggish, to put on psychology has an aspect of neurology to it. As mentioned
weight, and to feel very despondent. As a result of this, earlier in the chapter, neuropsychology is the branch of
doctors often first check a patient’s thyroid gland function psychology that tries to understand how brain structure
ing before making a diagnosis of depression. An overactive and function relate to psychological processes and behav
thyroid gland leads to a person being very active and thin. iour. Ultimately, the connection between brain and mind
The adrenal glands are situated on top of the kidneys. is not far removed from the connection between body and
They produce many different hormones. They are made up soul, and so continues to raise philosophical and theo
of the adrenal cortex and the adrenal medulla. The adrenal logical debate. This section of the chapter will consider the
cortex regulates salt and carbohydrate metabolism, while roles of psychiatrists and neuropsychologists in under
the adrenal medulla prepares the body for the fight-or- standing brain function.
flight reaction to stress. You will find more information Students may well wonder how psychiatry fits into this
about the endocrine system in the chapter on stress interdisciplinary picture. Traditionally a psychiatrist is a
(Chapter 21). medical doctor who specialises in the diagnosis and treat
The pancreas is situated in the abdomen and regulates ment of mental illness and emotional disorders. It is
levels of insulin and blood sugar. It is also involved in becoming more and more common for neurology and
digestion. When the pancreas does not secrete enough psychiatry to deal with the same issues and problems.
insulin, the person will be diagnosed with diabetes (high Historically, however, the two disciplines dealt with appar
blood sugar levels). ently different medical problems. In the 19th century (when
Lastly, a female’s ovaries and a male’s testes are also this distinction first arose), doctors classified mental disor
glands, and they are responsible for sexual behaviour, the ders that were caused by a structural change in the brain as
development of the reproductive hormones, and general neurological – they could see these changes when they did
physical growth. an autopsy on the brain. Mental disorders that could not
be seen in brain changes were classified as psychiatric and
were considered to be disorders of brain function.
• The endocrine system (hormones and glands) also has an This was the start of the trend where brain structures
SUMMARY
effect on our psychology; the nervous system and the were viewed separately from brain functions. However,
endocrine system work in harmony. these days psychiatrists point out that many of the func
• The pituitary gland is the master gland; it works closely tional disorders (such as bipolar disorder and schizophre
with the hypothalamus, and regulates and controls all the nia) are due to micro-level changes (such as over-activity
other glands in the body. or under-activity in a particular neurotransmitter system),
• The thyroid gland is responsible for the body’s and so they treat them with medicines that act on these
metabolism. neurotransmitter pathways. Many neurological disorders
• The adrenal glands consist of the adrenal cortex and (such as epilepsy and Parkinson’s disease) have a similar
the adrenal medulla; they produce many different basis and approach to treatment. This shows that the
hormones. difference between structure and function is no longer
• The pancreas regulates levels of insulin and blood sugar. clear-cut. These days some psychiatrists specialise in what
• A female’s ovaries and a male’s testes are responsible for they call neuropsychiatry; in other words, they specialise
sexual behaviour, the reproductive hormones, and gen- in the psychiatric or functional aspects of ‘structural’ neu
eral physical growth. rological disease.
In general, neuropsychology is still concerned primarily
with neurological (as opposed to psychiatric) disorders, as
Neuropsychology it attempts to describe the mental changes that result from
structural changes in the brain. In this respect, the differ
There is a special relationship between the brain and the ence between neuropsychology and neuropsychiatry cor
mind. The functions and dysfunctions of the brain have responds roughly with the difference between cognition
immediate and direct effects on the mind – so much so and affect (emotion). Clinical neuropsychology focuses
that people often say that the brain is the organ of the mainly (but by no means exclusively) on cognitive rather
mind. This means that everything that we deal with in than emotional disorders. The same does not apply to
175

research neuropsychology, however. This chapter focuses functions. His compromise position put forward the
mainly on clinical neuropsychology. This emphasis also idea that there were groups of cortical zones that worked
reflects the fact that neuropsychology in South Africa is together to produce each complex mental ability (like
very much a clinical discipline. (For an introduction to speech). Luria argued that mental abilities were combi
neuropsychology, see Kalat, 2009; Martin, 2006; Solms & nations of many low-level or basic functions, and that
Turnbull, 2002.) only the low-level elements could be narrowly localised
(like sound production or awareness of sounds). The
The early history of abilities themselves were made up of dynamic interac
neuropsychology tions between the components. While this meant that
the abilities as a whole could not be narrowly localised,
In the 1860s, Pierre Paul Broca discovered that damage to a Luria argued that the task of neuropsychology was to
particular part of the left hemisphere of the human brain identify the localisable components of each complex
results in loss of language. This part of the brain is now ability. (For a good indication of Luria’s approach, see
known as Broca’s area (see Figure 7.4 earlier in this chapter). Luria, 1973a, 1973b, 1979.)
Broca’s discovery caused considerable excitement in the Luria’s idea that complex mental functions are pro
European scientific circles at the time because language is duced by dynamic neural networks as opposed to static
a mental function (and, more specifically, a human mental centres gained rapid support and is still the standard way
function). Therefore, a part of the brain had been identified of thinking in neuropsychology today.
where language production was located. This discovery led
to an increase in research into the brain, but mainly focused
on trying to localise mental functions. This included the
The influence of cognitive
work of Carl Wernicke who localised the ability to under psychology on neuropsychology
stand speech to the temporal lobes (see Figure 7.4 earlier in
Cognitive psychology has been hugely influential in
this chapter), and this area is now called Wernicke’s area.
modern neuropsychology because it provided a way to
These classical localisations were made by inferring a
divide our cognitive capacities into smaller and smaller
relationship between the mental function that was lost,
processing units, which became closer and closer to
and the damaged part of the brain seen when an autopsy
describing the individual processing units of cortical
was done. This research led to school of thought that
tissues. Computer-based approaches have thus gained
argued that all mental functions could be located in par
popularity as a means of simulating the way neural con
ticular places in the brain.
nections work in the brain.
Localisation was not completely accepted, however. In
However, such models have not been useful in the study
1891, Sigmund Freud criticised the authoritative works of
of areas such as emotion, motivation, the structure of per
Broca, Wernicke and Ludwig Lichtheim, which argued that
sonality and intersubjective experiences such as empathy,
the various components of language – spontaneous speech,
free will and the self. Computer-based models do not seem
comprehension, repetition, reading and writing – were
able to describe the physiological processes that govern
localised in a patchwork of centres on (and just below) the
the instinctual and subjective poles of the mind. For these
surface of the left hemisphere. Other authorities also criti
aspects of neuropsychology, molecular-biological, etho
cised the diagram makers for reducing the dynamic com
logical and perhaps even psychoanalytical theories might
plexities of the mind to simple models of nervous centres
offer more appropriate conceptual and observational tools
and their connections. Other theorists proposed that the
for the neuropsychology of the future.
brain functioned as an integrated unit and that mental
functions were holistic things that depended on the con
certed functioning of the brain as a whole. Research methods
Aleksandr Romanovich Luria argued that both these
views were right to a degree. Luria said that although a
in neuropsychology
whole mental capacity cannot be reduced to the activi For more than a century, clinico-anatomical correlation
ties of a limited zone of the cerebral cortex, it was also provided the methodological backbone for all neuropsy
true that different cortical zones performed different chological research. This relied on autopsy studies.
176

However, with the increase in the number of head injuries

in World Wars I and II, it became possible to infer the site
of a patient’s brain damage during life by tracking the entry
and exit points of bullet or shrapnel wounds. The develop
ing use of X-rays for visualising the location of bullets,
shrapnel and skull fragments embedded in the brain pro
vided further localising information.
These methods were basic research methods in neu
ropsychology, which took a major leap forward with the
development of brain imaging (see Figures 7.12−7.15).
This allowed the soft tissue inside the skull to be visualised
while the person was still alive. Researchers no longer
required autopsy results to support their hypotheses.
Clinical observations of behaviour could be related to the
images of brain pathology that were displayed by the
technology. However, these imaging techniques are very
expensive.
Computerised tomographic (CT) scanning became
widely available in the 1970s. By the 1980s, CT scanning
had been widely replaced by a second generation of imag
ing technology known as magnetic resonance imaging
(MRI). MRIs had better resolution, which meant that
pathology and changes to the brain could be viewed with
greater accuracy and precision. Figure 7.13 An image from an MRI scan
Figure 7.12 An image from a CT scan Figure 7.14 An image from a PET scan
177

different ways, both of these technologies measure differ

ences in the rate of metabolic activity in the brain. Looking
at an image from a PET or fMRI scan, one is able to see
how active certain parts of the brain are when a person is
actually performing a task. Thus one can infer which parts
of the brain are used for particular cognitive functions.
This research seems logical, but it is important not to

misinterpret the results. Some reports write about a par
ticular brain region as though it is the only one that per
forms a task. We must remember that mental functions are
produced not by circumscribed cortical locations, but
rather by dynamic constellations of cortical and sub-
cortical zones working together.
The qualitative and quantitative

approaches to clinical
Figure 7.15 An image from an fMRI scan
neuropsychology
The specialist neuropsychologist takes an integrated (quan
The latest advance is functional brain imaging which titative and qualitative) approach in assessment. He or she
involves obtaining images of the brain while the person is starts with a particular clinical question and then proceeds
performing a certain function or is exposed to a stimulus. flexibly, selecting the appropriate assessment tools as the
There are two major forms: positron emission clinical picture unfolds. (This was Luria’s approach.) The
tomography (PET) and functional MRI (fMRI). In aim is to identify a particular pattern of cognitive symptoms
7.4 THE CASE OF THE GIRL WHO NEARLY DROWNED

An eight-year-old girl slipped while playing next to her parents’ remained: ‘Was the change attributable to neurological or
swimming pool, banged her head, and fell into the water. It is emotional factors?’
unclear how long she was submerged in the water before she If this girl was referred to a clinical psychologist trained only in
was found by her mother. However, she was unconscious and standard psychometric assessment techniques, the psychologist
blue in the face. The mother administered mouth-to-mouth would carry out a battery of standardised intelligence tests (as dis-
resuscitation, and after this the child vomited violently and cussed in Chapter 15), projective tests or behavioural inventories. If
resumed breathing. She was taken to casualty, semi-conscious, the results were – as they would be in this case – low average
and was admitted for a period of observation. The laceration scores on the standardised intelligence tests, and evidence of anx-
over her right forehead required six stitches. Although she iety and insecurity on the projective tests, how would that help a
passed through a period of confusion and drowsiness, she psychologist say whether the change in the girl was attributable to
appeared to have recovered completely by the following day. neurological or emotional factors?
An MRI scan of her brain showed no abnormality. She was The psychologist could also use tests that are known to be
therefore discharged home on the following day and, a few resistant to the effects of brain injury. The psychologist could then
days later, she returned to school. However, her teachers compare the child’s scores on tests that are sensitive to the effects
noticed a change in her. She was no longer her bright and of injury to her scores on tests that are resistant to the effects of
cheerful self. She seemed far less confident both academically injury. However, this would still only provide us with an idea of
and socially, and at the end of term she performed poorly in how the girl’s present performance is different from her past per-
her examinations. Both parents and teachers attributed the formance, and not whether the girl was struggling at school
change to the near-drowning incident. However, the question because of neurological or emotional factors.
178

Table 7.2 Differential diagnosis possibilities for the girl discussed in Box 7.4
Differential diagnosis possibilities Secondary possibilities Tests

1. Brain damage a) Closed-head injury Cognitive tests known to correspond to anatomical
regions associated with the injury
b) Anoxia (lack of oxygen) Cognitive tests known to correspond to anatomical
regions associated with the injury
2. Emotional trauma Lack of syndromes of above two possibilities
Clinical interview and projective tests
3. Both brain damage and  emotional trauma Both of the above Features of all of the above
and signs that makes clinico-anatomical sense, thereby This section has described the process of using neuro
integrating the observable clinical picture, via its causal psychological assessment in a specific case. This kind of
mechanism, with the underlying neuropathology. assessment may also be used in a variety of situations
In a purely quantitative approach, by contrast, a general where cognitive performance has been impaired (Harvey,
clinical psychologist or psychometrician typically uses a 2012). Overall, neuropsychological assessment may be
standardised battery of tests, which measure the patient’s needed for diagnosis (e.g. dementias, stroke, traumatic
performance across a range of mental functions. They then brain injury), differential diagnosis (e.g. distinguishing
compare this measure to an established population norm. between different kinds of dementias), predicting a per
This approach is quantitative as it calculates the degree of son’s potential (e.g. following a brain injury or the onset of
abnormality in the functions assessed, but it may not dementia), evaluating response to treatment (e.g. cognitive
answer the clinical questions that the patient was referred remediation following a stroke) and matching clinical find
for in the first place. Consider the case that was referred for ings to imaging results (e.g. vascular lesions that indicate
a neuropsychological assessment in Box 7.4. a risk of stroke) (Harvey, 2012). Neuropsychological
In order to answer the question about whether the assessments may also be required for workers who are
change was attributable to neurological or emotional fac applying to be ‘boarded’ (granted early retirement on full
tors, the specialist neuropsychologist would begin by con benefits due to ill health) and for assessments of a person’s
sidering the possible differential diagnoses. Table 7.2 sets competence to manage their financial affairs.
out these possibilities for this case.
To assess for brain damage, the neuropsychologist would 7.5 THE PROFESSIONAL ROLES OF THE
test for the cognitive symptoms that are typically seen in a CLINICAL NEUROPSYCHOLOGIST
patient with a closed-head injury or a patient with anoxia.
Neuropsychologists usually work in hospitals and private
If there is an absence of these symptoms, then it is reason
practices. In hospitals, neuropsychologists are often based in
able to conclude that the girl is unlikely to have suffered
neurology, neurosurgery and psychiatry departments. In neu-
brain damage. Then, by exclusion, the neuropsychologist
rology departments, they play a role in diagnosing neuro
would infer that the girl’s difficulties in school were due to
logical disease. In neurosurgery, they often assess a patient’s
emotional (functional) causes, rather than organic (struc
current cognitive status and the cognitive functions of par-
tural) causes. This diagnosis would be more secure if
ticular brain areas during surgery.
positive features of an emotional trauma (such as post-
In psychiatric departments, they help to differentiate
traumatic stress disorder) were demonstrated.
between neurological disorders on the one hand and func-
While the quantitative and qualitative approaches have
tional, psychotic or mood disorders on the other. This often
been contrasted here, in practice the two approaches over
means working with children as complex combinations of
lap. The main difference is that in neuropsychological
neurological and psychiatric problems are particularly com-
assessment, measurement and standardisation are s ervants
mon in paediatric cases.
of the assessment process, not its masters, while in general
In private practice, neuropsychologists may assess indi
psychometric assessment the structure of the assessment
viduals for medico-legal reasons, as well as offering therapy
is determined by the fixed requirements of the tests rather
and counselling. Neuropsychologists also work within edu-
than the flexible, unfolding clinical picture in relation to the
cational, industrial and primary health settings.
referral question.
179

Neuropsychology in South Africa s tandardised assessments has more value as this popula
tion is more homogenous.
Because neuropsychology is still developing, the impact of Because neuropsychology is still a young science, and
individual practitioners in the field is more strongly felt than because its official professional status is still evolving in
in other branches of psychology. Michael Saling – a research relation to the other, more established psychological cat
psychologist formerly from the University of the egories, whether a person is able to register as a neuropsy
Witwatersrand – played a pioneering role in neuro chologist depends in part on his/her country of residence.
psychology in South Africa, and his qualitative, Luria-based In South Africa, the Professional Board for Psychology of
approach to neuropsychological assessment continues to the Health Professions Council has established a profes
be practised and propagated by his erstwhile students today. sional category for neuropsychology, and the training
However, different countries have different assessment requirements for registration in this new category are now
practices for neuropsychology. In South Africa, where the being finalised. In addition, aspirant neuropsychologists
population is diverse in terms of language, culture, liter may undergo a certification process run by the South
acy and socio-economic status, Luria’s approach is a suit African Clinical Neuropsychological Association (SACNA),
able one, while the use of standardised psychometric tests which is currently the only body that credentials neuropsy
has limited value. But in the UK, for example, the use of chologists in South Africa.
• There is a special relationship between the brain and • However, computer-based models have not been useful for
SUMMARY
the mind. the instinctual and subjective aspects of mind; molecular-

• Neuropsychology is the branch of psychology that tries to biological, ethological and psychoanalytical theories might
understand how brain structure and function relate to psy- be more appropriate here.
chological processes and behaviour. • For more than a century, neuropsychological research was
• Psychiatry is a medical speciality in the diagnosis and treat- based on clinico-anatomical correlation.
ment of mental illness and emotional disorders. • After the world wars, X-rays were used for visualising the
• Historically, brain structures (neurological) were viewed location of foreign bodies and skull fragments embedded in
separately from brain functions (psychiatric). the brain.
Neuropsychiatrists specialise in the psychiatric or functional • Brain imaging techniques have developed rapidly, allowing
aspects of ‘structural’ neurological disease. the soft tissue inside the skull to be visualised while the
• Neuropsychology attempts to describe the mental changes person is still alive. Techniques include computerised tomo-
that result from structural changes in the brain. Clinical n
europsy- graphic (CT) scanning, magnetic resonance imaging (MRI)
chology focuses on cognitive rather than emotional disorders. and functional brain imaging (positron emission tomography
• In the 1860s, Broca identified a part of the brain where (PET) and functional MRI (fMRI)).
language production was located. • Looking at an image from a PET or fMRI scan, one is able to
• Further research focused on trying to localise other mental see how active certain parts of the brain are when a person is
functions; Wernicke localised the ability to understand speech performing a task.
to the temporal lobes. • The specialist neuropsychologist takes an integrated (quanti-
• This research led to the idea that all mental functions could tative and qualitative) approach in assessment.
be located in particular places in the brain; however, other • The aim is to identify a particular pattern of cognitive symp-
theorists proposed that the brain functioned as an integrated toms and signs that makes clinico-anatomical sense, thereby
holistic unit. integrating the observable clinical picture, via its causal
• Luria argued that both these views were partially right; he mechanism, with the underlying neuropathology.
argued that mental abilities were combinations of many • In a quantitative approach, a standardised battery of tests is
low-level or basic functions. used to measure the patient’s performance across a range of
• Cognitive psychology provided a way to divide cognitive mental functions; these are compared to an established
capacities into smaller processing units, analogous to population norm.
computer-based operations. • In practice, the quantitative and qualitative approaches overlap.
180

• Neuropsychology is still a developing discipline in South Africa. • The Professional Board for Psychology of the HPCSA has
• Michael Saling has developed a qualitative, Luria-based established a professional category for neuropsychology.
approach to neuropsychological assessment. • Certification is conducted by the South African Clinical
• Because of South Africa’s diverse population, Luria’s approach Neuropsychological Association (SACNA).
is more suitable.
Conclusion
Both the nervous system and the endocrine system affect neuropsychology in South Africa. These days no-one can
our feelings, thoughts and behaviour, but the brain, in afford to overlook the role of neuropsychology in the field
particular, has a pivotal role to play. Apart from describing of psychology, as each day researchers are linking what
these systems, this chapter has briefly outlined the history we know about people to certain areas of brain function
of neuropsychology and the main debates in this area. It ing. Because there is a huge demand for neuropsycho
has described neuropsychological research methods, logical expertise in this country, it is hoped that some
analysed both the qualitative and quantitative approaches psychology students will devote their psychological skills
in clinical neuropsychology, and explained the area of and energies to this absolutely fascinating profession.
KEY CONCEPTS
❖❖ acetylcholine (ACh): a neurotransmitter that is ❖❖ axon terminal: the part of a neuron where an electri
involved with muscle movement, as well as learning cal impulse or message passes to another neuron
and memory ❖❖ basal ganglia: parts of the limbic system that are
❖❖ action potential: the state of a neuron when some involved in movement
thing causes the permeability of its cell membrane to ❖❖ brain: the ‘centre’ of the central nervous system,
change, allowing sodium ions to rush into the cell, which is responsible for higher nervous functions
which results in the generally negative charge of the ❖❖ brain imaging: imaging techniques where images
cell becoming more positive of the soft tissue within the skull (the brain)
❖❖ adrenal cortex: an adrenal gland that regulates salt are obtained
and carbohydrate metabolism ❖❖ brain pathology: the study of the causes and nature
❖❖ adrenal glands: glands that are made up of the of brain diseases and dysfunctions
adrenal medulla and the adrenal cortex ❖❖ Broca’s area: a particular part of the frontal lobes in
❖❖ adrenal medulla: an adrenal gland that prepares the the left hemisphere which, in most people, results in
body for the fight-or-flight reaction to stress a loss of language if damaged
❖❖ amygdala: a part of the limbic system that is involved ❖❖ cerebellum: a part of the hindbrain that is responsi
in learning, experiencing emotion, remembering ble for coordinated movement, balance and posture,
emotional events and recognising fear in other people as well as being involved in some kinds of learning
❖❖ association areas: areas of the cerebrum that are ❖❖ cerebral cortex: the outermost layer of the cerebrum
involved in the more complex mental functions ❖❖ cerebrum: the most complex section of the fore
❖❖ autonomic nervous system: a division of the periph brain, comprising the frontal, temporal, parietal and
eral nervous system that controls the muscles involved occipital lobes
in mainly involuntary actions, such as heartbeat ❖❖ cerebrospinal fluid: the fluid in which the brain
❖❖ autopsy: a detailed dissection and examination of a floats, which nourishes the brain and protects it from
body, or parts of a body, after death bumps and knocks
❖❖ axon: that part of a neuron that transmits the ❖❖ clinical neuropsychology: a discipline within
electrical impulse or message to other neurons neuropsychology that focuses on cognitive
181

disorders and is mainly concerned with diagnosing person is performing certain functions or being
and managing the mental aspects of neurological exposed to certain stimuli
disease ❖❖ gamma amino butyric acid (GABA): an inhibitory
❖❖ clinico-anatomical correlation: a method used to neurotransmitter that is implicated in emotion,
detect localisations in the brain, whereby inferences anxiety, arousal and sleep
of a relationship between a mental function that was ❖❖ hindbrain: a part of the brain that is made up of the
lost and a damaged part of the brain when an medulla oblongata, the pons, the cerebellum and
autopsy was done are made portions of the reticular formation
❖❖ computerised tomographic (CT) scanning: an ❖❖ hippocampus: a part of the limbic system that is
imaging technique where X-rayed images of responsible for certain kinds of memory
cross-sections of the brain are combined into a ❖❖ hypothalamus: a part of the forebrain that controls
three-dimensional image of its structure the pituitary gland and is involved in emotions,
❖❖ corpus callosum: a thick band of tissue that con regulating body rhythms for sleep, sexual activity,
nects the two hemispheres of the brain and allows temperature regulation, hunger and thirst
communication between them ❖❖ inhibitory neurotransmitters: neurotransmitters
❖❖ dendrites: those parts of a neuron that receive that stop the action potential in a neuron
messages from other neurons ❖❖ lateralisation: the specific functions for which
❖❖ depolarisation: a process that occurs when the each hemisphere of the brain is responsible or
threshold of excitation in a neuron is reached and the dominant
permeability of the cell changes, causing sodium ❖❖ limbic system: a number of structures in the fore
ions to rush into the cell brain that are involved in emotion, memory, learning
❖❖ dopamine: a neurotransmitter found especially in and motivation
the limbic system, the cerebellum and the basal ❖❖ localisation: the idea that mental functions could be
ganglia of the brain, which is involved in thought located in particular places in the brain
disorders such as schizophrenia and movement ❖❖ magnetic resonance imaging (MRI): an imaging
disorders such as Parkinson’s disease technique using magnetism where cross-sectional
❖❖ dynamic localisation: an argument put forward by images of the brain are combined into a three-
Luria that complex mental functions are produced by dimensional image of its structure
dynamic ‘neural networks’ made up of components ❖❖ medulla oblongata: a part of the hindbrain that is
in the brain as opposed to static ‘centres’ responsible for breathing, circulation, heart function
❖❖ endocrine system: the system of hormones and ing and other involuntary behaviours such as
glands in the body vomiting, coughing, sneezing, hiccupping and
❖❖ excitatory neurotransmitters: neurotransmitters blinking if something flies towards the eye
that start the action potential in a neuron ❖❖ meninges: membranes that surround the brain,
❖❖ forebrain: a part of the brain that is made up of the which serve to protect the brain and store the
thalamus, the hypothalamus, the limbic system, the cerebrospinal fluid
basal ganglia and the cerebrum, and which is ❖❖ motor cortex: the primary area in the frontal lobes that
involved in many of the activities that we consider to is responsible for movement, which receives informa
be human activities, such as complex cognitive tion from the spinal cord, the cerebellum and the basal
functions, emotions and sensory processes ganglia, and is involved in voluntary movements such
❖❖ functional brain imaging: an imaging technique as walking, jumping, running and threading a needle
where images of the soft tissue within the skull are ❖❖ multiple sclerosis: a disease that breaks down
obtained while a person is performing certain neurons’ myelin sheaths and uncovers parts of their
functions or being exposed to certain stimuli axons, which affects the transmission of messages
❖❖ functional magnetic resonance imaging (fMRI): an that travel from the brain to the muscles
imaging technique using magnetism where ❖❖ myelin sheath: a coating around an axon that serves
cross-sectional images of the brain are combined to insulate the axon and make the message stronger
into three-dimensional images of its structure while a and faster
182

❖❖ neurologist: a medical doctor who specialises in the ❖❖ psychiatrist: a medical doctor who specialises in the
disorders of the nervous system prevention, assessment, diagnosis and treatment of
❖❖ neurology: the branch of medicine that deals with mental illness and emotional disorders
disorders of the nervous system ❖❖ psychiatry: the medical speciality that deals with the
❖❖ neuropsychiatry: the field of medicine that special prevention, assessment, diagnosis and treatment of
ises in the structure and function of the brain, and mental illness and emotional disorders
how they relate to psychological processes and overt ❖❖ psychologist: a person who has undergone
human behaviour extensive training in order to study and assess
❖❖ neuropsychologist: a non-medical specialist who the mental processes and behaviour of humans
deals with the structure and function of the brain, and animals
and how they relate to psychological processes and ❖❖ psychology: the study of the mental processes and
overt human behaviour behaviour of humans and animals
❖❖ neuropsychology: the branch of psychology that ❖❖ refractory period: the period when the membrane
combines with neurology to investigate how the potential of a neuron returns to the state in which it
structure and function of the brain relates to psycho was initially, waiting for the next depolarisation
logical processes and overt human behaviour incident
❖❖ norepinephrine: a neurotransmitter that is derived ❖❖ research neuropsychology: a discipline within
from epinephrine (adrenaline), and which is neuropsychology that is interested in how mental
involved with arousal, mood, eating and sleeping functions are organised in the brain, and what the
❖❖ occipital lobes: parts of the cerebrum that are study of the brain can reveal about the organisation
located at the back of the brain and are responsible of the mind
for vision ❖❖ resting potential: a neuron’s resting state when it is
❖❖ pancreas: organ in the abdomen that produces mainly negatively charged, with its surrounding fluid
hormones (as part of the endocrine system) and being mainly positively charged
digestive enzymes (as part of the digestive system) ❖❖ reticular formation: a structure in the hindbrain and
❖❖ parasympathetic system: a division of the auto midbrain that connects to all the areas of the brain
nomic nervous system that, once the body has and is responsible for arousal and sleep/wake
reacted to a stressor by either fighting or running consciousness
away, inhibits the action and relaxes the body ❖❖ serotonin: a neurotransmitter that is involved in
❖❖ parietal lobes: parts of the cerebrum that are mood, sleep, eating and arousal
responsible for the sense of touch, the detection of ❖❖ soma: the body of a neuron
movement, the ability to locate where something is ❖❖ somatic nervous system: a division of the peripheral
in space, and the ability to perceive how one’s body is nervous system that controls voluntary movement by
located in space controlling all the muscles attached to your bones
❖❖ pituitary gland: the master gland that regulates all ❖❖ somatosensory cortex: an area in the parietal lobes
the other glands in the body, and which is also that receives sensory information from the body
responsible for growth, and the regulation of the salt ❖❖ spinal cord: the part of the central nervous system
and water metabolism that is responsible for sending and receiving mess
❖❖ pons: a part of the hindbrain that acts like a relay ages from the muscles and the sensory organs of
station, sending signals from the spine to the brain the body
and from the brain to the spine ❖❖ sympathetic nervous system: a division of the
❖❖ positron emission tomography (PET): a nuclear autonomic nervous system that is used to get the
medicine technique where, as a result of injecting body ready for action (whether this is fighting or
small quantities of radioisotopes into a person that running away)
find their way to the brain, early warning signs of ❖❖ synapse: the region where two neurons meet
diseases of the brain can be detected ❖❖ synaptic gap: the space between the terminal
❖❖ primary areas: areas of the cerebrum that process buttons of one neuron and the dendrites of a second
raw sensory information neuron
183

❖❖ temporal lobes: parts of the cerebrum that are on ❖❖ vesicles: small sacs in neurons that contain
the sides of the brain and are mainly responsible for neurotransmitters
hearing and language, but are also involved in visual ❖❖ Wernicke’s area: an area in the temporal lobes of the
association left cerebral hemisphere that is involved in the
❖❖ thalamus: the first structure in the forebrain to process interpretation of speech
incoming sensory information before relaying it to the ❖❖ X-rays: images that are obtained by projecting
appropriate area of the brain for further processing electromagnetic rays into body tissues to varying
❖❖ thyroid gland: a gland that is responsible for degrees
metabolism
EXERCISES
Multiple-choice questions a) the amygdala
1. Neurons receive information from other neurons b) the thalamus
through their: c) the hippocampus
a) axons d) the hypothalamus.
b) terminal buttons
c) dendrites 6. Which of the following psychological abilities is usu
d) myelin sheath. ally disrupted after damage to Broca’s area?
a) spatial ability
2. The purpose of the myelin sheath is to: b) numerical skills
a) insulate the axon against cold c) vision
b) insulate the axon so that the neural messages d) speech.
remain strong and fast
c) store fat 7. The attempt to identify the ‘seat’ of each mental
d) route the neural impulse. function in a particular part of the brain is known
as:
3. Vinesh is walking down the street one evening and a) localisationism
sees someone following him. He starts feeling scared, b) equipotentialism
his pupils widen, his heart rate speeds up, and he feels c) mind−body dualism
slightly sick in his stomach. What part of the nervous d) second-order phrenology.
system is at work in this example?
a) the central nervous system 8. Which of the following methods has been in longest
b) the nervous system use in neuropsychology?
c) the parasympathetic nervous system a) magnetic resonance imaging (MRI)
d) the sympathetic nervous system. b) parallel distributed processing (PDP) models
c) X-rays
4. The period when a neuron cannot fire is called: d) clinico-anatomical correlation.
a) the refractory period
b) the all-or-none law 9. Wernicke’s area is located in the __________________,
c) the action potential and is involved in ______________
d) depolarisation. a) left hemisphere of the brain; language production
b) right hemisphere of the brain; the interpretation of
5. Thandi was in an accident, during which a pipe speech
entered her brain. Doctors find that some of her sub c) left hemisphere of the brain; the interpretation of
cortical structures were damaged. When she awakes speech
she has no fear of danger and does not recognise fear d) right hemisphere of the brain; language production.
in other people’s faces. What area of the brain is likely
to have been damaged?
184

10. Computerised tomographic (CT) scanning is: Short-answer questions

a) an imaging technique where X-rayed images of
1. Which neurotransmitters are involved in mood and
cross-sections of the brain are combined into a
how do they work?
three-dimensional image of its structure
2. Explain the function of the limbic system and describe
b) an imaging technique where magnetic images of
what would happen if this area was damaged.
3. Design a table that allows you to list the areas of the
three-dimensional image of its structure while
cerebrum and to state the structures, functions and
people are awake
dysfunctions of each of these areas. Fill this table in.
c) an imaging technique where small quantities of
4. What happens to a patient whose corpus callosum
radio-isotopes are injected into the brain
has been severed? What behaviour are you likely
d) an imaging technique where X-rayed images of
to see?
5. Why do the hormones sent out by the endocrine sys
three-dimensional image of its structure while
tem affect the body more slowly than the nerve
people are asleep.
impulses sent out by the nervous system?
6. Describe the sorts of methods that are used in modern
neuropsychology.
7. Discuss the localisationism versus equipotentialism
debate.
185

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CHAPTER

Biological and neuropsychology

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­ alance and posture. This structure is affected when you

The midbrain Thalamus

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Motor area (voluntary movement) Somatosensory cortex (sensation)

Wernicke’s area (speech hearing)

Broca’s area (speech formation) Temporal lobe

Figure 7.4 The frontal, parietal, temporal and occipital lobes

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The left hemisphere and the right hemisphere

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Figure 7.5 illustrates the normal visual pathway in the

forebrain; in evolutionary terms, the hindbrain developed

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Central nervous system Peripheral nervous system

Brain Spinal cord

Somatic system Automatic system

Cerebrum Limbic Corpus Cerebellum Pons Medulla

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body, and the axon, which carries electrical impulses to

Soma (cell body) Nucleus

Figure 7.7 The components of a neuron

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1. When the threshold of excitation is reached, the perme­ Synaptic transmission

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Types of neurotransmitters that the mood neurotransmitters have a better chance to

Norepinephrine Gamma amino butyric acid (GABA)

Neurotransmitter Location Function Dysfunction

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The endocrine system Hypothalamus

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However, with the increase in the number of head injuries

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different ways, both of these technologies measure differ­

This research seems logical, but it is important not to

The qualitative and quantitative

7.4 THE CASE OF THE GIRL WHO NEARLY DROWNED

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Differential diagnosis possibilities Secondary possibilities Tests

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the mind. the instinctual and subjective aspects of mind; molecular-­

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10. Computerised tomographic (CT) scanning is: Short-answer questions

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alance and posture. This structure is affected when you

Figure 7.4 The frontal, parietal, temporal and occipital lobes

1. When the threshold of excitation is reached, the perme Synaptic transmission

different ways, both of these technologies measure differ

the mind. the instinctual and subjective aspects of mind; molecular-