What is the nature of a medical or genetic problem?
A medical problem is any illness, disorder or condition that can affect the body and mind. Typical causes of medical problems include infections such as viruses or bacteria, lifestyle factors such as diet and exercise, environmental exposures such as toxins or allergens, and aging.
A genetic problem is caused by mutations in a person’s DNA. These genetic problems may be inherited from one or both parents or be the result of a spontaneous mutation that occurs at conception of the human embryo. There are three main types of genetic disorders: single gene disorders where one gene has been altered, chromosomal disorders where large sections of DNA are missing, and duplicated or rearranged and multifactorial conditions where the genetic condition results from an interaction of genes and the environment.
Dr. Brunner’s experience evaluating medical or genetic conditions
Over the last 20-plus years I have worked with over a thousand people with a very broad array of medical problems that are either caused by psychological issues, or are causing psychological issues. Sometimes both of these situations are present at the same time in one person.
Over this same time, I have psychologically evaluated a multitude of people with a genetic condition. Here is a list of conditions that I have experience evaluating, which are either caused purely by a genetic mutation or caused by an interaction of genetics and environmental conditions:
- Down syndrome
- Cystic fibrosis
- Sickle cell disease
- Hemophilia A
- Duchenne muscular dystrophy
- XYY syndrome
- Fragile X syndrome
- Fetal Alcohol syndrome
- Type 2 diabetes
- Hypertension
- Obesity
- Coronary artery disease
As a PhD neuropsychologist with expertise in assessing how medical or genetic problems interact with psychological problems, I take pride in working closely with medical and or genetic professionals on a daily basis.
Having practiced for more than 20 years, I have developed very strong and deep relationships with a broad array of medical and genetically trained professionals. Every day I continue to learn new things from my medical colleagues that allow me to continue practicing cutting edge neuropsychological assessment.
Reasons to consider a medical or genetically related neuropsychological evaluation:
- Your medical problem is causing you to feel significant anxiety or depressiveness
- You are having trouble with focusing on other life tasks and you’re not sure if your medical problem is the reason
- The genetic problem you’ve been diagnosed with is known to commonly cause emotional, behavioral or cognitive problems
- You have just been diagnosed with a medical or genetic problem and you are feeling highly anxious and need some strategies to cope with your anxiety
- You or your child have been diagnosed with a medical or genetic problem that causes cognitive impairments and you want to use the most effective mental tactics to minimize the psychological effects of the condition(s).
What does a medical or genetic neuropsychological assessment clarify?
- How the medical or genetic condition is currently negatively impacting your day-to-day mental or emotional functioning
- How you can use specific mental or personality strengths in order to minimize the negative impact of the medical or genetic condition
- What daily habits you should develop in order to maximize your daily physical and mental functioning
What are the hidden realities of a neurological condition?
- Mental performance problems such as not being able to remember things could look like a neurological problem like Alzheimer’s, but could actually be caused by problems with ADHD, anxiety or depression
- Depression can cause people to struggle to do things as quickly as they were able to previously, but many people never consider the role that a psychological condition like depression can play
- ADHD can sometimes cause dramatic problems with a variety of mental processes that cause people to run to the medical doctor to get checked out. Meanwhile, they forget that a neuropsychologist can play a vital role in helping them assess whether their mental issues are medical versus psychologically caused
- Neurological conditions commonly cause emotional, behavioral or memory related problems that can be rectified using evidence-based psychological tactics
- If a neurological condition is severe enough, a neuropsychological disability evaluation can offer the individual the opportunity to have the benefit of receiving Social Security disability benefits
How do I go beyond generic medical or genetic evaluation?
Many psychological clinicians narrowly focus on making diagnoses and then they consider their job to be done. But my clients have told me for over 20 years that when they just are given a diagnosis it feels very impersonal and transactional. That is why over the last two decades I’ve developed an approach where I help a person see exactly how their medical or genetic condition is interacting with their personality.
I do this by developing a dynamic mind map. This map clarifies key factors affecting your functioning and shows how certain factors interact with other factors. That way you gain a clear understanding of what is going on in your mind and body. You also gain a clear understanding of how to effectively combat current problems you are suffering from.
Feel free to read my blog about how Great psychological assessment goes far beyond diagnosis.
What are the elements of my assessment process?
- Methodically gathering historical information in the following categories: family history, birth, development, medical, neurological, educational, learning, emotional, behavioral, social, and academic or work performance
- Asking you to create a chronological timeline of important events to ensure I understand the life of the person being evaluated as a series of different stages. This is critical to get a nuanced, in-depth understanding for the person I am evaluating
- Reviewing this information together during the intake appointment, and beginning to develop hypotheses that I will scientifically review by collecting data
- Interviewing the people who have the most intimate knowledge of the day-to-day functioning of the person being evaluated. Unlike practitioners who only collect information from the person being evaluated, or only their parents, I believe that collecting this additional perspectives is vital to establishing a confident and credible diagnosis
- Choosing a tailored group of measurements that include self-report questionnaires, intelligence or cognitive tests, and personality measures that identify your predominating characteristics
- Rigorously testing different hypotheses designed to play devil’s advocate to test our perception of the situation, and following up with questions to either the person being evaluated or those who know the person best
- Writing a report tailored to the exact needs of the situation. I specialize in customizing your report to address different situations, such as the need for workplace or educational accommodations
- Conducting a feedback meeting in my conference room where I use a dry erase board to visually show you the important factors causing the problems the person being evaluated is experiencing. I call this our cognitive map, and it serves as a user-friendly roadmap. You can take a picture of and always have your roadmap with you for guidance
- During the feedback meeting, I clarify the diagnostic conditions at play, the non-diagnostic but critical factors contributing to problems, and give you bullet-point, user-friendly recommendations, organized into thematic groups. I clarify what professionals can best serve you, and save you the most money and time.
- After this feedback meeting, I follow-up with you to make sure that my work has met your expectations, and/or to provide further consultations to make sure our work is resulting in the life changes you are seeking.