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Differentiating neuropathology from psychopathology with longitudinal and retrospective data: report of a case.

This case study report of diagnostic psychological testing considers the implications of a 53-point verbal-performance IQ differential, with the benefit of neuropsychological and neuroradiologic imaging studies, a 6-month follow-up Wechsler Adult Intelligence Scale-Revised (WAIS-R; Wechsler, 1981) evaluation, and retrospective examination of early school records and test findings. The approach highlights the limitations of cross-sectional clinical studies in differential diagnosis, particularly when both psychodynamic and neuropsychological factors are at issue. This report demonstrates how an early acquired neurodevelopmentally based deficit can alter or restructure the appearance of adult cognitive-perceptual functions. Further, early neurodevelopmental impairment is considered from the standpoint of its influence on compromised autonomous ego functions.