Elementaristic vs. holistic approaches to dissociation of agraphia symptoms following acquired brain damageстатья
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Дата последнего поиска статьи во внешних источниках: 14 августа 2019 г.
Аннотация:Background: Two approaches to the explanation of dissociations of symptoms were established in the history of neuropsychology: through the structural changes and through the changes of activity form. The theoretical origins of these explanations are related to the two methodological traditions in psychology: elementaristic and holistic. In this study, the advantages of the elementaristic and the holistic approach to the explanation of dissociated neuropsychological agraphia symptoms are discussed.
Aims: The goal of our study was to reveal the variability of writing disorders following sensory agraphia depending on performance in writing tasks of different types. We hypothesise that manifestations of psychological disorders in Wernicke’s agraphia vary in different types of writing tasks:
1.1. We expect the dissociated symptoms of Wernicke’s agraphia to vary in tasks that actualise different culturally defined functions of writing;
1.2. Tasks actualising culturally determined functions of writing would lead to specific differences of symptoms in Wernicke’s agraphia compared with the performance on traditional diagnostic tests.
Methods & Procedures: The study involved 29 individuals with Wernicke’s agraphia due to left hemisphere stroke in the basin of the left middle cerebral artery. To identify agraphia symptoms, tasks traditionally applied in neuropsychological diagnostics of writing were used, representing typical cultural-historical functions of writing (communicative, mnestic, and regulatory). Analysis with the Chi-square Friedman test showed that the differences for all types of error rates were statistically significant (p = .001), which allowed the Wilcoxon test for further pairwise comparison ratios of errors in written tasks.
Outcomes & Results: Two approaches to the explanation of dissociations of symptoms have been used – through structural changes (elementaristic approach) and changes of a person’s activity form (holistic approach). The advantages of the holistic approach were the most evident while analysing the significant prevalence of errors in orthography in the regulatory task compared with the task of sentence composition. These tasks did not differ in their structural components, so the elementaristic approach did not explain the resulting dissociation. The explanation of this phenomenon comes from the psychological importance of the cultural function of writing using a permissive psychological strategy.
Conclusions: The holistic approach can be a valuable complement to the more widely utilised elementaristic approach. Despite the fact that a holistic approach is less common in modern clinical neuropsychology, its advantages are evident in the analysis of dissociation symptoms within the same syndrome when performing identical tasks in a set of involved neuropsychological components.