Q&A: Michael Daniel

Michael Daniel is an associate professor in the School of Professional Psychology (SPP) in downtown Portland. He has been with the University for five years and was hired to begin a track in neuropsychology, which involves the study of brain function.

In addition to research in the field, Daniel supervises 10 neuropsychology students at Tuality Community Hospital in Hillsboro and heads SPP’s cognitive assessment team which helps evaluate incoming clients at the Portland clinic.

Photo: Michael Daniel

What exactly is neuropsychology? What is new and exciting in the field?

Neuropsychology is a specialty in psychology that focuses on brain function. Clinical neuropsychology is the application of neuropsychology to the evaluation and treatment of patients. The brain is very complex and there is still a lot about brain functioning that we do not understand. However, we do know that certain areas of the brain control different types of cognitive abilities (cognitive abilities is another name for thinking skills like attention, memory, language, etc.). So by giving tests of different cognitive abilities it is usually possible to determine two types of information: first, we can tell if there is an area of cognitive functioning that is impaired and, second, we can usually tell by the pattern of test results if there is a certain area of the brain that is not functioning normally. Most of the time, neuropsychological evaluation includes assessment of emotional and personality functioning to determine to what extent these areas are affected by brain dysfunction or, alternatively, to determine to what extent the patient’s problems are due to emotional factors rather than brain dysfunction.

Probably the most exciting findings in neuropsychology in the last few years are in the area of functional imaging. Positron Emission Tomography (PET) scans measure what areas of the brain have increased activity when the person is engaged in certain types of cognitive tasks. This has allowed us much more specific and accurate knowledge about what areas of the brain mediate specific types of cognitive abilities.

What’s involved in your role as clinical supervisor for the Cognitive Assessment Team? What, exactly does your team evaluate and how does it go about that?

SPP operates a training and research clinic in downtown Portland called the Psychological Services Center (PSC). One of the programs at the PSC is the assessment team. The “team” is actually divided into two teams with about 5-6 doctoral graduate students on each team. I supervise one team and Dr. Benson Schaffer supervises the other team. Patients are referred to the assessment program from local colleges; professional schools like nursing, chiropractic, and art; psychotherapists, and physicians. Most of the patients are referred because they are encountering difficulty in some area of their life, like school or work, and there is a question whether or not problems with cognitive functioning are somehow involved.
The students on the assessment team see the patients for the entire evaluation, which includes a thorough psycho-social/medical history and eight to 10 hours of cognitive and psychological testing. I supervise the students in the interpretation of the test results. We see patients who have learning disabilities, attention deficit hyperactivity disorder, other types of cognitive disorders, and a few who have had head injuries or histories of substance abuse. Some of the patients do not have cognitive deficits and emotional factors are the primary source of their problems. Other patients have both; they have a cognitive impairment and a problem with emotional adjustment.

One of your research interests is on the effects of depression on memory after brain damage. What briefly, have you discovered?

This is an area where there are still some unanswered questions. Our research has been in a couple of specific areas, such as, does depression make the cognitive deficits caused by a stroke worse? The answer is, it depends. Even though a stroke is a real trial to go through most people are able to adjust pretty well. In the acute period after a stroke, that is in the first eight weeks or so while the person is still in the hospital and going through rehabilitation, most people either cope with the stroke pretty well or become, at most, mildly depressed. We found that this mild level of depression does not make cognitive deficits resulting from a stroke worse. There are a few people, and fortunately it is a small proportion, that have more severe depression following a stroke. It appears that this more severe level of depression does make cognitive deficits caused by a stroke worse. So, for the typical stroke patient, depression does not make their cognitive deficits worse, probably because the typical stroke patient tends not to have too much depression.

One of your other areas of expertise involves the neuropsychological performance of adults who were abused as children. What does your research reveal about this group of people?

This also is an area with unanswered questions. The idea for this study came from two areas. One was with patients that have neurological-appearing symptoms but have no demonstrable problems with brain functioning. Often, these patients’ symptoms ultimately are felt to be due to psychological or personality functioning. It has been found that many of these patients have a history of childhood abuse. The other finding is, some studies have shown that high levels of stress and trauma are associated with damage to the brain. So we started thinking about these two things together and wondered if the stress and trauma of childhood sexual abuse could have caused some impairment in brain functioning that would affect the person as an adult. For the most part, we found no differences between the neuropsychological performance of adults who were sexually abused as children and those who were not. However, the abused group did score lower on a test of visual memory. Now, so far, there is no clear reason why childhood sexual abuse would affect the area of the brain involved in visual memory and not affect the area of the brain involved in verbal memory. So it’s not completely clear what the finding means. It appears that, for the most part, childhood sexual abuse does not affect brain functioning, but the difference in visual memory raises the possibility that there may be some affect on brain functioning.

What other research are you involved in?

I supervise 10 students in our neuropsychology program at Tuality Healthcare. We’re involved in neuropsychological testing of 100 adolescents from St. Mary’s and Hillcrest who have had conduct or behavioral problems. We’re already seeing that some have “executive function” issues, that area of the brain’s frontal lobes that governs decision making and behavior. This research will contribute to the idea of whether or not these children have problems in this area of cognitive abilities.