Psychiatry: basic sciences
Cognitive psychology & neuropsychology
Cognitive psychology studies mental processes such as attention, memory, perception, language and decision-making; neuropsychology links them to the brain. Psychiatrists use it to assess thinking problems in conditions like dementia, schizophrenia and depression.
Depth by stage, Pre-U → Consultant (details)
What is it?
Cognitive psychology asks how people take in, store and use information. It covers perception, attention, the different kinds of memory, language, problem-solving, reasoning and the mental shortcuts and biases that affect decisions.
Neuropsychology connects these abilities to brain structures and tests them formally, using standardised tasks to measure memory, attention, language and executive function. Clinical neuropsychologists often work alongside psychiatrists.
Many psychiatric illnesses affect cognition, and cognitive models also underpin psychological treatments such as CBT, so the subject is central to both diagnosis and therapy.
Why does a psychiatrist need it?
Psychiatrists routinely assess memory and concentration, distinguish dementia from depression, recognise cognitive impairment in schizophrenia, and judge mental capacity. Understanding cognitive biases also helps them understand anxiety and depression, explain CBT, and avoid errors in their own clinical reasoning.
What level is expected at each stage?
Scale: 1. Aware → 2. Understands → 3. Applies → 4. Masters / Teaches. What the levels mean.
- Pre-UNot expected
- Pre-clinicalUnderstandsLearns basic models of perception, memory and learning in behavioural science.
- ClinicalUnderstandsPerforms simple cognitive screening (orientation, recall) in medicine and psychiatry.
- HousemanshipAwareUses brief cognitive tests to detect delirium and confusion on the wards.
- Medical officerUnderstandsAdministers standard cognitive screening tools and interprets them with care.
- Psych traineeAppliesExplains memory, attention and executive models and the neuropsychology of major disorders at exam level.
- Specialist / consultantAppliesIntegrates cognitive findings with imaging and neuropsychology reports in complex cases and capacity work.
What are the key topics?
Perception and attention
- Sensation versus perception; gestalt principles
- Top-down and bottom-up processing
- Selective, divided and sustained attention
- Perceptual abnormalities as a bridge to psychopathology
Memory
- Sensory, short-term and working memory (Baddeley's model)
- Long-term memory: episodic, semantic, procedural
- Encoding, consolidation and retrieval; forgetting
- Amnesia types: anterograde and retrograde
- False memories and the reconstructive nature of memory
Language, thinking and executive function
- Language production and comprehension; aphasia
- Problem-solving and reasoning
- Executive function: planning, inhibition, flexibility
- Heuristics and biases (availability, anchoring, confirmation)
- Intelligence: concepts, IQ testing and its limits
Neuropsychological assessment
- Bedside screening tools such as MMSE, MoCA and ACE (Addenbrooke's Cognitive Examination)
- Formal neuropsychological batteries and what they measure
- Premorbid IQ estimation
- Effects of education, language and culture on test results, important in multilingual Malaysia
- Effort and validity testing
Cognition in psychiatric disorders
- Cognitive deficits in schizophrenia
- Depressive 'pseudodementia' versus dementia
- Cognitive biases in anxiety and depression (Beck's cognitive model)
- Cognitive profile of the main dementias
- Cognitive remediation as a treatment
How is it learned and assessed?
- Behavioural science teaching in pre-clinical years
- Cognitive screening practised and examined in clinical OSCEs
- Basic sciences in psychiatry training; examined in MMed Psychiatry Part I and MRCPsych Paper A
- Joint work with clinical psychologists and neuropsychologists during old age and neuropsychiatry rotations
Typical textbooks and resources
- Cognitive Psychology: A Student's Handbook — Eysenck and Keane
- Neuropsychological Assessment — Lezak and colleagues; comprehensive reference
- Lishman's Organic Psychiatry — David and colleagues
- MRCPsych Paper A revision guides — various authors
Titles are widely used examples; editions change. Use university libraries or legitimate purchases.
Common questions
Is a memory test enough to diagnose dementia?
No. Screening tests show whether thinking is impaired, but diagnosis needs a full history from the patient and family, physical examination, blood tests and often brain imaging. Education level, language and mood can all affect scores.
How is a psychiatrist's cognitive assessment different from a neuropsychologist's?
Psychiatrists usually do bedside screening as part of the whole assessment. Clinical neuropsychologists carry out longer, standardised test batteries that give a detailed profile of strengths and weaknesses.