Very Interesting Patient

[PA-CtoMD]

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I did an intake on a new patient the other day. She suffers from clinical depression, OCD, and possibly complex PTSD. She is a very intelligent woman. During college she received an A for all four semesters of Calculus, an A for physics, and As in other courses. But, she can't do arithmetic or long division in her head. So, if she went to the store and wanted to buy something that was on sale (percentage off an item), she couldn't figure it out in her head. She claims that her "memory won't hold all those numbers," so she has to work out problems on paper. She has been tested for a learning disorder several times over several years. She does not have dyscalculia, dyslexia, dyspraxia or any other learning disorder, and she is obviously very intelligent. Is this unusual for this to happen? Has anyone experienced this before with a patient or anyone for that matter? This is very interesting.

 

[erg923]

1. Do you know she did this well in school? People say all kinds of things.
2. I dont think it unusual for people to have to write down arithmetic problems that require calculations such as percentages.
3. If she has ad/hd, or ptsd, or depression, or OCD, etc. then her working memory is likely not very effecient. Working memory is independent from general intelligence/IQ, although the two are often correlated.
4. Get a good LD psych eval by someone who you know knows the area.

 

[watto]

How do you know she doesn't have acalculia? Primary anarithmetia can occur in left angular gyrus lesion, sparing a lot of other high-order processes.

 

[watto]

There are also other forms of acalculia - aphasic if cannot comprehend symbols (probably not her) or spatial acalculia where displace the numbers (also probably not her but can't be sure based upon your post).

 

[birchswing]

Could be medication related (esp. benzos, do strange thing to cognition)?

 

[erg923]

Could be medication related (esp. benzos, do strange thing to cognition)?

Then it probably wouldn't be confined to numbers/calculations.

 

[Shikima]

Is she being overwhelmed when having to do "regular" math compared to the abstract nature of Calc/DEQ?

 

[TexasPhysician]

I don't think most people could do 35% off of $55 in their head without writing it down.

 

[Armadillos]

How bad are we talking here?

Like could she tell you 10% of 45 or 20% of 50?

Would she have trouble with concentration related to non-numbers? For example spelling words backwards

 

[PA-CtoMD]

1. Do you know she did this well in school? People say all kinds of things.
2. I dont think it unusual for people to have to write down arithmetic problems that require calculations such as percentages.
3. If she has ad/hd, or ptsd, or depression, or OCD, etc. then her working memory is likely not very effecient. Working memory is independent from general intelligence/IQ, although the two are often correlated.
4. Get a good LD psych eval by someone who you know knows the area.

1. definitely, she showed me her grades.
2. I agree with.
3. is almost a given.
4. She has been tested by the top neuropsychologists in our area.

 

[PA-CtoMD]

Is she being overwhelmed when having to do "regular" math compared to the abstract nature of Calc/DEQ?

I think it is. I know that she feels overwhelmed when this happens with other people around.

 

[EEGNeurofeedback]

she could just be a tactile learner. there are learning strategies that she could pickup on. Since she did well in school and if that is not an issue now, no reason to worry about it.

 

[Shikima]

I think it is. I know that she feels overwhelmed when this happens with other people around.

What talk therapy is she getting?

 

[PA-CtoMD]

What talk therapy is she getting?

Psychodynamic therapy with her psychologist and also some EMDR sessions too, and it does seem to help her.

 

[Euthymia]

Wouldn't you expect working memory & capacity to "hold all those numbers" to naturally decline with age? I have a hard time multiplying two two-digit numbers in my head now too despite it being fairly easy back in high school.

 

[Shikima]

Wouldn't you expect working memory & capacity to "hold all those numbers" to naturally decline with age? I have a hard time multiplying two two-digit numbers in my head now too despite it being fairly easy back in high school.

No, you're just having difficulty because you're euthymic.

 

[Zenman1]

Well, I guess she's not smart enough to use a calculator!

 

[PikminOC]

• What did the testing show ?

 

[EEGNeurofeedback]

• What did the testing show ?

No learning disability. Very high in spatial ability and verbal.