Assess Abstraction

Abstraction is a higher cerebral function that requires comprehension and judgment. Proverbs are commonly used to test abstract reasoning. The patient should be asked to interpret the following:

' 'People who live in glass houses shouldn't throw stones.'' ''A rolling stone gathers no moss.''

A patient with an abnormality in abstract reasoning might respond to the first quotation with a concrete interpretation, such as, ''The glass will break if you throw a stone through it.'' A concrete interpretation of the second proverb might be ''Moss grows only under rocks that don't move and not under a rolling stone.'' Concrete responses are common in patients with mental retardation or brain failure. Schizophrenic patients often answer with concrete interpretations, but bizarre assessments are also common. Be careful when assessing abstraction in patients who are not fluent in English.

Another method of testing abstract reasoning is to ask the patient how two items are similar or dissimilar. You might ask, ''What is similar about a dog and a cat?'' ''What is similar about a church and a synagogue?'' or ''What is dissimilar about an apple and a chicken?''

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