Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Chapter 3: Clinical Assessment & Diagnosis Amber Gilewski Tompkins Cortland Community College Assessing Psychological Disorders Purposes of Clinical Assessment To understand the individual To predict behavior To plan treatment To evaluate treatment outcome Key Concepts in Assessment Reliability Consistency is measurement Examples include test-retest & inter-rater reliability Validity What an assessment approach measures & how well it does so Examples include concurrent/descriptive and predictive validity Standardization and Norms Ensures consistency in the use of a technique Provides population benchmarks for comparison Examples include structured administration, scoring, and evaluation procedures The Clinical Interview Clinical Interview Most common clinical assessment method Mental Status Exam Appearance and behavior Thought processes Mood and affect Intellectual functioning Sensorium (awareness of environment) Clinical Interview (continued) Confidentiality – between patients & mental health professionals; protected by law in most instances (i.e. except in Tarasoff’s law) Types of interviews: unstructured & semistructured clinical interviews Physical Examination Rules out medical explanations for psychological disorders Examples: toxic state, hyperthyroidism, hypothyroidism, brain tumors, drug ingestion Behavioral Assessment Focus on the present – Here and now Direct observation of behavior-environment relations Purpose is to identify problematic behaviors and situations Identify antecedents, behaviors, and consequences Can be either formal or informal Self-monitoring vs. being observed by others Problem of reactivity using direct observation Psychological Tests Psychological Testing Must be reliable and valid Projective Tests – Roots in Psychoanalytic Tradition Project aspects of personality onto ambiguous test stimuli Require high degree of inference in scoring and interpretation Examples The Rorschach Inkblot Test, Thematic Apperception Test Reliability and validity data tend to be mixed Psychological Tests (continued) Personality Tests Minnesota Multiphasic Personality Inventory (MMPI, MMPI-2, MMPI-A) Extensive reliability, validity, and normative database Intelligence Tests Nature of intellectual functioning and IQ First tests developed by Alfred Binet Weschler developed more tests used with adults & children Verbal and performance domains Neuropsychological Testing Purpose and Goals Assess broad range of skills and abilities Goal is to understand brain-behavior relations Examples The Bender Visual Motor Gestalt Test The Luria-Nebraska Battery Problems with Neuropsychological Tests False Positives & False Negatives Neuroimaging Neuroimaging: Pictures of the Brain Allows for a window on brain structure and function Imaging Brain Structure Computerized axial tomography (CAT or CT scan) : utilizes X-rays Magnetic resonance imaging (MRI): Utilizes strong magnetic fields & better resolution than CT scan Neuroimaging (continued) Imaging Brain Function Positron emission tomography (PET) Single photon emission computed tomography (SPECT) Both involve injection of radioactive isotopes Isotopes react with oxygen, blood, and glucose in the brain Functional MRI (fMRI) – Brief changes in brain activity; provides structural & functional images Diagnosing Psychological Disorders Diagnosis – identifying a general class of problems together Prognosis – likely future course of a disorder Classification – most widely used by mental health professionals is the DSM-5 DSM-5 (2013) DSM-5 is largely unchanged from DSM-IV Divided into three main sections How to use the manual Disorders Description of disorders Most notable change is the removal of the multiaxial system DSM-5 introduces cross-cutting dimensional symptom measures Includes social and cultural considerations Criticisms of the DSM-5 The Problem of Comorbidity Defined as two or more disorders for the same person High comorbidity is the rule clinically Threatens the validity of separate diagnoses Labeling Issues and Stigmatization