Download Clinical Syndromes Scales

Matakuliah
Tahun
: Psikologi Diagnostik
: 2010
Assessment of Psychopathology I
Pertemuan 8
Millon Clinical Multiaxial Inventory (MCMI)
• The MCMI-III is a 175 item true-false self-report measure
composed of 11 Clinical Personality Patterns scales, 3
Severe Personality Pathology scales, 7 Clinical Syndromes
scales, and 3 Severe Syndromes scales plus a validity
scale and 3 modifying indices.
• Wide range of information related to a client’s personality,
emotional adjustment, and attitude toward taking tests.
• Focus on personality disorders along with symptoms that
are frequently associated with these disordersDesigned for
use with adults 18 years and older who are being evaluated
and/or treated in mental health settings.
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MCMI – Theoretical Basis
• One of his core principles is the use of the polarities of
pleasurepain, active-passive, and self-other (R. Davis,
1999; Millon & Davis, 1996; Strack, 1999) *
• These three fundamental polarities form a foundation,
based in the larger framework of evolutionary theory
• Scale elevations should always be placed into the
context of the person’s life. A high score is not diagnostic
of a personality disorder in and of itself.
• Thus, the distinction between a personality “style” and an
actual personality “disorder” should be stressed.
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MCMI – Theoretical Basis
• MCMI-III is based on an integrative conception of
personality and psychopathology; conceptions of the
individual’s manifest symptoms in terms of the
interaction between longstanding coping styles and
psychosocial stressors.
• Clinicians must retrace the above historical progression
within the individual person, in order to achieve a
conception of each patient’s psychopathology that
contextualizes these manifest disorders in terms of the
larger context of the individual’s style of perceiving,
thinking, feeling, and behaving.
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MCMI - Scales
• Clinical Personality Patterns scales are described in the
following sections: Schizoid, Avoidant, Depressive, Dependent,
Histrionic, Narcissistic, Antisocial, Aggressive/Sadistic,
Compulsive, Negativistic (Passive-Aggressive), Self-Defeating
• Severe Personality Pathology Scales are three additional
pathological personality patterns the schizotypal, borderline, and
paranoid *
• Clinical Syndromes Scales (Axis I Syndrome) –Anxiety,
Somatoform, Bipolar: Manic Disorder, Dysthymia, Alcohol
Dependence, Drug Dependence, Post-Traumatic Stress
Disorder.
• Severe Syndromes Scales – Thought Disorder, Major
Depression, Delusional Disorder
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Beck Depression Inventory
• The BDI-II is a 21-item self-administered
inventorydesigned
• to measure the intensity of depressive symptoms in
psychiatric and nonpsychiatric populations of both adults
and adolescents (Beck et al., 1996).
• Items are rated on a 4-point scale (0 to 3) and total
scores are obtained by tallying the ratings for all 21
items. Scores range from 0 to 63, with higher scores
reflecting increased depressive severity
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BDI - Theoretical Basis
• The BDI-II items were specifically selected to evaluate
the symptoms and attitudes characteristic of the
phenomenology of depression rather than to adhere to
any particular theory (Beck et al., 1996).
• Additionally, although the BDI-II’s items are congruent
with the DSM-IV, the BDIII is intended to identify the
severity of symptoms and not nosological depression.
Thus, the BDI-II should be supplemented with other
information for a comprehensive assessment and
diagnosis of depression.
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Test Development
• The original BDI (Beck et al., 1961) was designed to be
administered in an interviewer-assisted fashion by
trained professionals
• The BDI items were initially drawn from clinical
observations and typical descriptions of symptoms
provided by depressed patients.
• The 1978 revision, which was published as the BDI-IA in
Beck et al. (1979), permitted simpler administration and
scoring (see Beck & Steer, 1984).
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BDI – Assets and Limitations
• Among the most frequently used psychological tests to date
• A number of different populations have been studied over the
years
• Clinically sensitive instrument that may be used for
determining a baseline level of severity, formulating clinical
hypotheses, deriving a case conceptualization, monitoring
session-by-session treatment change, and determining
treatment outcome
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Difficulties at the individual item level
Limited ability to detect deviant response sets and styles
Instability of scores over time
Lack of normative information for different ethnic groups
Lack of established criteria for determining the accuracy of
an examinee’s response.
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Assessment of Children and Adolescents
Personality Inventory for Children (PIC)
• multidimensional true-false objective questionnaire
completed by a parent or a parent surrogate that
assesses both broad and narrow dimensions of
behavioral, emotional, cognitive, and interpersonal
adjustment of children and adolescents.
– Standard form
– Behavioral Summary
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PIC – Adjustment Scales
• The nine full-length adjustment scales, each followed by
their factor-guided two or three component subscales,
are then presented in the following order:
(1) cognitive status (Cognitive Impairment) with subscales
measuring limited ability (Inadequate Abilities), inadequate
academic achievement (Poor Achievement), and problematic
development (Developmental Delay);
(2) disruptive or externalizing problem behaviors (Impulsivity and
Distractibility [Disruptive Behavior, Fearlessness] and
Delinquency [Antisocial Behavior, Dyscontrol,
Noncompliance]);
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PIC – Adjustment Scales cont’d..
(3) Family status (Family Dysfunction [Conflict Among Members, Parent
Maladjustment]);
(4) Overcontrolled or internalizing problem behaviors (Reality Distortion
[Developmental Deviation, Hallucinations and Delusions], Somatic
Concern [Psychosomatic Preoccupation, Muscular Tension and
Anxiety], and Psychological Discomfort [Fear and Worry,
Depression, Sleep Disturbance/Preoccupation With Death]); and
(5) Social status (Social Withdrawal [Social Introversion, Isolation] and
Social Skill Deficits [Limited Peer Status, Conflict With Peers]). Scale
interpretation may be supplemented by endorsed responses to a
critical item list of 106 statements placed into nine broad clinical
categories.
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• Eight shortened 12-item versions of the adjustment
scales (Cognitive Impairment is omitted) are placed on
the profile form in standard format order followed by a
profile of four summary composites: Externalization,
Internalization, Social Adjustment, and Total Score.
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Personality Inventory for Youth
• a self-report companion to the PIC for students in
Grades 4 through 12 (Lachar & Gruber, 1993).
• The PIY and PIC-2 are closely related in that the majority
of the 270 true-false PIY items were derived from
rewriting content-appropriate PIC items into a firstperson format.
• three response validity scales and nine substantive
scales
• Developmental or historical items were excluded in the
self-report inventory because children cannot be
expected to be accurate reporters of developmental
delay
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Theoretical Basis
• developed without reference to any specific theory of
personality or psychopathology
• Dimensions assessed by these instruments were
selected to reflect established empirical and important
clinical phenomena, taking into account problem
frequency in childhood and adolescence and problem
dimension salience in diagnostic assessment.
• Multidimensional and multisource assessment
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Theoretical Basis
• Multidimensional instruments efficiently measure a
comprehensive range of complementary problem
dimensions using a consistent format and
standardization process.
• Comorbidity of problem dimensions is more likely to be
the rule than the exception
• The diagnostic process for youth requires the accurate
assessment of both problem presence and problem
absence.
• Assessment of only the inferred condition in such cases
would result in a highly inaccurate evaluation
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