2.3 Assessment + Diagnosis Flashcards
fraction of australians experienced mental disorder at some point in their life? and how many in past 12 months?
2/5; 1/5
likelihood to seek help from a health professional?
45.1%
females and young people more likely
what are the primary challenges to mental health assessment?
- cultural + social factors
- comorbidity
- biases in assessment
- ethics - confidentiality, mis/over-diagnosis
contrast the DSM and ICD
- DSM for america + australia - evolving document, guide only, comparative systematic framework for identifying disorders,gradual move to dimensional classification/diagnosis
- ICD for europe - entirely digital, global standard, multilingual, input from >90 countries
differentiate categorical and dimensional approaches for diagnoses
- dimensional = how severe
- categorical = either you have it or you don’t
what are the advantages and disadvantages of a categorical approach?
+ve: clarity and ease of communicating info, aligns better w disease classification in medicine
-ve: dificult to distinguish threshold where person crosses from what’s considered ‘normal’ personality traits through to meeting criteria for personality disorder
outline positives of a DSM diagnosis
- better communication between researchers/professionals
- conducive the research, treatment planning
- community understanding
- helpful personally - attribution
- practicality: funding, insurance
outline cons of DSM diagnosis
- labeling/stigma
- oversimplification of human behaviour
- misdiagnosis/overdiagnosis
- overmedicalising/pathologising reasonable reactions to stress
what do clinical psychologists do?
AT SPRT
* assessment - diagnostic interviews
* treatment - making + enacting plans
* supervision - regular supervision
* professional development - 30 hrs learning /year to be registered
* research - some can continue while practicing, not req
* teaching - some can teach undergraduate/graduate, not req
what is clinical assessment
careful tailored dialog and rapport - therapeutic alliance to determine what is important to patient
- open-ended diagnostic questioning
- biopsychosocial model inc cultural/spiritual factors
- psychological assessment: clinical interviews, questionnaires
outline the process of clinical interviews
- administered by trained clinicians familiar w DSM-V
- tailored to client - response determines next question
outline + assess self-report questionnaire
- to SCREEN for possible diagnosable disorders - more narrow than interview, can be dimensional
+ve: quick + easy
-ve: cannot be used in isolation - clinical judgement needed
give 3 examples of self-report questionnaire
- DASS21 - depression anxiety and stress within past week
- AUDIT - Alcohol Use Disorder Identification Scale
- EDDS - Eating Disorder Diagnostic Scale based on DSM, measuring propensity towards eating disorders
give examples of reports, direct observation of behaviour, physiological measurements
- reports: Spence Children’s Anxiety Scale, which uses child AND parent reports
- direct observation of behaviour: antecedent, behaviour, consequence
- physiological measurements: brain scans, heart rate –> none of these are diagnostic
what is case formulation and decision-making
hypothesis-driven process that integrates multiple sources of info to understand client’s difficulties + guide treatment
- helps identify underlying causes, differentiation, individualise treatment, track progress
what is the case formulation template
- vulnerabilities (predisposing factors)
- stressors/triggers (precipitating factors)
- positive + negative prognostic (predictive factors)
- maintaining factors (perpetuating factors)
steps in diagnostic decision-making
- interview + gather info
- identify symptoms + clusters
- consider differential diagnoses
- apply biopsychosocial model
- formulate working hypothesis - diagnose
- develop treatment plan
- monitor + adjust, applying intervention
what are, and what are the benefits of, multidisciplinary teams?
- psychiatrists, nurses, psychs, social workers, OTs
- complex understanding of mental health
- well-rounded care, holistic
- mutual support + learning
what is the future of mental health assessment?
AI!
* machine learning in diagnosis
* mood wearables, tracking, measurement tools
* therapy chatbots
* automation of session notetaking
* decoding dreams + internal voices
what are the risks of using AI in mental health assessment?
ethical + practical considerations
* client consent, data privacy, data security
* who owns the data collected from wearables + AI tools?
* deepening inequities reflecting biases in the data
