Assessment and Diagnosis Flashcards
Psychological assessment
Collection, organization, and interpretation of information
Psychological diagnosis
Determining whether client’s issues meet criteria for specific psychological disorder
Goals of psychological assessment
Description and prediction
Reliability
Consistency
Validity
Accuracy
Norms
Way normal people answer questions on a test
Standardization
Presenting the test the same way every time
Areas queried in an interview
Presenting problem
Current context
History of presenting problem
Biopsychosocial history (family life, support system, living conditions, etc.)
Sensorium
Orientation to a situation: awareness of identity, current day, current time, etc.
Unstructured interview
Talk with client, ask questions based on answers
Advantage: respond to client
Semi-structured interview
Root questions with room for followup
Structured interview
Ask scripted questions
Advantage: reliability
Used in court settings and in research
Interview bias in interviewer and interviewee
Interviewer: areas queried, confirmation bias
Interviewee: social desirability, forgetting
Tachycardia
Racing heart
Physical condition that mimics panic disorder
Hypothyroidism
Physical condition that mimics depression
ABC’s of behavior assessment
Antecedents: what happened before
Behaviors
Consequences: what happened afterwards
Self-report
Indirect behavioral observation
Retrospective account of events
Self-monitoring
Indirect behavioral observation
Client writes down what he/she did at specific time and how he/she was feeling then
Psychological test
Structured tool used to assess symptoms that might be associated with a specific disorder
Quantifies symptoms
Projective tests
Give ambiguous stimulus and ask to provide meaning
Provides glimpse into unconscious
Examples: Rorschach inkblot test, Thematic Apperception Test (TAT)
Pros and cons of projective tests
Pros: lots of data generated, hard to fake
Cons: poor reliability and validity, complex and time consuming
Objective tests
Clients asked to report on their beliefs, emotions, or experiences through questionnaires
True-false and rated using number scale
Comprehensive personality inventories
Form of objective test
MMPI (Minnesota Multiphasic Personality Inventory): rate on several different disorders (high score means tendency towards specific disorder)
Symptom assessments
Form of objective test
BDI (Beck Depression Inventory): ask questions relating to symptoms of depression using number scales
Pros and cons of objective tests
Pros: can query specific information, high validity and reliability, provide information relative to others
Con: only face valid (people can fudge answers- questions aren’t ambiguous)
Areas assessed on intelligence tests
Verbal intelligence
Performance of tasks
Processing speed
Working memory abilities (store info in short-term memory and use)
IQ nuts and bolts
Measuring performance relative to others
Score of 100 is average
15 points= 1 standard deviation
Pros and cons of cognitive tests
Pros: identification of strengths and weaknesses, good reliability and validity
Cons: cultural bias (minorities compared to majority), stigma (set of expectations come with test, which people then live up to), overuse
Neuropsychological tests
Assessment of psychological functioning as it relates to brain structures or pathways
Functional testing rather than scanning brain
Focus of neuropsychological tests
Attention, memory, executive functioning, sensory and motor abilities, sensorium
Examples of neuropsychological tests
Halstad-Reitan and Nebraska-Luria: big batteries of tests
Wisconsin card sort: teach rules for sorting, then make person adapt to new rules
MMSE ( mini mental status exam): ask questions related to sensorium, naming, problem solving, reading, etc.
Psychophysiology assessment
Computer-aided procedures that allow non-intrusive examination of bodily processes
EEG (electroencephalography)
Psychophysiological test
Electrodes touching scalp: measure electricity in brain
EKG (electrocardiography)
Psychophysiological test
Measure heart beat
GSR (galvanic skin response)
Psychophysiological test
Measure amount of sweat on skin
PSG (polysomnography)
Psychophysiological test
Measure sleep
CT (computerized tomography) scan
Test of brain structure
X-rays of brain
MRI (magnetic resonance imaging)
Test of brain structure
Use magnet to align protons in brain- shows density
PET (positron emission tomography) scan
Test of brain function
Radioactive dye binds to glucose: active areas receive glucose
Considerations in regard to psychological assessment
Bulk of tests are self-report
Tester has biases
Tester can fail to use test as it was intended
Testing is a long and expensive process
Sensitivity
Pick up all symptoms (diagnose people), but lots of false positives
Specificity
Doesn’t pick up all symptoms (miss people), but little to no false positives
Pros of diagnosis
Common nomenclature Provide a prognosis Guide treatment and accommodations Normalize client experience Inform benefits/ insurance
Categorical model
Qualitatively different (either depressed or not; difference from other people)
Dimensional model
Quantitively different (continuum: how many symptoms do you have; clear cut off point)
Prototype model
Compare to prototype (compare your symptoms with the traditional symptoms of the disorder)
ICD-6
1949: 1st diagnostic system of mental disorders to be used in medicine
DSM taxonomy model
Categorical/prototype based
Number of diagnoses in DSM
Over 400
Focus of DSM
Reliability is focus (observable characteristics); validity is less important
Diagnostic criteria included in DSM
Essential features (diagnostic criteria) Associated features (commonly seen symptoms, but not diagnostic criteria) Cultural features Prevalence Course
Multiaxial assessment
DSM-IV only (not DSM V)
Axis 1: Clinical symptoms (mental disorders)
Axis 2: Personality disorders and intellectual disabilities
Axis 3: General medical conditions (especially those that worsen disorders)
Axis 4: Psychosocial/environmental stressors
Axis 5: Global assessment of functioning (GAF) (Score of 0-100, with 100 being perfect and 0 being total mess)
Cons of diagnosis
Creates illusions that disorders are qualitatively different (actually quantitatively) and that disorders provide explanations (actually just describe symptoms)
Labels may be harmful (stigma and identification with disorder)
Comorbidity
Diagnosis of more than 1 disorder at a time
Caused by poor diagnostic criteria/overlap, one disorder is a risk factor for another, or both caused by same mechanism
Internal validity
Extent to which you can be confident that the independent variable is causing the dependent variable to change
External validity
How well results relate to things outside your study
Case study
Critically observe specific cases
Survey
Questionnaires that assess area of interest
Epidemiology
Study distribution in the population
Correlational study
Relation exists between two variables
Cannot assume causation
Experimental research
Manipulation of one variable (independent variable) impacts another variable (dependent variable)
Allows for cause-effect conclusions
Randomized control trials
Participants randomly assigned and given standard treatment
Cross-sectional studies
Measure relationship between variables at one point in time
Allows for group (cohort) comparison
Single case designs
One subject, repeated measurements
Withdrawal design
Type of single case design
Researcher tries to determine whether the independent variable is responsible for changes in behavior
Multiple baseline design
Type of single case design
Researcher starts treatment at different times across settings
Longitudinal study
Measure behavior of interest over a long period of time
Useful for studying risk factors and course of disorders
