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Abnormal Psych: Exam 1 > Assessment and Diagnosis > Flashcards

Assessment and Diagnosis Flashcards

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1
Q

Why do we do an initial assessment and usually assign a diagnosis?

A
  • determine main symptoms/problems
  • select appropriate treatment
  • formulate treatment goals
  • gather baseline data for later comparisons
  • help us communicate with other providers
  • to permit insurance reimbursement
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2
Q

Psychological Assessment

A
  • what is the client’s presenting problems?
  • may use psychological tests, observations, interviews
  • summarize clients symptoms and problems
  • ongoing process
  • more of a narrative
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3
Q

Clinical Diagnosis

A
  • under what “label” does the client best fit?
  • use results of the assessment to arrive at a summary classification
  • DSM-5 (US) or ICD-10 (rest of world)
  • usually needs to be set at the onset of treatment, but may change over time
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4
Q

Important Issues to Consider

A
  • what is the client’s behavior like in different settings? is it consistent?
  • what personality characteristics stand out?
  • what does the client’s social context look like?
  • Am I assessing the client in a culturally sensitive manner?
  • How does my professional orientation impact my assessment?
  • Are my assessment instruments reliable? valid? standardized?
  • Does my client trust me?
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5
Q

Physical Exam

A

=especially important for certain disorders

  • depression, anxiety: check thyroid
  • bipolar: check for substance abuse
  • major neurocognitive disorders: may be B12 deficiency
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6
Q

Neurological Exam

A

=electroencephalograms (EEG)
=CT scans, MRI scans
=PET scans

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7
Q

EEG

A
  • record voltage changes occurring at the scalp

- reflect activity in brain underneath the scalp

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8
Q

CT scans, MRI scans

A
  • very detailed snapshots
  • looks at anatomy
  • can show brain changes in relation to psychiatric disorders, ex schizophrenia has enlargement of some areas
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9
Q

PET scans

A
  • appraisal of how an organ is functioning
  • provides metabolic portraits by tracking compounds such as glucose as the are metabolized
  • useful in Alzheimer’s research
  • used to locate location of stroke or tumor
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10
Q

fMRI scans

A
  • functional MRI
  • measure changes in local oxygenation
  • measure activity of brain areas based on oxygen levels
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11
Q

Neuropsychological Examination

A
  • use of various testing devices to measure a person’s cognitive, perceptual and motor performance as clues to the extent and location of brain damage
  • doc can use standard group of tests or choose which for that individual
  • Halstead-Reitan battery for adults
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12
Q

Psychosocial Assessment

A
  • may be structured or unstructured

- may include use of role plays, self monitoring, and or rating scales

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13
Q

Adv and Disadv of structured psychosocial assessment

A

Adv -easier to compare, a form to follow

DisAdv -may feel like rapid fire questioning

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14
Q

Symptoms vs Signs

A

Symptoms: why they came to you, what they are saying
Signs: what you see going on, ex constant fidgeting

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15
Q

Psychological Tests

A
  • standardized sets of procedures/tasks
  • obtain samples of behavior
  • responses are compared to test norms
  • values depend on skill of clinician
  • more common in research and hospital/clinic settings
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16
Q

Intelligence Testing

A
  • Wechsler IQ Score
  • WAIS testing: adult version
  • comprehension, arithmetic, information
17
Q

Personality Testing

A
  • can be projective or objective

- contain very extensive validity scales

18
Q

Projective (explanation, strengths, weaknesses)

A

-ambiguous, stimulus, picture
-ex: Rorschach- comes from psychodynamic framework
=Strengths:
-qualitative data, ice breakers
=Weaknesses:
-answers can be influenced by tester’s attitude, setting
-subjective scoring
-validity? reliability?

19
Q

Objective (explanation, strengths, weaknesses)

A

-restricted responses, not ambiguous stimuli
-ex: Likert Scale, MMPI 2
=Strengths:
-economical
-objective scoring
-valid, reliable
=Weaknesses
-one score
-self knowledge
-faking
-little info on dynamics underlying behavior

20
Q

MMPI 2

A 
=567 True False Questions 
=Measures 10 Clinical Scales 
-rough assessment of disorders 
-intrapersonal relations 
-behavioral problems 
-treatment possibilities
-characteristics 
=very strong validity measures
21
Q

About Validity Scores for MMPI 2

A
  • Measures 9 validity scales
  • used to determine malingering or pretending to be healthier than you are
  • very hard to malinger on this test
22
Q

About Clinical Scales for MMPI 2

A
  • 10 scales
  • each associated with a personality characteristic that can be seen in disorders
  • elevated scores on different combinations of scales suggest different disorders
  • no one elevated scale is enough on its own to make a diagnosis
23
Q

Validity Scales of MMPI 2: 1-4

A
  1. Cannot say score - measures total number of unanswered items
  2. Infrequency scale (F) - measures false or exaggerated claims in first half of booklet, detects random responding
  3. Infrequency scale (FB) - false or exaggerated claims on items toward end of booklet
  4. Infrequency scale (Fp) - exaggerate problems among psychiatric patients
24
Q

Validity Scales of MMP2: 5-9

A
  1. Lie scale (L) - claim excessive virtue
  2. Defensiveness scale (K) - see oneself in an unrealistically positive way
  3. Superlative Self-Presentation scale (S) - present in a highly positive manner
  4. Response Inconsistency scale (VRIN) - endorse items in an inconsistent/random manner
  5. Response Inconsistency scale (TRIN) - endorse items in an inconsistently true or false manner
25
Q

Clinical Scales of MMPI2: 1-5

A
  1. Hypochondriases (Hs) - excessive physical complaints
  2. Depression (D) - symptomatic depression
  3. Hysteria (Hy) - ex “rose colored glasses”, tendency for physical problems under stress
  4. Psychopathic deviate (Pd) - antisocial
  5. Masculinity-femininity (Mf) -gender role reversal
26
Q

Clinical Scales of MMPI2: 6-10

A
  1. Paranoia (Pa) - suspicious, paranoid ideation
  2. Psychasthenia (Pt) - anxiety and obsessive worrying behavior
  3. Schizophrenia (Sc) - peculiarities in thinking, feeling, and social behavior
  4. Hypomania (Ma) - unrealistically elated mood state and tendencies to yield to impulses
  5. Social Introversion (Si) - social anxiety, withdrawal, over control
27
Q

Always consider….

A
  • why someone may be responding the way they did

- the effects of coaching

28
Q

Diagnosis

A
  • 3 approaches to classifying abnormal behavior
    1. categorical
    2. dimensional
    3. prototypical
29
Q

Categorical Approach

A
  • either normal or abnormal
  • can be a category within abnormal, but only one
  • no overlap, no comorbidity
30
Q

Dimensional Approach

A
  • everyone is somewhere on the scales (depression, anxiety, etc)
  • where do you fall? how much of a symptom set?
31
Q

Prototypical Approach

A
  • how do you compare to a prototype of the disorder?

- a prototype is a very typical presentation of the disorder

32
Q

Classification systems

A

=ICD-10: WHO, most of the world
=DSM-5: APA, US
-since the DSM-3, has given an exact recipe for the disorder, before it was more prototypical

Abnormal Psych: Exam 1 (9 decks)

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