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507 midterm > Assessment, Diagnosis and the DSM > Flashcards

Assessment, Diagnosis and the DSM Flashcards

1
Q

Objectives in assessment

A
  • Determine a diagnosis
  • Conceptualize current problem
  • Understand the sociocultural context of the symptoms
  • Tailor a treatment strategy
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2
Q

What type of questions test your hypothesis during assessment?

A
  • Questions related to suspected diagnosis

- Questions related to alternative and rule-out conditions

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3
Q

What sources of info can you use in assessment?

A
  • patient self-report
  • spouse/parent/sibling
  • clinician’s observations
  • formal psych testing
  • available medical records
  • school/legal/medical records
  • internet
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4
Q

Assessment techniques

A

-interviews
-psychological tests (questionnaires, formalized tests)
-behavioral observations
(multiple sources of info are generally preferred)

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5
Q

Types of reliability measures

A
  • inter-rater

- test-retest

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6
Q

How is reliability measured?

A

correlation coefficients +1 to -1, .8 or better

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7
Q

What is validity?

A

A measure of the accuracy of a test’s or study’s results; are you measuring what you intend to measure?

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8
Q

Types of validity

A
  • construct validity
  • content validity
  • concurrent/criterion: the degree to which the measures gathered from one tool agree with the measures gathered from other assessment techniques.
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9
Q

Structured interviews

A

Mental Stats Exam (MSE)- physician administered
Structured Clinical Interview for DSM-SCID
Clinician administered PTSD Scale- CAPS

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10
Q

Semi-structured interviews

A

Less formal, more guided by clinical judgment

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11
Q

Types of self-report questionnaires

A 
Screening tools like BDI
Patient Health Questionnaire
PTSD Checklist
WHO Disability Assessment Schedule
Brief Addiction Monitor
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12
Q

What are the downsides to self-report questionnaires?

A

Bias and misrepresentation from patient because they know what is being measured.

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13
Q

Types of personality inventories

A

Minnesota Multiphasic Personality Inventory
Millon Clinical Multiaxial Inventory (MCMI)
NEO Personality Inventory Revised
Personality Assessment Inventory - 5 factor models

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14
Q

What types of projective measures are used in assessment?

A

Rorshach test
Thematic Apperception Test
Sentence Completion
Draw a person

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15
Q

Types of Neuropsychologcial assessments

A

Wechsler Adult Intelligence Scale, WAIS-IV (and the children’s version, WISC-V)
Repeatable Battery for the Assessment of Neuropsych Status (RBHNS)
Trail Making Test A and B (executive functioning)
Delis-Kaplan Executive Functioning System (D-KEFS)

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16
Q

Purpose of neurological assessment

A

Assess ability to carry out various functions that tap into different structures in brain

17
Q

CAT or CT scan

A

shows brain structure

18
Q

PET scan

A

Shows chemical activity

19
Q

fMRI scan

A

shows detailed neuronal activity by looking at blood flow in the brain

20
Q

What types of things are measured with biofeedback?

A 
Heart rate variability
Galvanic skin response
EMG- muscle tension
Thermal
EEG- used for brain training in autism disorders
21
Q

Idiographic

A

Focuses on the individual

22
Q

Nomothetic

A

Understanding general rules and laws; based on research and scientific method

23
Q

How does a good assessment combine both idiographic and nomothetic approaches?

A

Application of science to the individual
Common language/understanding
Tailors treatment to individual

24
Q

What is a categorical approach to diagnosis?

A

Each diagnosis is unique with non-overlapping and essential features. (medical model)

25
Q

What is a prototypical approach to diagnosis?

A

It is a type of categorical approach that is a combination of essential features and minimum number of common features- used since DSM-III

26
Q

What is a dimensional approach to diagnosis?

A

a rating of how severe a client’s symptoms are and how dysfunctional the client is across various dimensions of personality and behavior

27
Q

DSM-5 diagnoses

A
  • List disorders, with codes
  • “provisional” specifier can be used when strong presumption criteria will be met but not enough current info
  • “rule out” can be used when suspect a potential diagnosis or think there could be enough evidence
  • other conditions that may be Focus of Clinical Attention
28
Q

What would be included in a “other condition that may be focus of clinical attention”?

A

Other problems that are not mental disorders but may be the presenting problem. Not meant to be a laundry list but targets for treatment or factors that impact dx or tx.

29
Q

Level 1 DSM 5 assessment measure

A

Brief screening measures targeted to a variety of problem areas (eg mood, anxiety)- helps identify areas for further inquiry.

30
Q

Level 2 DSM 5 assessment measure

A

Brief targeted assessment measures on specific problem areas (eg depression anger)

31
Q

Value of diagnostic categories

A
  • Behavioral problems can be grouped into clusters
  • Aids communication: etiology, course, epidemiology, treatment
  • Heuristic value by stimulating research
  • Normalizes problems and provides guidance
32
Q

Logical problems with the DSM

A

300% increase in diagnostic categories in last 40 years

Categories become reified and used to explain the very behavior they describe

33
Q

Empirical problems with the DSM

A

Overlap in diagnostic categories and comorbidities

Validity: relationship to treatment is questionable

34
Q

Practical problems with the DSM

A

Social stigma
Pathologizes “problems in living”
Diagnostic categories often used to alleviate responsibility for behavior.
Diagnostic errors: wrong category, ignores sociocultural context, culture and gender bias, behaviors may be accentuated/ignored to fit category.

35
Q

Using the DSM-5 in diagnosis

A
  • not everyone requires a diagnostic label
  • clinical significance is critical
  • be patient and cautious
  • constantly revisit a diagnosis
36
Q

Criticisms of the validity of DSM

A
  • Have mental illnesses remained the same over time?
  • Does mental illness look the same across cultures?
  • Is the DSM applicable to all cultures?
  • Do we have it right with the idea of mental illness being due to biology?

507 midterm (8 decks)

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