Ch. 3 Clinical Assessment and diagnosis Flashcards
Clinical assessment
th systematic evaluation and measurement of psychological, biological and social factors in an individual presenting with a possible psychological disorder
reliability
the degree to which a measurement is consistent
validity
the degree to which a technique measures what it is supposed to measure
standardization
application of certain standards to ensure consistency
systematic observation of behaviour
any behaviour is happening, even what is not being described, always need to watch
mental health exam covers 5 categories
appearance and behaviour, thought processes, mood and effect, intellectual functioning, sensorium
appearance and behaviour category
overt behaviour, attire, appearance, posture, expressions
thought processes
rat of speech, slow, ranting, continuity of speech, content of speech
mood and effect
predominant feeling state of the individual. feeling state accompanying what individual says
intellectual functioning
type of vocabulary, use of abstractions and metaphors
sensorium
awareness of surroundings in terms of person, know who you are, day or time and where you are
structured clinical interview
more general
physical examination
lots of emotional disturbances can happen from health
behavioural assessment
thoughts, feelings and behaviour directly observed. target behaviours identified and observed
ABCs of observation
Antecedents (precede a behaviour - stressed at work give you feelings you cannot control), behaviours (eliciting the behaviour), consequences (trying to cope, how it is affecting the person)
informal observation
subject to observers interpretation
formal observation
behaviours are observable and measured (how many twitches and how bad), pattern, design treatment based on pattern
self monitoring or self observation
most people monitor their behaviour outside the session. can use checklist or behaviour rating scales
reactivity
observational data subject to distortion upon being observed. resistant to self monitoring
psychological testing
determine cognitive, emotional or behavioural responses. Can use Intelligence tests (memory, attention, judgement) or neurobiological procedures (determine brain damage or dysfunctions)
projective testing
psychoanalytic tradition, rorschach inkblot test, thematic apperception test
psychoanalytic tradition
determine something by what a person is seeing
rorschach inkblot test
people have to talk about what they are seeing and then interpreted by the psychoanalyst (questionable reliability and validity)
thematic apperception test
cards and the person has to tell a story about them (widely used)
minnesota multiphasic personality inventory (MMPI)
finds features of personality disorders, traits of a person that us unlikely to go away
Intelligence testing
now standardized, below 70 could have a mental disorder
neuropsychological testing
pinpoint the location of brain dysfunction. Common tests: bender visual motor gestalt test and Halstead Reitan neuropsychological battery. Issues are false positives or false negatives
bender visual motor gestalt test
used in children to determine issue with attention. How kids can copy images. uses visual and motor measurements
halstead reitan neuropsychological battery
takes in account strength, rhythm and memory
Neuroimaging of brain structure
Cat scan and MRI, identify structural abnormalities that might be associated with psychological disorders
Neuroimaging of brain function
PET scan - inject someone with aceptope, see where brain is active
Single photon emission computed temography - uses radioactive tracer
fMRI - look at blood flow. All find neurobiological factors to psychological disorders
Electroenphalgram (EEG)
event related potential - expose a person to something. evoked potential - what happens after stimulus
electrodermal response (skin conductance)
measures changes, body temperature
Diagnosing psychological disorders
classification, taxonomy, nosology, nomenclature
classification
construct groups or categories and to assign objects or people to these categories on the basis of their shared attributes
taxonomy
classification in scientific context
nosology
application of a taxonomic system to psychological or medical ohemonena
nomenclature
names or labels of the disorder that make up the nosology
DSM-5-TR
psychological
ICD-11
has every disease you can imagine
classification issues
distinctions between normal and abnormal unclear, behaviours a category instead of a continuum,
classical categorical approach
signs that there is something wrong biologically, same symptoms with no vairations
dimensional approach
measured in scales, more rigid
prototypical appoach
average of numbers in a category, some aspects are common for everyone but there are lots of expressions within the category
reliability of DSM
personality order classification unreliable and biased, they are complex, definitons keep getting redefined and may not disclose some infromation
validity of DSM
label for disorder right, lots of symptoms for the same disorder
social and cultural considerations in the DSM-5-TR
different cultures and locations create differences genetically or societal factors
criticisms of the DSM-5-TR
comorbidy, defintions are flawed and can changee
comorbidity
people may have more than one disorder at a time, may need to redefine how the disorders are classified
labelling
categorizing people as individuals with psychological disorders as their totality
stigma
negative connotation attached to individuals with impaired cognitive abilities or behavioural functioning
mixed anxiety-depression
not included in DSM, not enough for people to get diagnosed, not severe enough or prelevant
pre-menstrual dysphoric disorder
part of DSM, huge debate if it should be included or not.
Autisim spectrum disorder
allows for more variations and helpful with treatments
