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Abnormal Psychology > Ch. Diagnosis & Assessment > Flashcards

Ch. Diagnosis & Assessment Flashcards

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1
Q

diagnosis

A
  • consensus-based definitions and classifications based on symptoms and signs
  • far from ideal; opposite of medical field
  • DSM-5-TR
  • diagnostic categories have evolved over time
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2
Q

advantages of diagnosis

A
  • first step in good clinical care
  • facilitates communication among professionals
  • advances research for causes and treatments
  • comorbidity
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3
Q

reliability

A
  • consistency of measurement (0-1.0)
  • 0.6-1.0 is good
  • 0.65-0.7 is the standard
  • assessment scores during the day should be similar
    types:
  • inter-rater
  • test-retest
  • alternate forms
  • internal consistency
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4
Q

interrater

A

two clinicians assess the same individual that make the same diagnosis

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5
Q

test-retest

A

pre and post test situation; when test scores are compared, they should correlate

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6
Q

alternate forms

A

multiple types of assessments for disorders and can be used to test for symptoms that correlate similar findings; converge on one diagnosis

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7
Q

internal consistency

A

scales may be multiple items and answers should cluster together from each question on the scale

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8
Q

validity

A
  • are the tools we are using measuring what they are supposed to be measuring?
  • unreliable measures → questionable validity
  • reliability does not guarantee validity
  • mental illness is like a moving target; it is always changing and needs constant assessment
    -types:
    content
    construct
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9
Q

content validity

A

measure adequately represents the domain of interest (i.e., all symptoms of disorder)

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10
Q

construct validity

A

measure accurately represents the phenomenon
- multiple measures of the same domain
ex. sadness and depression
- distinguished from measures it should not be related to
ex. happiness and depression

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11
Q

diagnostic system of the american psychiatric association: DSM-5-TR

A
  • diagnostic and statistical manual of mental disorders
  • first edition published in 1952
  • five revisions
  • current edition: released in 2022
  • continual refinement
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12
Q

what the DSM-5-TR provides

A
  • diagnostic criteria
  • description of associated features
  • summary of research literature
  • defines diagnosis on basis of symptoms
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13
Q

diagnostic criteria

A

each revision → more detailed and concrete

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14
Q

description of associated features

A

laboratory findings and results of physical exams
ex. scan of person who has possible schizophrenia has enlarged ventricles

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15
Q

summary of research literature

A

age of onset, course, prevalence, risk and prognosis factors, cultural and gender factors, differential diagnosis

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16
Q

defines diagnosis on basis of symptoms

A

our knowledge is not strong enough to organize around etiology
- chapters organized to reflect patterns of comorbidity (dual diagnosis) and shared causes

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17
Q

culture can influence

A

-risk factors
individualistic vs. collectivist
- symptom experience
invalidation
- stigma
less developed parts of the world
- willingness to seek help
men do not want to get help
- availability of treatments

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18
Q

DSM-5-TR cultural sensitivity

A
  • discussion of culture-related issues for most disorders
  • cultural formation interview questions for clinicians
  • descriptions of how symptoms present across cultures
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19
Q

cultural concepts of distress

A
  • DSM-5-TR Appendix 9
    9 syndromes observed in specific cultures
    shenjing shuairuo (China)
    weakness, mental fatigue, negative emotions, sleep problems
  • cross-cultural approach
    syndromes that can be identified across cultures
  • culture-specific approach
    cultural concepts of distress are key in understanding disorders
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20
Q

criticisms of DSM

A
  • too many diagnoses
  • categorical vs. dimensional diagnosis
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21
Q

too many diagnoses

A
  • comorbidity
  • many risk factors increase risk for multiple disorders
  • should common reactions be pathologized?
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22
Q

research domain criteria (RDoC)

A
  • investigation of psychological variables relevant for many conditions
  • use of basic science to develop a new classification system
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23
Q

hierarchical taxonomy of psychopathology (HiTOP)

A

syndromes that frequently co-occur → subfactors → higher-order dimensions

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24
Q

categorical

A
  • do symptoms fit a category or not?
  • one threshold with actual, hard boundaries
  • threshold can provide help treatment guidance
25
Q

dimensional

A
  • severity (included in DSM-5-TR)
  • sub-threshold symptoms
26
Q

negative effects of diagnosis

A
  • life changing event; period of adjustment
  • stigma
  • deindividuation
27
Q

stigma of diagnosis

A
  • BUT–labels serve to provide explanations for behaviors that people perceive as negative
  • avoidance-based
  • serve to provide explanations; perceived as a consequence of a mental disorder
28
Q

deindividuation of diagnosis

A
  • “schizophrenic” versus “person with schizophrenia”
  • all unique individuals not just mental illnesses
29
Q

clinical interviews

A
  • establish rapport
  • empathize with client experiences
  • encourage client to elaborate on concerns
30
Q

structured clinical interviews

A

standardized interview
- same questions in the same order
- maximize ability of high interrater reliability for most categories
- used in research settings; ability to replicate
most clinicians asses DSM symptoms informally
- a weakness overall; use own discretion and judgment

31
Q

hans seyle & general adaptation syndrome (GAS)

A
  • stress is connected to overall functioning
  • an approach to understanding pattern of stress
  • outlines evolutionary adaptation
  • provides insight when stressor endures longer than is maintainable
32
Q

GAS phase 1

A

the Alarm Reaction
- ANS activated by stress; more oxygen to brain, blood to vessels

33
Q

GAS phase 2

A

resistance
- damage occurs or organism adapts to stress
- stress in a small amount is good for people

34
Q

GAS phase 3

A

exhaustion
- organism dies or suffers irreversible damage
- damage to soft tissues, bones, cardiovascular system

35
Q

stress

A
  • subjective experience of distress in response to perceived environmental problems
  • biopsychosocial perspective
36
Q

life stressors

A
  • environmental problems that trigger stress
  • could be positive or negative
    ex. graduating from high school; car crash, loss of job
37
Q

Bedford College Life Events and Difficulties Schedule (LEDS)

A
  • semi-structured interview covering 200+ stressors; open for discussion
  • evaluates importance of an event in the context of a person’s life circumstances; how was the event experienced in an individual at a certain time
  • excludes life events that are consequences of symptoms
    family crisis in responses of delusional experiences
  • carefully dates when life stressors occur
  • genes are sensitive to stress in the environment
38
Q

personality tests: inventories- self-report questionnaires

A

standardized (i.e., comparable with statistical norms)

39
Q

Minnesota Multiphasic Personality Inventory-2-Restructured Format (MMPI-2-RF)

A
  • personality test
  • profile of psychological functioning with validity scales to detect over/under reporting of symptoms
  • needs to be given by a professional to correctly assess scores
40
Q

Rorschach Inkblot Test

A
  • apperception tests; how they view ambiguous images allow for us to obtain insight how they view the world
  • not as easily scored, a lot of personal judgment, responses are subjective
  • perceive threat, danger, sexuality
41
Q

Thematic Apperception Test (TAT)

A
  • ask to tell story of the individual in the drawings
  • recurring theme of threat or anxiety show how they view the world
  • not to be used in isolation
42
Q

Big Five Inventory-2 (BFI-2) and NEO Personality Inventory (NEO-PI)

A
  • OCEAN traits
    openness to experience, conscientiousness, extraversion, agreeableness, neuroticism
  • both assess the five broad domains of personality
43
Q

cognitive tests

A
  • cognitive ability
    currently used to predict school performance
  • diagnose learning and intellectual disabilities with neuropsychological examinations
    highly reliable and good validity, but explains very little school performance
    impacted by stereotype threat
    ex. a woman shows up to take a math test who has an experimenter that is a male and could inhibit her performance from distracted from knowledge of stereotype
44
Q

neuropsychological tests

A
  • pinpoints cognitive impairment
    assumption: cognitive functions are supported by physical structure of the brain
  • brain imaging techniques used to identity where “brain damage” may be
    damage → performance deficit
  • neuropsychological batteries
45
Q

observational method

A

assess (problematic) behavior as it occurs
- frequency & form; antecedent and consequences
go in with a theory

46
Q

methods of observation

A
  • direct observation
    ex. verbal dialogue, behaviors
  • interviews
  • self-report measures
  • laboratory structured
    researcher is on one side of a one-sided mirror observing interactions of children playing with an adult
47
Q

experience sampling: daily diaries

A
  • self-monitoring / tracking of behavior
  • moods, events, thoughts
  • notifications are sent randomly assigned times to participants
48
Q

Computerized axial tomography (CT or CAT)

A
  • brain structure → brighter is more dense tissue
  • detects tissue density differences and structural abnormalities
49
Q

Magnetic resonance imaging (MRI)

A
  • brain structure
  • higher quality than CT
  • electromagnetic signals
50
Q

Functional MRI (fMRI)

A
  • brain structure and function
  • blood flow in brain is proxy for neural activity
    do not actually see activity
    BOLD signal (blood oxygenation level dependent)
51
Q

Positron emission tomography (PET)

A
  • invasive
  • uses radioactive glucose in the bloodstream
  • if it is metabolizing sugar, then area is active
52
Q

connectivity

A
  • structural (white matter)
  • functional (BOLD signals)
  • effective (direction and timing of BOLD activations)
53
Q

psychophysiology

A
  • bodily changes associated with psychological events
  • eye training with schizophrenia → disjointed, not smooth
54
Q

brain stimulation (noninvasive)

A
  • transcranial magnetic stimulation (TMS)
  • transcranial direct current stimulation (tDCS)
55
Q

autonomic nervous system reveals aspects of emotion

A
  • electrocardiogram (EKG)
  • electrodermal responding (skin conductance)
    anxiety, fear, anger
    looking at the activation
56
Q

things to keep in mind regarding neurological assessment

A
  • measures do not distinguish between emotional states
  • scanning environment → change
  • unable to manipulate brain activity and then measure change in behaviors
    i.e., no “proof” that brain activity causes change in behavior
57
Q

things to generally keep in mind

A
  • alternative explanations
  • complete assessments require multiple methods
  • pre existing abilities prior to diagnosis affect consequences of dysfunction
58
Q

cultural & ethic diversity in assessment

A
  • assessments are developed within cultures; culturally bound
  • cultural bias = over/under estimation of problems
    mistakes based on assumptions about culture and emotion
59
Q

avoiding bias

A
  • ongoing professional development in cultural awareness
  • ensure that research participants understand tasks
  • distinguish “cultural responsiveness” from cultural stereotyping

Abnormal Psychology (7 decks)

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