Chapter 3 (Adult) Flashcards
What is a clinical assessment?
The systematic evaluation and measurement of psychological, biological and social factors in an individual with possible psychological disorder.
Classical medical definition of a diagnosis?
The process of identifying a disease by its manifestations (symptoms, signs, results) of various special investigations.
Define diagnosis
Process of determining if a presenting problem meets established criteria for a specific psychological disorder.
2 components of diagnosis.
Securing symptoms and signs and interoperating adjunctive sources of information
The knowledge of normal functioning and behavior and their pathological counterparts required by diagnosis
What are signs and symptoms? Are they important to a psychologist for diagnosis?
- A symptom characterizes a state, condition or entity.
- symptoms indicate change from a former state.
- it is also a manifestation of a state or condition conceptualized as indicating an abnormality as indicated by the affected individual - A sign is a manifestation of a condition that may indicate abnormality observed by another person like a doctor or a psychologist.
Why is it usually difficult to differentiate between a symptom and a sign?
Other features of an issue are both a sign and a symptom. Eg, mood, sweaty palms and shaking.
What 3 things should be known for a diagnosis?
Who? Why? What?
- who is the person?
-why are they being consulted?
- what can be observed?
By what means do psychologists examine?
Observing mental state and behavior.
State 3 standardized test instruments
- Neuropsychological batteries
- Intelligence assessments
- Personality assessments.
State and explain the types of diagnosis
Phenomenological diagnosis- when only observed and reported information is available
Syndromal diagnosis- the refers to when the reoccurrence of predictable clusters of phenomena is recognized. There is more information known because there is enough observable phenomena
What is the so-called hypothetico deductive method?
An intermediate approach that best exemplifies the logical underpinnings of the diagnostic process
Outline the process of the so-called hypothetico deductive method
- The clinician forms a hypothesis about the problem from the onset
What combination of the approaches is best for a diagnosis?
- History- presents the main substance of the hypothesis
- A focused, further direct enquiry to confirm or refute the hypothesis
- An examination, which provides similar information to special investigations.
What are pathognomonic diagnosis
It means that there is one symptom or sign or set of symptoms of signs that uniquely define a condition. They are rare and relying on this approach is p e r i l o u s
Define delirium
When a syndrome and the available evidence does not shed anymore light on what the causes and what the outcomes might be
Name four things that indicate delirium
Decrease arousal
Poor attention
Cognitive disturbances hallucination
What are two rare examples of a e t i o l o g i c diagnosis in mental health
Huntington’s disease which is a major neuro cognitive disorder and neurosyphilis formally called general paresis of the insane
Why is functional diagnosis useful?
Allows us to consider the functional implications of a condition and and it’s useful in dramatic brain injury chronic psychotic conditions and neuro developmental disorders
What is a differential diagnosis?
Refers to a list of possible conditions that conform to the available clinical information
What is a final diagnosis
It is reached only after other disorders on the lists have been eliminated through further investigations
What is a syndrome
Implies the clustering of given symptoms signs and results of special investigations that occurs with sufficient regularity and predictability constituting a putative disease entity. A syndrome also refers to asset of Clinical and supporting information that coo occur at a frequency greater than change
What is a disease?
A disease consists of a combination of Clinical phenomenology course behavior pathogenesis and atlogy or initial cause
What three basic concepts that help determine the value of our assessment help lesions understand the different choice to assess psychological problems?
Reliability validity and standardization
Define reliability
Refers to the extent at which a measurement is consistent
Explain one way that psychologists improve fair reliability
Like carefully designing their assessment devices and then conducting research on them to ensure that two or more raters will get the same answers this is called inter-rater reliability
What is the test- retest reliability
A neurocognitive parameter such as attention span should remain stable from one assessment to the next
Define validity
Refers to weather or not something measures what it was designed to measure in this case whether a technique assesses what it is supposed to
What comparison is known as the concurrent or descriptive validity
Comparing the result of an assessment measure under consideration with the result of others that are better known which allows you to begin to determine the validity of the first measure
What is predictive validity?
It refers to how will your assessment tells you what will happen in the future
Define standardization
It is the process by which a certain set of standards or norms is determined for a technique to make its use consistent cross different measurements
To what do the standards apply?
Standards might apply to the procedures of testing scoring and evaluating data
What does the value of assessment depend on?
Reliability validity and standardization
What is another word for clinical interview? Why?
Clinical encounter or consultation the term interview gives the impression of a question and answers session which impedes the free flow of information that is important to get to the bottom of any presentation
State four features that should be considered in the clinical Encounter
The clinical encounter must be systematized, structured, goal- directed,and rooted in scientific understanding but should be natural and not threatening
- questions must be avoided so as to allow the patients to speak Revealing more information
- the system structure goals and scientific underpinningings should inform the clinician but should not prevent the two from interacting
What are the three legs of Clinical Encounter?
History mental state examination and behavioral observations
What is standardization?
That is the process of establishing specific norms and requirements for a measurement technique to ensure that is used consistently across a measurement occasions. It includes instructions for administering the measure evaluating it’s findings and comparing them to a data f o r numbers of people
What does asking someone who they are informs you on…
Their name age where they reside who they live with relationships education current and past work religion and social support structures
What can the way in which someone tells you their age reveal?
The person’s cognitive ability motivation mood and reality testing
Does asking about past and present illnesses and treatments reveal
Vulnerability or strengths
What does asking a person why help with?
It tells you about the primary complaint what troubles the person what is on their mind or sometimes how they believe the problem to be which often sheds light on the diagnostic hypothesis
You’ll be fine.
Keep pushing!
What can the clinician tend to with the information obtained from the presenting complaint?
They can ask Direct questions
What is the most difficult for clinicians to ask?
To ask about psychotic phenomena for example the Conundrum that is faced by practitioners is how to ask someone if they’re hearing voices without actually asking it
State the 6 elements of Clinical history
- Identifying the demographic information
- Primary or presenting complaint
- Systematic inquiring
- Medical history
- Habits
- Psychosocial adaption and functioning
State nine aspects under identifying demographic information in clinical history
- Age
2.home
3.relationship status - name
- education
- Children and dependants 7.language
- occupation
- Financial security religion
Name six aspects concerning primary or presenting complaints in the elements of Clinical history
- The nature
- associated features
- severity
- temporal pattern
- aggravating and relieving factors 6. onset course and development
Which clusters of symptoms must be surveyed in systematic enquiry?
- Mood, emotions and feelings- stability, reactivity, hopelessness, irritability
- Anxiety- apprehension, abdominal discomfort, panic
- Neurovegetative features -sleep quality and quantity, nightmares, energy and motivation.
- Obsessions and compulsions- ability to recognize their origin and to resist.
- Reality testing- perceptual disturbancesike hallucinations, illusion, delusions, magic thinking
- Withdrawal indicators- cravings and other features of specific withdrawal syndromes.
- Other symptoms like dissociation phenomena, somatic concerns, mnestic (memory) distortions like Deja vu, forced thinking, parasitised thoughts, etc.
What is a mental state examination?
part of the medical examination and an addition to the neurological examination (often referred to as higher functions(cognition feeling and bought as opposed to motor and sensory function) by non-psychiatrists)
What does the mental state examination involve?
Systematic observation of a person’s State of Consciousness arousal cognitive ability feelings and emotions thinking thoughts communication and behavior
What is the mental state examination?
Is the product of observation using all our senses that is reported in a systematic way. This type of observation occurs when any one person interact with each other
How does systematically and consistently reporting mental state findings helped clinicians?
It makes communication is your and more accurate between clinicians
What is a mental state examination?
It is a brief but systematic overview of global mental functioning across the domains of consciousness cognitive functions emotions reality testing and behavior.
Outline the six ways to approach and record mental state
- A hierarchical systematic approach
- Cognitive parameters indicating the integrity of the person’s central nervous system and general health
- impaired attention, memory and other cognitive functions may signal serious physical disease and can also better account for other psychological phenomena.
- Mood and affect because disturbances in these areas may explain disturbances in reality testing.
- And appraisal of reality testing- thinking thoughts, apperceptions and organization.
- description of motoric behaviors such as tension, fidgetiness, lethargy, mannerisms, stereotypes or movements disorders
Explain the six ways to approach and record mental state
- The one systematic approach to describing the mental state is hierarchical and considers the following domains- general appearance cognition mood and effect reality testing and organization behavior and uh description of general appearance is easy to make an provides useful information about appearance physical state contact and cooperation. Secondly cognitive parameters provide an indication of the integrity of the person’s central nervous system in general health- someone who lapses in an out of consciousness demands immediate attention. Describing a patient is comatose describes no less than that patients mental state and agree one at the. Thirdly impaired attention memory and other cognitive functions may signal a serious physical disease and can also better account for others icological phenomen- a person with newly emergent word finding problems and the inability to recognize faces warrant immediate examination for stroke. The patients neurological condition may explain other abnormal findings such as emotional incontinence. And other words cognitive disturbances trump other psychopathologies because of their potential severity risk to life as well as reversibility. Number four mood and affect follow next and are considered at the stage because mood and effective disturbances may often account for disturbances in reality testing. Number five appraisal of reality testing-thinking thoughts and organization and lastly the description of motoric behaviors such as tension fidgetiness lithargy minorisms movement disorders
State six mental state examination domains and features
- General appearance
- consciousness
- arousal and cognitive functions
- mood and affect
- reality testing
- motoric and other behaviors
State and explain the six domains and features of mental state examination
General appearance- mobility activity injuries hygiene neatness engagement interaction cooperation. Consciousness arousal and cognitive functions
Still under domains and features of mental state examination explain attention and memory under consciousness arousal and cognitive functions
Attention refers to focus sustain shift resist destruction and memory- for recent information typically presented verbally also assist other domains like episodic memory spatial memory
Still under domains and features under consciousness arousal and cognitive functions outline features of communication
Language- fluency understanding naming repetition reading and writing. Speech-the mechanical production of verbal communication. Language is symbolic communication and is not speech which is the mechanical production of verbal communication. Aphasia good first to language disturbance and disarthria refers to speech disturbance. Practice refers to performance of previously learned to complex multitasks. G n o s i s refers to the recognition of all things across all sensory modalities. Executive functioning refers to program solving concept formation planning organization execution solve monitoring and also subsums abstract reasoning and cognitive flexibility.
Identify each domain of the mental state examination and its features
- General appearance( mobility activity injuries hygiene neatness engagement interaction corporation)
- consciousness
- arousal and
- cognitive functions
- mood and effect
- Reality testing motoric and
- other behaviors and other observations
State the two levels of consciousness and give the features or cognitive factors for each level
- arousal; features:
-attention- focus sustain shift resist distraction.
-memory- for recent information typically presented verbally and also assesses other domains. - communication.
Features:
-language, speech, practice g n o s i s, executive functioning and estimates of general intelligence and adaptive functioning. Practice refers to the performance of previously learned to complex motor toss while G and o s i s refers to the recognition of things across all sensory modalities like faces and numbers. Executive functioning refers to problem solving concept formation planning organization execution so monitoring
What are the features of the mood and affect domain of mental state examination?
Mood- depressed irritable manic anxious reactivity. Affect- nature congruence range of expression and reactivity. Hedonic tone and motivation
State the features of the reality testing domain of mental state examination
Thinking-speed coherence associations logic. Thoughts- also referred to as thought content ideas delusions preoccupations and obsessions. A p p e r c e c t i o n s- hallucinations illusions misidentifications. Organization- logical organization of communication and behavior
State the features of the motoric and other behaviors domain under mental state examination
Intensity- agitation retardation purposefulness and goal-directedness. Adventitious behavior for example mannerisms and other movement disorders. Compulsions and Catatonia.
What do the abbreviations mmse m o c a stand for?
Mmse- f o l s t e i n mini Mental status examination. M o c a Montreal cognitive assessment
Purpose of the mmse and moca
They are standardized screening tools designed to detect cognitive impairment at the bedside.
They are also useful to monitor progress through serial administration.
What may physical issue may prese t eith panic only?
Cardiac ischaemia-insufficient blood supply to the heart muscle
What is the mode of an under functioning thyroid? Thyroidism
Depression
What are the components of a physical examination ?
Physical assessment- History and examination (Physical examination: vital signs, general observations, cardiovascular, respiratory, abdominal, rectal examination, pelvic, urological and gynecological exam, musculoskeletal, ear nose and throat, eyes, oral cavity, dermatological, neurological).
Semistructured clinical interview
Behavioral assessment
How is physical history approached?
Exactlyhow clinical history is approached except thr practitioner focuses on physical symptoms and enquires into different physical systems in the systematic enquiry.
Explained at is meant by each aspect of physical examination.
Vital signs- blood pressure, pulse, respiration
General observations- distress, colour (jaundice, anaemia, etc), oedema (swelling) , bruising, nutritional state.
Cardiovascular- pulse, heart exam
Respiratory- observe chest movement, etc
Abdominal- observe, percuss and listen.
Rectal exam
Pelvic, urological and gynecological
Musculoskeletal- joints and bones
Ears, nose, throat
Eyes
Oral cavity qnd teeth
Dermatological- skin and appendages
Neurological- cranial nerves motor, somatosensory, cerebellum, gait and mental state exam
What are neurocognitive problems?
Impulsivity and problems with practice and communication
What are motor abnormalities?
They are encountered in psychotic disorders notably schizophrenia, usually during the physical examination for example patients may resist passive movements may hold limbs in an awkward posture or cool faces and may also attempt to assist often in a bizarre way with the examination technique
What is meant by the term nutritional changes?
It is evidence of recurring vomiting salivary gland in largement. C a r i o u s tth may alarm the doctor of ulimia bulimia nervosa
What what are tell signs of substance abuse?
Needle tracks in the arms and the groin(introvenous narcotic use) necrosis of the nasal septum ( cocaine snorting) nodules of the skin( met- aqualone use close)
What symptoms are often ready distinguishable from neurological lesions due to identifiable neuropathology?
The pseudo neurological symptoms
Differentiate between semistructured and unstructured interviews
Unstructured interviews follow no systematic format. In a semi structured interview, clinicians may depart from set questions to follow up on specific issues
Why are clinicians confident in semi structured interviews?
Because the wording and sequencing of questions has been carefully worked out over a number of years
Explain one drawback if a semi structured clinical interview is applied to rigidly
It may inhibit the patient from volunteering useful information that is not directly relevant to the questions being asked. This job back has hindered the use wide acceptance of fully structured interviews which are sometimes entirely computer-based
What is the purpose of semi-structured interviews?
to explore specific suspected abnormalities
What is the ‘anxiety disorders interview schedule for dsm- 5’?
An example of a semi-structured interview whereby a clinician first asks if the patient is bothered by obsessions or feels compulsions
What is a behavioral assessment?
It uses Direct observation to formally assess an individual’s thoughts feelings and behavior in specific situations
When are behavioral assessments more appropriate than interviews?
When assessing individuals who are not old enough or skilled enough to report their problems and experience
What is the target behavior when it comes to behavioral assessment?
The identified cause of bother in the particular person
How do you know if someone’s claims are truthful?
Clinicians sometimes arrange analogue settings which are settings that are similar to the one under scrutiny normally for children who are self- injurious( self-hitting and head brushing) and autistic which are discovered by placing the children in simulated situations like sitting alone at home or playing with a sibling asked to complete a difficult task
Name the eight different assessment techniques
1.The clinical encounter
2. physical examination 3.semi-structured clinical interviews
4. behavioral assessment 5.psychological testing and 6.neurosychological testing
7. neuroimaging 8.psychophysiological assessment
What is a clinical assessment?
It is the systematic evaluation and measurement of psychological biological and social Factors in an individual presenting with a possible psychological disorder
What is a diagnosis?
The process of identifying a disease by its manifestations- symptoms signs and results of various special investigations
two components that the diagnostic process relies on to reach a diagnostic conclusion
- Securing symptoms and signs and interpreting ajunctive sources of information.
- Diagnosis requires knowledge of normal functioning and behavior and their pathological counterparts
Differentiate between a sign and the symptom
Symptom; characterizes Estate condition or entity and especially indicates change from a former state. Sign; is a manifestation of a condition that may indicate of normality which is observed by another person
What does a diagnosis follow in its most basic form?
It follows an algorithm where all observations are considered against all their possible causes
What is the intermediate approach (hypothetical deductive method)?
It is when the clinician forms a hypothesis about the problem right from the outset
Define the concept p a t h o g n o m o n i c diagnosis
It states that there is one symptom or sign or a set of symptoms or signs that uniquely define a condition
What are the various types of diagnosis?
- Experiential/phenomenological- if only observed and reported information is available.
- S y n d r o m a l diagnosis- when more is known about the presentation because enough phenomena can be observed to recognize clustering.
What are the two types of reliability?
Inter-rater reliability- stable across time. Test-retest reliability; stable across to or more raters
What are the two types of validity?
- Concurrent validity; the extent to which the results of one assessment measure correspondence with that of an existing measure.
- Predictive validity; how well your assessment tells you what will happen in the future
What are the three components of the clinical Encounter?
Clinical history the mental state examination and behavioral observation/assessment
Name the components of Clinical history
What is the mental state examination?
It is a brief but systematic overview of global mental functioning across the domains of consciousness cognitive functions and emotions
What are the components of the mental state examination?
General appearance consciousness arousal and cognitive functions mood and affect reality testing moderate and other behaviors
What are semi-structured clinical interviews?
They are made up of questions that have been carefully phrased and tested to give useful information in a consistent way so that tunisians can be sure that they have inquired about the most important aspects of particular disorders
Give two disadvantages of the semi structured clinical interview
It robs the interview of some of the spontaneous quality of two people’s talking about a problem. If two rigidly upload it may inhibit the patient from volunteering English for information that is not directly relevant to the questions being asked
What are the two components of behavioral assessment?
The ABCs of observations and self monitoring
Define Behavioral assessment
It uses Direct observation to formerly assess an individual sports feelings and behavior in specific situations on contexts
What do techniques of behavioral assessment include?
Talking to the patient in an office and going to the person’s home or workplace
State a disadvantage of reactivity
Simply observing a behavior may cause it to change due to the individuals knowledge of being observed
What are the two types of observation in The ABCs of observation?
- Informal observation which relies on the observers recollection and interpretation of events
- Formal observation which involves identifying specific behaviors that are observable and measurable if you’re fridge to as operational definition
What is self monitoring?
A refers to when people observe their own behavior to unlock patterns. It is particularly useful when behaviors occur only in private ( for example in people with bulimia)
Give two formal and structured ways to observe behavior
Checklists and behavior rating scales
Which phenomenon can distort any observational data?
Reactivity
What are the three types of psychological tests?
Projective tests personality Inventories and Intelligence testing
What are the characters of psychological testing?
It is used to assess psychological disorders in must meet the standard set. They must be reliable meaning that two or more people using same test must come to the same conclusion and they must be valid meaning that they measure what they say they measure
What tools do psychological tests include?
Specific tools which determine cognitive emotional or behavior or responses that might be associated with a specific disorder general tools which assesses long standing personality features such as the tendency to be suspicious
What is projective testing?
It includes a variety of methods in which ambiguous stimuli such as pictures of people or things are presented to people who are asked to describe what they see
Which are the three widely used projective tests?
R o r s c h a c h ink b l o t test. Thematic a perception test. Sentence-completion method
State one strength and one weakness of projective testing
Strength- it is a useful Icebreaker and it gathers qualitative information. Weakness; Lex validity and reliability
What are the two types of Personality Inventories?
- Face validity- the wording of the questions seem to fit the type of information desired.
- Personality Inventories- soft report questionnaires that assist personal traits by asking respondents to identify descriptions that apply to them
What is the most widely used personality Inventories and what were the concerns when developing them?
The Minnesota multi p h a s i c personality inventory. One concerns that arose was the potential of some people to answer in ways that would downplay their problems
What are the strengths and weaknesses of Personality Inventories?
The strengths include extensive real liability validity and normative database and the weaknesses are that it is lengthy and time consuming
What is intelligence quotient (IQ)?
What is the score on an intelligence test estimating a person’s deviation from average test performance
Give two examples of intelligence tests
The stanford-b i n e t test and the w e c h s l e r tests- w e c h s l e r adult intelligence scale and w e c h s l e r intelligence scale for children and the w e c h s l e r preschool and Primary scale of internal intelligence
What are the strengths and weaknesses of intelligence tests?
The strengths include high reliability and validity and the weaknesses are that it disregards the influence of external factors like culture and language when it also confuses IQ with intelligence
What is a neuropsychological test?
It is an assessment of the brain and nervous system functioning by testing individuals performance on behavioral tasks
What are the strengths and weaknesses of neuropsychological testing?
The strengths include reliability and validity while the weaknesses include lengtheness time consumption and a possibility of false positive and false negative
What is a false positive?
It is an assessment error in which pathology is reported when none is actually present so the test results are positive
What is a false negative?
It is an assessment error in which no pathology is noted when one is actually present so test results are negative
What are two types of neuro imaging?
Structural neuro imaging and functional neuroimaging
What is neuroimaging?
They are sophisticated computer-aided procedures that allow non-intrusive examination of nervous system structure and function
What is a psychophysiological assessment?
What is the measurement of changes in the nervous system reflecting psychological or emotional events such as anxiety stress or sexual arousal
What is the most widely used physiological investigation in neurosychiatry?
The electroencephalogram or eeg it is useful in monitoring sleep and is used extensively in sleep Laboratories
What does diagnosing psychological disorders include?
Questions about classification the dsm-5 and the dsm-55 and t r and beyond the dsm-5; dimensions and spectra
What is the idiographic strategy
It is a close-end detailed investigation of an individual emphasizing what makes that person unique
What is the nomothetic strategy?
It is the identification and examination of large groups of people with the same disorder to note similarities and develop general laws
Define the term classification
It refers to assignment of objects/ people to categories on the basis of shared characteristics
What is taxonomy?
Is a system of naming and classification
What is nosology
Refers to the classification and naming system of disease medical and psychological phenomena
What is nomenclature
It’s in naming a system or noxology of the actual labels that are applied including mood disorders and eating disorders
What are the three questions about classification?
Categorical and dimensional approaches reliability and validity
What are the three approaches under categorical and dimensional approaches?
The classical/ pure categoricong approach; it is a classification method founded on the assumption that clear cut differences between disorders each with a different known cause(strict category)
The dimensional approach semicolon is a method of categorizing characteristics want to continue on rather than a binary either all-or- none basis (classification along dimensions)
The prototypical approach- system for categorizing disorders using both essential defining characteristics and the range of variations or other characteristics (combines a classical and dimensional views)
Explain reliability in the context of classification
Unreliable classification systems are subject to diagnostic bias. The more reliable that classification the less likely it is for biased to creep in during diagnosis
What are the three types of diagnostic validity?
Construct validity- the signs and symptoms chosen as criteria for the diagnostic category constantly go to together and what they identify different from other categories.
Predictive validity-tells the clinician what is likely to happen with the proto typical patient.
Content validity-if you create criteria for a diagnosis it should reflect the way most experts in the field think of social phobia
What is familial aggression?
It is the extent to which a disorder is found among a patients relatives
What are the new disorders included in the dsm-5-tr?
- Prolonged grief disorder
- major/ mild disorder due to unknown etiology
What are the Social and cultural considerations in the DSM-5?
The dsm-iv included a plan for integrating important social and Culture influences on diagnosis. The plan is referred to as cultural formulation and allows the disorder to be described from the perspective of the patients personal experience and primary social and cultural group
What are the criticisms of the dsm-5?
High comorbidity rate between disorders. It emphasizes reliabilities sometimes at the expense of validity and lastly it can lead to labeling and stigmatization
What is labeling?
Refers to applying a name to a phenomenon or a pattern of behavior. The label may acquire negative connotations or be applied irraneously to the person rather than the person’s behavior
What is the clinicians attention usually directed to in observational assessment?
It has directed towards the immediate behavior it’s antecedence(what happened just before the behavior) and it’s consequences (what happened afterwards)
What is a relatively informal assessment and what is fit disadvantage?
It realize on the observers recollection and interpretation of events
What is formal observation
It involves identifying specific behaviors that are observable and measureable(operational definition)
What is an operational definition?
Clarifies behavior by specifying
Provide an overall definition of the observational assessment
Target behavior is selected in defined and the Observer rights John each time it occurs along with what happened just before (anticident) and just after( consequence)
What is the goal of collecting information in an observational assessment?
To see whether there are any obvious patterns of behavior and then design a treatment based on the patterns
What does observational assessment focus on?
It Focuses on antecedence behavior and consequences
What does the brief psychiatric rate in scale assist?
It assesses 18 general areas of concern where each symptom is rated on a 7-point scale from 0 (not present) to six(extremely severe)
What does the brief psychiatric rating scale screen?
Somatic concern (preoccupation with physical health and fear of physical illness etc) feelings of guilt(self- blame and shame) g r a n d e u r(exaggerated self opinion and arrogance)
What is reactivity and when does it occur?
It is a reaction to the observation by change and behavior also occurs when one observes their own behavior or self monitors
What strict standards do psychological tests need to meet?
They must be reliable so that two or more people using the same test… and they must be valid
What is the theory behind projective testing?
People project their own personality motivation and unconscious fears and expectations want to other people and things without realizing it to revealing their unconscious thoughts to the therapist
Which test in neuropsychological assessment reveals much about the patients motivation preoccupations fears and attitudes?
The controlled oral word association test
What does the r o r s c h a c h ink blot test include?
It’s includes 10 ink blood pictures that serve as the ambiguous stimuli. The examiner presents the ink blood one by one to the person being assessed and then a person responds by telling what they see
What is the standardized version of the r o r s c h a c h ink plot test created um to respond to the concerns about its validity and relaxability?
The comprehensive system which specifies how the cards should be presented and what the examiner should say and how the response should be recorded
What is the best known projective test after the ro s c h a c h
The rename a perception test which consists of a series of 31 cards 30 with pictures and one blank only 20 cards are typically used during each administration
What is the difference between the r o r a c h a c h ink plot test and the tat the rename a perception test?
The first involves asking for a straightforward description of what the test taker sees while the t a t are asks the person to tell a dramatic story about the picture but both intend on revealing unconscious mental processes in their stories about the pictures
What other variations of the tat have been developed
Children’s upperceptions test (cat) and a senior a perception technique( s a t)
What is the role of clinicians when it comes to tests?
They should be able to know how to administer the tests and to be aware of research that suggests that tests have limited usefulness as a means of diagnosing psychopathology
What are personality Inventories?
self-report questionnaires that assess personal traits
What is the importance of Personality Inventories?
What the answers to these questions depict
How does the mmpi contrast with projective tests?
Projective tests rely on theory for an interpretation but the mmpi and similar Inventories are based on empirical approach which is the collection and evaluation of data and our straightforward true or false statements
What are some statements from the mmpi?
Cry readily often happy for no reason I’m being followed or fearful of things or people that cannot hurt me
What is a problem that comes with administering the mmpi?
The time in tedium of responding to the 560 items in the new version of the mmpi
What is examined instead of individual responses to the mmpi?
The pattern of responses is reviewed to see if it resembles patterns from groups of people who have specific disorders with with each group being represented on separate standard scales
What does the mmpi do to assess the possibility of dawn playing problems?
It includes additional scales that determine the validity of each administration like that lie scale and the infrequency scale which measures false claims about psychological problems or determines if the person is answering randomly and lastly The Subtle to fenceiveness skill which assesses whether the person sees themselves in unrealistically positive ways
Is the psychopathic deviation scale
It measures the tendency to behave in antisocial ways
Give two criticisms of the mmpi
It was criticized as sexist and insensitive to cultural diversity
What is deviation IQ?
It is 1 a person’s score is compared to scores of others of the same age only so the IQ score is an estimate of how much hrs performance in school deviates from the average performance of other children the same age we’ll stop
What do verbal scales and Performance scores measure?
Verbal skills measure vocabulary knowledge facts short-term memory and for a while reasoning skills while performance scores assist cycle water abilityities nonverbal reasoning and the ability to learn new relationships
What are the South African local adaptations of the w e c h s l e r protocol
The s a w a i s in the jsais
What is one of the biggest mistakes made by non psychologists?
To confuse IQ with intelligence
Is a lower than average IQ score mean that a person is not intelligent? Why?
No because there are numerous reasons for a loan IQ score for example language barriers. Thank you scores test the abilities such as attention perception memory reasoning and variable comprehension
Is the difference between IQ and Intelligence?
IQ test tends to be reliable in predicting academic success and are a valid assessment two and they also assist disorders like delirium and intellectual disability( cognitive impairment Close work it
Which ability is the neuropsychological tests measure
- Receptive and expressive language
- attention
- concentration
- memory
- motor skills,
- Perceptual abilities
- Learning and abstraction
What does neuropsychological test in assist how
It assesses brain dysfunction by observing the effects of the dysfunction on the person’s ability to perform certain tasks
Are the steps in the bender visual-motor g e s t a i t test
The patient is given a series of cards with various lines and shapes. The task is to copy what is drawn on the kind. Errors on the test are compared with the test results of the same age if the number of errors exceeds a certain figure then bring this function is suspected
What are the two popular advanced test of neural damage and cognitive dysfunction?
Luria- Nebraska neurosychological battery and the Halstead- r e i t a n neuropsychological battery which includes a rhythm test which asks the person to compare rhythmic beats testing soundclognition attention and concentration. And so hosted retain neurosychological battery test also includes the strength of trip test which Compares the grips of the right and the left hands and the Tech tile performance test which requires the test taker to place wooden blocks on a phone board while blindfolded testing learning and memory skills
Definition of structural and functional neurofunctioning
Structural: includes procedures that elucidate the structure of the brain like the size of various parts of the presence of lesions and neural functioning is indirectly assayed by mapping
What is the ability to look inside the nervous system?
Neuro imaging
What is computerized tomography?
It is a procedure that uses normal x-rays and takes about 15 minutes it is colloquially cold acat scan or CT scan after computerized axial tomography
What is the use of CT scans?
They are useful in locating space occupying lesions such as bleeds tumors injuries involution( loss of brain bulk) and other structural and anatomical abnormalities. There are entirely none invasive and are limited to axial views/ views in an imaginary horizontal plane through the head
What does magnetic resonance imaging do?
It exploits the physical phenomenon of nuclear magnetic resonance in which a hydrogen ion or a proton changes its rotation and orientation when subjected to a magnetic field
What is an MRI?
Magnetic resonance imaging- it is a procedure that requires a patient to life physically still in a long tunnel while being as exposed to loud noises due to the shock waves generated by a liquid helium that is required to super cool the magnets used
State two things that an MRI can be used for
To provide axial coronal and sagittal views and to demonstrate to lesions and white matter structure
State two disadvantages of an MRI
It is more expensive and and the person going through an MRI scan is required to be totally enclosed inside a narrow tube with a magnetic foil surrounding the hint which my not pee tolerable to people with claustrophobia
What was the original technique to measure brain functioning
Pet scanning or positron emission tomography
What is the process of a PET scan
The subject undergoing the procedure is injected with a tracer substance that is attached to Radioactive isotopes or groups of atoms that react distinctively. The substant interact with the blood oxygen or glucose and when parts of the brain become active blood oxygen or glucose Rushes to the area of the brain creating hotspot which are then picked up by detectors that identify the location of the isotopes by doing this we can learn which parts of the brain are working and which parts are not
Why are pet scans useful
The supplement MRI and CT scans when localizing the site of trauma resulting from head injury or stroke as well as when localizing brain tumors.
Pet scans are used to look at varying patterns of metabolism that might be associated with neurocognitive disorders. It has shown that many patients with Alzheimer’s typed dementia show produced to glucose metabolism in parietal lobes
What is a single Photon emission computed tomography
It works much like pet although a different tracer substance is used and the procedure is somewhat less accurate less expensive and requires less sophisticated equipment to pick up the signals
Which type of imaging has been developed and shows more promised Than pet or s p e c t
Functional magnetic resonance imaging fmri and it’s most common technique used to study psychological disorders is the Bold fmri ( blood oxygen level dependent fmri
What do these new technologies detect and what do they allow researchers to do. Which chemicals do they use nspect and pet imaging to study the distribution and density of neuro receptors
So they can detect activity of the receptors for neurochemical such as dopamine and serotonin allowing researchers to look at action in general areas and to differentiate activities and different and specific receptor sites. They use radio labeled neural receptor ligands( radioactive chemicals that are designed to congregate its specific receptor sites)
What is the electroencephalogram
It is a measure of electrical activity patterns in the brain taken through electrodes placed on the scalp
Define psychophysiology
It refers to the measurable changes in the nervous system that reflect emotional or psychological events which can be taken either directly from the brain or peripheraly from other parts of the body
What does e e g rely on
electrical potential difference over time between groups of neurons that are recruited into activity.
What is an extension of the eeg principle
The measurement of invent related evoked potentials(ERP)
What is an event related potential (ERP) or evoked potential?
It is when brief periods of eeg patterns are recorded in response to specific events such as hearing a psychologically meaningful stimulus
Explain what is meant by the following- B subtracting the background of eeg activity using sophisticated computer algorithms specific evoked potentials already demonstrated as isolated electrical spikes. the amplitude and timing of these spikes are important in central information processing and predictable abnormalities are found in certain psychiatric conditions. The most frequently thermistrated abnormality is that of the PSO response. That is a positive wave of 50 milliseconds after sensory stimulation which typically indicates the brains response to an unexpected stimulus
Doctors can use eegs to filter out normal brain activity from special brain waves called evoked potentials. These evil put potentials are like Tiny electrical signals that happen in the brain when you’re experiencing something like hereing or seeing something new or unexpected. The size and timeing of these signals are really important because they talk as how the brain is purchasing information. In certain mental health conditions these signals can look different from what considered normal. One of the most common changes seen is something called the PSO response it is basically a tiny lip of activity that shows up about middle 50 seconds after something surprising or unusual happens. So by study in these brain signals doctors can learn more about how the brain responds to different stimuli especially in conditions like mental illnesses
What are evoked potential studies used for and what is their use
There are used made you for research and clinically in neurology. They help diagnosed conditions like multiple sclerosis by showing Central d e m y l i n a t i o n which refers to the loss of protective sheets around nerves
What is the relationship between alpha waves and stress reduction?
Techniques that reduce stress of an aim to increase alpha wave frequency in the brain promoting relaxation and calmness
What does a psychophysiological assessment involve?.
It involves bodily responses like heart rate respiration and electrodermal responding towards/ skin conductance known as galvanic skin response). These measures reflect the bodies reaction to stress an emotions and they are important in diagnosing disorders like PTSD
What is biofeed back
It involves providing patients with continuous feedback about their physiological responses like blood pressure so they can learn to regulate them. It is used in conditions like headaches and hypertension
What are the challenges of physiological assessment
But requires skill and technical expertise and can sometimes produce inconsistent results due to procedure all difficulties or the nature of the response itself
Give an example of a psychological tests that can help identify personality to treat or patterns (personality profiling)
The mmpi
Define the term classification
Grouping object or people to categories on shared characteristics often called taxonomy in psychology where behaviors are classified
What is nostrology
It refers to a taxonomic system applied to phenomena
What term describes the names or labels of the disorders that make up the noseology for example anxiety or mood disorders
Nomenclature
What is the difference between the dsm-5 and the icd-10
The dsm-5 is a diagnostic manual used to identify specific psychological disorders while the icd10 is another classification system used globally particularly in health statistics
What does the dsm-5 stand for and what does the icd-10 stand for
The dsm-5 is the diagnostic and statistical manual of mental disorders while the icd is the International specification of diseases
Why is classification why is classification important
Classification is crucial for organizing and communicating scientific knowledge it allows the systematic understanding and discussion of concepts systematically
What controversy arises in human behavior classification
Classification is essential in fields like biology and geology so it becomes more controversial when applied to human behavior because some question if it is appropriate to categorize human behavior in the same way as objects or organisms
What controversy arises in psychopathology concerning the classification of human behavior
In psychology there are debates about what constitutes normal and abnormal behavior. Some are you that behaviors and emotions should be seen on a c o n t i n you hear m rather than rigid categories like manual or depression
What is nomenclature
The refers to the labels or names used in classification systems such as mood disorders or eating disorders in psychopathology
Disadvantage of classical category approach
It is too rigid on how criteria must be met so it is not suitable for psychological disorders since they are complex and likely involve multiple factors (biological psychological and social Close record. It is suitable in medicine for making accurate diagnosis like this distinguishing meningitis from a cold based on symptoms
What is the disadvantage of a dimensional approach
It has been applied to personality disorders but has been less satisfactory due to the disagreement of the number of dimensions needed for accurate classification
What is the advantage of a prototypical approach
It fits best with the current state of our knowledge of psychopathology and it is relatively use a friendly
Explain how the prototype approach works in the case of a major depressive episode
In order to meet the criteria one needs to be either depressed or losing interest in activities plus at least four other symptoms out of eight. Two people with major depressive episodes may have different combinations of symptoms but still meet the criteria. The DSM five uses this project typical approach women meeting a certain number of criteria being someone closed enough to the prototype for a diagnosis
The dsm-5 criteria for major depressive episode
At least one of the symptoms should be a depressed mood or loss of interest. Depressed mood for most of the day almost every day diminished interest in almost all activities most of the day almost every day significant weight change when not dieting Insomnia or hypersomnia psychomotor agitation or retardation fitting or loss of energy feelings of worthlessness or excessive or inappropriate guilt diminished ability to think or concentrate or indecisiveness recurrent thoughts of death recurrent suicidal idiation without a specific plan or suicide attempt
What are the qualities of a reliable classification system
Consistency in diagnosis- the consistency and accuracy of a classification system when identifying specific symptoms that define a psychological disorder. So if clinicians diagnosis differ substantially it may indicate bias or an unreliable classification system. Unreliable systems are prone to diagonistic by West objective factors influence diagnosis rather than objective criteria.
What are the several types of diagnostic validity
Construct validity which ensures that the signs and symptoms chosen for a diagnostic category consistently relates to each other and are distinct from symptoms of other categories and predictive validity which Focuses on whether a diagnosis can predict the cause of the disorder and effectiveness of various treatment methods. It also includes predicting the likelihood of the disorder appearing among the patients relative known as familiar aggregation.
What is the importance of a valid diagnosis
It’s not only distinguishes one disorder from another but also helps clinicians understand the Likely progression of the disorder and the effectiveness of different treatment options. And other words validity ensures that a diagnostic category accurately captures the symptoms and characteristics of a particular disorder predict its course and response to treatment and distinguishes it from other disorders
State the changes in axis in the multi-axial form of the DSM IV
Axis I- pervasive developmental disorders learning disorders Motors skills disorders communication disorders previously on access II were moved here
Axis II- personality disorders and intellectual disability where the only conditions coded on this axis
Axis IV - the rating of psychosocial stress was considered unuseful and replaced with reporting psychosocial and environmental problems impacting the disorder
Axis V- this axis remained essentially unchanged
What differences have been made from the dsmiv to the dsm-5
The manual is now divided into three main sections- the introduction which introduces the manual and describes how to best use it presentation of disorders and description of conditions needing further research.
The multiaxial systems want to and three have been eliminated. Relevant psychosocial or contextual factors and extent of disability are known noted separately
Dsm-5-dimensional assessment
Videos M4 expands the use of dimensional axis for ratings severity intensity frequency or duration of disorders uniformly across all diagnosis
Tsm-5 cross cutting symptom measures
These measures evaluate common symptoms like anxiety depression and sleep problems across this orders helping and treatment monetary and planning
What what is a dimensional rating in the dsm-5
when clinicians rate symptoms like anxiety on a scale from 0( no disorder to 4( very severe disorder) providing additional information for assistment and treatment
Ways to approach and record mental state
- Hierarchical
- Cognitive parameters that indicate the integrity of a person’s central nervous system and general health
- Impaired attention, memory and other cognitive functions, which may signal q serious physical disease, etc.
