CHAPTER 3: Clinical Assessment, Diagnosis and Treatment Flashcards

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1
Q

Definition of assessment?

A

Collection of relevant information to reach a conclusion;

idiographic information

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2
Q

Definition of Clinical assessment?

A

Information used to determine whether, how, and why a person is behaving abnormally and how that person may be helped
- Idiographic; program-based

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3
Q

Hundreds of clinical assessment tools have been developed and fall into three categories; What are the three categories?

A
  • Clinical interviews
  • Tests
  • Observations
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4
Q

To be useful, assessment tools must be…

A

standardised and have clear reliability and validity

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5
Q

What is standardisation?

A

Standardising is a technique involves setting up common steps to be followed whenever it is administered

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6
Q

What are the three characteristics of assessment tools?

A
  1. Validity
  2. Reliability
  3. Standardization
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7
Q

What is reliability?

A

The consistency of an assessment measure

A good tool will always yield the same situation

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8
Q

What are the two main types of reliability?

A
  • Test-retest reliability

- Interrater reliability

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9
Q

What is Test-retest reliability?

A

Yields the same results every time it is given to the same people

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10
Q

What is Interrater reliability?

A

Different judges independently agree on how to score and interpret a particular tool

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11
Q

What is validity?

A

The accuracy of a tool’s results

An assessment tool must accurately measure what it is supposed to measure

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12
Q

What are the three specific types of validity?

A
  • Face validity
  • Predictive validity
  • Concurrent validity
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13
Q

What are clinal interviews?

A
  • Face-to-face encounter
  • Basic background data gathered with specific theoretical focus
  • Unstructured or structured
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14
Q

What are limitations of clinical interview?

A
  • Lack of validity or accuracy
  • Interviewer bias or mistakes in judgment
  • Lack of reliability
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15
Q

What are clinical tests used to gather information about?

A

• Used to gather information about psychological functioning from which broader information is inferred

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16
Q

What do projective tests require?

A
Projective tests require client interpretation of vague or ambiguous stimuli or open-ended instruction; psychodynamic orientation
• Rorschach test
• Thematic Apperception Test (TAT)
• Sentence-completion test
• Drawings
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17
Q

What is the Mindtech: Psychology’s WikiLeaks?

A
  • In 2009, an emergency room physician posted all 10 Rorschach cards on the online encyclopedia, Wikipedia.
  • Many psychologists argue that the test responses of patients who have previously seen the cards on Wikipedia cannot be trusted.
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18
Q

What is the Rorschach test? (InkBlot Test)

A

The Rorschach test is a projective psychological test in which subjects’ perceptions of inkblots are recorded and then analyzed using psychological interpretation, complex algorithms, or both.

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19
Q

What is the Thematic Apperception Test (TAT)

A

The Thematic Apperception Test (TAT) is useful in revealing a patient’s dominant motivations, emotions, and core personality conflicts. The TAT consists of a series of 20 cards depicting people in various interpersonal interactions that were intentionally created to be ambiguous.

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20
Q

What is the Sentence-completion test?

A

Sentence completion tests are a class of semi-structured projective techniques. Sentence completion tests typically provide respondents with beginnings of sentences, referred to as “stems”, and respondents then complete the sentences in ways that are meaningful to them.

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21
Q

What are drawing tests commonly used to assess?

A

Drawing tests are commonly used to assess the psychological functioning of children.

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22
Q

Strengths of clinical tests?

A
  • Until the1 950s, the most commonly used tests for personality assessment
  • Now used to gain supplementary information
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23
Q

Limitations of clinical tests?

A
  • Reliability and validity not consistently shown

* May be biased against minority ethnic groups

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24
Q

What are personality inventories designed to measure?

A

• Designed to measure broad personality characteristics

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25
Q

What do personality inventories focus on?

A

• Focus on behaviors, beliefs, and feelings

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26
Q

What are personality inventories usually based on?

A

• Usually based on self-reported responses

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27
Q

What is the most widely used personality inventory?

A

Minnesota Multiphasic Personality Inventory
• For adults: MMPI (original) or MMPI-2 (1989 revision)
• For adolescents: MMPI-A

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28
Q

How many clinical scales does the MMPI consist of?

A

10 clinical scales

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29
Q

What scores range is the MMPI?

A

0 to 120

30
Q

Strengths of personality inventories?

A
  • Easier, cheaper, and faster to administer than projective tests
  • Objectively scored and standardized
  • Appear to have greater validity than projective tests
31
Q

Limitations of personality inventories?

A
  • Cannot be considered highly valid
  • Measured traits often cannot be directly examined
  • Tests do not allow for cultural differences in responses
32
Q

What are clinical tests?

A

Response inventories
• Usually based on self-reported responses
• Focus on one specific area of functioning
• Have strong face validity
• Not all have been subjected to careful standardisation, reliability, and/or validity procedures

33
Q

Clinical test Focus on one specific area of functioning what are these areas?

A
  • Affective inventories (i.e., Beck Depression Inventory)
  • Social skills inventories
  • Cognitive inventories
34
Q

What is the Beck Depression Inventory?

A

The Beck Depression Inventory, created by Aaron T. Beck, is a 21-question multiple-choice self-report inventory, one of the most widely used psychometric tests for measuring the severity of depression.

35
Q

What do Psychophysiological tests measure?

A

Measure physiological response as an indication of psychological problems
• Includes heart rate, blood pressure, body temperature, galvanic skin response, and muscle contraction
• Polygraph (lie detector)

36
Q

Weaknesses of clinical tests?

A
  • Require expensive equipment that must be tuned and maintained
  • Can be inaccurate and unreliable
37
Q

Polygraphs are less trusted and used today. TRUE or FALSE?

A

TRUE

38
Q

MRI studies are less accurate than polygraphs, but some variability and false- positive issues exist. TRUE or FALSE

A

FALSE

39
Q

Neurological tests directly assess ….

A

Neurological tests directly assess brain function by directly assessing brain structure and activity

40
Q

What is intelligence tests designed to do?

A

Designed to indirectly measure intellectual ability

41
Q

Intelligence tests typically consist of a series of tests assessing…?

A

Typically consist of a series of tests assessing both verbal and nonverbal skills

42
Q

What is the general score of intelligence tests?

A

IQ - Intelligence Quotient

43
Q

Do intelligence tests have low or high reliability and validity?

A

High validity and reliability

44
Q

Weaknesses of intelligence tests?

A
  • Tests may contain cultural biases in language or tasks
  • Members of minority groups may have less experience and be less comfortable with these types of tests, influencing their results
45
Q

Where do naturalistic observations occur?

A

Naturalistic observations occur in everyday environments

46
Q

Naturalistic observation are generally made by?

A

• Observations are generally made by “participant observers” and reported to a clinician

47
Q

What is a concern of Naturalistic and analog observations?

A

Reliability and validity are a concern

48
Q

If naturalistic observation is impractical, analogue observations are used and conducted in what settings?

A

artificial settings

49
Q

What is self-monitoring?

A

People observe themselves and carefully record the frequency of certain behaviors, feelings, or cognitions as they occur over time

50
Q

Self-monitoring is useful in assessing?

A

Useful in assessing infrequent or overly frequent behaviours

51
Q

Self-monitoring provides a means of measuring?

A

Provides a means of measuring private thoughts or perceptions

52
Q

What is classification systems?

A

Using all available information, clinicians attempt to paint a “clinical picture” and make a diagnosis

  • A determination that a person’s psychological problems constitute a particular disorder
  • Based on an existing classification system
53
Q

In North America and around the world, the DSM faces competition from two other diagnostic systems; what are they?

A
  • International Classification of Disorders (ICD)

* Research Domain Criteria (RDoC)

54
Q

Where is the DSM-5 (2013) most often used?

A

most often used in the United States

55
Q

What is the DSM-5 (2013)?

A
  • Lists of categories, disorders, and symptom descriptions, with guidelines for assignment
  • Focus on clusters of symptoms (syndromes)
56
Q

What is the ICD-10?

A

• Some differences, but some matching with DSM-5

57
Q

What does the DSM-5 requires clinicians to provide?

A

DSM-5 requires clinicians to provide both categorical and dimensional information as part of a proper diagnosis

58
Q

What is categorical information?

A

The name of the category (disorder) indicated by the client’s symptoms.

59
Q

What is dimensional information?

A

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

60
Q

What is the DSM-5 categorical information?

A

Anxiety disorders
• Generalised anxiety disorder; social anxiety disorder; panic disorder; separation anxiety disorder

Depressive disorders
• Major depressive disorder; persistent depressive disorder; premenstrual dysphoric disorder

61
Q

What is the DSM-5 dimensional information?

A

Assessment of current client disorder severity

Rating scales for each disorder
• Cross-Cutting Symptom Measure
• Emotional Distress-Depression Scale

62
Q

Is DSM-5 an effective classification system?

A
  • Predictive validity is most used clinically?

* DSM-5 has greater validity than any previous edition (Validity is still a concern)

63
Q

Can diagnosis and labeling cause harm?

A
  • Misdiagnosis and reliance on clinical judgment are concerns
  • Labeling may be a stigma and lead to a self-fulfilling prophecy
64
Q

What is treatment decisions?

A

Begin with assessment information and diagnostic decisions to determine a treatment plan
• Use a combination of idiographic and nomothetic information

65
Q

Therapy outcome studies typically ask one of three questions: What are they?

A

1) Is therapy in general effective?
2) Are. particular therapies generally effective?
3) Are particular therapies effective for particular problems?

66
Q

Is therapy in general effective?

A

• People in therapy are usually better off than people with similar problems who receive no treatment.

67
Q

Are particular therapies generally effective?

A

• Various therapies do not appear to differ dramatically in their general effectiveness.

68
Q

Are particular therapies effective for particular problems?

A

Certain therapies or combinations of therapies do appear to be more effective than others for certain disorders.

69
Q

Proper diagnoses and effective treatments rest on the shoulders of accurate ______

A

clinical assessment.

70
Q

Brain-scanning techniques continue to offer assessment information about an increasing range of ________

A

psychological disorders.