Chapter 3: Diagnosis and Assessment Flashcards
What is diagnosis?
the determination that the set of symptoms or problems of a patient indicates a particular disorder
What is reliability?
the extent to which a test, measurement, or classification system produces the same scientific observation each time it is applied
What is inter-rater reliability?
the degree two which two independent observers agree on what they have observed
What is test-retest reliability?
the extent to which people being observed twice or taking the test twice receive similar scores (only works when we can assume that people won’t change considerably between test sessions)
What is alternate-form reliability?
the extent to which scores on two different forms of a test are consistent
What is internal consistency reliability?
assesses whether the items on a test are related to one another
What is validity?
internally, the extent to which results can be confidently attributed to the manipulation of the independent variable, and externally, the extent to which results can be generalized to other populations and settings
What is criterion validity?
considered in developing a test; assesses whether a test predicts related measures
What is content validity?
refers to whether a measure adequately samples the domain of interest
What is construct validity?
the extent to which scores or ratings on an assessment instrument relate to other variables or behaviors according to some theory or hypothesis (relevant when we want to interpret a test as a measure of a characteristic not observed directly - such as artistic ability)
What is the Diagnostic and Statistical Manual of Mental Disorders?
provides the major diagnostic guidelines for mental health syndromes in the United States
What is a syndrome?
a collection of certain symptoms
Who authored an influential early classification system?
Emil Kraepelin
What were the two major groups of severe psychological disorders proposed by Kraeplin?
dementia praecox and manic-depressive psychosis
What is the multiaxial system?
system used in DSM-III in which diagnoses were listed on separate dimensions/axes (not sued anymore)
What were the additions to DSM-5 to enhance cultural sensitivity?
- culture related issues are discussed in the text for almost all of the disorders
- a cultural formulation interview provides 16 questions clinicians can use to help understand how culture may be shaping the clinical presentation
- an appendix describes syndromes that appear in particular cultures, culturally specific ways of expressing distress, and cultural explanations about the causes of symptoms, illness, and distress
What are cultural concepts of distress?
psychological syndromes that have been observed in specific cultural groups; nine well-studied cultural concepts of distress descried in DSM-5
What is Dhat Syndrome?
a term used in India to refer to severe anxiety about the discharge of semen
What is Shenjing shuairuo?
syndrome commonly diagnosed in China characterized by weakness, mental fatigue, negative emotions, sleep problems
What is Taijin kyofusho?
fear that one could offend others through inappropriate eye contact, blushing, perceived body deformation, or body odor
What is Khyal cap?
observed in Cambodian, Thai, Vietnamese cultural groups; includes dizziness, rapid heart rate, shortness of breath, and other indicators of intense anxiety and autonomic arousal
What is Ataque de nervios?
intense anxiety, anger, or grief; screaming or shouting uncontrollably, crying, trembling; most commonly observed among people from Latino cultures and usually preceded by acute life stressor
What is ghost sickness?
extreme preoccupation w/ death and those who have died; found among certain Native American tribes
What is Hikikomori?
observed in Japan, Taiwan, South Korea, where an individual (usually adolescent or young adult male) shuts himself into room for a period of 6+months and does not socialize w/ anyone outside of room
What is resignation symptom?
interested Swedish symptom where children of refugee families denied asylum were mute, did not move, did not eat/drink - cases dwindled after Sweden changed asylum policies
What is the DSM-5 category “unspecified” used for?
when a person meets many but not all of the criteria for a diagnosis
What are some criticisms of the DSM-5?
- too many diagnoses (347)
- too many minute distinctions based on small differences in symptoms
- reliability in practice may be lower than that achieved in research studies
- has a categorical approach to diagnosis
What is comorbidity?
the co-occurrence of two disorders, as when a person has depression and social phobia
What is the Research Domain Criteria (RDoC)?
long term project to develop new ways of classifying psychological disorders based on dimensions of observable behavior and neurobiological meausres
What is categorical classification?
an approach to assessment in which a person is or is not a member of a discrete grouping
What is a criticism of categorical classification?
they foster a false impression that psychological disorders have actual, hard boundaries
What is a dimensional diagnostic system?
describes the degree of an entity that is present (e.g., a 1-10 scale)
What should a valid diagnosis help predict?
course (time period of disease), etiology (causes/progress of a disease), treatment
What is a clinical interview?
a conversation between a clinician and a patient that is aimed at determining diagnosis, history, causes of problems, and possible treatment options
What is a structured interview?
an interview in which the questions are set out in a prescribed fashion for the interviewer; assists professionals in making diagnostic decisions based on standardized criteria
What is stress?
the subjective experience of distress in response to perceived environmental problems
Who introduced the term general adaptation syndrome and set the stage for our current conceptualizations of stress?
Hans Selye
What does the term general adaptation syndrome (GAS) refer to?
the biological response to sustained high levels of stress
What are the three phases of general adaptation syndrome (Selye’s syndrome)?
- The Alarm Reaction
- Resistance
- Exhaustion
What happens during the alarm reaction?
the ANS is activated by stress
What happens during resistance?
the organism tries to adapt to the stress through available coping mechanisms
What happens during exhaustion?
if the organism is unable to adapt effectively during resistance, the organism dies or suffers irreversible damage
What is the Life Events and Difficulties Schedule (LEDS)?
a comprehensive, semistructured interview in which the interviewer and interviewee produce a calendar of each of the major events within a given time period, and rate the severity of each stressor
What are three goals of LEDS?
- evaluate the importance of any given life event in the context of a person’s life circumstances
- exclude life events that might just be consequences of symptoms
- carefully date when a life stressor occurred
What is a projective test?
a psychological assessment device employing a set of standard but vague stimuli on the assumption that unstructured material will allow conscious motivations and fears to be uncovered; assumes that the respondent would be either unable or unwilling to express their true feelings if asked directly
What is the Thematic Apperception Test (TAT)?
test where a person is shown a series of black-and-white pictures and asked to tell a story related to each; not very reliable and low construct validity
What is the Rorschach Inkblot Test?
test where a person is shown 10 inkblots and asked to tell what the blots look like
What are two examples of projective tests?
Thematic Apperception Test (TAT) and Rorschach Inkblot Test
What is the most commonly used system for scoring the Rorschach Inkblot Test?
the Exner scoring system
How does the Exner scoring system work?
concentrates on the perceptual and cognitive patterns in a person’s responses
What is a personality inventory?
a self-report questionnaire comprised of statements assessing habitual behavioral and affective tendencies
What is standardization?
the process of constructing a normed assessment procedure that meets the various psychometric criteria for reliability and validity
What is the Minnesota Multiphasic Personality Inventory-2 (MMPI-2)?
a lengthy personality inventory that identifies individuals w/ states such as anxiety, depression, masculinity-femininity, and paranoia, through their true or false replies to groups of statements
What are the 5 domains of personality on the Big Five Inventory-2?
- openness to experience
- conscientiousness
- extraversion
- agreeableness
- neuroticism
OCEAN
What is an intelligence test?
a way of assessing a person’s current mental ability
What functions believed to constitute intelligence do IQ tests measure?
language skills, abstract thinking, nonverbal reasoning, visual-spatial skills, attention and concentration, speed of processing
What is stereotype threat?
the notion that calling attention to stereotypes interferes with performance on IQ tests (and other tests)
What is ecological momentary assessment (EMA)?
form of self-observation involving collection of data in real time (e.g., diaries) regarding thoughts, moods, and stressors
What is the Dysfunctional Attitude Scale (DAS)?
cognitive questionnaire that has been shown to differentiate people with and without depression
What is the direct observation assessment method?
used by clinicians to identify problem behaviors and antecedents/consequences
What is the self-monitoring assessment method?
people monitor and keep records of their own behavior
What is brain imaging?
CT and MRI scans reveal structure of brain, PET reveals brain function and brain structure, fMRI assesses brain structure and brain function
What is neuropsychological assessment?
behavioral tests assess abilities such as motor speed, memory, spatial ability; deficits on particular tests help point to an area of possible brain dysfunction
What is psychophysiological assessment?
includes measures of electrical activity in the ANS, such as skin conductance, or the in the CNS, such as EEG
What is a CT/CAT Scan?
a method of diagnosis in which X-rays are taken from different angles and then analyzed by computer to produce a representation of the part of the body in cross section
What is magnetic resonance imaging (MRI)?
produces higher quality images and uses less radiation than a CT scan; uses a magnet to produce electromagnetic signal that is read by computer and translated into pictures of brain tissue
What is a functional MRI (fMRI)?
allows researchers to measure both brain structure and brain function - blood flow in brain can be measured
What is the BOLD signal?
stands for blood oxygen level dependent; is the signal detected by fMRI studies of the brain that measures blood flow and neural activity in any given region
What is a PET scan?
stands for positron emission tomography, is more expensive and invasive (but less precise than MRI) - computer generated picture of living brain, created by analysis of emissions from radioactive isotopes injected into the bloodstream
What is a SPECT scan?
stands for single photon emission computed tomography; is less expensive than PET scan - measures gamma rays produced by injection of radioisotope and generates images of activity in different regions of the brain
What is connectivity?
aims to identify how different areas of the brain are connected with one another
What are the 3 different types of connectivity?
- structural connectivity
- functional connectivity
- effective connectivity
What is structural connectivity?
how different structures of the brain are connected via white matter
What is functional connectivity?
the connectivity between brain regions based on correlations between their BOLD signal measured w/ fMRI
What is effective connectivity?
combines both types of connectivity - reveals correlations between BOLD activations and the direction/timing of those activations by showing which cortex is being activating first, second, etc
What are the 3 Halstead-Reitan battery tests?
- Tactile Performance Test - Time
- Tactile Performance Test - Memory
- Speech Sounds Perception Test
What does the Tactile Performance Test for time consist of?
while blindfolded, person tries to fit differently shaped blocks into spaces of a form board, first using the preferred hand, then the other, then both (sensitive to damage in right parietal lobe)
What does the Tactile Performance Test for memory consist of?
after completing the timed test, person is asked to draw the form board from memory, showing blocks in their proper location (sensitive to damage in right parietal lobe)
What does the Speech Sounds Perception Test consist of?
participants listen to a series of nonsense words, each comprising two consonants w/ long e sound in the middle, then select word they heard from a set of alternatives (measures left hemisphere function)
What is an advantage of the Luria-Nebraska battery test?
one can control for educational level so that a less educated person won’t receive a lower score
What is psychophysiology?
concerned with the bodily changes associated w/ psychological events
What is an electrocardiogram (EKG)?
a recording of the electrical activity of the heart, made with an electrocardiograph
What is electrodermal responding?
a recording of the minute electrical activity of the sweat glands on the skin, allowing inference of an emotional state
What are some problems with neurobiological assessments?
- many of the measurements do not differentiate clearly among emotional states
- being in a scanner is a threatening experience
- brain imaging techniques do not allow us to manipulate brain activity and then measure a change in behavior
