Chapter 4 Flashcards
Psychological assessment:
procedure by which clinicians, using psychological tests, observations, and interviews, develop a summary of a client’s symptoms and problems
Clinical diagnosis:
process through which a clinician arrives at a general “summary classification” of the patient’s symptoms by following a clearly defined system such as DSM-5 or ICD-11 (International Classification of Diseases)
Reliability:
A term describing the degree to which an assessment measure produces the same result each time it is used to evaluate the same thing
Test-retest reliability
is whether a test result gives us a similar value today as it did a few days earlier (should allow for change sensitivity though…)
Inter-rater reliability
would describe, for example, the degree to which different clinicians agree on a diagnosis
Validity:
The extent to which a measuring instrument actually measures what it is supposed to measure
Standardization:
The process by which a psychological test is administered, scored, and interpreted in a consistent (“standard”) manner. Many tests are standardized to allow the test user to compare a particular individual’s score to a normative sample
Presenting problem:
the major symptoms or behaviors the client is experiencing
•Important to assess social and cultural context in which the individual functions: environmental demands, supports, and/or special stressors
Assessment is an ongoing process
factors on assessment
The client must feel comfortable with the clinician
Limits of confidentiality (harm to self or others…)
Reason for referral can be important
Clinical Interviews
A clinical interview usually involves a face-to-face interaction in which clinician obtains information about client’s situation, behavior, and personality
Mental status exam
(also consider insight/judgement)
examine appearance+behavior, thought processes (i.e. rate, continuity, content of speech), mood and affect, intellectual functioning, sensorium
sensorium
awareness of surroundings in terms of person (self and clinician), time, and place, –oriented *3
The main purpose of direct observation
is to learn more about the person’s psychological functioning by attending to their appearance and behavior in various contexts
direct observation tools
Role-playing is a type of analogue situation; a more controlled behavioral setting for conducting observations
Self-monitoring is a client’s objective reporting of behavior, thoughts, and feelings as they occur in various natural settings (their reactivity matters though)
–Rating scales can help both to organize information and to encourage reliability and objectivity
STRUCTURED INTERVIEWS
•Follow a predetermined format •Each question is structured in a manner so as to allow responses to be quantified or clearly determined
SEMI-STRUCTURED INTERVIEWS•
Interviewer is required to ask questions in a specific order and in a specific way, but is free to ask follow-up questions to better determine if the interviewee actually has the symptom being assessed
UNSTRUCTURED INTERVIEWS•
Subjective and do not follow a predetermined set of questions
rosenhan experiment
For the study, eight “pseudopatients” – Rosenhan himself and seven volunteers – presented themselves at institutions across the country with the same symptoms: they reported hearing voices that said, “thud, empty, hollow.” Beyond a few biographical adjustments for privacy reasons, the pseudopatients used their own life stories. All eight were admitted and diagnosed with serious mental disorders. The question became, once you’ve been labeled with a psychiatric condition, how do you prove yourself “sane”…Yet it may not have been all it seemed. A six-year investigation into the real story behind the study has revealed many troubling inconsistencies, suggesting that there were multiple levels of deception in this iconic experiment.
INTELLIGENCE TESTS
•Most commonly used adult intelligence test is the Wechsler Adult Intelligence Scale–Revised (WAIS)•Includes both verbal and performance material –Average IQ= 100, sd=15
PROJECTIVE PERSONALITY TESTS
•Unstructured and rely on various ambiguous stimuli such as inkblots rather than on explicit questions–Rorschach Inkblot Test, Thematic Apperception Test, Sentence Completion Test
Point is to elicit analyses
Rorschach Inkblot Test,
:, uses 10 inkblot pictures, to which a subject responds to “what you see, what it makes you think of” and “what it means to you”–
Thematic Apperception Test
uses a series of simple pictures about which a subject is instructed to make up stories
Sentence Completion Test
designed for children, adolescents, and young adults; consists of the beginnings of sentences that clients are asked to complete
OBJECTIVE PERSONALITY TESTS –
•Structured; questionnaires, self-report inventories, or rating scales
Minnesota Multiphasic Personality Inventory (MMPI)▪
Prototype and standard for personality assessment; widely used in clinical and forensic (court-related) assessment ▪Includes 10 clinical scales measuring tendencies to respond in psychologically deviant ways, as well as validity scales detecting honesty/straightforwardness of responses
physical assessment
part of psych diagnosis often
Physical examinations are particularly important for disorders that present with physical problems, such as panic disorder or conversion disorder
Neuropsychological assessment:
Various tests to measure a person’s cognitive, perceptual and motor performance
Can provide important clues about extent and location of brain damage
Tests are performance based and standardized, comparing performance to normative standards
Neurological approaches:
EEG (electroencephalogram) (assesses brain waves, changes in brain can be recorded almost immediately, responses to seizures
Computed tomography scan can reveal images of parts of brain that might be diseased, it’s a structural image
MRI:another technique used to provide images of the brain
–Functional MRI tells us about neuronal activity (the working brain)
PET SCANS: A METABOLIC PORTRAIT•Position Emission Tomography (PET):radioactive agents are injected into a person to show how an organ is functioning
IQ evil history
IQ began as a way to id those who needed help and ended up servicing ideologies
Military used IQ test to sort recruits and screen for officer training but people believed in eugenics and created intelligence linked with race scale (which obviously isnt a thing)
Forced sterilization of people with low iq scores in virginia..
Nazis murdered children with low iqs
Did research, found environmental influences
Iq test results have justified awful policies and unscientific ideologies
IQ is good for reasoning and problem solving but not for potential
Categorical approach:
seeks to classify behavior into distinct categories; approach used in the DSM
concern of comorbidities
THE DIMENSIONAL APPROACH
Dimensional approach: assumes that a person’s typical behavior is the product of differing strengths or intensities of definable dimensions (mood, emotional stability, etc.)
Preserves information about variability
THE PROTOTYPAL APPROACH
Prototypal approach: clinician decides if their patient fits the pattern of a “perfect” or “theoretically ideal” case
Provides a standard against which individuals can be compared in order to assign them to a particular category
evolution of dsm
Currently in its fifth edition, published in 2013 after considerable debate and controversy Evolved over the past 60 years from vague, jargon-laden description of disorders to today’s “operational” method The number of recognized mental disorders has increased enormously from DSM-I to DSM-5
