Chapter 4-Assessment, Diagnosis, Treatment

Question 1

Psychodiagnosis

Answer 1

Categorizing individuals based on behaviors or symptoms

Question 2

Disorders

Answer 2

Clusters of behaviors that seem to reliably go together in a given culture

*highly subjective

Question 3

Clinical assessment

Answer 3

Determine whether/how/why a person is behaving abnormally & how to help them

Question 4

Personality assessment

Answer 4

Assess personality and probe for unconscious conflicts

Question 5

Behavioral assessment

Answer 5

Observe & record the frequency & duration of target behavior

Direct overt behavior observation

Question 6

Advantages to classification

Answer 6

1. Can potentially PREDICT future behaviors
2. Means of COMMUNICATION amongst clinicians
3. Provides categories for RESEARCH
4. Provides basis for epidemiological RECORDS to increase understanding

Question 7

Disadvantages to classification

Answer 7

1. Puts a label on people
   - Can produce social stigma
   - can result in self fulfilling prophecy (increase severity of symptoms)
2. Categories are not perfect and may overlap across disorders
3. Diagnoses may not be reliable
   - different clinicians come to different conclusions
   - variations in client behavior over time
4. Subjectivity of diagnostic categories

Question 8

Multi-axial approach (DSM 3-4)

Answer 8

Axis 1: primary diagnosis
Axis 2: personality disorders, mental retardation
Axis 3: relevant physical disorders or medical conditions
Axis 4: psychosocial and environmental stressors
Axis 5: global assessment of functioning

Question 9

Changed to DSM 5

Answer 9

1. Moved from categorical (like 3 symptoms of these, 2 of these, etc) to dimensional scales (none, slight, mild, moderate, severe)

Purpose: to increase reliability & validity

2. Eliminated multiaxial system-collapsed first 3 axes (diagnosed, severity, additional info)
3. Added “causal specifiers (biol/genetic, environmental, developmental, cultural, social, behavioral)
4. Cultural sections include how they vary across cultures, genders, age groups

Question 10

Criticisms to changes of DSM 5

Answer 10

Might decrease reliability & validity

Does it pathologize previously normal behavior?

Question 11

Reliability

Answer 11

Consistency

1. Is the diagnosis of the client consistent with other clinicians?
2. Is the diagnosis consistent across time?

Question 12

Validity

Answer 12

Accuracy

1. Does it group people together whose symptoms have the same cause
2. Does it group people together for whom the same treatments are effective?

Question 13

Culture and assessment issues

Answer 13

1. Constructs may not be equivalent cross-culturally
   Ex. “Intelligence”, collectivism vs individualism
2. Scores on some measures may not be comparable to the same scores obtained on a different cultural sample

Question 14

Rhee et al self esteem study

Answer 14

Ex of how scores may not be equivalent cross culturally

Various Chinese individual (those who have always lived in china, been abroad, recent immigrants to US, etc)

Found self esteem scores went up the longer they had been in western culture

Question 15

Culture & diagnosis

Answer 15

Behaviors associated with a disorder in one culture may not be abnormal in another culture

Question 16

Therapeutic interview

Answer 16

Includes both assessment and therapy

Question 17

Assessment interview

Answer 17

Obtain overall picture of the person

Includes assessment of both verbal and non-verbal behaviors

Question 18

Structured interviews

Answer 18

Standardized both in terms of items and administration

Pre-established questions & format
Requires single word or numerical answers (close ended)

Question 19

Intelligence tests

Answer 19

Measure intellectual functioning & speed of cognitive functioning

• verbal & spatial reasoning/functioning
• highly standardized in administration/scoring
• subtest scores “scatter” (I.e. Verbal comprehension, working memory, processing speed etc)

Question 20

Objective personality assessment

Answer 20

Yields an objective score

Ex: MMPI-500+ T/F numbers, yields a visual profile of traits

Question 21

Projective personality assessment

Answer 21

Psychodynamic orientation, more subjective

Assumes: given an ambiguous stimulus, and individual will project unconscious elements of their personality onto the stimulus

Ex: Rorschach inkblot test-how long they look, what orientation, unusual emotions expressed

Thematic Apperception Test- ask person to weave story around picture

Children’s Apperceptions Test-child weaves story around picture

Question 22

Cognitive assessment

Answer 22

Measure thoughts, beliefs, attitudes, etc

through questionnaires, interviews, self monitors, etc

Question 23

Relational assessment

Answer 23

Emphasis on CONTEXT of behavior

Question 24

Bodily assessment

Answer 24

Measure of physiological functioning (often arousal states)

e.g. Skin conductance, BP, etc.

Question 25

Test-retest reliability

Answer 25

Scores obtained at one time are consistent with scores obtained at different time

Question 26

Internal consistency

Answer 26

Consistency within your measure Feel confident that all items in measure yield similar results (rule out rogue items)

Question 27

Interrater reliability

Answer 27

Consistency in results obtained when different people administer the test

Question 28

Construct validity

Answer 28

Is measure accurately depicting the COMPLEX PHENOMENON I set out to measure

Question 29

Predictive validity

Answer 29

Do scores obtained accurately predict the behavior that is supposedly being measured? Ex: SAT, GRE

Question 30

Content validity

Answer 30

Does it cover all the important aspects of what is being measured?

Question 31

Face validity

Answer 31

Does the measure appear to measure what is is supposed to?

Question 32

Concurrent validity

Answer 32

Degree measured from one tool agrees with other tools

Question 33

Personality inventory

Answer 33

Wide range of questions about behavior, beliefs, feelings

Question 34

Response inventories

Answer 34

Asked to provide detailed information, but focus on one specific area of functioning Affective: severity of emotions Social skills: indicate how they would react in certain social situations

Question 35

Psychological tests

Answer 35

Measure physiological responses as possible indications of psychological problems

Question 36

Neurological tests

Answer 36

Measure brain structure/activity directly Ex: EEG, neuroimaging

Question 37

Reactivity

Answer 37

Effect of observation on behavior | People will change if known they are being observed

Question 38

Evidence based treatments

Answer 38

Treatments supported by empirical study

Question 39

Scientist-practitioner gap

Answer 39

Some studies highly supported by research, but practitioners have experience in the field *may depend on specific client

Question 40

Effectiveness of treatment

Answer 40

1. People receiving treatment have better outcomes than 75% of those not receiving treatment 2. No particular therapy more effective than others 3. Certain therapies better for certain problems

Question 41

Important therapist characteristics

Answer 41

1. Give feedback to clients 2. Help client to focus on thoughts/behaviors 3. Pays close attention to therapist/client interactions 4. Promotes self master in clients

Question 42

Best therapy for phobias/some anxiety disorders

Answer 42

Behavior therapies

Question 43

Best therapy for psychotic disorders

Answer 43

Meds, CBT, ACT

Question 44

Best therapy for depression

Answer 44

CBT, meds* for sever depression

Question 45

Telehealth programs

Answer 45

Online therapy | Some success in serious mental illnesses (psychotic, bipolar, etc)