Chapter 4 - Clinical Assessment and Diagnosis Flashcards
psychological assessment
procedure by which clinicians, using psychological tests, obsrvations, and interviews, develop a summary of the clients symptoms
clinical diagnosis
the process through which a clinicial arrives at a gneral “summary classification” of the patient’s symptoms by following a clearly defined system (such as the DSM)
presenting problem
major symptoms and behavior the client is experiencing
what types of information are part of the social or behavioral history?
personality factors and the social context
dysrhythmia
irregular pattern in the brain’s electrical activity
EEG
electrodes on the scalp record brain’s electrical activity
CAT scan
x-rays of the brain
(more structural than functional)
MRI
sharper images of the interior of the brain. does not submit patient to radiation
(more structual than functional)
PET scan
measures metabolic processes to appraise how well an organ is functioning
(more functional than structural)
fMRI
measures changes in blood flow in specific areas of brain tissue
(both structural and functional)
aphasia
a disorder in which there is a loss of ability to communicate verbally
limitations of fMRI
- sensitive to inacuracies due to slight movement of the patient
- results may be difficult to interpret
neuropsychological assessment
measuring a person’s cognitive, perceptual, and motor performance as clues to the extent and location of brain damage
Brief Psychiatric Rating Scale (BPRS)
objective method of rating clinical symptoms that provides scores on 18 variables
useful in clinical research, less so in diagnosis or treatment
Hamilton Rating Scale for Depression (HRSD)
similar to BPRS, but more specifically targeted. Most widely used procedure to select depressed people for clinical research
pros and cons of psychological tests
- more precise and more reliable than interviews
- value depends on competence of clinician who interprets them
what are the two primary types of psychological tests?
intelligence tests and personality tests
two intelligence tests that are widely used for children
- Wechsler Intelligence Scale for Children - Revised (WISC-IV)
- Stanford-Binet Intelligence Scale
most common intelligence test for adults
Wechsler Adult Intelligence Scale - Revised (WAIS-III)
Wechsler Adult Intelligence Scale (WAIS-III)
Measures intelligence of adults. Includes both verbal (vocabulary) and performance (digit span) components
thematic apperception test (TAT)
patients are asked to make up stories about a set of ambiguous pictures
Minnesota Multiphasic Personality Inventory (MMPI-2)
objective personality test that measures tendencies to respond in psychologically deviant ways and includes a number of validity scales (which detect falsehood or inconsistencies)
factors to keep in mind when evaluating test results
- cultural bias of instrument or clinician
- theoretical orientation of the clinician
- underemphasis on the external situation
- insufficient validation
- inaccurate data or premature evaluation
reliability
the degree to which a test produces the same result each time
validity
the degree to which a test measures what it is supposed to measure
symptoms
subjective description of complains that the patient presents about what is wrong
signs
objective observations that the diagnostician may make directly or indirectly
Axis I
Clinical disorders or other conditions that may be the focus of clinical attention (ex: distress in maritial relationship if this is the focus of clinical discussion)
Axis II
Personality disorders and mental retardation
Axis III
General medical conditions
Axis IV
Psychosocial and environmental problems (only those relevant to treatment of mental disorder) ex: problem with primary support groups
Axis V
Global Assessment of Functioning (GAF) : 100 point scale used to assess overall ability to function. (closer to 100 is good, closer to 0 is bad)
