Chapter Three: Clinical Assessment and Diagnosis Flashcards
A clinical ____________ is the systematic evaluation and measurement of psychological, biological, and social factors in an individual presenting with a possible psychological disorder.
assessment
All clinical assessment techniques are subject to strict requirements, including evidence that they actually do what they are designed to do. Which of the following qualities determine the precision and accuracy of a clinical assessment?
A. Therapeutic validity and acculturation
B. Reliability, validity, and standardization
C. Reliability and practicality
B. Reliability, validity, and standardization
A clinic creates a new survey to measure its clients’ sense of progress in their therapy. The scores on the survey correlate well with the therapy progress ratings that the clients’ therapists completed the same week. This suggests that the survey has good ________, specifically good ____________ _________.
- validity
- concurrent validity
During the testing of a new semi-structured diagnostic interview, the interview developers find that multiple clinicians interviewing the same patient disagree on whether the patient meets the criteria for borderline personality disorder. This suggests that the new interview has poor __________ , specifically poor __________ __________.
- reliability
- interrater reliability
Which of the following describe a process to provide a measure that is well standardized? Check all that apply.
A. Translate the measure into several different languages.
B. Pool individuals’ scores with others like them to use as a standard, or norm, for comparison purposes.
C. Provide very strict procedures for delivering and scoring the assessment.
D. Give the measure to large numbers of people who differ on important factors such as age, race, gender, socioeconomic status, and diagnosis.
A, B, and D
The clinical interview is at the core of most clinical assessments. It is used to gather important information about an individual’s current and past behaviours. The clinical interview typically assesses what brought the individual into treatment as well as significant events from the individual’s history.
Which of the following statements is true of the semistructured interview?
A. Clinician may depart from set questions to follow up on specific issues.
B. This interview is the most common type of psychologist interview.
A. Clinician may depart from set questions to follow up on specific issues.
During a clinical interview, observations about a person’s feelings, for example, would be put into the category of:
mood and affect
_______ ____________ are made up of questions that have been carefully phrased and tested to elicit useful information in a consistent manner, so clinicians can be sure they have inquired about the most important aspects of particular disorders.
semistructured interviews
What are the 5 things the mental status exam consists of?
- appearance and behaviour
- thought processes
- mood and affect
- Intellectual functioning
- Sensorium
Mental status exam - thought processes questions to ask
Does the person talk really fast or really slowly?
Do the patients make sense when they talk or are ideas presented with no apparent connection?
Is there any evidence of delusions or hallucinations?
Mental status exam - Intellectual functioning questions to ask
Do they seem to have a reasonable vocabulary?
Can they talk in abstractions and metaphors (as most of us do much of the time)?
How is the person’s memory?
what is sensorium when it comes to the mental status exam?
It is our general awareness of our surroundings (A&Ox3)
A problem with an informal observation is that it relies on the observer’s _________, as well as ___________, of the events. Formal observation involves identifying specific behaviours that are __________ and _________.
- recollection
- interpretation
- observable
- measureable
What are the ABC’s that observational assessments focus on?
A - antecedent (what happened just before the behaviour)
B - the immediate behaviour that occurs
C - Consequence (what happened after the person’s behaviour)
__________ _________ is the use of direct observation to formally assess an individual’s thoughts, feelings, and behaviour in specific situations or contexts.
Behavioural assessment
Any time you observe how people behave, the mere fact of your presence may cause them to change their behaviour. This is called ________.
reactivity
In behavioural assessment, _________ __________ are identified and observed with the goal of determining the factors that seem to influence those behaviours.
target behaviours
This test contains both verbal scales, which measure vocabulary, knowledge of facts, short-term memory, and verbal reasoning skills, and performance scales, which assess psychomotor abilities, nonverbal reasoning, and ability to learn new relationships.
WAIS - IV
This simple psychological test requires the person undergoing the assessment to copy various lines and shapes that are drawn on a card.
Bender Visual-Motor Gestalt Test
This psychological test can be scored and interpreted by a computer program.
MMPI
This test requires the person undergoing assessment to tell what they see in 10 inkblot pictures.
The Rorschach inkblot test
When it comes to MMPI, the reliability and validity are very ____.
high
How reliable and valid are TAT and Rorschach tests? Why?
Despite attempts to bring standardization to the TAT and Rorschach, questions remain about the reliability and validity of these projective tests because they are not always administered according to the instructions, and the interpretation of the projections often depends on the examiner’s frame of reference.
The WAIS and the Stanford-Binet are two types of _________ test
IQ
the Halstead-Reitan Neuropsychology Battery and the Luria-Nebraska Neuropsychology Battery are two types of ______________ tests
neuropsychological
TRUE OR FALSE: IQ Tests are valid and reliable
TRUE
TRUE OR FALSE: Neuropsychological tests are reliable but not very valid
FALSE: They are both reliable and valid
Psychological tests include specific tools to determine __________, __________, or ____________ responses that might be associated with a specific disorder and more general tools that assess long-standing __________ features.
- cognitive
- emotional
- behavioural
- personality
Two of the more widely used projective tests are the ____________ ____________ test and the _________ __________ Test.
- Rorschach inkblot test
- Thematic Apperception Test
The ________ _________ test is one of the early projective tests.
Rorschach Inkblot test
Self-report questionnaires that assess personal traits by asking respondents to identify descriptions that apply to them are called __________ _________. The most widely used one in the US is the ____.
- personality inventories
- MMPI
There is only one set of causative factors per disorder, which does not overlap with those of other disorders. This is know as the ________ classification approach
categorical
Diagnosis is a process of deciding the degree to which a particular characteristic or set of characteristics is present. This is known as the _________ classification approach.
dimensional
This approach identifies certain essential characteristics and also allows for certain nonessential variations without changing the classification. This is known as the _________ classification approach.
prototypical
Which of the following is a critique of the categorical approach?
A. Theorists have not been able to agree on the number of dimensions.
B. This approach cannot account for the complexity of psychological disorders.
B. This approach cannot account for the complexity of psychological disorders.
Any system of classification should describe specific subgroups of symptoms that are clearly evident and can be readily identified by experienced clinicians. If the clinicians are unable to agree on a diagnosis, even after observing the same patient at the same time, it suggests that the psychological diagnostic criteria, themselves, might be __________.
Unreliable
One of the most unreliable categories in current classification is that of ___________ disorders.
personality
The lack of agreement among clinicians when diagnosing personality disorders indicates that:
more reliable criteria are needed.
A taxonomic system applied to psychological or medical phenomena is called ________. All diagnostic systems used in health care settings, such as those for infectious diseases, are __________ systems. The term ____________ describes the names or labels of the disorders that make up the nosology (for example, anxiety or mood disorders).
- nosology
- nosological
- nomenclature
_______ validity is the degree to which the signs and symptoms chosen as criteria for the diagnostic category are consistently associated and what they identify differs from other categories.
construct
____________ is the process of determining whether a particular problem afflicting an individual meets all criteria for a psychological disorder. The diagnosing clinician refers to the criteria listed in the DSM-5.
Diagnosis
The _________ and the _________ were the first nosologies to have any influence, but they lacked precision and reliability, and they relied heavily on unproven theories of etiology not accepted by all mental health professionals. To make matters worse, the systems had little reliability. Two mental health practitioners looking at the same patient often came to different conclusions based on the nosology at that time.
- DSM I
- DSM II
The _______ and _________ proceeded more or less simultaneously with that of the International Classification of Diseases and Health Related Problems, 10th edition (ICD-10).
DSM-IV and DSM-IV-TR
The ________ proceeded more or less simultaneously with that of the International Classification of Diseases and Health Related Problems, 11th edition (ICD-11)
DSM 5
The ___________ and ________ allowed individuals with possible psychological disorders to be rated on five dimensions, or axes. This multiaxial format, which emphasizes a broad consideration of the whole individual rather than a narrow focus on the disorder alone, was also useful.
DSM-III (1980) and DSM-III-R (1987)
Which of the following is a criticism of the DSM-5?
A. It contains definitions from past decades that are flawed.
B. It contains a completely new nosology that is unrecognizable from previous versions.
A. It contains definitions from past decades that are flawed.
The _________ was the first to take an atheoretical approach, rather than relying on psychoanalytic or biological theories of etiology. This made it more useful to clinicians from a variety of points of view.
DSM-III
Perhaps the most substantial change in DSM-IV is that the distinction between _________ based disorders and ___________ based disorders that was present in previous editions has been eliminated.
- organically
- psychologically
The _______ removed the multiaxial system and expanded the use of dimensional assessments for rating severity, intensity, frequency, and duration of specific disorders. This system incorporates approved scales that are supported by empirical research to assist clinicians in assessing the aforementioned characteristics.
DSM-5
Which of the following is a criticism of the DSM-5?
A. It still leads to a high level of comorbidities.
B. It has eliminated the occurrence of comorbidities.
A. It still leads to a high level of comorbidities.
List three things things a researcher could do to increase the standardization of a new measure.
- pool individual scores from different groups for use as a standard for comparison purposes
- provide strict procedures for delivering and scoring the assessment
- give the measure to large numbers of people who differ on important factors such as age, race, gender, socioeconomic status, and diagnosis.
_________ involves administering and scoring assessment measures in a consistent way so that the interpretation of the scores is the same for everyone
Standardization
How can the interpretation of test scores be standardized?
the interpretation of test scores can be standardized by collecting normative data from large groups of people across age, gender, and race, allowing the test scores to be compared among members of these groups. Researchers and clinicians can then interpret these scores by seeing whether they are higher or lower than average scores that members of the appropriate normative group obtained.
________ is the degree to which a measurement measures, or assesses, what it is designed to measure. ________ __________ refers to how well the assessment tells you what will happen in the future. ________ _________ is demonstrated when a test correlates well with a measure that has previously been validated.
- Validity
- Predictive validity
- Concurrent validity
__________ is the degree to which a measure is consistent. An assessment technique has good _________ __________ when two or more raters using an assessment tool get the same answer (or answers). An assessment technique has good __________ _________ when it is stable across time—for example, when the scores you get from the assessment are the same each time you administer it.
- Reliability
- interrater reliability
- test-retest reliability
