Classification and assessment in clinical psychology Flashcards
Name 2 of the diagnostic criteria for generalised anxiety disorder as part of the DSM-5?
Excessive worry for at least 6 months. Not attributable to any substance or other medical condition.
Name 3 of the symptoms anxiety and worry must be associated with at the very least to be diagnosed with anxiety as part of the DSM-5.
Restlessness, difficulty concentration, sleep disturbance.
State one of the diagnostic criteria for generalised anxiety disorder as part of the ICD-10.
Prominent tension, worry, and feelings of apprehension for at least 6 months.
List four of the symptoms from numbers B1 and B2 in the ICD for GAD.
Palpitations, difficulty breathing, dry mouth, depersonalisation.
Why is it important to classify psychological disorders?
It helps us to understand causes and determine if treatment has been effective or not. It can also help to identify the most appropriate treatment.
What is the first objective of the classification system?
Provide necessary and sufficient diagnostic criteria for correct differential diagnosis
What is the second objective of classification systems?
Provide a distinction of true psychopathology from non-disordered problems in living
What is the third objective of classification systems?
Allows diagnostic criteria to be systematically applied by different clinicians in different settings.
What is the fourth objective of classification systems?
Diagnostic criteria should theoretically be neutral.
Why is the fact that classification systems only describe observable symptoms a problem?
As it doesn’t explain the causes
What are some other problems with classification systems and diagnostic manuals?
They can be stigmatising. Makes diagnoses categorical (can’t quantify the severity of the disorder)
What are some specific criticisms of the DSM-5?
Proliferation of disorders with each revision. A gradual lowering of thresholds. Favours over rather than underdiagnosis.
What are the goals of assessment of psychological disorders?
What problems does this person have and what psychological disorders should they be diagnosed with
What are the four methods of assessment?
Clinical interviews, clinical observation, psychological tests (questionnaires etc), biologically based assessments (psychophysiology, neuroimaging)
What is diagnosis almost always reliant on?
Subjective judgement
What are the 3 type of reliability?
Test re-test reliability, inter-rater reliability, and internal consistency
What are the four types of validity
Concurrent, face, predictive, and construct
What is test-retest reliability?
The extent that a test will produce roughly similar results when the test is given to the same person several weeks/months apart
What is inter-rater reliability?
The degree to which two independent clinicians agree when interpreting or scoring a particular test
What is concurrent validity?
A measure of how highly correlated scores of one test are with scores from other types of assessment that we know also measure that attribute
Define predictive validity
The degree to which an assessment method is able to help the clinic predict future behaviour/symptoms
What is the structure of the clinical interviews for the DSM?
Predetermined questions, client’s response determine the next question to be asked,
What are some limitations of clinical interviews?
The reliability is low due to the different skills and personalities of clinicians. Some clients may purposefully mislead, Interviews prone to biases
What are the advantages and uses of clinical observation?
Can capture frequency of target behaviours, better ecological validity than self report
What are some limitations of clinical observations?
Time consuming, observers need a lot of training, presence of observer may influence behaviour. Inter-observer reliability will depend on how intensely trained the observers are.
What are the three types of psychological tests?
Self-report questionnaires, projective tests, and intelligence tests
Describe the characteristics of a self report questionnaire
Assesses a specific characteristic or trait, rigid response requirements allowing for objectivity, many of them have good concurrent validity. Allows statistical norms to be established.
What are some limitations of self-report questionnaires?
Time consuming, answers can be faked (however can be combatted by lie scales)
What are some examples of projective tests?
Rorschach inkblot tests, thematic apprehension test, sentence completion task.
Evaluate projective tests.
All have low inter-rater reliability and validity, and may not reveal anymore than a self report questionnaire
What is an example of an intelligence test?
WAIS - Weschler Adult Intelligence scale
What is the strength of the WAIS?
Extensively studied and developed over decades. High internal consistency, test-retest reliability and predictive validity.
What are some limitations of the WAIS?
Culturally biased. Doesn’t capture other equally important parts of intelligence, such as emotional.
What are some examples of biologically based assessments?
Electromyogram (detects muscle activity, ie smiling and frowning)
ECG - heart activity
EEG - brain activity
PET neuroimaging - brain function
MRI neuroimaging - brain structure
What are the 6 components of case formulation?
1) Create a list of the client’s problems
2) Identify and describe underlying psychological mechanisms
3) Understand how those mechanisms generate the client’s problems
4) Identify the kinds of events that precipitate the problems
5) Identify how the underlying psychological mechanisms mediate the antecedent with symptom link
6) Develop a treatment plan based on the above
What are the advantages of case formulation?
No need for a diagnosis - reduced stigma. Client is treated as unique with a tailored solution.
What are the disadvantages of case formulation?
Relies on a lot of assumptions that are not tested, for example, causes of most disorders are not well understood.
