clinical assessment and diagnosis Flashcards
what is a clinical assessment
Clinical assessment is a systematic evaluation and measurement of psychological, biological, and social factors in an individual presenting with a possible psychological disorder
what is diagnosis
diagnosis is the process of determining whether the particular problem afflicting the individual meets all criteria for a psychological disorder as said in the DSM 5
key concepts in assessment
- reliability is the degree to which a measurement is consistent, suspend techniques should be stable across time, test retest reliability.
- validity is whether something measures what it is designed to measure and whether a technique assesses what it’s supposed to, the result of an assessment measured under consideration with the results of others that are better known allow you to begin to determine the validity of the first measure this is called a concurrent or descriptive validity , predictive validity is how well your assessment tells you what will happen in the future
- standardization is the process by which a certain set of standards or norms is determined for a technique to make it use consistent across different measurements.
four purposes of psychological research
- Describe (what it is, categorize)
- Explain (causation and mechanisms)
- Predict (what do they go on to do, longitudinal predictive value, prognosis)
- Apply (change behaviour, application, clinical = how do we treat people)
functions of a good classification system
- Organization of clinical info
a. Summarized clients symptoms coherently and concisely - A shorthand from of communication
a. Improves exchange of info: highlights important features - Prediction of the disorder natural course
a. Allows accurate short - and long - term prediction of outcomes - Provides treatment recommendations
a. Allows accurate prediction of the most effective intervention - Organisational scientific framework
a. facilitates scientific study of psychological disorders (behavioural/behaviourist) - Guidelines of financial support
a. Guidance for needed service: research funding
three ways to classify
categorical
dimensional
prototypical (DSM)
Diagnostic criteria
- presence of # of symptoms out of total
- for given duration
- not better explained by another mental disorder
- not better explained by a medical illness or substance use
- clinically significant distress or impairment
- determining a general class of problems to which the presenting problems belong is known as nomothetic strategy, we are attempting to name or classify the problem
- the term classification itself is broad, referring simply to any efforts to construct groups or categories and to assign objects or people to these categories on the basis of their shared attributes or relations
what is sub syndromal
- several criteria met but don’t pass the threshold to meet diagnosis
- the presence of several symptoms of a mental disorder but are not severe enough to meet full criteria
differential diagnosis and principles
- process of distinguishing a particular disorder from others that share similar clinical features of symptoms
- critical thinking, clinical knowledge
principles
o parsimony
fewest # if diagnosis the better
simplest is the best and easiest
o probability
more common with that feature,
o ruling out, not just ruling in
its not just why is it, its why is it not
conformation bias to some degree
o skepticism (critical thinking)
o consider comorbidity
possible to have more than one
o temporality
the experience of and in time
what is a functional analysis
- A functional analysis is a step in Cognitive Behavioral Therapy that is used to identify problematic thinking and where change can best begin. At its core, it is a breakdown of operant and respondent conditioning to determine the relationship between the stimuli and responses
- Functional analysis examines the causes and consequences of behavior
RDOC and network analysis
comorbidity: presence of more than one disorder within same person
o RDOC: RDoC characterizes mental illnesses as extremes along prespecified neuropsychological dimensions. RDoC is a research framework for investigating mental disorders. Its goal is to foster new research approaches that will lead to better diagnosis, prevention, intervention, and cures. RDoC is not meant to serve as a diagnostic guide, nor is it intended to replace current diagnostic systems.
o Network analysis: Network analysis examines the pattern of relationships between causal factors and the focal event to provide a model of the perceived causal structure
self diagnosing
- Diagnostic services are often inaccessible – financially or in wait times
- Proliferation of psychological information on the internet has led to increasing self-Diagnosis
- No clear answer
- the goal here is to help clients monitor their behavior more conveniently as one behaviors occur only in private like purging self monitoring is essential
- a more formal and structured way to observe behaviors through checklist an behavior rating scales which are used as assessment tools before treatment and then periodically during treatment to assess changes in persons behavior
- a phenomenon knows is reactivity can disturb any observational data, anytime you observe how people behave the mere fact of your present may cause them to change their behavior
- clinicians sometimes depend on the reactivity of self monitoring to increase the effectiveness of their treatment.
assessment and diagnosis
- main difference is that assessment is to describe, while diagnosis is to categorize
- psychological testing: using clinical evaluation tool, one data point in the assessment process
- clinical assessment: a process which clinicans develooop a systematic summary of the clients symptoms and challenges
- clinical diagnosis: a process which clinicans classify the clients symptoms using a precisely defined diagnostic system
reliability
degree to which an assessment tool is consistent in its measurement
o inter rated: Inter-rater reliability is a measure of consistency used to evaluate the extent to which different judges agree in their assessment decisions
o test retest:
validity and types
degree to which an assessment tool measures what it is suppose to measure
o face validity: Face validity is about whether a test appears to measure what it’s supposed to measure. This type of validity is concerned with whether a measure seems relevant and appropriate for what it’s assessing only on the surface
o concurrent validity: refers to the extent to which the results of a particular test or measurement correspond to those of a previously established measurement for the same construct.
o Construct: the extent to which your test or measure accurately assesses what it’s supposed to.
o content: the extent to which a test measures a representative sample of the subject matter or behavior under investigation.
o Discriminant: Discriminant validity specifically measures whether constructs that theoretically should not be related to each other are, in fact, unrelated
