Clinical Assessment and Diagnosis

Question 1

What are the four common types of assessments?

Answer 1

Psycho-diagnostic
Psycho-educational
Neuropsychological
Assessment at the beginning of psychotherapy

Question 2

Assessment to identify and diagnose specific mental disorders (non-cognitive)

Answer 2

Psycho-diagnostic assessment

Question 3

To identify and diagnose specific learning problems, neurodevelopmental disabilities, and mental health problems (cognitive)

Answer 3

Psycho-educational assessments

Question 4

Assessing and diagnosing the possible contribution of brain damage or dysfunction to the patient’s condition

Answer 4

Neuropsychological assessments

Question 5

Assessment when a diagnosis may not be requested or necessary

Answer 5

Assessment at the beginning of psychotherapy

Question 6

List the seven limits to confidentiality

Answer 6

A person is at serious risk of harming themselves or others

A child is being abused or neglected

Any information about a regulated health profession committing a sexually inappropriate act (reported to that professions college)

Information about a person being neglected in a long-term care home

If a psychologist receives a subpoena from a judge

If the College of Psychologists audits a psychologist’s files

In missing persons investigations when information is requested from authorities

Question 7

Used to gather relevant information related to the client’s mental health (i.e. presenting problem, demographic information)

Answer 7

Clinical interview

Question 8

What are the three main types of clinical interviews?

Answer 8

Unstructured interviews
Semi-structured interviews
Structured interviews

Question 9

Interview style focusing on free speech, not guided

Answer 9

Unstructured interviews

Question 10

Interview style using a structure that can be naturally built off of to gather more information

Answer 10

Semi-structured interviews

Question 11

Interview style that’s useful for research but not as common in clinical practice

Answer 11

Structured interviews

Question 12

Name a pro and con of each main interview style

Answer 12

Unstructured interviews:
Pro - more natural conversation
Con - important information may be missed

Semi-structured interviews:
Pro - information can be gathered both systematically and efficiently
Con - can be challenging to balance flexibility and structure

Structured interviews:
Pro - guarantees all relevant information will be collected; contains specific scoring instructions for disorders
Con - may be overly rigid; may negatively affect relationship with client; time- consuming

Question 13

What are the five key focuses of a mental status exam?

Answer 13

Appearance and behaviour: Dress, general appearance, posture, and facial expression.

Thought processes: Speech rate and coherence

Mood (described by the individual) and affect (what you notice as the clinician)

Cognitive/intellectual functioning: Any concerns with ability to pay attention, follow the conversation, remember details

Sensorium: Are they oriented to space and time?

Question 14

Behavioural observations (e.g. mental status exam) are made through direct observation in a specific setting (at school, at home)

Answer 14

Behavioural assessment

Question 15

The act of measuring a behaviour changes that behaviour

Answer 15

Reactivity

Question 16

Does the test measure what it is supposed to measure?

Answer 16

Validity

Question 17

Does the test consistently measure the same thing?

Answer 17

Reliability

Question 18

What characterizes a good test?

Answer 18

Good validity and reliability

Question 19

Name the two noted types of validity and give an example of each

Answer 19

Concurrent validity (e.g. one measure of anxiety correlates with other measures of anxiety)

Predictive validity (e.g. intelligence tests correlate with school grades in the future)

Question 20

Why are projective tests for personality not commonly used in the 21st century?

Answer 20

Questionable validity and reliability

Question 21

Self-report questionnaires about personality that have been administered to thousands of people (allows for norms)

Answer 21

Personality inventories

Question 22

Give two examples of personality tests

Answer 22

The Multiphasic Minnesota Personality Inventory (MMPI-2)

NEO-PI

Question 23

Name and describe the “Big 5” personality traits

Answer 23

Extroversion: socially outgoing and excitement-seeking

Agreeableness: friendliness and compassion

Openness to experience: curiosity and adventurousness

Conscientiousness: organized and systematic

Neuroticism: sensitive and nervous

Question 24

Give a reason as to why intelligence testing is controversial

Answer 24

There are objections about whether the tests are culturally-appropriate and are valid for people from all backgrounds

Question 25

Name two types of intelligence tests

Answer 25

WAIS-IV and WISC-V

Question 26

Name four different types of intelligence that modern tests such as the WAIS-IV and WISC-V assess

Answer 26

Verbal comprehension Perceptual reasoning Working memory Processing speed

Question 27

What are five areas of cognitive functioning that neuropsychological tests assess?

Answer 27

Receptive and expressive language, attention and concentration, memory, motor skills, perceptual abilities

Question 28

Using self-report measures throughout treatment to measure effectiveness

Answer 28

Outcome monitoring

Question 29

In the DSM-5 TR, most diagnostic categories...

Answer 29

Assess for the dysfunction and distress associated with mental health problems and whether they are culturally expected

Question 30

Which characteristics of the symptom are considered when making a diagnosis?

Answer 30

Severity/intensity Duration Frequency

Question 31

A tool that allows us to classify the distinct patterns that characterize mental health problems

Answer 31

Diagnosis

Question 32

Name the three different approaches to diagnosis

Answer 32

Categorical approach Dimensional approach Prototypical approach

Question 33

A diagnostic approach treating mental disorders as clear categories with a clear physiology and underlying cause

Answer 33

Categorical approach

Question 34

Name an advantage and a disadvantage of the categorical approach to diagnosis

Answer 34

Advantage: simplicity Disadvantage: excludes significant numbers of people

Question 35

Why has the categorical approach to diagnosis largely been abandoned?

Answer 35

Mental disorders are not caused by a single underlying pathology

Question 36

Diagnostic approach that treats mental disorders as existing on a continuum

Answer 36

Dimensional approach

Question 37

Name an advantage and a disadvantage to the dimensional diagnostic approach

Answer 37

Advantage: captures the full range of mental health problems Disadvantage: more challenging to tell when problems become a “disorder”; little agreement on how many dimensions to consider

Question 38

Diagnostic approach that requires some essential features while also containing flexibility

Answer 38

Prototypical approach

Question 39

Name an advantage and a disadvantage of the prototypical approach

Answer 39

Advantage: captures a wide range of problems while also keeping categories distinct Disadvantage: People can present in many different ways

Question 40

Which diagnostic approach does the DSM-5 use?

Answer 40

Prototypical approach

Question 41

List five advantages to diagnoses in general

Answer 41

Allows for communication among professionals Creates some structure and consistency within the healthcare system Allows us to study specific problems and test specific interventions for those problems May allow people to access certain services Can give people a sense of relief

Question 42

List six disadvantages to diagnoses in general

Answer 42

Certain labels can be stigmatizing Diagnoses are not entirely objective of thoughts, behaviours, and emotions and they can be wrong Some labels are persistent (even if they may not be accurate) A diagnosis implies a disease or pathology Diagnostic categories have changed over time and are influenced by the current culture Many mental health problems are co-morbid and overlapping

Question 43

What does it mean that diagnosis is a "controlled act?"

Answer 43

Only medical doctors and psychologists can diagnose mental disorders in Ontario

Question 44

Rule stating that "A psychiatrist may share with the public his or her expertise about psychiatric issues in general. However, it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement.”

Answer 44

Goldwater rule

Question 45

The process of determining which of two or more diseases or disorders with overlapping symptoms a particular patient has

Answer 45

Differential diagnosis

Question 46

What are four tricky issues with differential diagnoses?

Answer 46

Equifinality and multifinality What is “normal” Understanding overlap across diagnoses Change/onset/symptom progression