CLINICAL ASSESSMENT AND DIAGNOSIS Flashcards
The systematic evaluation and measurement of psychological, biological, and social factors in an individual presenting with a possible psychological disorder.
Clinical Assessment
The process of determining whether the particular problem afflicting the individual meets all criteria for a psychological disorder, as set forth in the fourth edition, of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-IV- (American Psychiatric Association).
Diagnosis
A judgment or an interpretation by an observer based on the speech, ideas, behaviors, and experiences of the patient.
Diagnosis of mental illness
The degree to which a measurement is consistent.
Reliability
Is whether something measures what it is designed to measure—in this case, whether a technique assesses what it is supposed to.
Validity
The process by which a certain set of standards or norms is determined for a technique to make its use consistent across different measurements.
Standardization
The core of most clinical work used by psychologists, psychiatrists, and other mental health professionals. The interview gathers information on current and past behavior, attitudes, and emotions, as well as a detailed history of the individual’s life in general and of the presenting problem.
Clinical interview
It involves the systematic observation of an individual’s behavior. This type of observation occurs when any one person interacts with another.
Mental status exam
It can be structured and detailed, but mostly they are performed relatively quickly by experienced clinicians in the course of interviewing or observing a patient.
Mental status exam
The clinician notes any overt physical behaviors such as:
- leg twitch
- the individual’s dress general appearance
- posture and facial expression.
Appearance and behavior
What is the rate or flow of speech? Does the person talk quickly or slowly? What about continuity of speech?
Thought processes
A disorganized speech pattern
Loose association or derailment
Distorted views of reality
Delusions
Which someone thinks people are after him and out to get him all the time
Delusions of persecution
Which one individual thinks she is all-powerful in some way.
Delusions of grandeur
Does the person appear to be down in the dumps or continually elated? Does the individual talk in a depressed or hopeless fashion? How pervasive is this mood? Are there times when the depression seems to go away?
Mood and affect
The predominant feeling state of the individual.
Mood
Refers to the feeling state that accompanies what we say at a given point.
Affect
When you feel emotions but show practically nothing visually.
Flat affect
Refers to feelings/emotions but only showing some of what you’re feeling.
Blunted affect
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? Clinicians usually make a rough estimate of intelligence that is noticeable only if it deviates from normal, such as concluding the person is above or below average intelligence.
Intellectual functioning
Refers to our general awareness of our surroundings.
Sensorium
Does an individual know what the date is, what time it is, where he or she is, who he or she is, and who you are?
Sensorium
Are made up of questions that have been carefully phrased and tested to elicit useful information in a consistent manner so that clinicians can be sure they have inquired about the most important aspects of particular disorders .
Semistructured interviews
(Overactive thyroid gland), may produce symptoms that mimic certain anxiety disorders, such as generalized anxiety disorder.
Hyperthyroidism
(Underactive thyroid gland) might produce symptoms consistent with depression.
Hypothyroidism
Method used in clinically assessing and diagnosing behavior by using direct observation in order to assess formally an individual’s thoughts, feelings, and behavior in specific situations or contexts. This may be more appropriate than any interview in terms of assessing individuals who are not old enough or skilled enough to report their problems and experiences.
Behavioral assessment
(ABC’s of observation) What happened just before the behavior?
Antecedent
(ABC’s of observation) Actual behavior manifested.
Behavior
(ABC’s of observation) What happened afterwards?
Consequence
These include specific tools to determine cognitive, emotional, or behavioral responses that might be associated with a specific disorder and more general ones that assess longstanding personality features, such as a tendency to be suspicious.
Psychological tests
Determines the structure and patterns of cognition.
Intelligence testing
Determines the possible contribution of brain damage or dysfunction to the patient’s condition.
Neuropsychological testing
Uses sophisticated technology to assess brain structure and function.
Neuroimaging
Swiss psychiatrist named Hermann Rorschach developed a series of inkblots, initially to study perceptual processes, then to diagnose psychological disorders. Individuals are asked to formulate an unstructured response to some form of ambiguous stimuli.
Projective tests
- I feel that my father seldom… talks in
Tagalog (He’s Japanese). - When the odds are against me… I’m against them too.
- I always wanted to… travel.
- If I am in charge… I would change the
world. - To me the future looks… very futuristic.
SSCT ( Sack Sentence Completion Test)
It was developed in 1935 by Christiana Morgan and Henry Murray at the Harvard Psychological Clinic
TAT(Thematic Apperception Test)
Were developed for one specific purpose: to predict who would do well in school.
Intelligence testing
Measure abilities in areas such as receptive and expressive language, attention and concentration, memory, motor skills, perceptual abilities, and learning and abstraction in such a way that the clinician can make educated guesses about the person’s performance and the possible existence of brain impairment.
Neuropsychological testing
Child is given a series of cards on which are drawn various lines and shapes. The task is for the child to copy what is drawn on the card. This can be useful for psychologists, because it provides a simple screening instrument that is easy to administer and can detect possible problems.
Bender Visual–Motor Gestalt Test
Used in visualizing the structure and function of the brain divided into two categories. (1) Procedures that examine the structure of the brain, such as the size of various parts and whether there is any damage. (2) Procedures that examine the actual functioning of the brain by mapping blood flow and other metabolic activity. e.g. CT scan, PET, MRI, CAT among others
Neuroimaging
Refers to measurable changes in the nervous system that reflect emotional or psychological events. The measurements may be taken either directly from the brain or peripherally from other parts of the body. E.g. EEG/ECG/GSR
Psychophysiology
A technique by which patients monitor their own bodily functions in an attempt to alter those functions. Primarily used in treating painful or stress-related conditions, biofeedback helps a patient control physiological processes that are normally considered involuntary.
Biofeedback
Individual’s unique personality, cultural background or circumstances. This information lets the clinician tailor their treatment to the person.
Idiographic Strategy
To determine a general class of problems to which the presenting problem belongs. Clinician is attempting to name or classify the problem.
Nomothetic Strategy
Originates in the work of Emil Kraepelin (1856–1926) and the biological tradition in the study of psychopathology. Here we assume that every diagnosis has a clear underlying pathophysiological cause, such as a bacterial infection or a malfunctioning endocrine system, and that each disorder is unique.
Classical (or pure) categorical approach
The clinician notes the variety of cognitions, moods, and behaviors with which the patient presents and quantify them on a scale. For example, on a scale of 1 to 10, a patient might be rated as severely anxious (10), moderately depressed (5), and mildly manic (2) to create a profile of emotional functioning (10, 5, 2).
Dimensional approach
