Clinical Assessment and Diagnosis Flashcards
What do the tools used in an assessment depend on?
the clinician’s theoretical orientation
What are the categories of clinical assessment tools?
Clinical interviews
tests
observations
What are the types of reliability?
Test-Retest:
Test produces similar results when given at two points in time
Alternate Form:
Two versions of the same test produce similar results
Internal:
Different parts of the same test produce similar results
Interrater or Interjudge:
Two or more raters or judges who administer a test to an individual and score it come to similar conclusions
What are the types of validity?
Face:
Test appears to measure what it is supposed to measure
Content:
Test assesses all important aspects of phenomenon
Concurrent:
Test yields the same results as other measures of the same behavior, thoughts, or feelings
Predictive:
Test predicts the behavior it is supposed to measure
Construct:
Test measures what it is supposed to measure and not something else
What is malingering?
Intentionally providing a false report of symptoms or exaggerating existing symptoms
either for material gain or to avoid unwanted events
Why is it important to get a patient history? Why is it hard?
Past factors or events may illuminate the current difficulties
Some patients are poor historian due to their illness
- Schizophrenia
- Dementia
- Malingering
What are the two types of interviews?
Unstructured and structured
In an unstructured interview, clinicians ask open-ended questions
In a structured interview, clinicians ask prepared questions, often from a published interview schedule
- may include a mental status exam
What is the behavioral assessment?
Behavioural assessment takes this process one step further by using direct observation to formally assess an individual’s thoughts, feelings, and behaviour in specific situations or contexts; this information should explain why the person is having difficulties at this time.
Target behaviors identified and observed
ABCs of observation
- Antecedents, behaviors, and consequences
4 kinds: Informal observation, formal observation, self-monitoring or self-observation, reactivity
What is self-monitoring?
A behavioral assessment tool where people observe themselves and carefully record the frequency of certain behaviors, feelings, or cognitions as they occur over time
Checklists used to observe behavior
Behavior rating scales
What are Personality inventories?
A clinical test that is designed to measure brand personality characteristics. Focuses on behaviors, beliefs, and feelings. Usually based on self-reported responses
Most widely used: Minnesota Multiphase Personality Inventory
For adults: MMPI (original) or MMPI-2(1989 revision)
For adolescents: MMPI-A
What are response inventories?
A clinical test that focuses on one specific area of functioning, usually based on self-reported responses.
Affective inventories (ex. Beck Depression Inventory)
Social skills inventories
Cognitive inventories
What are intelligence tests?
A clinical test designed to indirectly measure intellectual ability. They are typically comprised of a series of tests assessing both verbal and nonverbal skills. The general score is an intelligence quotient (IQ). It should be done at the same time as other tests (autism, etc.)
Most popular: Wechsler Adult Intelligence Scale (WAIS) and Wechsler Intelligence Scale for Children (WISC)
What are the Strengths and Weaknesses of Intelligence tests?
Strengths:
Are among the most carefully produced of all clinical tests
- highly standardized on large groups of subjects
- have very high reliability and validity
Weaknesses:
Performance can be influenced by non intelligence factors (e.g. motivation, anxiety, test-taking experience)
Tests may contain cultural biases in language or tasks
Blind spots in most testing
Tests designed on white Europeans might not work the same on other cultures
Why do we diagnose?
Classification, although it has it’s issues, provides the ability to describe a condition in a few words, group certain abnormal behaviors and experiences together, convey etiology, course, and indication for treatment, study cases, course, and effects of treatments, indicate whether an individual is in need of attention support, or benefits, and allow patients to identify with others.
Its useful for professional shorthand
Potential benefits
* Autism gets funds and change because of highly motivating parents
Can provide identity and community
Research fund
What are the forms of classification systems?
Classical (or pure) categorical approach - Strict categories
Dimensional approach - Classification along dimension
Prototypical approach - Combines classical and dimensional views
