Clinical Assessment and Diagnosis

Question 1

Specific phobias are excessive…

Answer 1

irrational fears of a given object or situation

Question 2

The prevalence of phobias is…

Answer 2

high, affecting ~9% of Americans and twice as many women as men

Question 3

The five possible subtypes of phobias are…

Answer 3

animal, environmental, blood-injection-injury, situational, and “other”

Question 4

Onset of phobias is often in…

Answer 4

childhood, with animals phobias usually earliest (~age 7), then blood (~age 9)

Question 5

Assessment

Answer 5

a process that may or may not result in a DSM diagnosis

Question 6

Purposes of assessment:

Answer 6

Gather information about a person’s concerns and functioning, especially the problems that brought them in, Form diagnostic impressions, Provide treatment recommendations or plan treatment, Evaluate treatment outcome

Question 7

What do psychologists do to assess a person?

Answer 7

Examine medical or previous treatment records, Clinical interviews, Behavioral assessment and observation
Psychological tests

Question 8

Clinical interviews

Answer 8

Including the Mental Status Exam

Question 9

Psychological tests

Answer 9

Projective tests, Self-report inventories, Psychoeducational, Neuropsychological

Question 10

Clinical Interviews can be…

Answer 10

Structured (e.g., SCID, DISC, MINI), Semi-structured, or even un-structured (Often includes a mental status exam)

Question 11

The goal of clinical interviews is to understand:

Answer 11

The presenting problem or chief complaint, the person’s history and functioning in a variety of domains, any symptoms that are present

Question 12

Why are unstructured clinical interviews occasionally unsuccessful?

Answer 12

Because information is commonly missed

Question 13

What is the purpose of the Behavioral Assessment and Observation?

Answer 13

To focus on and understand a current problematic (or “target”) behavior and to help the client to identify the ABC’s

Question 14

What are the ABC’s and when do they occur?

Answer 14

Antecedents, Behavior, and Consequences (A and C occur immediately before and after the B)

Question 15

In the behavioral assessment and observation the clinician will have to decide…

Answer 15

Will the person self-monitor or be observed by another person? (Problem of reactivity using direct observation by another person)

Question 16

Projective Tests

Answer 16

Have roots in the psychoanalytic tradition, Involve presenting an ambiguous stimulus and asking for a response, Idea is that the person will “project” attitudes, motivations, and personality onto the stimulus, Require a high degree of inference/opinion in scoring and interpretation = generally unscientific

Question 17

Examples of Projective Tests

Answer 17

The Rorschach Inkblot Test

Thematic Apperception Test

Question 18

Strengths of Projective Tests

Answer 18

Can be more engaging and helpful with resistant clients, harder to “fake” responses

Question 19

Weaknesses of Projective Tests

Answer 19

Based on little scientific evidence, poor reliability and validity

Question 20

The Rorschach Inkblot Test

Answer 20

xxx

Question 21

Thematic Apperception Test

Answer 21

xxx

Question 22

Self-Report Inventories are often called “objective” tests, because…

Answer 22

they are rooted in the empirical (research-based) tradition

Question 23

Description of Self-Report Inventories test

Answer 23

Tests are less ambiguous and purpose is more obvious, Require minimal inference/opinion in scoring = more valid/scientific, interpretation can still be challenging depending on the test (Example of a very useful but very complicated test = MMPI-2 (or MMPI-A)

Question 24

Psychoeducational Testing

Answer 24

Often done by school psychologist, but most clinical/counseling psychologist are also trained in administration/interpretation; Includes IQ (aptitude) testing and Achievement Testing

Question 25

IQ (aptitude) Testing

Answer 25

IQ is a score assumed to reflect an individuals intellectual abilities as compared to same-aged individuals (vernal vs. performance domains)

Question 26

Achievement Testing

Answer 26

Used to assess a persons level of academic achievement; Necessary when conducting a learning disability assessment

Question 27

Neuropsychological Testing

Answer 27

Conducted most often by neuropsychologist, but some Clinical psychologist are trained as well; purpose is to understand brain behavior relationship, may also involve Nero imaging techniques, test are more focused on cognitive functioning (ex. attention, memory, visuospatial tasks, processing speeds)

Question 28

Examples of Neuropsychological Tests

Answer 28

The Luria-Nebraska and Halstead-Reitan Batteries

Question 29

Two Distinct approaches for classifying psychological disorders

Answer 29

Categorical vs. Dimensional

Question 30

Categorical

Answer 30

Very black-and-white; the person either has a disorder or does not

Question 31

Dimensional

Answer 31

Evaluate the extent to which a person is exhibiting a problem

Question 32

The DSM has traditionally been…

Answer 32

Categorical, and still is to a large extent. However there is an obvious shift toward dimensional classification in DSM-5 and this will continue moving forward

Question 33

Often cited problems with DSM

Answer 33

Extensive comorbidity of disorders, Labeling and stigmatization, Using dimensions (lower diagnostic threshold), Are there too many new diagnoses as the DSM evolved?, Does it do well taking culture into account?(DSM is a controversial manual with many supporters and many critics)