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pyb309: individual differences and assessment > Clinical Assessments: methods and purpose > Flashcards

Clinical Assessments: methods and purpose Flashcards

1
Q

What are the methods of clinical assessment?

A
  • Clinical interview
  • Personality Assessments
  • Questionnaires
  • Corroborative reports
  • Self-report
  • Self-monitoring forms
  • Observation
  • Measuring Process and Outcome of therapy
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2
Q

What is the purpose of a clinical interview?

A
  • Mental Status Examination
  • Diagnosis
  • Risk assessment (suicidal?)
  • Formulation
  • Understand client’s goals for assessment or therapy
  • Understand process issues that might guide the course of therapy
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3
Q

What are the 3 phases of a clinical interview?

A
  • Opening
    • warm up and rapport building
    • assess the suffering, empathies
  • Middle
    • history, mental status, assessment, determine client’s level of insight
  • End
    • summaries conclusions
    • focus on goals and hope for future
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4
Q

What are the areas covered by a clinical interview?

A

• Ask about presenting problem (what brings them in today)
• Explore current psychological functioning and symptom formation (identify diagnoses and differential diagnoses)
• Mental Status Examination throughout interview
• Risk assessment
Personal history
• Current social systems
• Strengths, competencies and abilities

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5
Q

What is included in a Mental Status Examination?

A 
observation of the clients:
	○ Appearance
	○ Behaviour 
	○ Thought Form
	○ Thought Content
	○ Perception
	○ Affect\Mood
	○ Orientation
	○ Judgement
	○ Insight
	○ Intelligence
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6
Q

What is included in the observation of thought?

A
  • Rate, responsivity and spontaneity
    • Coherence – use of standard grammatical forms and sentence structure
    • Capacity to sustain train of thought
    • Circumstantiality
    • Tangentiality
    • Flight of ideas
    • Thought block
    • Word salad
    • Unusual word usage – neologisms
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7
Q

What is included in Perception observation?

A
  • Sensory distortions and illusions
  • Hallucinations:
    • hearing
    • vision (implications)
    • smell, taste and touch
  • Depersonalisation and derealisation (the world isn’t real they are in a movie)
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8
Q

What is included in Cognition observation?

A
  • Orientation to time, place and person
  • Attention and concentration: distraction due to intrusive thoughts, impaired reasoning, impaired concentration
  • Memory
  • Capacity for abstraction and reasoning
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9
Q

What are the risk factors in a Suicide Risk Assessment?

A
  • Ideation, Plans, Intent to act, Means,
    • Acute stress (especially interpersonal)
    • Depression
    • Impulse control problems
    • Humiliation/embarrassment
    • Hopelessness
    • Use of substances
    • Previous models of self-harm
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10
Q

What are the protective factors in a Suicide Risk Assessment?

A
  • Beliefs (e.g. moral or religious)
    • Family (e.g. children)
    • Social Support
    • Upcoming positive experiences to look forward to
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11
Q

What is the purpose of diagnosis?

A
  • Description of levels of psychopathology
  • Communication between health professionals
  • Guide Treatment
  • Inform prognosis
  • Guides Research
  • Identifying the capacity of someone to stand trial
  • Cognitive or functional impairment
  • Help client
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12
Q

What is included in diagnostic reasoning?

A

Cues -> inferences -> pattern -> hypotheses -> Inquiry (evidence as well) -> conclusion -> formulation

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13
Q

What is a mental disorder?

A

A significant behaviour that occurs in an individual that is associated with distress or disability, or an increased risk for suffering death, pain, disability, or an important loss of freedom. This syndrome must not be due to a culturally sanctioned response.

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14
Q

What is a categorical system e.g. DSM?

A
  • Presence/absence of a disorder: either you are anxious or you are not anxious.
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15
Q

What is a dimensional system?

A
  • Rank on a continuous quantitative dimension: how anxious are you on a scale of 1 to 10?
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16
Q

What are the advantages of categorical and dimensional systems?

A

Dimensional systems may better capture an individual’s functioning but the categorical approach has advantages for research and understanding

17
Q

Describe the DSM I

A

○ 1952
○ Myers psychobiological view
○ Disorders cause by personality “REACTION”

18
Q

Describe the DSM II

A

○ 1968

○ Basically the same but references to “reaction” were removed

19
Q

Describe the DSM III

A

○ Published in 1980
○ Free from theories of etiology
○ Initiates use of Multi-axis system

20
Q

Describe the DSM III-R

A

○ 1987 Revisions made to clarify diagnoses

21
Q

Describe the DSM IV

A

○ Published 1994
○ Categorical
○ Cultural and ethnic considerations
○ Not based on deviant behaviors

22
Q

Describe the DSM V

A

○ Published 2013
○ changes in diagnostic criteria (e.g. removal of criteria e.g. bereavement is no longer an exclusion criteria for depression)

23
Q

What is in the DSM-5?

A

Describes criteria for diagnoses, key clinical features, and related features that are often, but not always, present

24
Q

The Major depressive disorder criteria requires Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either…

A

(1) depressed mood: most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful)
or (2) loss of interest or pleasure: in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).

25
Q

What are the other symptoms that may constitute the 5 symptoms of major depressive disorder?

A

○ Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)
○ insomnia or hypersomnia nearly every day.
○ Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
○ Fatigue or loss of energy nearly every day.
○ Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
○ Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
○ Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

26
Q

What is noted in Criterion A for a major depressive disorder?

A

The recent significant loss may resemble a depressive episode

27
Q

What does reliability refer to?

A

the consistency of measurements, including diagnostic decisions

28
Q

What does validity refer to?

A

whether or not accurate statements and predictions can be made from knowledge of membership class

29
Q

What is the difference between a disgnosis and a formulation?

A

diagnosis describes

formulation explains

30
Q

What is a formulation?

A
  • Provides a basis for a treatment plan
  • Based on a theoretical framework
  • Identify critical events in a person’s life and link these to the presenting problems by key psychological mechanisms
  • Balance between comprehensive and parsimonious
31
Q

What is included in a formulation?

A
  1. Presentation
    Current expression of problem
  2. Pattern of behavior
  3. Predisposition
    Pre-morbid events that have lead to the presentation
  4. Precipitation
    Triggers for current presentation
  5. Perpetuation
    Maintaining factors of problem/s
  6. Potentials
    Client/family/system strengths
  7. Prognosis
32
Q

What is the self-monitoring of ABCs?

A

Antecedents
Beliefs
emotional Consequences

33
Q

What is an example of the self-monitoring of ABCs?

A 
A = friend walks by without saying hello
B = she does not like me anymore (90% believed)
C = Sad 7/10

pyb309: individual differences and assessment (12 decks)

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