Diagnosis and Assessment Flashcards
what is the DSM-5
the main psychiatric dictionary
what is the main issue with the DSM
polythetic criteria - only need some of the properties detailed
there are vastly different ways in which a diagnosis can be made
why is DSM complicated
trying to put order on the complex natural space of the brain and human experiences
why do we bother with the DSM
help treat patients
allows for consistent communication between clinicians and researchers (Standardisation)
having a label
comes with an explanation - separates self from feelings
allows for medical insurance and disabillity claims
when are new diagnoses added
when groups identified whose symptoms are not adequately explained by existing labels
what is comorbidity
having 2 or more disorders at one time
why is there so much comorbidity
shared genetic risk - certain genes can confer risk for multiple disorders
shared environment risk - stress, trauma, and neglect increase risk for many disorders
shared treatment efficacy - SSRIs are effective for MDD, OCD, GAD, PTSD, eating disorders
shared neurobiological profile - changes to PFC function and size is common in many disorders (SCZ, MDD, PTSD, OCD)
what is the research domain criteria project
NIMH in USA, 2013
changed framework of research from categorical to dimensional
studied that variation of (psych, cog, bio experiences) not the label
what is reliability
gives the same answer consistently across time (and raters)
what is test-retest reliability
if you give the same assessment to patient again and again, still get same answer
what is inter-rater reliability
level of agreement between 2 raters doing evaluation - do they agree in decision (correlation)
what is validity
measures what it is supposed to
what is a clinical interview
an evaluation of current level of functioning and presence of symptoms
what is the goal of a clinical interview
to build and understanding of the individual (case formulation)
what resources do clinical interviews provide
coping strategies and social supports
what is the mental state exam
talking to patient in clinical setting and considering
- appearance, behaviour, hygiene, eye contact
- thought processes (is it logical or tangential)
- mood through self reported evidence
- affect (overall tone of interview)
- speech (racing thoughts, pressure to speak, unable to speak)
-perceptions, hallucinations
-disorientation of person/place/time
- insight (do they think something is wrong)
- risk of suicide
what is a structured clinical interview (SCID)
go through criteria from DSM
usually used for research
what does self report history demonstrate
stress - life events and difficutlies schedules
psychophysiology - skin conductance, heart rate
biofeedback - used in exposure therapy for extinction of fear
what are personality tests
a characteristic pattern of thinking, feeling, behaving
what are the areas in a personality test
extraversion
agreeableness
conscientiousness
openness
neuroticism
what do projective personality tests help with
tell us about the unconscious
interpretation of stimulus in line with current thoughts and feelings
examples of personality tests
thematic appreciation (shown picture and asked to tell/describe it with a story)
Rorschach test (inkblot test)
draw a person (used to dissect trauma and mood in minors)
sentence completion
what are the major drawbacks of tests
difficult to implement
biassed responses from clients
clinicians subjectivity in evaluation
confirmation bias
lack of standardisation for scoring and administration
intelligence tests and what are they used for
score is predictive of important outcomes (grades, achievement, income)
necessary for diagnosis of intellectual developmental disorder
behavioural and cognitive assessment
children observed by assessor
behavioural responses of children
self monitoring - alcohol consumption, mood, sleep, anxiety, exercise etc
what is the problem of observing behaviour
may cause change (reactivity) - people may modify answers to manage impression on clinicians
brain imaging
mostly used for neurology
can rule out neurological problems (strokes etc)
methods of brain imaging
computerised axial tomography (CAT) - 3d x-ray detect tissue density
positron emission tomography (PET) - measures brain structure and function
