EXAM 1 - ch3 -Assessment & Diagnosis Flashcards
Reliability
Degree of consistency of a measurement
Example: “Agreement” between two different testing times or between two different evaluators
Anxiety, schizophrenia diagnosis are usually very reliable
Validity
Does the test measure what it’s supposed to? Several types: Concurrent Predictive Construct
Concurrent:
Comparison between results of one assessment with another measure known to be valid
Predictive:
How well the assessment predicts outcomes
Construct:
Degree to which test or item measures the unobservable construct it claims to measure (e.g., “depression”)
Clinical interview
Assesses multiple domains
Presenting problem Current and past behavior Detailed history Attitudes and emotions Patient Distress Impairment in Functioning
Structured diagnostic interviews
are the most valid and reliable method to diagnose psychiatric disorders
Semi-structured diagnostic interviews
are less valid and reliable than structured but are used most often in clinical settings
Mental status exam
Appearance and behavior Thought processes Mood and affect Intellectual functioning Sensorium/Orientation (X3) (Person, Place, Time) Perceptual disturbances Suicidality/Homicidality
observational assessment focuses on
antecedents
behavior
consequences
Psychological testing
Specific tools for assessment of: Personality Cognition Emotion Behavior Academic (Learning) Disabilities Developmental Disabilities Academic Giftedness
Projective tests
Rooted in psychoanalytic tradition
Used to assess unconscious processes
Project aspects of personality onto ambiguous test stimuli
Require high degree of inference in scoring and interpretation
Examples:
The Rorschach Inkblots
The Thematic Apperception Test (TAT)
The Rorschach Inkblots
Projective test
Objective tests
Roots are in an empirical tradition
Test stimuli are less ambiguous or not ambiguous
Require minimal clinical inference in scoring and interpretation
Are more reliable and valid typically
Are easier to score and to administer to groups
Examples:
The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the MMPI-A (for adolescents) as well as the newer RF versions
The Beck Depression and Anxiety Inventories
The Conners ADHD Rating Scales
And 100’s more
The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the MMPI-A (for adolescents) as well as the newer RF versions
The Beck Depression and Anxiety Inventories
The Conners ADHD Rating Scales
And 100’s more
Objective tests
Test for Academic/Intellectual Giftedness
Learning Disabilities
Developmental Disabilities
The Wechsler and Woodcock Johnson test batteries for IQ and Academic Assessment
The Vineland for Adaptive Behavior Assessment
Neuropsychological Tests
Description/Purpose Examples The Halstead-Reitan Neuropsychological Battery The Luria Nebraska The NEPSY-II The Wechsler Memory Scale
First systematic classification system
by Emil Kraepli“Syndromes”
Dementia Praecox
Manic-depressive Psychosis
Classical (or pure) categorical approach
strict categories (e.g., you either have social anxiety disorder or you don’t)
Dimensional approach
classification along dimensions (e.g., different people have varying amounts of anxiety in social situations)
Prototypical approach
combines classical and dimensional views. Identifies the essential features of a disorder so it can be classified, but allows for nonessential variations that do not necessarily change the classification (DSM-5)
Purposes of Diagnosis
Treatment Planning
Communication
Research
Insurance Reimbursement
Problems with Diagnosis
They can be dehumanizing (Rosenhan)
The can turn into a self-fulfilling prophesy (Sick Roles)
They can be limiting in terms of understanding other aspects of the patient (e.g., personality, environment)
Some diagnoses have weak inter-rater reliability (e.g. personality disorders)
Two Main Systems of Classification
The Diagnostic & Statistical Manual of Mental Disorders (DSM)
The International Classification of Diseases (ICD)
The Diagnostic & Statistical Manual of Mental Disorders (DSM)
Published by the American Psychiatric Association
The International Classification of Diseases (ICD)
Published by the World Health Organization
Introduction of DSM-III in 1980 revolutionized classification
Diagnoses classified along five “Axes”
Axis I: Clinical Disorders
Other Conditions That May Be a Focus of Clinical Attention
Axis II: Personality Disorders
Mental Retardation
Axis III: General Medical Conditions
Axis IV: Psychosocial and Environmental Problems
Axis V: Global Assessment of Functioning
Diagnoses classified along five “Axes”
Axis I: Clinical Disorders
Other Conditions That May Be a Focus of Clinical Attention
Axis II: Personality Disorders
Mental Retardation
Axis III: General Medical Conditions
Axis IV: Psychosocial and Environmental Problems
Axis V: Global Assessment of Functioning
Comorbidity
it means you have more than one diagnosis
Defined as two or more disorders for the same person
Clinical assessment and diagnosis
Aims to fully understand the client
Aids in understanding and ameliorating human suffering
Based on reliable, valid, and standardized information
