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Psych 300 > Psychological assessments and clinical diagnosis > Flashcards

Psychological assessments and clinical diagnosis Flashcards

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1
Q

What is the goal of clinical psychological assessments?

A

To understand the individual, predict behaviour (e.g. are they dangerous to themselves?), plan treatment (evidence based practice) and evaluate treatment outcome

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2
Q

what are Assessment of psychological disorders?https://www.brainscape.com/decks/11113908/cards/quick_new_card

A

Systematic evaluation and measurement of psychological, biological and social-cultural factors. they try to integrate biological, psychological, interpersonal, social, and cultural into a cohesive model of psychological disorders

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3
Q

value of clinical assessment procedures are determined by

A

Reliability (consistency)
Validity (accuracy)
Standardization: Procedure to ensure consistency of a technique.

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4
Q

Interrater reliability

A
  • if different people administer the same measure with the same patient they get to the same outcome
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5
Q

Major methods for clinical psychological assessments?

A 
Clinical interviews
Observation techniques
Tests
Biological - measuring psychophysiological responses\
Life records
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6
Q

Clinical interviews types

A

Open-ended (unstructured)
semi-structured
observation techniques

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7
Q

Open-ended (unstructured) Clinical interview

What does the therapist analyze?

A 
The clinician uses their judgment and intuition to ask questions 
he looks at
Appearance and behaviour
Thought process
Mood and affect
Intellectual 
Sensorium (awareness)
 of the patient
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8
Q

Semi-Structured Clinical interview

A

Here the interviewer follows a list of questions (but they can do it in different ways).
Example: Structured Clinical Interview for Diagnosis (SCID)

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9
Q

Semi-Structured advantage and disadvantage

A

Advantage: It is comprehensive - it covers every aspect of every disorder - increases inter-rater reliability. The gold standard for diagnosis
Disadvantage: Time consuming

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10
Q

Behavioral Interview

A

Focus on the here and now
identify problematic behaviour and situations
+ ask about antecedents of behaviour and consequences

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11
Q

What are Observation techniques?

A

Type of psychological assessment
Where the observer notes the behaviour of patient (different observers can be used - family, clinician, own patient). can be in the lab, clinic, in daily life

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12
Q

Examples of observation techniques

A

Structured observation schedules
Behaviour approach tests (lab)
Behavioural self-observation

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13
Q

Tests as a psychological assessment procedure

A

Provide patient with a Consistent stimulus - And the person is scored according to specific criteria. Interpreted relative to normative sample

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14
Q

Tests as a psychological assessment. What can they measure?

A

Can assess Verbal and nonverbal behavior. Can also assess performance
symptoms, personality, intelligence and neuropsychological, others

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15
Q

Projective tests - assumption

A

Assumption: person will project aspects of personality onto ambiguous test stimulus
Example: TAT - Thematic apperception test

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16
Q

Projective tests - procedure

A

Patient projects onto ambiguous stimulus

Clinician interprets this projection, which Requires more clinical inference - mix of validity and reliability data

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17
Q

Objective (Empirical) tests

A

Test stimuli are less ambiguous
Individuals compared to a large normative group
Examples: Objective personality tests (Such as MMPI), Objective Intelligence tests (WAIS), Neuropsychological tests

18
Q

Objective (Empirical) tests advatages

A

extensive reliability, validity and normative info

19
Q

What does it mean for a test to be compared to a normative group?

A

Your results are compared to people like you (of your culture, sex, age, etc.) and evaluated based on this comparison - or else confounds may appear

20
Q

Biological - psychophysiological assessments - domains and use

A

Electroencephalogram (EEG)
Heart rate and respiration (HR)
Electrodermal response and levels (GSR)
Electromyography (EMG)
Penile/ Vaginal plethysmograph - Sexual arousal
Less commonly used in clinics. More in research

21
Q

Advantages of Biological psychophysiological assessments

A

They are more objective, patients can’t control as easily, measures key variables in some disorders

22
Q

Limitations of Biological psychophysiological assessments

A

It is affected by many aspects: diet, influences of patient’s emotional setting, situational stress, who the assessor is
It can only be operated by a specialist + expensive equipment

23
Q

Life Records - psychological assessment

types, advantages and limitation

A

Types: school records, occupational records, medical history, legal records
Advantages - They are objective. Reflect significant events.
Limitations - Records can have errors

24
Q

What is the best clinical psychological assessment?

A

All assessment procedures have strengths and weaknesses

The ideal is to combine information from multiple sources into a coherent picture to get to a conclusion

25
Q

Clinical Diagnosis

Definition

A

The act of identifying a disorder from its signs and symptoms

26
Q

Signs vs Symptoms

A

signs (what the therapist observes) and symptoms (what the patient reports)

27
Q

Why conduct diagnosis?

A

For treatment and prevention planning, summarize information (professional communication), to make research (separate into groups)

28
Q

Advantages of diagnosis

A

Patient management and well being (identifying injuries, insurance). Misdiagnosis may be very costly to the individual (e.g. court problems)

29
Q

Criticisms of diagnosis

A

Loss of information of the patients psychological frame, diagnosis doesn’t tell you exactly what to do. More analysis is important.
+ Labeling effects - stigma (by patient and people around)
problems with organizing symptoms

30
Q

Barlow presents 4 models of diagnosis

A

Categorical
Prototype
Dimensional
Biomedical

31
Q

Categorical model of diagnosis

Assumptions

A

Each disorder is unique from every other

All criteria must be met - patients have all the same symptoms

32
Q

Prototype model of diagnosis

A

Identifies certain essential characteristics but Allows for symptom variation
DSM-5
Prototypical syndrome
It uses syndromes but patients may not share the same symptoms, while also getting the same diagnosis

33
Q

DSM-5 Criticism

A

There are a lot of comorbidity categories
Dichotomous decisions (tem ou nao tem)
only some evidence for decision rules
Reliability at the expense of validity
Cultural and social biases/differences - diagnostic colonialism. + gender bias

34
Q

Cultural differences Chinese Classification of Mental Disorders (CCMD)

A

Neurosis, some psychotic disorders that are not in DSM, Neurasthenia, Hysteria are still there
Traveling psychosis, Psychogenic disorders
Koro: Belief that genitals retract

35
Q

Psychogenic sub-category of culture-related disorders

A

Qigong-induced: short-lived fright, delusions, identity disturbance, suicidal, bizzare and violent behaviour
+ Mental disorders related to superstition and witchcraft

36
Q

Dimensional models of diagnosis

A

Rates individual on the severity of symptoms in a variety of symptoms
Yields a profile of symptoms or of syndromes - of the patient which actually reflects the way symptoms appear in humans
+ Psychopathology hierarchy of dimensional models

37
Q

Critique of hierarchical dimensional model

A

It is essentially categorical - like the other models

Problems with construction - what should you use to to develop the categories of dimensions?

38
Q

Biomedical model

A

National institute of Mental Health
Psychological disorders conceptualized as “brain dysfunctions”
classification based on clinical observation
Identifying genetic influences, neurochemistry and brain circuits is necessary to determine the true nature of psychopathology - The objective model

39
Q

biomedical model - Research Domain Criteria (R-DoC)

A

“grid” of variables - the total grid can potentially create 312 factorial combinations = Research domain matrix

40
Q

Biomedical model criticism (Hayes)

A

Biomedical studies do not know a single biological marker for any disorder
Lack of specificity in neural and genetic correlates
Correlation is not causation
Confounds with effects of medication, Socioeconomic status and etc

41
Q

Stigma in Biomedical explanation

A

Increases patients pessimism and perceived danger
Reduces blame by others but heightens self blame
Ignores epigenetics, learning, culture and SES.
Too complex + not enough research for treatment

Psych 300 (8 decks)

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