week 3 - assessment and classification Flashcards
diagnostic assessment
multi method (interview, observation, self report, review of records)
Multiformat (could be client/patient, parents or teachers)
assessment : clinical interview
-establishes rapport
-gathers present symptoms
-social and cultural context
-areas of current distress, past mental problems, social history
the mental status exam
observation of client concerning - appearance, behavior, mood, speech quality, perception
structured interviews
used to analyze, interpret and evaluate events and relationships within a theoretical framework and used to describe unique experiences and complex disorders, not easily reduced to a single variable
cultural dimensions - cultural formulation interview
assesses -
persons cultural identity, cultural conceptions of distress, pyschosocial stressors, overall cultural assessment
reliability
is the instrument consistent?
internal reliability - do individual questions relate to each other?
test retest reliability - do 2 measurements result in the same outcome
alternate corm reliability - do 2 difference versions of the measure result in the same outcome?
inter-rater reliability - do 2 raters make the same observation/ interpretations of the measure
validity
Does the instrument measure what its supposed to?
content validity - does the measure assess all the aspects of a phenomenon
predictive validity - does the measure accurately predict thoughts, feelings, behaviors in the future?
concurrent validity - does the measure show similar results to the others already validated that measure the same thing?
construct validity - does the measure assess what it is supposed to?
ecological validity - the data is meaningful and collected in ways that go beyond the local context
questionnaires: the beck depression inventory
-used by both clinicians and researchers to assess symptoms associated with depression (21 multiple choice items)
-used to determine symptom severity (mild, moderate, severe)
questionnaires - the Minnesota multiphasic personality inventory - (MMPI-3)
-335 true or false questions
-empirically developed with matched samples
-compares individuals scores to a normative sample or chosen comparison group
-ten different clinical categories and can detect how much a patients responses deviates from normal
projective tests
-Freuds ideas of repression
-used to window into thoughts of clients see how they differ from the thoughts of others
the Rorschach test (projective test)
Developed by Swiss psychiatrist - Herman Rorschach
-assessed for - use of color and movement and focus on details rather than big picture
thematic apperception test (projective test)
30 black and white drawings of people and scenes
-the emotion in the patients narrative gives insight into what they are thinking and feeling
benefits and criticisms of projective tests
benefits - less structured format, fewer demand characteristics, less socially desirable responses, assess desires that are often unconscious
criticism - questionable reliability and validity, not really predictive or diagnostic due to lack of supporting scientific evidence
neuropsychological tests
tests designed to assess brain damage
the wechsler adult intelligence (neuro test)
a general adult intelligence test
2 subscales - verbal (comprehension and reasoning)
performance - spatial processing and attention to detail
Wisconsin card sorting test (neuro test)
client sorts card into 4 miles based on shape or color - asks to switch sorting category which should be easy for a normal person
continuous performance test (neuro test)
measures various aspect of patients attentional abilities, shown letters and have to respond to target letter then person must respond to letter when its followed by another
people with adhd find this hard
neuroscience and diagnosis
Brain scanning can classify illnesses
categorical and dimensional approaches to diagnosis
categorical - diagnosis based on whether people show presence or absence of a particular symptoms
dimensional - diagnosis depending on degrees of symptoms
comorbidity
the presence of more than one disorder at the same time
internalizing - the focus of the disorder is inside the person like depression
externalizing - the focus of the disorder is outside the person like substance abuse
purpose of classification systems
as a nomenclature to provide standard names for disorders, basis of info, descriptive system
The ICD
International Statistical Classification of disease and related Illness
involves short narratives describing each condition
the DSM
diagnostic and statistical manual of mental disorders
uses specific criteria for symptoms rather than broad descriptions of disorders
research domain criteria
seeks to create a classification system with 7 differences from the DSM
