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Flashcards in Assessment and Diagnosis Deck (67):
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Psychological assessment

Collection, organization, and interpretation of information

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Psychological diagnosis

Determining whether client's issues meet criteria for specific psychological disorder

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Goals of psychological assessment

Description and prediction

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Reliability

Consistency

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Validity

Accuracy

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Norms

Way normal people answer questions on a test

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Standardization

Presenting the test the same way every time

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Areas queried in an interview

Presenting problem
Current context
History of presenting problem
Biopsychosocial history (family life, support system, living conditions, etc.)

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Sensorium

Orientation to a situation: awareness of identity, current day, current time, etc.

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Unstructured interview

Talk with client, ask questions based on answers
Advantage: respond to client

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Semi-structured interview

Root questions with room for followup

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Structured interview

Ask scripted questions
Advantage: reliability
Used in court settings and in research

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Interview bias in interviewer and interviewee

Interviewer: areas queried, confirmation bias
Interviewee: social desirability, forgetting

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Tachycardia

Racing heart
Physical condition that mimics panic disorder

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Hypothyroidism

Physical condition that mimics depression

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ABC's of behavior assessment

Antecedents: what happened before
Behaviors
Consequences: what happened afterwards

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Self-report

Indirect behavioral observation
Retrospective account of events

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Self-monitoring

Indirect behavioral observation
Client writes down what he/she did at specific time and how he/she was feeling then

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Psychological test

Structured tool used to assess symptoms that might be associated with a specific disorder
Quantifies symptoms

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Projective tests

Give ambiguous stimulus and ask to provide meaning
Provides glimpse into unconscious
Examples: Rorschach inkblot test, Thematic Apperception Test (TAT)

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Pros and cons of projective tests

Pros: lots of data generated, hard to fake
Cons: poor reliability and validity, complex and time consuming

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Objective tests

Clients asked to report on their beliefs, emotions, or experiences through questionnaires
True-false and rated using number scale

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Comprehensive personality inventories

Form of objective test
MMPI (Minnesota Multiphasic Personality Inventory): rate on several different disorders (high score means tendency towards specific disorder)

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Symptom assessments

Form of objective test
BDI (Beck Depression Inventory): ask questions relating to symptoms of depression using number scales

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Pros and cons of objective tests

Pros: can query specific information, high validity and reliability, provide information relative to others
Con: only face valid (people can fudge answers- questions aren't ambiguous)

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Areas assessed on intelligence tests

Verbal intelligence
Performance of tasks
Processing speed
Working memory abilities (store info in short-term memory and use)

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IQ nuts and bolts

Measuring performance relative to others
Score of 100 is average
15 points= 1 standard deviation

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Pros and cons of cognitive tests

Pros: identification of strengths and weaknesses, good reliability and validity
Cons: cultural bias (minorities compared to majority), stigma (set of expectations come with test, which people then live up to), overuse

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Neuropsychological tests

Assessment of psychological functioning as it relates to brain structures or pathways
Functional testing rather than scanning brain

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Focus of neuropsychological tests

Attention, memory, executive functioning, sensory and motor abilities, sensorium

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Examples of neuropsychological tests

Halstad-Reitan and Nebraska-Luria: big batteries of tests
Wisconsin card sort: teach rules for sorting, then make person adapt to new rules
MMSE ( mini mental status exam): ask questions related to sensorium, naming, problem solving, reading, etc.

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Psychophysiology assessment

Computer-aided procedures that allow non-intrusive examination of bodily processes

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EEG (electroencephalography)

Psychophysiological test
Electrodes touching scalp: measure electricity in brain

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EKG (electrocardiography)

Psychophysiological test
Measure heart beat

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GSR (galvanic skin response)

Psychophysiological test
Measure amount of sweat on skin

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PSG (polysomnography)

Psychophysiological test
Measure sleep

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CT (computerized tomography) scan

Test of brain structure
X-rays of brain

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MRI (magnetic resonance imaging)

Test of brain structure
Use magnet to align protons in brain- shows density

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PET (positron emission tomography) scan

Test of brain function
Radioactive dye binds to glucose: active areas receive glucose

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Considerations in regard to psychological assessment

Bulk of tests are self-report
Tester has biases
Tester can fail to use test as it was intended
Testing is a long and expensive process

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Sensitivity

Pick up all symptoms (diagnose people), but lots of false positives

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Specificity

Doesn't pick up all symptoms (miss people), but little to no false positives

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Pros of diagnosis

Common nomenclature
Provide a prognosis
Guide treatment and accommodations
Normalize client experience
Inform benefits/ insurance

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Categorical model

Qualitatively different (either depressed or not; difference from other people)

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Dimensional model

Quantitively different (continuum: how many symptoms do you have; clear cut off point)

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Prototype model

Compare to prototype (compare your symptoms with the traditional symptoms of the disorder)

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ICD-6

1949: 1st diagnostic system of mental disorders to be used in medicine

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DSM taxonomy model

Categorical/prototype based

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Number of diagnoses in DSM

Over 400

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Focus of DSM

Reliability is focus (observable characteristics); validity is less important

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Diagnostic criteria included in DSM

Essential features (diagnostic criteria)
Associated features (commonly seen symptoms, but not diagnostic criteria)
Cultural features
Prevalence
Course

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Multiaxial assessment

DSM-IV only (not DSM V)
Axis 1: Clinical symptoms (mental disorders)
Axis 2: Personality disorders and intellectual disabilities
Axis 3: General medical conditions (especially those that worsen disorders)
Axis 4: Psychosocial/environmental stressors
Axis 5: Global assessment of functioning (GAF) (Score of 0-100, with 100 being perfect and 0 being total mess)

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Cons of diagnosis

Creates illusions that disorders are qualitatively different (actually quantitatively) and that disorders provide explanations (actually just describe symptoms)
Labels may be harmful (stigma and identification with disorder)

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Comorbidity

Diagnosis of more than 1 disorder at a time
Caused by poor diagnostic criteria/overlap, one disorder is a risk factor for another, or both caused by same mechanism

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Internal validity

Extent to which you can be confident that the independent variable is causing the dependent variable to change

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External validity

How well results relate to things outside your study

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Case study

Critically observe specific cases

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Survey

Questionnaires that assess area of interest

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Epidemiology

Study distribution in the population

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Correlational study

Relation exists between two variables
Cannot assume causation

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Experimental research

Manipulation of one variable (independent variable) impacts another variable (dependent variable)
Allows for cause-effect conclusions

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Randomized control trials

Participants randomly assigned and given standard treatment

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Cross-sectional studies

Measure relationship between variables at one point in time
Allows for group (cohort) comparison

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Single case designs

One subject, repeated measurements

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Withdrawal design

Type of single case design
Researcher tries to determine whether the independent variable is responsible for changes in behavior

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Multiple baseline design

Type of single case design
Researcher starts treatment at different times across settings

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Longitudinal study

Measure behavior of interest over a long period of time
Useful for studying risk factors and course of disorders