Chapter Three: Clinical Assessment and Diagnosis

Question 1

A clinical ____________ is the systematic evaluation and measurement of psychological, biological, and social factors in an individual presenting with a possible psychological disorder.

Answer 1

assessment

Question 2

All clinical assessment techniques are subject to strict requirements, including evidence that they actually do what they are designed to do. Which of the following qualities determine the precision and accuracy of a clinical assessment?

A. Therapeutic validity and acculturation
B. Reliability, validity, and standardization
C. Reliability and practicality

Answer 2

B. Reliability, validity, and standardization

Question 3

A clinic creates a new survey to measure its clients’ sense of progress in their therapy. The scores on the survey correlate well with the therapy progress ratings that the clients’ therapists completed the same week. This suggests that the survey has good ________, specifically good ____________ _________.

Answer 3

• validity
• concurrent validity

Question 4

During the testing of a new semi-structured diagnostic interview, the interview developers find that multiple clinicians interviewing the same patient disagree on whether the patient meets the criteria for borderline personality disorder. This suggests that the new interview has poor __________ , specifically poor __________ __________.

Answer 4

• reliability
• interrater reliability

Question 5

Which of the following describe a process to provide a measure that is well standardized? Check all that apply.

A. Translate the measure into several different languages.
B. Pool individuals’ scores with others like them to use as a standard, or norm, for comparison purposes.
C. Provide very strict procedures for delivering and scoring the assessment.
D. Give the measure to large numbers of people who differ on important factors such as age, race, gender, socioeconomic status, and diagnosis.

Answer 5

A, B, and D

Question 6

The clinical interview is at the core of most clinical assessments. It is used to gather important information about an individual’s current and past behaviours. The clinical interview typically assesses what brought the individual into treatment as well as significant events from the individual’s history.
Which of the following statements is true of the semistructured interview?

A. Clinician may depart from set questions to follow up on specific issues.
B. This interview is the most common type of psychologist interview.

Answer 6

A. Clinician may depart from set questions to follow up on specific issues.

Question 7

During a clinical interview, observations about a person’s feelings, for example, would be put into the category of:

Answer 7

mood and affect

Question 8

_______ ____________ are made up of questions that have been carefully phrased and tested to elicit useful information in a consistent manner, so clinicians can be sure they have inquired about the most important aspects of particular disorders.

Answer 8

semistructured interviews

Question 9

What are the 5 things the mental status exam consists of?

Answer 9

1. appearance and behaviour
2. thought processes
3. mood and affect
4. Intellectual functioning
5. Sensorium

Question 10

Mental status exam - thought processes questions to ask

Answer 10

Does the person talk really fast or really slowly?
Do the patients make sense when they talk or are ideas presented with no apparent connection?
Is there any evidence of delusions or hallucinations?

Question 11

Mental status exam - Intellectual functioning questions to ask

Answer 11

Do they seem to have a reasonable vocabulary?
Can they talk in abstractions and metaphors (as most of us do much of the time)?
How is the person’s memory?

Question 12

what is sensorium when it comes to the mental status exam?

Answer 12

It is our general awareness of our surroundings (A&Ox3)

Question 13

A problem with an informal observation is that it relies on the observer’s _________, as well as ___________, of the events. Formal observation involves identifying specific behaviours that are __________ and _________.

Answer 13

• recollection
• interpretation
• observable
• measureable

Question 14

What are the ABC’s that observational assessments focus on?

Answer 14

A - antecedent (what happened just before the behaviour)
B - the immediate behaviour that occurs
C - Consequence (what happened after the person’s behaviour)

Question 15

__________ _________ is the use of direct observation to formally assess an individual’s thoughts, feelings, and behaviour in specific situations or contexts.

Answer 15

Behavioural assessment

Question 16

Any time you observe how people behave, the mere fact of your presence may cause them to change their behaviour. This is called ________.

Answer 16

reactivity

Question 17

In behavioural assessment, _________ __________ are identified and observed with the goal of determining the factors that seem to influence those behaviours.

Answer 17

target behaviours

Question 18

This test contains both verbal scales, which measure vocabulary, knowledge of facts, short-term memory, and verbal reasoning skills, and performance scales, which assess psychomotor abilities, nonverbal reasoning, and ability to learn new relationships.

Answer 18

WAIS - IV

Question 19

This simple psychological test requires the person undergoing the assessment to copy various lines and shapes that are drawn on a card.

Answer 19

Bender Visual-Motor Gestalt Test

Question 20

This psychological test can be scored and interpreted by a computer program.

Answer 20

MMPI

Question 21

This test requires the person undergoing assessment to tell what they see in 10 inkblot pictures.

Answer 21

The Rorschach inkblot test

Question 22

When it comes to MMPI, the reliability and validity are very ____.

Answer 22

high

Question 23

How reliable and valid are TAT and Rorschach tests? Why?

Answer 23

Despite attempts to bring standardization to the TAT and Rorschach, questions remain about the reliability and validity of these projective tests because they are not always administered according to the instructions, and the interpretation of the projections often depends on the examiner’s frame of reference.

Question 24

The WAIS and the Stanford-Binet are two types of _________ test

Answer 24

IQ

Question 25

the Halstead-Reitan Neuropsychology Battery and the Luria-Nebraska Neuropsychology Battery are two types of ______________ tests

Answer 25

neuropsychological

Question 26

TRUE OR FALSE: IQ Tests are valid and reliable

Answer 26

TRUE

Question 27

TRUE OR FALSE: Neuropsychological tests are reliable but not very valid

Answer 27

FALSE: They are both reliable and valid

Question 28

Psychological tests include specific tools to determine __________, __________, or ____________ responses that might be associated with a specific disorder and more general tools that assess long-standing __________ features.

Answer 28

- cognitive - emotional - behavioural - personality

Question 29

Two of the more widely used projective tests are the ____________ ____________ test and the _________ __________ Test.

Answer 29

- Rorschach inkblot test - Thematic Apperception Test

Question 30

The ________ _________ test is one of the early projective tests.

Answer 30

Rorschach Inkblot test

Question 31

Self-report questionnaires that assess personal traits by asking respondents to identify descriptions that apply to them are called __________ _________. The most widely used one in the US is the ____.

Answer 31

- personality inventories - MMPI

Question 32

There is only one set of causative factors per disorder, which does not overlap with those of other disorders. This is know as the ________ classification approach

Answer 32

categorical

Question 33

Diagnosis is a process of deciding the degree to which a particular characteristic or set of characteristics is present. This is known as the _________ classification approach.

Answer 33

dimensional

Question 34

This approach identifies certain essential characteristics and also allows for certain nonessential variations without changing the classification. This is known as the _________ classification approach.

Answer 34

prototypical

Question 35

Which of the following is a critique of the categorical approach? A. Theorists have not been able to agree on the number of dimensions. B. This approach cannot account for the complexity of psychological disorders.

Answer 35

B. This approach cannot account for the complexity of psychological disorders.

Question 36

Any system of classification should describe specific subgroups of symptoms that are clearly evident and can be readily identified by experienced clinicians. If the clinicians are unable to agree on a diagnosis, even after observing the same patient at the same time, it suggests that the psychological diagnostic criteria, themselves, might be __________.

Answer 36

Unreliable

Question 37

One of the most unreliable categories in current classification is that of ___________ disorders.

Answer 37

personality

Question 38

The lack of agreement among clinicians when diagnosing personality disorders indicates that:

Answer 38

more reliable criteria are needed.

Question 39

A taxonomic system applied to psychological or medical phenomena is called ________. All diagnostic systems used in health care settings, such as those for infectious diseases, are __________ systems. The term ____________ describes the names or labels of the disorders that make up the nosology (for example, anxiety or mood disorders).

Answer 39

- nosology - nosological - nomenclature

Question 40

_______ validity is the degree to which the signs and symptoms chosen as criteria for the diagnostic category are consistently associated and what they identify differs from other categories.

Answer 40

construct

Question 41

____________ is the process of determining whether a particular problem afflicting an individual meets all criteria for a psychological disorder. The diagnosing clinician refers to the criteria listed in the DSM-5.

Answer 41

Diagnosis

Question 42

The _________ and the _________ were the first nosologies to have any influence, but they lacked precision and reliability, and they relied heavily on unproven theories of etiology not accepted by all mental health professionals. To make matters worse, the systems had little reliability. Two mental health practitioners looking at the same patient often came to different conclusions based on the nosology at that time.

Answer 42

- DSM I - DSM II

Question 43

The _______ and _________ proceeded more or less simultaneously with that of the International Classification of Diseases and Health Related Problems, 10th edition (ICD-10).

Answer 43

DSM-IV and DSM-IV-TR

Question 44

The ________ proceeded more or less simultaneously with that of the International Classification of Diseases and Health Related Problems, 11th edition (ICD-11)

Answer 44

DSM 5

Question 45

The ___________ and ________ allowed individuals with possible psychological disorders to be rated on five dimensions, or axes. This multiaxial format, which emphasizes a broad consideration of the whole individual rather than a narrow focus on the disorder alone, was also useful.

Answer 45

DSM-III (1980) and DSM-III-R (1987)

Question 46

Which of the following is a criticism of the DSM-5? A. It contains definitions from past decades that are flawed. B. It contains a completely new nosology that is unrecognizable from previous versions.

Answer 46

A. It contains definitions from past decades that are flawed.

Question 47

The _________ was the first to take an atheoretical approach, rather than relying on psychoanalytic or biological theories of etiology. This made it more useful to clinicians from a variety of points of view.

Answer 47

DSM-III

Question 48

Perhaps the most substantial change in DSM-IV is that the distinction between _________ based disorders and ___________ based disorders that was present in previous editions has been eliminated.

Answer 48

- organically - psychologically

Question 48

The _______ removed the multiaxial system and expanded the use of dimensional assessments for rating severity, intensity, frequency, and duration of specific disorders. This system incorporates approved scales that are supported by empirical research to assist clinicians in assessing the aforementioned characteristics.

Answer 48

DSM-5

Question 49

Which of the following is a criticism of the DSM-5? A. It still leads to a high level of comorbidities. B. It has eliminated the occurrence of comorbidities.

Answer 49

A. It still leads to a high level of comorbidities.

Question 50

List three things things a researcher could do to increase the standardization of a new measure.

Answer 50

1. pool individual scores from different groups for use as a standard for comparison purposes 2. provide strict procedures for delivering and scoring the assessment 3. give the measure to large numbers of people who differ on important factors such as age, race, gender, socioeconomic status, and diagnosis.

Question 51

_________ involves administering and scoring assessment measures in a consistent way so that the interpretation of the scores is the same for everyone

Answer 51

Standardization

Question 52

How can the interpretation of test scores be standardized?

Answer 52

the interpretation of test scores can be standardized by collecting normative data from large groups of people across age, gender, and race, allowing the test scores to be compared among members of these groups. Researchers and clinicians can then interpret these scores by seeing whether they are higher or lower than average scores that members of the appropriate normative group obtained.

Question 53

________ is the degree to which a measurement measures, or assesses, what it is designed to measure. ________ __________ refers to how well the assessment tells you what will happen in the future. ________ _________ is demonstrated when a test correlates well with a measure that has previously been validated.

Answer 53

- Validity - Predictive validity - Concurrent validity

Question 54

__________ is the degree to which a measure is consistent. An assessment technique has good _________ __________ when two or more raters using an assessment tool get the same answer (or answers). An assessment technique has good __________ _________ when it is stable across time—for example, when the scores you get from the assessment are the same each time you administer it.

Answer 54

- Reliability - interrater reliability - test-retest reliability