module 3 Flashcards
(57 cards)
1
Q
assessment involves
A
- the clinical interview
- behavioral assessment
- psychological testing
2
Q
diagnosis involves
A
- classification issues
- DSM-5-TR
- categorical vs. dimensional
3
Q
modern treatment approaches
A
- biological
- psychodynamic
- humanistic
- cognitive-behavioural
- computer-assisted
4
Q
clinical assessment/interview
A
- the systematic evaluation and measurement of psychological, biological and social factors in an individual presenting with possible psychological disorder
- used by psychologists, psychiatrists, mental health professionals
- gather information about current and past behaviour, attitudes, and emotions
- current and past interpersonal/social history
Information on upbringing, sexual development, religious attitudes, cultural factors
5
Q
the mental status exam
A
- done covertly
- look at:
1. appearance and behaviour
2. thoughts/thought process
3. mood/affect
4. intellectual functioning
5. sensorium
6
Q
mood/affect
A
does their mood or affect match what they are saying?
7
Q
sensorium
A
- general awareness of your surroundings
- can include date, time, and location
- this can be done more deliberately rather then covertly
8
Q
clinical interview approaches
A
- unstructured
- semi-structured
- structured
9
Q
unstructured
A
- raw-dog questioning
- ask a question , client answers and you go off that continuously
- follow what client tells you
- can potentially miss things if the client doesn’t bring it up and allows for variation among practitioners
- doesn’t minimize bias; overlook potential explanation because of confirmation bias to prove a hunch
10
Q
semi-structured
A
guideline of questions that you can stray from as needed
11
Q
structured
A
rigid step by step interviews that are designed for high accuracy and full coverage
12
Q
assessment: behavioural assessment
A
- direct observation
- ABC’s of observation
13
Q
direct observation
A
thoughts feelings and behaviors in specific environments to determine why they are struggling
14
Q
ABC’s of observation
A
- antecedents: before
- behaviours: during
- consequences: after
- used to form intervention
- advantageous for those who can’t verbalize their issues or may be withholding or unaware of information
15
Q
self-monitoring and reactivity
A
- gather information about their own ABC’s and document
- reactivity: change in behaviour due to monitoring b/c they notice their own behaviour
16
Q
assessment: psychological testing
A
- projective tests
- multidimensional instruments
17
Q
projective tests
A
- still commonly used despite poor theoretical, psychometric support, and generally doesn’t work to diagnose
- when presented with an ambiguous stimuli, individuals will project unconscious personality, thoughts and fears onto the ambiguous, test stimuli
- Rorschach Inkblot Test:
- Thematic Apperception Test (TAT)
- draw-a-person test
18
Q
multidimensional instruments
A
- many types of symptoms (200-600 items) covered in LOTS of questions
- often include validity scales to see if answers are consistent, honest and valid
- comparison to established norms
- 3 kinds
1. MMPI-3
2. PAI
3. brief scales
19
Q
multidimensional instrument validity scales
A
- positive impression management: “faking good” which is when someone is attempting to appear better then they are and are concealing psychopathology
- negative impression management: “malingering” which is making your actual symptoms worse then they are; exaggerating psychopathology
Random responding: pick up inconsistent responding
20
Q
MMPI-3
A
- developed using the empirical method & is a widely used measure of psychopathology
- created test items based on what people with a disorder would endorse
- 8 Restructured Clinical Scales
- 26 Specific Problems Scales (somatic/cognitive, internalizing, externalizing, & interpersonal
- 10 validity scales
- 335 T/F Items
- good reliability and predictive validity
- no underlying theory, item overlap amongst scales
21
Q
PAI
A
- more favoured test compared to MMPI-3
- developed using a construct validation approach; using research about how disorders manifest, their constructs, and looked at emotional behavioural and cognitive perspectives
- 344 items, 4-point scale
- 11 symptom scales, 4 validity scales
- good reliability, predictive validity, construct validity, and discriminant validity
- extensive psychometric testing and theoretical support (makes clear cut conclusions)
22
Q
brief scales
A
- Ddon’t take as long, but is typically not for diagnostic purposes
- more depth, but less breadth
- rarely involves validity scales
- multiple symptoms (e.g. IDAS-ll)
- specific symptoms (e.g. BAI & BDI)
- etiological factors (e.g. WW-ll)
23
Q
assessment neuropsychological testing
A
- captures a range of information such as areas like receptive or expressive language, sustained attention, memory, motor skills, perception, etc
- intelligence testing
- the bender-gestalt
- sport concussion assessment tool (SCAT5)
- neuroimaging
24
Q
intelligence testing
A
- measures components decided upon by researchers on what constitutes intelligence
- main use is for diagnosing learning disabilities
- other uses: brain trauma or diagnosing cognitive disabilities
25
the bender gestalt
- subjective scoring, low reliability and low validity
- study how individuals can coordinate visual motor abilities
- used as a screener for brain trauma, perceptual distortions, psychotic disorders
26
sport concussion assessment tool (SCAT5)
- used to evaluate injured athletes for concussion
- pre-season baseline results typically established for comparison after an injury
- measures: Immediate memory, concentration, delayed recall, balance, and orientation
27
neuroimaging
- CAT or CT and MRI = brain structure
- PET and fMRI = brain functioning
28
diagnosis
the process of determining whether the particular problem impacting the individual meets criteria for a psychological disorder
29
purpose of diagnosis
- ease of communication
- influences treatment decisions
- provide clients with a name for their experiences (label)
30
diagnosis - categorical approach
- every disorder:
- clear underlying pathophysiological cause
- unique
- one set of causative factors & one set defining criteria
- useful in medicine
- not useful in diagnosing psychopathology
31
diagnosis - dimensional approach
- all symptoms can range from high to low
- no cut-offs
- how many continuums are needed?
32
diagnosis - prototypical approach
- must have core features, with other symptoms varying
- creates many “subtypes” for each disorder
- DSM-5-TR
33
criticisms of DSM-5
- multiple disorders co-occuring
- problems with diagnostic criteria
- should we create more disorder categories
- is comorbidity natural?
34
assessment - modern treatments
- biological therapies
- psychodynamic therapies
- humanistic-existential therapies
- cognitive-behavioural therapies
- computer-assisted therapies
35
biological therapies - medications
1. anxiolytics
2. antidepressants
3. mood stabilizers
4. antipsychotic drugs
5. neurosurgery
6. electroconvulsive therapy
36
anxiolytics
- benzodiazepines
- typically treat anxiety
- increase GABA in the system (agonists)
- effective only in short-term bc its very addictive & can cause rebound anxiety
37
antidepressants
- SSRIs (e.g., Prozac, Zoloft, Paxil)
- SNRIs (e.g., Effexor, Cymbalta)
- often for anxiety, major depressive disorders and sometimes eating disorders
- increasing serotonin over time
- effective, but takes 2-6 weeks
38
mood stabilizers
- Lithium for people with mania; can be dangerous if the dose is to high so blood must be monitored cause its easy to overdose
- Anticonvulsants: effective and less side effects than lithium in calming frequency and duration of mania
39
antipsychotic drugs
- 1st wave
- 2nd wave
40
1st wave antipsychotic drugs
- chlorpromazine, haloperidol (antagonist)
- treat the ‘positive’ symptoms of schizophrenia (hallucinations & delusions)
- called ‘positive’ symptoms cause there’s something added
41
2nd wave antipsychotic drugs
- clozapine, risperidone (atypicals)
- treat both ‘positive’ and ‘negative’ symptoms
- e.g. lack of socializing, speech & empathy, like wednesday addams
42
neurosurgery
- 'new age lobotomy '
- extremely rare, poorly studied and only done for most extreme treatment resistant disorders
43
electroconvulsive therapy (ECT)
- stimulating the brain with 800 milliamps
- sedatives used to control seizures in the brain
- effective for severe depression, if an individual is extremely suicidal, or has schizophrenia/bipolar disorders
44
psychodynamic therapies
1. brief psychodynamic therapies
2. interpersonal psychotherapy (IPT)
45
brief psychodynamic therapies
- examining defence mechanisms, transference, and current relationship issues
- what we see today instead of psychoanalysis because it stemmed from it
- emphasized unconscious processes
- not very extensive
- uses experiences from childhood to inform about current relationship issues
46
interpersonal psychotherapy (IPT) - psychodynamic therapy
- work on interpersonal relationships through the therapeutic alliance
- focuses on alleviating symptoms by improving interpersonal functioning
- addresses current relationship problems
- focuses on the present
- therapists more directive, active, non-neutral, more supportive and hopeful
47
humanistic existential therapies
1. motivational interviewing (MI)
2. emotion-focused therapy (EFT)
48
motivational interviewing - humanistic therapies
- helps client to resolve ambivalence regarding treatment
- very collaborative approach with the client
- goal-oriented approach
- what are their own motivations for attending therapy and achieving goals
- atmosphere of complete acceptance and compassion
- a lot of attention to the language of change in terms of getting into "what would you get from it"
- effective when working with addictions or teenagers
49
emotion-focused therapy - humanistic therapies
- increase awareness and acceptance of emotions
- emotion-shifting techniques
- emotions are the key to change
- assumes that people with mental issues either lack awareness or are avoiding unpleasant emotions
- lots of roleplay involved and fostering emotional awareness
50
cognitive-behavioural therapies
- variations of Becks CBT
- exposure/exposure and response prevention (ERP)
- acceptance-and-commitment therapies (ACT)
- mindfulness-based therapies
51
variations of Becks CBT
- identifying automatic thoughts/faulty beliefs and challenging them through-in-therapy exercises and homework
- ie. cognitive distortions, black & white thinking, catastrophic thinking
- lots of variation of CBT, primarily to treat depression but can treat a lot of different disorders
52
exposure/exposure & response prevention (ERP)
- engaging in the activity you are avoiding, without use of anxiety-reduction strategies
- challenges cognitive distortions
- you would help individual identify what they typically do to alleviate their anxiety and prevent them from doing so
- effective in treating OCD and phobias
53
acceptance-and-commitment therapies (ACT)
- accepting and noticing thoughts rather than challenging them
- commit to make changes
- separating thoughts from “self”
- defining values and goals
- it fails to align with current CBT approach
54
mindfulness-based therapies
- promoting greater awareness in the moment
- observe and accept streams of thought
- often incorporated into other approaches
55
computer-assisted therapies
1. computer-assisted CBT
2. cognitive bias modification therapy
56
computer-assisted CBT
- effective with mild-moderate cases
- may be part of a stepped care approach
- can be used to wean off therapy
- flexible, can be done anytime from basically anywhere
- cheaper alternative
57
cognitive bias modification therapy
- targets implicit cognitions associated with anxiety and depression that are more attuned to notice negatives
- computer programs to help retrain attention away from negative to more neutral or pleasant things
