Psychological assessments and clinical diagnosis

Question 1

What is the goal of clinical psychological assessments?

Answer 1

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

Question 2

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

Answer 2

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

Question 3

value of clinical assessment procedures are determined by

Answer 3

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

Question 4

Interrater reliability

Answer 4

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

Question 5

Major methods for clinical psychological assessments?

Answer 5

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

Question 6

Clinical interviews types

Answer 6

Open-ended (unstructured)
semi-structured
observation techniques

Question 7

Open-ended (unstructured) Clinical interview

What does the therapist analyze?

Answer 7

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

Question 8

Semi-Structured Clinical interview

Answer 8

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

Question 9

Semi-Structured advantage and disadvantage

Answer 9

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

Question 10

Behavioral Interview

Answer 10

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

Question 11

What are Observation techniques?

Answer 11

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

Question 12

Examples of observation techniques

Answer 12

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

Question 13

Tests as a psychological assessment procedure

Answer 13

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

Question 14

Tests as a psychological assessment. What can they measure?

Answer 14

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

Question 15

Projective tests - assumption

Answer 15

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

Question 16

Projective tests - procedure

Answer 16

Patient projects onto ambiguous stimulus

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

Question 17

Objective (Empirical) tests

Answer 17

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

Question 18

Objective (Empirical) tests advatages

Answer 18

extensive reliability, validity and normative info

Question 19

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

Answer 19

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

Question 20

Biological - psychophysiological assessments - domains and use

Answer 20

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

Question 21

Advantages of Biological psychophysiological assessments

Answer 21

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

Question 22

Limitations of Biological psychophysiological assessments

Answer 22

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

Question 23

Life Records - psychological assessment

types, advantages and limitation

Answer 23

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

Question 24

What is the best clinical psychological assessment?

Answer 24

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

Question 25

Clinical Diagnosis | Definition

Answer 25

The act of identifying a disorder from its signs and symptoms

Question 26

Signs vs Symptoms

Answer 26

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

Question 27

Why conduct diagnosis?

Answer 27

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

Question 28

Advantages of diagnosis

Answer 28

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

Question 29

Criticisms of diagnosis

Answer 29

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

Question 30

Barlow presents 4 models of diagnosis

Answer 30

Categorical Prototype Dimensional Biomedical

Question 31

Categorical model of diagnosis | Assumptions

Answer 31

Each disorder is unique from every other | All criteria must be met - patients have all the same symptoms

Question 32

Prototype model of diagnosis

Answer 32

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

Question 33

DSM-5 Criticism

Answer 33

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

Question 34

Cultural differences Chinese Classification of Mental Disorders (CCMD)

Answer 34

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

Question 35

Psychogenic sub-category of culture-related disorders

Answer 35

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

Question 36

Dimensional models of diagnosis

Answer 36

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

Question 37

Critique of hierarchical dimensional model

Answer 37

It is essentially categorical - like the other models | Problems with construction - what should you use to to develop the categories of dimensions?

Question 38

Biomedical model

Answer 38

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

Question 39

biomedical model - Research Domain Criteria (R-DoC)

Answer 39

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

Question 40

Biomedical model criticism (Hayes)

Answer 40

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

Question 41

Stigma in Biomedical explanation

Answer 41

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