Topic 2 Clinical Assessment and Diagnosis

Question 1

TESTS v Assessments

Answer 1

tests; measure one specific construct, tests in fact operationally define constructs, could be structured/semi structured interview, examples might be IQ Beck depression index or ADIS 5 Anxiety and related disorders interview schedule, or neuroimaging
projective tests eg rorshark
self rating tests
personality inventories

assessments; try to get an overall picture of a person, could involve multiple tests, physical tests, external informant reports, interviewing

Question 2

taxonomy

Answer 2

the science of classifying

As a noun taxonomy is the science or the technique used to make a classification.

As an adjective nosological is (medicine) of or pertaining to nosology.

Question 3

nosology

Answer 3

how we are applying our evidence in a systematic way to the disease of interest

the branch of medical science that deals with classifying disease

As a noun taxonomy is the science or the technique used to make a classification.

As an adjective nosological is (medicine) of or pertaining to nosology.

Question 4

nomothetic

Answer 4

generalised information about a classified group

Nomothetic and idiographic are terms used by Neo-Kantian philosopher Wilhelm Windelband to describe two distinct approaches to knowledge, each one corresponding to a different intellectual tendency, and each one corresponding to a different branch of academe.

Nomothetic is based on what Kant described as a tendency to generalize, and is typical for the natural sciences. It describes the effort to derive laws that explain types or categories of objective phenomena, in general.
Idiographic is based on what Kant described as a tendency to specify, and is typical for the humanities. It describes the effort to understand the meaning of contingent, unique, and often cultural or subjective phenomena.

Question 5

operationalization and operational definition

Answer 5

In research design, especially in psychology, social sciences, life sciences and physics, operationalization or operationalisation is a process of defining the measurement of a phenomenon that is not directly measurable, though its existence is inferred by other phenomena. Operationalization thus defines a fuzzy concept so as to make it clearly distinguishable, measurable, and understandable by empirical observation. In a broader sense, it defines the extension of a concept—describing what is and is not an instance of that concept.

operational definition is a testable definition of a construct

Question 6

Prognosis

Answer 6

no prognosis in psych is highly valid, there are many unknowns in the clients life and things can really change, you can look at trends and give a guarded prognosis however, based on statistical likelihood

prognosis is guarded means they are just not sure which way it will go (but maybe bad)

Question 7

Validity;
FP
E
Conc
cont
predictive

Answer 7

false positive validity; how likely to get a false pos
external (generalisability)
concurrent (how well it correlates with other measures - shouldn’t actually 100% if you are trying to improve the measures!)
content validity - in psycho-metrics, getting the label right
predictive- able to predict what will happen with the prototypical client
construct validity - the signs and symptoms go together and make sense, may also predict familial aggregation

Question 8

Reliability;
I-R
TR
I C

Answer 8

inter rater, multiple people same questions same answers

test retest; same people multiply asked same answers (problematic for state like things that change over time, fine for trait like things )

Internal consistency, chrombacks alpha measures sameness on same construct asking questions - the more items in the test, the higher chrombacks alpha, it gets over inflated. >20 items problematic

Question 9

Benefits of categorical definitions in a dimensional world

Answer 9

• useful for communication b/w clinicians and b/w patients families society and clinicians
• useful for treatment and prognosis and legal and insurance
• useful for removing self fault beliefs and identifying with a group and understanding the self
• bad for deterministic
• personal nature of diagnosing someones personality as disordered
• medacalises neurodiversity and gender diversity and sexuality diversity

Question 10

Projective tests

Answer 10

old school style Rorshark, finish the sentence, one word prompt one word response

Thematic Apperception Test. The most widely known and used story telling technique is the TAT. It was developed by Morgan and Murray (1935) in the belief that the content of imagined stories would provide clues to the underlying dynamics of a subject’s interpersonal relationships and self-attitudes.

can be interesting and a conversation starting point for psychologists, not highly valid

Question 11

clinical interviewing technique

Answer 11

liked by clinicians
can include looking at attitudes (ABCs of attitudes= affect, behavior and cognition, in suicidality behavior is minimal and affect is big)
can look at
interpersonal factors
mood
appearance
past and present behaviors

Question 12

subjectivity in psychometrics Keiths work

Answer 12

pretending its objective to have a likard scale doesn’t make it so, only saying 1 5 best worst leaving the middle up to interpretation probably better. Saying recently instead of past 2 weeks probably better

Question 13

A good psychometric test should

Answer 13

• cover the full spectrum of severity picking up highest and lowest and all in between, having some (at least 3-5) people answer all questions at all levels and overall have some people achieving each possible score
• have a large complexly diverse sample (not just young black women, but old and young black woman and men etc)
• have strong psycho-metrics
• provide full details of the construct being measured

Question 14

mental status exam

Answer 14

mental status exam; most liked by clinicians can tell us if we can diagnose someone, look at their emotional state clothing appearance etc

1. appearance and behavior
2. thought processes
3. mood and affect
4. intellectual functioning
5. sensorium (awareness of person place and time)

Question 15

MMPI minnesota multiphasic personality inventory

Answer 15

looked at statistical liklihood of people in certain mental disorder classifications to answer personality questions in certain ways. Not really important what the questions say, but what people in certain groups usually answer as MMPI 2 was updated to better reflect cultural and gender factors - still creepy

Question 16

3 types of catagorisation

Answer 16

• catagorical
• dimensional
• prototypical

Question 17

Prototype method of classification

Answer 17

a prototype determined and certain non essential dimensional variations are allowed. The DSM is based on this, having a list of symptoms and saying you need to only have 4 of 8 for example

Question 18

latent trait theory

Answer 18

a general psychometric theory contending that observed traits, such as intelligence, are reflections of more basic unobservable traits (i.e., latent traits). Several quantitative models (e.g., item response theory, factor analysis) have been developed to allow for the identification and estimation of these latent traits from manifest observations.