CHAPTER 4: ASSESSMENT AND DIAGNOSIS
CLINICAL ASSESSMENT involves:
Collecting information and drawing conclusions using varied methodologies
Which of the following is NOT a methodology used in clinical assessment?
Assumptions
When is CLINICAL ASSESSMENT CONDUCTED?
Continuously, not just at the start
What do you NEED to UNDERSTAND to apply clinical assessment EFFECTIVELY?
Purposes and key concepts of clinical assessment
Clinical assessment can HELP IDENTIFY ISSUES RELATIVE to:
Classifying and diagnosing psychological disorders
What are the PURPOSES OF PSYCHOLOGICAL ASSESSMENT? (Select all that apply)
To understand the individual
To predict behavior
To plan treatment
To evaluate treatment outcome
Is a SYSTEMATIC MEASUREMENT and EVALUATION of PSYCHOLOGICAL, BIOLOGICAL, SOCIAL FACTORS in an individual presenting POSSIBLE PSYCHOLOGICAL DISORDERS
Clinical Assessment
What is CLINICAL DIAGNOSIS?
The process of determining whether the individual meets the criteria for a psychological disorder
In CLINICAL DIAGNOSIS, what should be IDENTIFIED?
Common potential etiologies or causes of signs and symptoms
What is the PURPOSE of IDENTIFYING the PRESENTING PROBLEM in an assessment?
To understand the reason why the individual sought consultation
What does it mean if a problem is "SITUATIONAL"?
The presenting problem manifests due to a specific situation
What is a "PERVASIVE" problem?
A problem that has been present for a long time
Why is the DURATION of the presenting problem important in assessment?
To know how long the problem has been manifesting
Why should PRIOR ATTEMPTS to HELP OR TREAT be assessed?
To know if the individual has consulted a mental health professional before
What does it mean if the PROBLEM MATCHES DSM-5 disorder criteria?
The problem aligns with recognized psychological disorder symptoms
What is the PURPOSE of DIAGNOSTIC CLASSIFICATION?
To provide nomenclature, which means a name or category for the illness based on combined signs and symptoms
What does "NOMENCLATURE" refer to in diagnostic classification?
The name or category of the illness based on its signs and symptoms
One PURPOSE of DIAGNOSTIC CLASSIFICATION is to PROVIDE a basis for:
Description and information retrieval of the illness and its mental, emotional, and psychological manifestations
What does GOOD ASSESSMENT include?
Social history noting apart from taking into consideration the personality factors
How can PERSONALITY FACTORS be DETERMINED?
Through psychological tests using personality tests and other inventory tests
What does "CULTURALLY SENSITIVE" mean in assessment?
It does not discriminate against any factors of the individual
What is an EXAMPLE of CULTURALLY SENSITIVE ASSESSMENT?
Evaluating whether the assessment is culturally appropriate for individuals from different backgrounds, like Filipinos or Asians
Why is it important to be aware of increasing population diversity in assessments?
To check if the assessment tools are applicable to our culture or the individual’s culture
What does it mean to adhere to the ethical code related to cultural competence?
Ensuring that the administrator is authorized to conduct the assessment
What types of tests can be administered by licensed psychometricians?
Inventories that require a master’s degree
What type of tests require a LICENSED PSYCHOLOGIST with a PhD to administer?
Projective tests
Which of the following are EXAMPLES of LEVEL B ASSESSMENTS. This test may purchased by individuals with: Mater's degree in psychology, education, speech language pathology, occupational therapy, and social work.
Wechsler Individual Achievement Test (WIAT III) - assesses a person's academic skills and development areas
Test of Auditory Perceptual Skills (TAPS) - measures how people process what they hear
Test of Visual Perceptual Skills (TVPS) - measures a person's processing and analysis skills
Which of the following are IMPORTANT STEPS to ENSURE CULTURALLY SENSITIVE ASSESSMENT procedures?
Be aware of increasing population diversity
Adhere to ethical code related to cultural competence
Include cultural variables in assessment
What must the TOOLS used for assessment be?
Reliable, valid, and standardized
What does RELIABILITY refer to in assessment tools?
The degree to which the assessment tool produces consistent results over time
What does it mean if a TOOL IS RELIABLE BUT NOT VALID?
It is producing consistent results, but those results are far from the goal
What characterizes a TOOL THAT IS BOTH RELIABLE AND VALID?
It provides consistent results and meets the intended goal
What is TEST-RETEST RELIABILITY?
The most common measure of reliability where participants are tested on two occasions and scores are correlated
What does it mean if the SCORES ARE SIMILAR WHEN RETAKING a TEST?
There is consistency in the scores
It INCREASES RELIABILITY by ensuring MULTIPLE RATERS GAIN the SAME RESULTS using the SAME MEASUREMENT
Interrater Reliability
In the context of pageants, what indicates HIGH INTERRATER RELIABILITY?
Scores that are close together (e.g., 92, 90, 91)
If judges give scores of 80, 95, and 75, what does this indicate?
Low interrater reliability
What does INTERNAL CONSISTENCY refer to in assessments?
It indicates that changes in assessment still produce consistent results
What does RELIABILITY refer to in assessment?
Results that are consistent
What does VALIDITY indicate in assessment?
Results that satisfy objectives
What is an EXAMPLE OF VALIDITY when measuring weight?
Using weighing scales
In terms of VALIDITY, what question should be asked regarding assessment tools?
Are the tools appropriate for what we want to assess?
What is an EXAMPLE of USING THE CORRECT TOOL for MEASURING HEIGHT?
Using a height scale
What is FACE VALIDITY?
The degree to which an assessment subjectively appears to measure the variable it is supposed to measure
What does PREDICTIVE VALIDITY involve?
Predicting possible manifestations of symptoms or tendencies in the future
How is PREDICTIVE VALIDITY established?
By correlating results of assessments with outcomes of individuals
What does CONCURRENT VALIDITY involve?
Correlating a new assessment for depression with established measurements for depression
What is an EXAMPLE of PREDICTIVE VALIDITY in admission tests?
High scores predicting future success or graduation with honors
What is CONSTRUCT VALIDITY?
The association of chosen symptoms as criteria for diagnosis
What does CRITERION VALIDITY measure?
The usefulness of a diagnostic category based on outcomes
What does STANDARDIZATION ENSURE in the USE OF A TECHNIQUE?
Consistency in the use of a technique
What does STANDARDIZATION PROVIDE FOR COMPARISON?
Population benchmarks
What is STANDARDIZATION?
A process where certain standards or norms are determined for consistent procedures
What are the THREE PROCEDURES COMMONLY USED in PSYCHOSOCIAL ASSESSMENTS?
Assessment interviews, clinical observation of behavior, psychological test
What is the purpose of ASSESSMENT INTERVIEWS?
To interview the client or other people who can provide information about the client
What does CLINICAL OBSERVATION of BEHAVIOR involve?
Observing the behavior of the individual without intervening
What TYPES OF INTERVIEWS can assessment interviews include?
Face-to-face interaction, structured interviews, and unstructured interviews
What characterizes STRUCTURED INTERVIEWS?
Following a set of predetermined questions
What can be asked in UNSTRUCTURED INTERVIEWS?
Anything related to the concern of the client
What is the MENTAL STATUS EXAM?
A kind of structured interview guide
What is the PURPOSE of the MENTAL STATUS EXAMINATION?
To organize information obtained during an interview
HOW MANY AREAS does the MENTAL STATUS EXAMINATION cover?
Five areas
MENTAL STATUS EXAMINATION has 5 areas:
Appearance and Behavior
Thought Processes
Mood and Affect
Intellectual Functioning
Sensorium
What does "APPEARANCE AND BEHAVIOR" refer to in the MENTAL STATUS EXAM?
Observable behavior, including attire and expressions
In the mental status exam, what is assessed under "THOUGHT PROCESSES"?
Flow and content of reasoning and speed or rate, continuity, and content of speech
What is "MOOD" in the context of the mental status exam?
The predominant feeling state of the individual
What does "AFFECT" refer to in the mental status exam?
The feeling state accompanying what the individual says
What does "INTELLECTUAL FUNCTIONING" evaluate in the mental status exam?
Memory and abstract thinking and also the type of vocabulary and the use of abstractions and metaphors
What does "SENSORIUM" assess in the mental status exam?
General awareness of surroundings (person, time, and place)
What can "DERAILMENT" in thought processes indicate?
Disorganized speech
What is a CRUCIAL aspect of assessing "INTELLECTUAL FUNCTIONING"?
Disturbances in memory
How is "SENSORIUM" commonly described in the mental status exam?
"Oriented times three"
What does "CLINICAL OBSERVATION in NATURAL ENVIRONMENTS" involve?
Observing individuals without them knowing you are observing
What does "CLINICAL OBSERVATIONS in THERAPEUTIC or MEDICAL SETTINGS" focus on?
Assessing behaviors in controlled medical or therapeutic environments
What are the TWO GENERAL CATEGORIES of PSYCHOLOGICAL TESTS for use in clinical practice?
Intelligence tests and personality tests
Which of the following is a COMMONLY USED INTELLIGENCE TEST?
WISC-IV, Standford-Binet V, and WAIS IV
What does WISC-IV stand for?
Wechsler Intelligence Scale for Children – Fourth Edition
What is the AGE RANGE assessed by the STANFORD-BINET INTELLIGENCE SCALE (SB-V)?
Ages 2 years to 89 years old
What does WAIS-IV stand for?
Wechsler Adult Intelligence Scale – Fourth Edition
What type of STIMULI ARE PRESENTED in PROJECTIVE PERSONALITY TESTS?
Unstructured stimuli
What do PROJECTIONS in PROJECTIVE TESTS REVEAL?
Hidden motives
What does the RORSCHACH INKBLOT TEST involve?
Interpreting inkblots to reveal thoughts and feelings
Who developed the THEMATIC APPERCEPTION TEST (TAT)?
Henry Murray
What does the THEMATIC APPERCEPTION TEST (TAT) involve?
Describing ambiguous scenes
What is the TAT popularly known as?
The “picture interpretation technique”
In the TAT, what do you ask the participant to do with the pictures shown?
Create a story based on the picture
What are the BENEFITS OF CLASSIFICATIONS of ABNORMAL BEHAVIOR?
Introduction of order, communication establishment, prevalence rates, and clarification of insurance issues
What are the THREE BASIC APPROACHES to CLASSIFICATION?
Categorical approach, dimensional approach, and prototypal approach
What does the CATEGORICAL APPROACH focus on?
Distinct categories of disorders
What does the DIMENSIONAL APPROACH EMPHASIZE?
The level and severity of manifestations
In the DIMENSIONAL APPROACH, what is being MEASURED?
The level of symptoms, such as how intense the worry is
What does the PROTOTYPAL APPROACH relate to?
Categorizing signs and symptoms based on cognitive theory
What are the FORMAL DIAGNOSTIC classifications of mental disorders?
Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD)
What is the global aim of the Diagnostic and Statistical Manual of Mental Disorders DSM?
To be used in scientific research settings
What is the aim of the International Classification of Diseases ICD?
To improve the clinical utility of the different diagnoses
What is a key feature of the DSM-5?
It is more comprehensive and includes more subtypes of disorders
What does the DSM-5 provide regarding CULTURAL INFLUENCES?
Structured interviews regarding cultural influences
What is a DISADVANTAGE of LABELING IN MENTAL HEALTH?
It can lead to stigma and discrimination
What does "DIAGNOSTIC CRITERIA" refer to?
Guidelines for making a diagnosis informed by clinical judgment
What does SEVERITY indicate in the context of psychological disorders?
Mild, moderate, severe, and extreme
What is meant by "CLINICAL JUDGMENT"?
Judgment made by the clinician or psychologist
What are SUBTYPES in the context of psychological disorders?
Specific categories within a disorder
When CONSIDERING the DIAGNOSIS of GENERALIZED ANXIETY DISORDER, which group should be evaluated?
People presenting with anxiety or significant worry
Which of the following is a CHARACTERISTIC of INDIVIDUALS who may have GENERALIZED ANXIETY DISORDER (GAD)?
They are repeatedly worrying about a wide range of different issues
In which demographic is reassurance about SOMATIC SYMPTOMS particularly relevant when diagnosing Generalized Anxiety Disorder GAD?
Older people and people from minority ethnic groups
What is a COMMON SITUATION for people who frequently ATTEND PRIMARY CARE and may have Generalized Anxiety Disorder GAD?
Having a chronic physical health problem
When should you CONSIDER that some SYMPTOMS may be due to Generalized Anxiety Disorder (GAD) in a person ATTENDING PRIMARY CARE?
When they seek reassurance about a chronic physical health problem or somatic symptoms and/or have repeated worrying
Which of the following FACTORS should be considered as POTENTIALLY AFFECTING the DEVELOPMENT, COURSE, and SEVERITY of a person’s generalized anxiety disorder (GAD)?
Any comorbid depressive disorder
Other anxiety disorders
Any comorbid substance misuse
Any comorbid medical condition
A history of mental health disorders
Past experience of, and response to, treatments