PSCH3044 Ch4. Clinical Assessment, Diagnosis, and Treatment
|Idiographic Understanding||An understanding of the behavior of a particular individual.|
|Assessment||The process of collecting and interpreting relevant information about a client or research participant.|
|Clinical Assessment||Used to determine how and why a person is behaving abnormally and how that person may be helped.|
|Personality Assessment||Method used by psychodynamic clinicians that assess a client's personality and probe for any unconscious conflicts he or she may be experiencing.|
|Standardization||The process in which a test is administered to a large group of people whose performance then serves as a standard or norm against which any individual's score can be measured.|
|Reliability||The measure of the consistency of test or research results.|
|Test-Retest Reliability||Reliability that is high when a test yields the sam results every time it is given to the same people.|
|Interrater (Interjudge) Reliability||Reliabilty that is high when different judges independently agree on how to score and interpret an assessment tool.|
|Validity||The accuracy of a test's or study's results; that is, the extent to which the test or study actually measures or shows what it claims.|
|Face Validity||Validity possessed by an assessment tool simply because it makes sense and seems reasonable.|
|Predictive Validity||Tool's ability to predict future characteristics or behavior.|
|Concurrent Validity||The degree to which the measures gathered from one tool agree with the measures gathered from other assessment techniques.|
|Clinical Interview||A face-to-face encounter.|
|Structured Interview||Interview in which clinicians ask prepared questions.|
|Interview Schedule||A standard set of questions designed for all interviews.|
|Mental Status Exam||A set of interview questions and observations designed to reveal the degree and nature of a client's abnormal functioning.|
|Clinical Interview Limitations|| 1. Sometimes lack validity or accuracy.|
2. Interviewers may make mistakes in judgments that slant info they gather.
3. Interviewer biases may influence interpretations.
4. May lack reliability (particularly unstructured ones).
5. Clinician's race, sex, age, appearance may influence responses.
|Test||A device for gathering information about a few aspects about a person's psych functioning from which broader info about the person can be inferred.|
|Projective Test||A test consisting of ambiguous material that people interpret or respond to.|
|Rorschach Test||Projective test in which clinicians present one inkblot card at a time and ask respondents what they see, what the inkblot seems to be, or what it reminds them of.|
|Thematic Content||The themes and images that the inkblots evoke during a Rorschach test.|
|Thematic Apperception Test (TAT)||A pictorial projective test in which respondents are commonly shown 30 black-and-white pictures of individuals in vague situations and are asked to make up a dramatic story about each card.|
|Hero||The one character on each card that clinicinas who use the TAT believe that people identify with.|
|Sentence-Completion Test||A projective test in which people are asked to complete a series of unfinished sentences.|
|Draw-a-Person (DAP) Test||The most popular drawing projective test in which individuals are first told to draw "a person" and then are instructed to draw another person of the opposite sex.|
|Projective Test Merits||1. Practitioners who follow the newer models have less use for these tests than psychodynamic clinicians.|
2. Have not consistently demonstrated much reliablity or validity.
3. Only a minority of these test administrators use a standardized procedure.
4. Clinicians conclusions often fail to match the self-report of the client, the psychotherapist's view, or the picture gathered from an extensive case history.
5. Sometimes biased against minority ethnic groups.
|Rorschach Comprehensive System||A highly regarded scoring system that has often yielded impressive reliablity scores among clinicians who are trained in the Roschach test's use and application.|
|Personality Inventory||A test designed to measure broad personality characteristics, consisting of statements about behaviors, beliefs, and feelings that people evaluate as either characteristic or uncharacteristic of them.|
|Minnesota Multiphasic Personality Inventory (MMPI)||The most widely used personality inventory consisting of more than 500 statements describing physical concerns, mood, morale, attitudes, and psych symptoms to be label "true." "false," or "cannot say."|
|Profile||A pattern seen when the 10 scale scores of a personality inventory are considered side by side that indicates a person's general personality.|
|Measures Made by the 10 Scales on the MMPI|| 1. Hypochondriasis (HS)|
2. Depression (D)
3. Hysteria (Hy)
4. Psychopathic deviate (PD)
5. Masculinity-femininity (Mf)
6. Paranoia (Pa)
7. Psychasthenia (Pt)
8. Schizophrenia (Sc)
9. Hypomania (Ma)
10. Social Introversion (Si)
|Personality Inventory Merits||1. Do not take much time to administor and they are objectively scored.|
2. Greater test-retest reliablity and validity than projective tests.
3. When used alone, they have not typically been able to judge a person's personality accurately - not highly valid.
4. Personality traits it seeks to measure cannot be examined directly.
5. Retain certain cultural limitations.
|Response Inventories||Tests designed to measure a person's responses in one specific ares of functioning, such as affect, social skills, or cognitive processes.|
|Affective Inventories||Response inventories that measure the severity of such emotions as anxiety, depression, and anger.|
|Social Skills Inventories||Response inventories used particularly by behavioral and family-social clinicians that ask respondents to indicate how they would react in a variety of social situations.|
|Cognitive Inventories||Response inventories that reveal a person's typical thoughts and assumptions and can uncover counterproductive patterns of thinking that may be at the root of abnormal functioning.|
|Psychophysiological Test||A test that measures physical responses (such as heart rate and muscle tension) as possible indicators of psychological problems.|
|Polygraph (Lie Detector)||A psychophysiological test in which electrodes attached to various parts of a person's body detect changes in breathing, perspiration, and heart rate while the individual answers questions.|
|Control Questions||Questions used in a polygraph whose answers are known to be yes.|
|Test Questions||Questions used in a polygraph that indicate that a person is lying when their breathing, persperation, and heartrate suddenly increase during the response.|
|Neurological Test||A test that directly measures brain structure or activity.|
|Electroencephalogram (EEG)||A neurological test that records brain waves, the electrical activity taking place within the brain as a result of neurons firing, and sends them to an oscillograph, a machine that records them.|
|Dysrhythmia||An abnormal brain-wave pattern which indicates the possible existance of brain injury, tumors, seizures, or other abnormalities.|
|Neuroimaging Techniques||Neurological tests that provide images of brain structure or activity, such as CT scans, PET scans, and MRIs.|
|CT Scan||A neuroimaging procedure in which X rays of the brain's structure are taken at different angles and then the images are combined by a computer.|
|PET Scan||A neuroimaging technique that reveals the functioning of different areas of the brain.|
|MRI||Neuroimaging procedure in which a computer gathers information about the magnetic properties of hydrogen atoms in the brain and then produces a very detailed picture of the brain's structure.|
|fMRI||Neuroimaging procedure that produces a detailed picture of the functioning brain.|
|Neuropsychological Test||A test that detects brain impairment by measuring a person's cognitive, perceptual, and motor performances.|
|Bender Visual-Motor Gestalt Test||One of the first neuropsychological tests in which 9 cards, each displaying a simple design, are shown to patients who are asked to copy each on to a piece of paper and are later asked to redraw the design from memory.|
|Battery||Series of neuropsychological tests.|
|Early Definition of Intelligence||The capacity to judge well, to reason well, and comprehend will.|
|Intelligence Test||A test designed to measure a person's intellectual ability.|
|Intelligence Quotient (IQ)||A score derived from intelligence tests that is considered to represent a person's overall level of intelligence.|
|Naturalistic Observation||Clinical observation technique in which clinicians observe clients in their everyday environments.|
|Analog Observation||Clinical observation technique in which clinicians observe clients in an artificial setting, such as a clinical office or laboratory.|
|Self-Monitoring||Clinical observation technique in which clients are instructed to observe themselves and carefully record the frequency of certain behaviors, feelings, or cognitionsas they occur over time.|
|Participant Observers||Key person in the client's environment that make naturalistic clinical observations and report them to the clinician.|
|Overload||`When a naturalistic observer is unable to see or record all of the important behaviors and events.|
|Observer Drift||A steady decline i accuracy as a result of fatigue or of a gradual unintentional change in the standards used when an observation continues for a long period of time.|
|Observer Bias||When an observer's judgments are influenced by iformation and expectations he or she already has about a person.|
|Clinical Observation Limitations|| 1. Not always reliable.|
2. Possible overload, observer bias, or observer drift can affect validity.
3. Client's reactivity may limit validity; that is, the presence of the observer may effect the client's behavior.
4. May lack cross-situational, external, validity.
|Clinical Picture||Integrated picture of factors that are causing and maintaining a client's disturbance that is constructed by a clinician who uses the info from interviews, tests, and observations.|
|Diagnosis||A determination that a person's problems reflect a particular disorder.|
|Syndrome||A cluster of symptoms that usually occur together.|
|Classification System||A list of disorders, along with descriptions of symptoms and guidelines for making appropriate diagnoses.|
|Emil Kraepelin||He developed the first modern classification system for abnormal behavior, which form the foundation for the psych part of the International Classification of Diseases (ICD).|
|Diagnostic and Statistical Manual of Mental Disorders (DSM)||A classification system developed by the APA.|
|DSM-IV-TR (DSM-IV Text Revision)||Most widely used classification system in the US.|
|Axis I||AN extensive list of clinical syndromes that typically cause significant impairment; most frequently diagnosed disorders listed are the anxiety disorders and mood disorders.|
|Axis II||Includes long-standing problems that are frequently overlooked in the presence of the disorders on Axis I; only 2 groups of disorders: mental redardation and personality disorders.|
|Axis III||Asks for information concerning relevant general medical conditions from which the person is currently suffering.|
|Axis IV||Asks about special psychosocial or environmental problems that person is facing, such as school or housing problems.|
|Axis V||Requires the diagnostician to make a global assessment of functioning (GAF).|
|Global Assessment of Functioning (GAF)||To rate on a 100-point scale the person's psychological, social, and occupational functioning overall.|
|Multiaxial System||System that uses several kinds of diagnostic information, each defined by a differnet "axis," such as the DSM-IV-TR.|
|Reliability of a Classification System||The degree to which different clinicians are likely to agree on the diagnostis when they use the system to diagnose the same client.|
|Validity of a Classification System||The accuracy of the info that its diagnostic categories provide.|
|DSM-IV-TR Merits||1. Some criterea and categories are based on weak research and some reflect gender or race bias.|
2. Its assumption that clinical disorders are qualitatively different from normal behaviors may be incorrect.
3. Certain categories reflect variations of a single, fundamental dimension of functioning vs. separate disorders.
|Empirically Supported (Evidence-Based) Treatment||An ever-growing movement in the US, the UK, and elsewhere to help clinicians become more familiar with and apply research findings.|
|Problems in Determining Effectiveness of Treatment|| 1. How to define "success."|
2. How to measure improvement.
3. Variety and complexity of the treatments currently in use.
|Therapy Outcome Studies|| Studies that measure the effects of various treatments and that typically ask 1 of 3 questions:|
1. Is therapy in general effective?
2. Are particular therapies generally effective?
3. Are particular therapies effective for particular problems?
|Meta-Analysis||Special statistical technique that combines the findings of different studies to find relationships, such as the relationship btwn treatment and improvement.|
|Rapprochement Movement||An effort to identify a set of common strategies that run through the work of all effective therapists.|
|Psychopharmacologist (Pharmacotherapist)||A psychiatrist who primarily prescribes medication.|