KHA329 Lecture Notes - Lecture 5: Trin, Mental Status Examination, Extraversion And Introversion
1 Jul 2018
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Week 5: psychopathology
Thinking critically about psychopathology:
- “The field of psychology that aims to understand, explain and modify
abnormal behaviour”
- Most concerned with a subset of abnormal behaviours known as psychological
disorders
- What is abnormal? What is normal?
oClinical psychology
oWe know that we are looking at something where..
oMental state is in terms of frequency, intensity, or duration means a
person doesn’t fit in normal bracket
oIn reality though.. is it something that happens to other people?
- Role of social acceptability
oA lot of it comes doe not what is considered socially acceptable
oSocial changes over time, so this must mean that disorders change over
time, as what is normal changes over time
oNeed great consideration of the social context we are in
oThe line of normality is not a line that we can be sure of
- We are all affected:
o20-30% of us in anyone year
o50% at some point in our lives
oFamily, friends, colleagues, health care, leave
oEven if it isn’t us who experience the disorder, we are still impacted by
it
- Labeling and restriction of freedom
oWhat does diagnosis mean for the person and their opportunities
- Sick roles
oIf they slip into this role, they might not try and get on with their lives
despite the disorder
o‘if I’m anxious, I can’t do that..”
- Degrees, continuous label
oSocially and morally sanctioned
oDepends on what is going on in a person’s lives
oCelebrities often have different norms
oFilter on how we perceive someone’s behaviour
Why assess psychopathology:
- May aid in understanding the client
oHelps to know where they are coming from
oWhy they are behaving the way they are
- Differential diagnosis
oOn the surface someone may present as having depression, but when
we assess them its more to do with their anxiety and rumination
- Feedback and insight
oHelps people understand why they are so
- Empathy and rapport
oEssential to building therapeutic alliance
oStrongest active ingredient for therapy
- Planning therapeutic intervention
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oPersonalized therapy
- May aid in anticipating the course of therapy and counseling
oPersonal characteristics, what will they respond and be open to
oApproaches
- First steps:
oConsider referral source
What kind of evaluation is actually needed
Surface vs. latent motives
Are they actually needing help for something they are not
mentioning
oNeed to provide appropriate information
What decision need to be made regarding the client
oWhat framework will you work with
DSM in Australia and US
ICD: used in many other areas such as Europe
Be aware of this completely different classifications of
disorders
oReferral environment will differ:
Psychiatric
General medical, forensic, educational or psychological clinic
oFaking and malingering
Is there likely to be so
What is the context
Is it a legal assessment for example?
oConsent:
Before assessment
- Clinical assessment:
oSometimes called whole person assessment
oLike IQ testing
oThe process of understanding a person’s problems, needs and concerns
oAs well as their strengths:
May form the basis for the intervention
oWhich assessment tools
Referral will inform this
What are you comfortable and competent in administering
Interviews can be surprisingly hard
Practical considerations
Time
What can you achieve in this time with this client
Good psychometric properties
oDepending on where you are working these choices may not be
available
Organisations may have certain guidelines and rules
- Unstructured interviews:
oAn effective way of obtaining information about clients
oAlways readily available to all clinicians
oDon’t need additional costs: time or money
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find more resources at oneclass.com
Good free assessments
License tests cost you money each time
oPattern about normal points to cover
oAs part of an overall assessment
oAims to elicit information about the client’s background, especially as
it may relate to current problems or complaints
oDirection of therapy will depend on initial assessment
oPerson centered approach
Putting the pieces of the puzzle together presenting problem,
current issues, background
Needs of the person is the focus
oPsychometric properties
Of an unstructured interviews
Are often poor
Because clinicians are susceptible to making errors
Eg. Inter-rater reliability : can get a different picture depending
on the types of questions you ask
Model:
Eg. CBT vs. psychoanalytic
Halo symptoms: may make the person seem better than
they are
Education: may lead you to think that they have greater
insight than someone who is less educated
Malingering:
Pretty good way to do this faking because people might
be able to exaggerate things more easily in an interview
compared to test
Distorted responses when finding out an issue, will they
be forthcoming or closed
oWhat to cover in the interview:
Identifying information about the client
Clarify and collect any additional information
General appearance and demeanor
Not just at the start but throughout the treatment
Reactive? Is there a topic they don’t like to talk about
Agitation over certain topics
History related to the presenting problems
Past psychiatric, psychological, counseling history
What brings you here today? What is troubling you?
oThis gives you are good starting picture
oHow often, when did this start, things around
this
What worked fro them or didn’t
Educational and job history
If they move around places this might indicate
something
Health, family, social and developmental history
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
The field of psychology that aims to understand, explain and modify abnormal behaviour . Most concerned with a subset of abnormal behaviours known as psychological disorders. Labeling and restriction of freedom: what does diagnosis mean for the person and their opportunities. Sick roles: if they slip into this role, they might not try and get on with their lives despite the disorder, if i"m anxious, i can"t do that . Degrees, continuous label: socially and morally sanctioned, depends on what is going on in a person"s lives, celebrities often have different norms, filter on how we perceive someone"s behaviour. May aid in understanding the client: helps to know where they are coming from, why they are behaving the way they are. Differential diagnosis: on the surface someone may present as having depression, but when we assess them its more to do with their anxiety and rumination. Feedback and insight: helps people understand why they are so.
