CRM 200 Lecture Notes - Lecture 3: Inter-Rater Reliability, Predictive Validity, Mental Status Examination
3 May 2018
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Chapter 3 – clinical assessment
Clinical assessment and diagnosis
• Assessing psychological disorders: we take different 3 factors and how they interact:
io, soial ad …
o Clinical assessment
▪ systematic evaluation and measurement of psychological, biological, and
social factors in an individual presenting with a possible psychological
disorder.
▪ we take overall whats happening
o Diagnosis
▪ process of determining whether the particular problem afflicting the
individual meets all criteria for a psychological disorder,
▪ process of determining of whether or not disorder is applied
DSM-5
• Reliability:
o degree to which a measurement is consistent.
o consistent measurement.
o do we have reliable standard for diagnosis
▪ inter-rater reliability
• do 2 independent observers agree?
▪ Test-retest reliability
• Does the same person taking the same test get the same score
each time?
• Validity:
o whether something measures what it is designed to measure
o in this case, whether a technique assesses what it is supposed to.
▪ Concurrent/ descriptive validity
• How do the results compare to the results of a better known
assessment tool?
▪ Predictive validity
• Does the assessment tell us what will happen in the future
• Standardization:
o process by which a certain set of standards or norms is determined for a
technique to make its use consistent across different measurements.
Clinical interview:
• gathers information on current and past behavior, attitudes, and emotions, as well as a
detailed histoy of the idiidual’s life i geeal and of the presenting problem.
• determine when the specific problem started and identify other events might have
occurred at the same time
NOT ALL STEPS HAVE TO BE TAKEN – DPEENDS ON THE PERSON
1. Mental status exam:
• ioles the systeati oseatio of a idiidual’s ehaio.
find more resources at oneclass.com
find more resources at oneclass.com
• The trick for clinicians is to organize their observations of other people in a way that
gives them sufficient information to determine whether a psychological disorder might
be present
• Structured or semi- structured
o Structured:
▪ list of questions that must be asked in the same order and same
words. Its very reliable that measures same thing to all patients.
▪ Flowchart – do’t ahe t oask eey uestio, o = oe oto
next set
▪ Can be slef reported (rate on scale)
o Semi-structured:
▪ collection of questions that some can be omitted or add another
and little less strict in case of pattern
▪ need to be trained before can do this
▪ series of predetermined but open ended questions
o Non-structured:
▪ no procedure and no standard. No rules
• Coarse preliminary test - The exam covers five categories:
1. Appearance and behavior:
o how the patient put himself for the day (clothes and stuff)
o Type of wearing and clothes
2. Thought processes: difficult to asses what others are thinking.
o Rate of speech:
▪ They observe his actions like speaking slowly means has
depressed. Or fast speaking
o Continuity of speech: speaking in full sentences
o Consent of speech: content makes since or not? L
3. Mood and affect: ask how they feel today
o Feeling state: if replies hes fine but then he cries. Emotions match our
behavior
o What is the dominate emotional state as they come into the place
o Is the mood related /appropriate to the situation
4. Intellectual functioning
o Type of vocab: type of words coming out
o Abstraction and metaphor: ability of this metaphor on our cognition
5. Sensoruym: how much knowledge of surroundings
o Awareness: awareness of how he is, who are others, places and
surroundings
o How much knowledge of surrounding?
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
L: mood and affect: ask how they feel today, feeling state: if replies hes fine but then he cries. Emotions match our behavior: what is the dominate emotional state as they come into the place. Personality inventories: minnesota multiphasic personality inventory (mmpi), around 500 questioner like true or false, but do(cid:374)"t gi(cid:448)e (cid:395)ualitati(cid:448)e (cid:396)esults, the individual being assessed (cid:396)eads state(cid:373)e(cid:374)ts a(cid:374)d a(cid:374)s(cid:449)e(cid:396)s eithe(cid:396) (cid:862)t(cid:396)ue(cid:863) o(cid:396) (cid:862)false. Individual responses on the mmpi are not examined; instead, the pattern of responses is reviewed to see whether it resembles patterns from groups of people who have specific disorders. They must follow the script word by word. Gives a lot of questions to answer problems. Like language, culture, social, environment that can affect score. Must combine many tests together: know that these 2 tests can have these 2 outcomes, false positi(cid:448)es: test sho(cid:449)s p(cid:396)o(cid:271)le(cid:373)s (cid:449)he(cid:374) (cid:396)eally the(cid:396)e"s (cid:374)othi(cid:374)g, false negatives: tests fails to detect the problem.
