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Psych 257 Chap 3 Psych 257 Psychopathology Barlow et Al: Abnormal Psychology 2nd CDN edition Chapter 3

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Uzma Rehman

Clinical Assessment and Diagnosis Clinical assessment systematic evaluation and measurement of psychological biological and social factors in an individual presenting with a possible psychological disorder Diagnosis process of determining if individuals problem meets all criteria for a psychological disorderas set forth in DSMIV Frank Young Serious and Anxious Frank 24 yr old Mechanic Severe distressanxiety over marriagefirst step describe openly major difficulties presenting problem insecureanxietyrecogd Frank repeatedly twitched every so ofter due to fear of seizuring Brian Unwanted Thoughts of Harm Brian 30 yr old bookkeeper thoughts of harming selfothers usu 3timesweek impaired work Assessing psychological disorders first collect information across broad range of indivs functioning determine source of problemnarrow focus via rule out problems in some areas concentrate on most relevant areas 3 concepts that help determine value of assessments i Reliability degree to which a measurement is consistent ii validity whether it measures what its meant to iii Standardization process by which a set of standards is determined for a technique to make its use consistent across diff measures The Clinical Interview gather info On currentpast behaviour emotions history of indiv find origin of presenting problemuse a mental status exam systematic obs Of someones behaviour see if pdisorder is present 5 categories appearancebehaviour thought procs moodaffect intellectual functioning sensoriumsensorium general awareness of surroundingsThe Mental Status Exam allow clinician to find which problematic area of behaviourcondition should be examined further first eg FrankBrian focus most of interview on existencerepression of intrusive unwanted thoughts OCDsometimes patients problem not major issue eg Franks marital problemsspecial focus on creating trustempathy confidentiality except if potential harm is imminentSemistructured Clinical Interviews carefully phrased questions tested to elicit useful info Consistently clinician can focus on specific issue problem robs interview of spontaneity if too rigid may stop patient from volunteering useful infospecialized versions eg DSM IVs anxiety disorders interview scheduleset to help make diagnoses for disorders in DSMIV Physical examination if no recent physical may be ordered spec focus on med Conds assocd w spec psych problemseg disorder may just be temp toxic state bad food wrong medicine drugs etcusu psychologists well aware of med Conds assocd w probs described by patient if disorder depression etc experienced prior to physiological problem drug use then its not causal Behavioural assessment further step use direct obs asses indivs thoughts feelings behaviour in spec Situations ie contextesp For patients not able too young unskilled to selfreport problems use sims of real life in BA identifyobs Target behaviours its influential factors go into homework to examine realityThe ABCs of Observation clinicians attention usu Directed to A antecedent immediate B behaviourC consequences informal obs visit home take rough noteselaborate at office formal obs identify specific behaviours that are observable and measureable find behaviour patterns
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