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

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Published on 16 Oct 2011
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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 individual’s problem meets all criteria for a psychological disorder
-as set forth in DSM-IV
Frank: Young, Serious, and Anxious
-Frank: 24 yr old Mechanic; Severe distress + anxiety over marriage
-first step: describe openly major difficulties (presenting problem); insecure + anxiety
-recog’d Frank repeatedly twitched every so ofter due to fear of seizuring
Brian: Unwanted Thoughts of Harm
-Brian: 30 yr old bookkeeper; thoughts of harming self/others; usu. 3times/week; impaired work
Assessing psychological disorders
-first, collect information across broad range of indiv’s functioning; determine source of problem
-narrow 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 it’s 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 current/past behaviour, emotions, history of indiv.; find origin of presenting problem
-use a mental status exam: systematic obs. Of someone’s behaviour; see if p-disorder is present
-5 categories: appearance/behaviour, thought proc’s, mood/affect, intellectual functioning, sensorium
-sensorium: general awareness of surroundings
The Mental Status Exam
-allow clinician to find which problematic area of behaviour/condition should be examined further first
-eg. Frank/Brian: focus most of interview on existence/repression of intrusive, unwanted thoughts (OCD)
-sometimes patients problem not major issue; eg. Frank’s marital problems;
-special focus on creating trust/empathy, confidentiality, except if potential harm is imminent
Semistructured 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 info.
-specialized versions: eg. DSM IV’s anxiety disorders interview schedule;
-set to help make diagnoses for disorders in DSM-IV
Physical examination
-if no recent physical, may be ordered; spec. focus on med. Cond’s assoc’d w/ spec. psych problems
-eg. disorder may just be temp. toxic state (bad food, wrong medicine, drugs, etc.)
-usu. psychologists well aware of med. Cond’s assoc’d w/ prob’s described by patient
-if disorder (depression etc.) experienced prior to physiological problem (drug use), then it’s not causal
Behavioural assessment
-further step; use direct obs.; asses indiv’s thoughts, feelings, behaviour in spec. Situations ie. “context”
-esp. For patients not able (too young, unskilled) to self-report problems; use sim’s of real life
-in B.A. identify + obs. Target behaviours + it’s influential factors; go into home/work to examine reality
The ABCs of Observation
-clinician’s attention usu. Directed to (A) antecedent, immediate (B) behaviour, & (C) consequences
-informal obs.: visit home, take rough notes & elaborate at office
-formal obs.: identify specific behaviours that are observable and measureable; find behaviour patterns
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Document Summary

First step: describe openly major difficulties (presenting problem); insecure + anxiety. Recog"d frank repeatedly twitched every so ofter due to fear of seizuring. 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 individual"s problem meets all criteria for a psychological disorder. Frank: 24 yr old mechanic; severe distress + anxiety over marriage. Brian: 30 yr old bookkeeper; thoughts of harming self/others; usu. First, collect information across broad range of indiv"s functioning; determine source of problem. 3 concepts that help determine value of assessments. I) reliability: degree to which a measurement is consistent. Ii) validity: whether it measures what it"s meant to. Iii) standardization: process by which a set of standards is determined for a technique. Narrow focus via rule out problems in some areas, concentrate on most relevant areas. To make its use consistent across diff. measures.

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