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Lecture

chapter 3

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Department
Psychology
Course
Psychology 2030A/B
Professor
David Vollick
Semester
Winter

Description
Chapter 3: clinical assessment and diagnosis Assessing psychological disorders - Clinical assessment (you come to a therapist and how he determine what to do?) o Systematic evaluation and measurement (what it is? How can I help?)  Psychological (feel helpless, hopeless…)  Biological  Social (what kind of social support they have) - Diagnosis: put all the information together to make a diagnosis. o Degree of fit between symptoms and diagnostic criteria - Purposes of clinical assessment: o To understand the individual (know a lot better the diagnosis is) o To predict behaviour (for example suicidal) o To plan a treatment o To evaluate treatment outcome (how much better, how long did it take?) - Analogous to a funnel (entonnoir): o Starts broad (friends, family, personality test, intelligence test) o Multidimensional in approach (we want to know how much we can) o Narrow to specific problem areas Three concepts determine value of assessment - Reliability if a therapist diagnosis someone as depressive, another therapist should find the same outcome. o Consistency is measurement  E.g. test/retest, inter-rater reliability - Validity: if I give an intelligence test, I am actually measuring intelligence? o What the test measures and how well it does so  E.g. content, concurrent, discriminant (btn one test and another), construct (test construct), and face validity (google it) - Standardization (for example a Rorschach test, the same thing again and again, so we need to compare to the other test, so need to standardize) o Standards and norms help ensure consistency o Examples: administration procedures, scoring and comparing results with peers (e.g. WAIS) Clinical interview and physical exam - Clinical interview: o Most common clinical assessment method o Structured or semi-structured (the interview might be really structured or semi) o Confidentiality not with harm to self/other (2 exceptions, child sexual abuse and someone who wants to kill somebody. o Physical exam o Mental status exam: rule out toxicity medicine side effects, etc.  Oriented x 3= ability to identify person, place and time. Behavioural assessment and observation How the patient presents himself. - Behavioural assessment o Focuses on here and now o Tends to be direct and minimally inferential o Goo for children, they can’t communicate well (they are not able to say properly their feelings such as anxiety) o Identify antecedents behaviors, and consequences = functional analysis. o Self-monitoring versus others observing  Problem of reactivity using direct observation o Brief psychiatric rating scale (prior, during and after treatment) o Need to operationalize reported behaviors Domains of assessment: psychological testing and projective tests - Psychological testing: o Must be reliable (consistent across people) and valid - Projective tests: o Project aspects of personality onto ambiguous test stimuli (they believe that unconscious processes can only be measured indirectly) o Roots in psychoanalytic tradition o High degree of clinical inference in scoring and interpretation o Reliability and validity data e.g. Rorschach/ The apperception test: look at the picture and tell a story (I see a man looking sad and at the back a huge sun with an apple tree) Domains of assessment: psychological testing and objective tests - Objective tests: o Less ambiguous (yes/no) o Roots in empirical tradition (empirical means data) o Require minimal clinical inference in scoring and interpretation - Objective personality tests: o Minnesota multiphasic personality Inventory (MMPI-2, MMPI-A), a bunch of data from a lot of people:  Over 549 true or false items  Extensive reliability (very reliable), very valid, and normative database.  Faking scales (L, F, K, &,?) who determine if the person lies or not (have you ever had a bad dream? Yes or no)  High L & K = trying to look good o Revised Psychopathy checklist (PCL-R) Robert Hare et al.; University of British Columbia:  Uses interviews, institutional files, and friends Intelligence testing - Initially for school testing - Objective intelligence tests (questions not ambiguous and easy to catch) o Stanford/Binet – Mental age/chronological age o WAIS- III & WISC- III  The deviation IQ (prepare each group to be able to do that)  Gives us an IQ for verbal and performance domains  IQ versus intelligence (IQ means intelligence ?? not sure) Neuropsychological testing Try to determine where in the brain the disorder comes from - Neuropsychological tests: o Assess broad range of motor, cognitive, memory skills and abilities o To determine location of any brain damage/dysfunction & understand brain- behaviour relations (i.
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