psych2030 goals of assessment.docx

Goals of Assessment: - What assessment procedures and instruments to administer - Tailoring an assessment to types of symptoms, age and medical status - Screening (identify psychological problems or predict the risk for future problems) o Risk of redeveloping? - Diagnosis (identification of illness) o - Treatment plan (individual’s plan of care to meet mental health needs) o What kind of treatment should we give them o Antidepressants? Which one is best for them? - Outcome evaluation ** Differential diagnosis is a process in which a clinician weighs how likely it is that a person has one diagnosis instead of another How to find a good screening tool: - Refer to yellow chart in textbook Cases of Misdiagnosis: - Deafness vs. intellectual disability - Epilepsy vs schizophrenia - Medication reaction vs depression o What kind of meds are they one, some meds (for other illnesses) can cause depression - Brain tumor vs anorexia nervosa - Impact of clinical significance And the usual properties of assessment instruments are.. - Standardization: o Means, tests given to diff groups, must be done the same way  Tests must be given under same conditions, marked in same conditions - Normative comparisons: o Ex. Take your age group and compare it to hundreds and hundreds of people you age o Compare like characteristics with like (female with female, kids with kids) - Self-referent comparisons: - Reliability: o Test retest reliability o Interrater agreement - Validity: o Construct, criterion, concurrent, predictive Assessing abnormality using the normal curve - Refer to red, green, yellow curve graph Developmental and cultural considerations: - Age - People involved in testing-age, developmental status - Nature of test chosen - “culturally fair” Assessment Instruments: - Self-report measures (ask patients to evaluate their own symptoms) Clinical Interviews - Conversations between an interviewer and a patient to gather information and make judgments related to assessment goals - Purpose: screening, diagnosis, treatment planning, or outcome evaluation - Types of interviews o Unstructured: conclusions unreliable o Structured: o Open-/closed-ended questions Psychological tests - Objective personality tests o ex. do you like fishing (straight forward) - Minnesota Multiphasic Personality Inventory (MMPI) – empirical keying = discriminates o Nine clinical subscales + faking good and bad, lie scales o Refer to line graph in pics - The Million Clinical Multiaxial Inventory (MCMI) o Lacks fit with the DSM system and categories Projective Tests: - From psychoanalytic theory- respond to ambiguous stimuli - Thematic apperception test (TAT; 1935) o Consists of 31 black and white pictorial cards and the patient is asked to make up a story about the image - Rorschach Inkblot test o Shown ambiguous stimuli and then projects a unique interpretation onto them that reflects his/her underlying unconscious processes and conflicts  Poor normative date- break the ice initially The Rorschach Inkblot Test - 25% of the exner’s comprehensive system scores are not considerered reliable, “the norms” published by Exner are outdated (from the 1970s and 1980s) - Adequate validity only exists for 20 of the 180 CS scores - There are both critics and advocates for the utility of the Rorschach; however no sound empirical data exists - Validity increases using clinical judgment plus information from other sources Neuropsychological testing - To detect impairment in cognitive functioning - Measures: memory, attention and concentration, motor skills, perception, abstraction and learning abilities - Halstead- Retain neuropsychological battery -