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Chapter 3

PSYC*3140 Chapter Notes - Chapter 3: Predictive Validity, Sensorium, Dementia

Course Code
Richard Brown

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Chapter 3—Clinical Assessment and Diagnosis
Abnormal Psychology
Pages 73-100
-Clinical assessment: is the systematic evaluation and measurement of psychological,
biological and social factors in an individual presenting with a possible psychological
-Diagnosis: is the process of determining whether the particular problem afflicting the
individual meets all the criteria for psychological disorder as set in the DSM-IV-TR
Assessing Psychological Disorders:
- The clinician begins by collecting a lot of information across a broad range of the
individual’s functioning to determine where the source of the problem may lie
- Three basic concepts that help determine the value of our assessments
oReliability: the degree to which a measurement is consistent
1) Expect similar results even when two different physicians use the
assessment on their client
oValidity: whether something measures what it is designed to measure
1) Comparing results of one assessment measure with the results of others
that are better known
2) Concurrent or descriptive validity: comparisons with other measures
3) Predictive validity: is how well your assessment tells you what will happen
in the future
oStandardization: is the process by which certain set of standards or norms is
determined for a technique to make it use consistent across different
-Clinical interview: clinicians acquire the information they need to understand their
patients and assist them
The Clinical Interview:
- The interview gathers information on current and past behaviour, attitudes and emotions
and of presenting problem
- When specific problem first started etc

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-Mental status exam: to organize information obtained during an interview
oClinicians organize their observations of other people in a way that gives them
sufficient information to determine whether a psychological disorder might be
oThe exam cover 5 categories:
1) Appearance and behaviour: notes any overt physical behaviours,
posture, facial expressions
2) Thought processes: listen to patient talk, they-re getting a good idea of
that person’s thought processes, how they talk, delusions of persecution
where someone thinks they are after them, ideas of reference where
everything else somehow relates back to him, hallucinations
3) Mood and affect: the feeling state of that individual
4) Intellectual functioning: whether they have a good vocabulary, seem
5) Sensorium: our general awareness of our surroundings, know what the
date is,
Semi structured clinical interviews:
- Unstructured interviews follow no systematic format
- Semi structured interviews are made up of questions that have been carefully phrased
and tested to elicit useful information in a consistent manner
- May also depart from set questions to follow up on specific issues
Physical Examination:
- Particular attention to the medical conditions sometimes associated with the specific
psychological problem

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- After an examination, may conclude that it is a temporary toxic state
Behavioural Assessment:
- Using direct observation to assess formally an individual’s thoughts, feelings and
behaviour in specific situations or contexts
- Appropriate for people that are too young to express their problems or experiences such
as young children
- Role-play stimulation is an example of behavioural assessment
- Target behaviours are identified and observed with the goal of determining the factors
that seem to influence those behaviours
- Most clinicians assume that a complete picture of a person’s problems requires direct
observation in naturalistic environments
The ABC’s of Observations:
- The clinicians attention is usually directed to the immediate behaviour, its antecedents
(what happened just before the behaviour), and its consequences (what happened
- The Antecedent-behaviour-consequences
-Informal observation—during a home visit, the clinician took rough notes about what
occurred for example
- Formal observation—involves identifying specific behaviours that are observable and
- People can also observe their own behaviour to find patterns
-Behaviour rating scales—more formal way to observe behaviour, used as assessment
tools before treatment and then periodically during treatment to assess changes
-Reactivity—can distort any observational data, whenever you observe behaviour, the
mere fact of you being there may alter their behaviour
Psychological Testing:
- Tests must be reliable and valid
Projective Testing:
- Variety of stimuli, are presented to a person who is asked to describe what they see
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