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Chapter 3

Chapter 3.docx

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PSYC 3140
Jennifer Lewin

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Chapter 3 -Clinical assessment is the systematic evaluation and measurement of psychological, biological, and social factors in an individual presenting with a possible psychological disorder -diagnosis is the process of determining whether the problem afflicting the individual meets all the criteria for a psychological disorder, as set 4 in the Diagnostic and Statistical manual of mental disorders or DSM-IV-TR Assessing psychological disorders -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. After getting the overall functioning of the person, the clinician narrows the focus by ruling out problems in some areas and concentrating on areas that seem most relevant -three basic concepts that help determine the value of our assessments: reliability, validity, and standardization -reliability is the dress to which a measurement is consistent. Psychologists improve their reliability by designing their assessment devices and conducting research to ensure that two or more raters will get the same answers (interrater reliability) -Validity is whether something measures what is designed to measure -comparing the results of one assessment measure with the results of others that are better known allows you to begin to determine the validity of the first measure. This is called concurrent or descriptive validity -predicitive validity is how well your assessment tells you what will happen in the future -standardization is the process which a certain set of standards or is determined for a technique to make its use consistent across different measurements -clinical assessment consists of strategies and procedures that help clinicians acquire the information they need to understand their patients and assist them. Procedures include clinical interview, mental status exam, physical examination, behavioral observation and assessment, and psychological tests The Clinical Interview Interview gathers information on current and past behavior, attitudes, and emotions as well as a detailed history of the individual’s life in general and of the problem -to organize information obtained during an interview, many clinicians use a mental status exam The mental status exam -the mental status exam involves the systematic observation of somebody’s behavior -the mental status exam, clinicians organize their observations of other people in a way that gives them sufficient information to determine whether a psychological disorder might be present -the exam covers five categories: appearance and behavior, thought processes, mood and affect, intellectual functioning, and sensorium 1) Appearance and behavior-clinician notes overt physical behaviors (dress, appearance, posture) 2) Thought processes- clinician listens to a patient talk, getting a good idea of that person’s thought processes 3) Mood and affect- mood is the predominant feeling state of the individual 4) Intellectual functioning- clinicians make a rough estimate of others’ intellectual functioning just by talking to them 5) Sensorium- general awareness of our surroundings Semistructured Clinical Interviews -unstructured interviews follow no systematic format -semistructured interviews are made up of questions that have been carefully phrased and tested to elicit useful information in a consistent matter, so clinicians can be sure they have inquired about the most important aspects of particular disorders -the disadvantage of semistructured interviews is that it robs the interview of some of the spontaneous quality of two people talking about a problem
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