Assessment and Diagnosis

Assessment

Systematic evaluation and measurement of psychological, biological, and social factors in an individual presenting with a possible psychological disorder

diagnosis

� The process of determining whether or not a particular problem afflicting an individual meets all the criteria for a psychological disorder, as set forth in the DSM V

International Classification of Diseases (10th edition, Clinical Modification)

used world wide for mortality statistics, and reimbursement in medicine

Homosexuality

Prior to the DSMIIIR- ________ was listed as a disorder

Major Disorders, Personality Disorders, General Medical Conditions, Psychosocial, Global

Axis I: _________ ________ Axis II: ________ ________ and MR
Axis III: ________ ______ _____ Axis IV: ____________ and Environmental Problems
Axis V: _______ Assessment of Functioning Scale (GAF) .... 0 to 100 (Lower is worse: ranges from persistent dange

3, GAF

-DSM-5 combined the first _____ DSM-IV-TR axes
-_____ has been replaced

psychological test

a device or procedure used to measure variables related to psychology

psychological assessment

Integrating psychological data for the purpose of making a psychological evaluation.
Accomplished through the clinical interview, mental status exam (MSE), psychological tests, and behavioral observations

psychological assessment, interview, behavior, mental, psychological

psychological assessment: (Multomodal)
1. Clinical ______ and ______ Observation (widely used and flexible, structured and unstructured)
2. _____ Status Exam (20 minutes)
3. ______ Testing

clinical interview

researchers use a flexible, conversational style to probe for the participant's demographic info, reason(s) for diagnostic visit, psychiatric and medical history, family history, previous level of functioning

mental status exam

(5-20 minutes)
?Appearance
? Behavioral disturbance, verbal and non-verbal
? Orientation x 3 (person, place and time)
? Memory, long term and recent
? Perceptions
? Mood or Affect
? Intelligence
? Thought: Form and Content
? Insight
? Judgment

behavioral observation

monitoring the actions of others or oneself by visual or electronic means while recording quantitative and/or qualitative information regarding those actions
-formal vs. informal
-self monitoring vs. others observing
-reactivity, observer error, ecologica

antecedent, behavior, consequence

Behavioral Assessment:
-Text's ABC's of Observation

Stimulus situation, organismic variables, responses, consequences that reinforce the behavior

Behavioral Assessment:
SORC chain

Reliability

consistency of measurement, including diagnostic decisions
-Types: Test-retest reliability and inner-rater reliability (agreement among raters)

Validity

refers to the meaning or importance of a measurement
- a test is considered valid when it measures what it purports to measure
-Types:
-Concurrent or descriptive validity- comparing the result of one assessment with the result of another assessment
-predi

projective, neurological or neuroimaging, neuropsychological, personality, vineland adaptive behavior scales

Types of Testing

projective testing

unstructured stimuli are presented to a subject; subject projects meaning or structure onto the stimuli; projections reveal hidden motives, unconscious thoughts and feelings (Rorschach Ink Blot Test) (Thematic Apperception Test)

Rorschach inkblot test

the most widely used projective test, a set of 10 inkblots, designed by Hermann Rorschach; seeks to identify people's inner feelings by analyzing their interpretations of the blots

Neurological or Neuroimaging

assesses the structure and function of the brain

Electroencephalogram (EEG)

An amplified recording of the waves of electrical activity that sweep across the brain's surface. These waves are measured by electrodes placed on the scalp; main use is research into diagnosis of epilepsy, and sleep disorders

Computerized Axial Tomography (CAT)

Structural neuroimaging; well accepted imaging modality for the entire body; uses thousands of narrow band x-rays to pass through the tissue . at different angles; CT used to detect major structural problems; ex. large brain tumor involving the left front

magnetic resonance imaging (MRI)

Structural neuroimaging � Uses magnetic fields and radio frequency energy � Hydrogen atoms respond by emitting energy that the machine uses to construct the image � Better resolution than CAT scan � EXAMPLE: right brain showing ventricular enlargement in

Positron Emission Tomography (PET)

Functional Neuroimaging � Patients injected with a radioactive substance � Substance emits positrons that collide with tissue to emit gamma rays detected by device � Gives images of cerebral blood flow � Shows which areas are most active

functional magnetic resonance imaging (fMRI)

Looks at functions using oxygen uptake � fMRI looks at hemoglobin (the blood protein that binds to oxygen) - in this way, it can measure the oxygen used by the brain, and the most active brain areas use the most oxygen.

neuropsychological tests

assesses the likelihood and nature of brain dysfunction

neuropsychological testing

assessment of...
Short-term and long-term memory � Ability to learn new skills and solve problems � Attention, concentration, and distractibility � Logical and abstract reasoning functions � Ability to understand and express language � Visual-spatial orga

Bender Visual Motor Gestalt Test

? Hutt and Briskin (1960) Scoring System: - 12 "essential discriminators" or errors - Subsumed under five factors ? Organization (i.e. collision) ? Size (i.e. cohesion) ? Changes in the form of gestalt (i.e. closure difficulty) ? Distortion of the gestalt

Collision, Cohesion, Closure Difficulty, Rotation, Motor Incoordination

Bender Visual-Motor Gestalt Test:
when figures are drawn so that they actually overlap or collide; isolated increase or decrease in the size of a figure or part of a figure in relation to the other figures; shows repeated difficulty in getting parts of fi

behavioral observation

In Bender Visual-Motor Gestalt:
________ ___________
Evidence of fatigue - Insufficient attention to stimulus - Extremely rapid and careless execution - Extreme care and deliberation - Dissatisfaction expressed for poorly executed drawings or repeated uns

Wisconsin Card Sort Test

-Widely used by psychiatrists, neurologists, and neuropsychologists in patients with acquired brain injury, neurodegenerative disease and mental illness; 12-20 minutes to complete
- Patients with any sort of frontal lobe lesion do poorly at the test
- The

Minnesota Multiphasic Personality Inventory (MMPI)

the most widely researched and clinically used of all personality tests. Originally developed to identify emotional disorders (still considered its most appropriate use), this test is now used for many other screening purposes; reliable and valid;
-567 se

Vineland Adaptive Behavior Scales

Assesses personal and social skills in children.
-Communication (receptive, expressive, written)
-Daily living skills (personal, domestic, community)
- Socialization (interpersonal relationships, play and leisure time, coping skills)
- Motor Skills (gross