CHAPTER 4 hang - PSY 339 CHAPTER 4 ASSESSMENT DIAGNOSIS...

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PSY 339 – CHAPTER 4 – ASSESSMENT, DIAGNOSIS, & TREATMENT CLINICAL ISSUES The Decision-Making Process Clinical assessments – use of systematic problem-solving strategies to understand children w/ disturbances & their family & school environments o Ultimate goal : achieve effective solutions to the problems being faced, & to enhance the child & family’s well- being A close & continuing partnership between assessment & intervention is vital Idiographic case formulation – detailed information about the individual child/family Nomothetic formuation – general inferences which apply to large groups of individuals Nomothetic knowledge aids in forming hypotheses at the idiographic level Developmental Considerations Age, Gender, & Culture Age, gender, & culture all have important implications when judging deviancy & selecting the most appropriate assessment/treatment Gender : o boys receive an excess of referrals due to having common disorders with more visible symptoms while girls are often overlooked o when angry, girls show their anger indirectly: verbal insults, ostracism, gossip, relational aggression (3 rd party retaliation) o children who engage in forms of social aggression not typical of their sex are significantly more maladjusted relationally aggressive boys & overtly aggressive girls Culture : o Culture can include : Ethnicity •language •religious/spiritual beliefs Race •gender •SES Age •group history •sexual orientation Education/upbringing •geographic origin Life experiences o Ethnic minority youth have a greater risk of being misdiagnosed & less likely to receive treatment o Culture-bound syndromes – recurrent patterns of maladaptive behaviors &/or troubling experiences specifically associated with different cultures/localities Rarely fit neatly into a western diagnosis o Data on validity of Western diagnosis criteria across cultures is lacking for many childhood disorders o Cultures define which coping styles are acceptable and which behaviors are problems o Acculturation (cultural assimilation) level can significantly impact assessment & intervention Lower acculturation level increased scores on psychopathology measures o “optimal functioning” may mean different things for different cultures Normative Information Usually, it’s the age appropriateness & pattern of symptoms that define childhood disorders o Not individual symptoms Symptoms that occur more frequently in referred children :
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o o All these occur in less extreme forms in normal children Purposes of Assessment Description & Diagnosis Clinical description – summarizes the unique behaviors, thoughts, & feelings that make-up the features of the child’s psychological disorder o Intensity, frequency, & severity of the problem o Age of onset & duration of the problem o Different symptoms & their configuration Diagnosis – analyzing information & drawing conclusions about the nature/cause of the problem, or assigning a
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