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assesement edith - Psychological Assessment Diagnosis...

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Unformatted text preview: Psychological Assessment Diagnosis Diagnosis Psychotherapy I. Purposes of Assessment I. 1. Differential diagnosis 2. Description of the problem 3. Comparison to normative data 4. Design and evaluation of intervention (therapy) II. Some General Principles of Assessment II. Norm-based assessment unique to Clinical Psychology. Clinical Content of assessment battery (typically) a) History – general and a) problem-specific problem-specific b) Cognitive functioning c) Psychoemotional functioning d) Context III. Clinical Interviews III. Most common assessment method A) Assets: 1. Flexible 2. Relationship building 3. Obtain client perspective of problem 4. Opportunity for therapist input 5. Opportunity for observation 6. Efficient way to obtain diagnostic information. B) Liabilities of Interviews 1. Unreliable (!!) 2. Client may withhold information face-to-face 3. Unstandardized 3. 4. Evidence of weak validity IV. Cognitive Tests IV. A) Intelligence tests 1. measure: 1. verbal and nonverbal reasoning abstract concept formation acquired knowledge 2. standardized, reliable, and valid 2. 3. individual administered and interpreted 3. B) Neuropsychological tests 1. tasks that most people can perform 1. 2. visual-motor, perceptual-motor abilities 2. 3. aphasia and language problems 3. 4. memory 4. V. Psycho-emotional and Personality Tests V. A) “Objective” Tests e.g., MMPI, symptom-related inventories unambiguous stimuli and non-inferential scoring usually normed and validated Clinical Test: MMPI Clinical Minnesota Multiphasic Personality Inventory Comprised of ten clinical scales: Hypochondriasis (HS) Depression (D) Conversion hysteria (Hy) Psychopathic deviate (PD) Masculinity-femininity (Mf) Paranoia (P) Psychasthenia (Pt) Schizophrenia (Sc) Hypomania (Ma) Social introversion (Si) Scores range from 0 – 120 Above 70 = deviant Graphed to create a “profile” B) “Projective” Tests B) e.g., Rorschach, TAT, sentence e.g., completion completion the “projective hypothesis” ambiguous stimuli and inferential scoring ambiguous informal norms and weak validity VI. Behavioral Observation VI. A) Uses 1. functional analysis 2. assess symptoms in context B) Procedures 1. Outsider observation - in vivo and analogue - “objective” - limited utility 2. Self monitoring - usually in vivo, widely applicable - subject to distortions - alters behavior Diagnosis: DSM-IV Diagnosis: Diagnostic and Statistical Manual of Mental Disorders – Diagnostic Fourth version Fourth Published in 1994, revised slightly in 2000 Lists approximately 400 disorders Listed in the inside back flap of your text Describes criteria for diagnoses, key clinical features, Describes and related features which are often but not always present present People can be diagnosed with multiple disorders People (comorbidity) (comorbidity) DSM-IV: Multiaxial DSM-IV: Uses 5 axes (branches of information) Uses Axis I Axis Axis II Most frequently diagnosed disorders except personality disorders and Most mental retardation mental Personality disorders and mental retardation Long-standing problems Relevant general medical conditions Relevant Psychosocial and environmental problems Global assessment of psychological, social, and occupational Global functioning (GAF) functioning Current functioning and highest functioning in the Current past year past 0–100 scale Axis III Axis IV Axis V Diagnosis Diagnosis Advantages of Diagnostic System 1. Arranges symptoms into coherent clusters 2. Allows for prediction to other domains 3. Communication among professionals Disadvantages of Diagnostic System 1. Self-fulfilling prophecy 2. Dangers of misdiagnosis 3. Stigma 4. Often does not guide treatment Evaluation of Psychotherapy Effectiveness Effectiveness Eysenck (1952): Concluded therapy was no more effective than no therapy Smith and Glass (1970s) Meta-analysis of research - average person in Rx better off than 75% of controls Gordon Paul: Gordon “What Rx, for what problem, by what therapist, at what time, etc. ?” ...
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