psych 337: assessment & diagnosis

reliability

able to get same results multiple times, consistency

internal consistency

degree to which items on scale r assessing same construct

test-retest reliability

whether test gives similiar value over time span

inter-rater reliability

subjective judgement— how similiar raters will be comparitively

content validity

degree to which content/criteria of diagnosis/test covers all relevant parts of factor/condition it aims to measure

• ex: bipolar test gages both manic & depressive aspects of bipolar

criterion validity

evaluates how closely results of test align w/ real world standard/outcome

• making sure ur anxiety test matches results w/ alr established anxiety test or depresive (PHQ9)

face validity

extent to which test is subjectively viewed as covering concept it attempts to measure

standardization & 3 benefits

equal distribution & process & testing of results in order to have better reliability, facilitates accurate comparisons, establishes validity

MMPI: significance & characteristics

personality questionaire, empirical data received to be analyzed in straight-forward manner

• low face validity

hernan rorschach

projective tests: leave tests up to patient to intepret to supposedly release unconscious thoughts

thematic apperception tests

another type of projective test— storytelling of photos reveal subconsciousness

what is focus of behavioral assessment

focus on abc’s— antecedents, behavior, consequences

behavioral self-monitoring forms

could potentially help someone quit by analyzing & keeping track of self-behavior

ex: daily cigarette load

neuropsychological assessment

asses cogn functions, behaviors & emotional. functioning to identify potetnial neuro or psych conditions

diff types of neuropsych test batteries

bender visual motor gestalt test, mini-mental state examination, luria-nebraska & halstead reitan tests

bender visual-motor gestalt test

very simple, kid has to copy whats drawn on card— doesn’t account for good localizing of error in cogntive processes

luria-nebraska & halstead-reitan tests

2 most popular/advanced tests— have variety of test: grip tests, blocks, rhythm tests

wechsler adult intelligenve scale-5 components

verbal IQ (VIQ) & performance IQ (PIQ)

• VIQ: verbal comprehension index (VIC)

  • vocab, phrase comprehension

  • working memory index (WMI)

    • arithmetic, digit sequencing

• PIQ: perceptual organization index (POI)

  • puzzles, block fit

• processing speed index: PSI

  • time at which u can process things

consequences of stroke

slow processing speed, memory issues, aphasia (L hemisphere), hemispatial neglect (R hemisphere)

closed-head injury/TBI’s consequences: behavioral

impulsivity, lack of self awareness of issues, exaggerated emotional display, irritability

TBI cognitive consequences

damage to selective & sustained attention, executive function, motivation/apathy & memory

2 types of neuroimaging

structural (anatomical) & functional (brain activity & functions)

CT scan

quick & easy, uses x-rays (radiation) to create detailed cross sectional of internal, has poor resolution

MRI

powerful magnets & radio waves to get detailed internal scan, safer than CT bc no radiation

PET scan

radioative tracer to look at brain activity, increased/decreased metabolic activtiy observed

MRA scan

uses powerful magnetic fields & radio waves to generate images of blood vessels

psychophysioogical testing

recording & quantifying varios responses in controlled condiitons using electromedical equipment

biofeedback

u feed responses back to someone so they’re able to train their body to phsyiologically alter response, ex: decreased muscle tension after stimuli

EEG

non-invasive way of looking at fucntional activity thru brain waves & u can average EEG signals time-locked to specific events, revelas how brain repsonds to stimuli

3 steps for clinical applications of psychological assessment

1. treatment planning

2. admision to standardized treatment planning

3. legal assessment of function & loss to procede for future use

sources of assesment info

client file, referral letter, family members description, clinical interview, test results

importance of clinical review: diff types too

structured (better for legal proceedings) vs unstructured

• used to understand history of patient, current issues, larger contextual info

• can use mental status exam

mental status exam: what does it evaluate?

evaluates

• physical appearance

• thought processes

• mood & affect

• intellectual functioning

• sensorium: awareness to space around them

Mr. L case study: conversion disorder

showed no signs of affective concern over symptoms

taxonomy

classification of groups for use— referred to an nosology in clinical/medical terms

nomenclature

term for range of language available to medical professionals to allow clear, targeted communication

classical approach to diagnosis

assumption that every diagnosis has clear underlying patholoigcal cause— not good for mental health criteria

• not much overlap btwn disorders’ criteria

dimensional approach

quantifying client’s problems along several dimensions

prototypical approach

identifies certain essential & non-essential variatioms that don’t change classifications, no underlying pathogens

• best for mental health— fuzzy categorization

emil kraeplin

known for introducing key diagnostic categories

• dementia praecoz— ealry dementia, now schizophrenia

• manic-depressive insanity— now bipolar disorder

DSM variations

provides diagnostic criteria

• DSM I: very concise

• DSM II: psychoanalytic theory influence

• DSM III: much more empirically-based evidence

  • multi-axial diagnosis— assesment of clients on diff dimensions—now rejected

• DSM IV: elevated rigor of research underpinning classifications

• DSM V: current, still has some improvements to be made

criticism of DSM:

can medicalize normal symptoms— over-diagnosing

cultural biases