Psych 470 Exam 2

to begin an intake you first have to

receive referral from healthcare provider or telephone call from client

record reviews look at

past assessments, classwork, office referral, videos of behavior, medical records

case conceptualization

a clinician's comprehensive, ongoing framework for understanding a client's presenting issues, history, and behaviors, integrating assessment data to guide treatment planning

purpose of intelligence test

to observe cognitive abilities and function

purpose of projective test

to observe emotions, worldview, and personality

the MMPI-2 is an example of what kind of test

self-report measures of personality

the MMPI-2 tests for what

psychopathology & social-emotional functioning

personality disorder

an enduring pattern of inner experience & behavior that deviates markedly from the expectations of the individual’s culture

an individual with a personality disorder sees deviations in (at least 2) of the following areas

cognition, affectivity, interpersonal functioning, impulse control

cognition

way of perceiving and interpreting self, other people, and events

affectivity

the range, intensity, lability, and appropriateness of emotional response

multimethod assessment

comprehensive approach that integrates data from various sources to evaluate an individual

the sources looked at in a multimethod assessment

informal data gathering, clinical interview, observations, assessments, tests, inventories

record review

looking at existing documents to evaluate mental health history without examining the client in person

this is what is done after record review

case conceptualization, prepare questions for the interview, prepare assessment measures

the general order of performing a clinical assessment

intake (referral or telephone), send out questionnaires, record review, prepare, behavioral observations, clinical interview, review data, feedback session

semi-structured/unstructured interview

informal styled interview that is geared to interview questions to what the clinician prioritizes

structured interview

formal styled interview that uses questionnaires and is often longer (around 6 hours)

goals for a clinical interview

assess for mental disorder, treatment selection, determine treatment intensity

purpose of tests of socio-emotional problems

clarify emotional/behavioral patterns and guide evidence-based treatment planning

purpose of reviewing the data

review other factors that could effect testing (tired, distracted, loud noises), interpret what data means, intervention recommendations

this is what happens in feedback session

review reasons for assessment and what happened during assessment, go over test results, themes, strengths & weakness, and discuss diagnosis, future steps, and interventions

general criteria for personality disorders

enduring pattern that is engaged everywhere, leads to clinically significant distress, pattern is long duration, not better explained as a result of another mental disorder, not as a result of drug abuse or medical conditions

how to assess someone with a personality disorder

use the most information from widest possible number of sources to lead to most accurate diagnosis; clinical impression, self-report scales, interviews, informant report

criteria for BPD

at least 5 or more of the following criteria:

• frantic efforts to avoid real/imagined abandonment

• unstable and intense interpersonal relationships

• persistent unstable self-image or sense of self

• impulsivity in at least 2 areas that are self-damaging

• recurrent suicidal behavior, gestures, threats, self-harm

• affective instability due to a marked reactivity of mood

• chronic feelings of emptiness

• inappropriate intense anger or difficulty controlling anger

• stress-related paranoid ideation or dissociative symptoms

what do statistics about BPD tell us about BPD

high comorbidity rate with substance abuse and mood disorders, more commonly diagnosed in women in clinical settings

etiology of BPD

early childhood experiences, neglect, abuse, genetics (linked to depression), impaired functioning of limbic system, early trauma

treatments for BPD

mood stabilizing medication (for symptoms), dialectical behavior therapy (DBT)

dialectical behavior therapy (DBT)

multi-component therapy (individual, skills training group, phone cocaching) that targets life-threatening behaviors, therapy interfering behaviors, and quality of life. teaches skills to regulate and tolerate emotions, problem solving, and interpersonal effectiveness

criteria for PTSD

need to meet the criteria for ALL of the following:

• traumatic exposure

• intrusion/re-experiencing (at least 1 of memories, nightmares, flashbacks, distress, or physiological reactions)

• avoidance (1 or both; internal or external)

• alterations in mood and cognitions

• alterations in arousal/reactivity (at least 2)

• symptoms persist 1 month+

• disturbance causes impairment in relationships

• not due to substance or medical condition

depersonalization

sense of being detached from one’s body

derealization

sense of unreality of surroundings

subtypes for PTSD

depersonalization and derealization

specifier for PTSD

delayed onset (full criteria not met until 6 months+ after event)

what happens if you do not met the time criteria for PTSD

may be diagnosed with acute stress disorder as a precursor to PTSD

acute stress disorder

experiences at least 9 symptoms of PTSD and undergone traumatic event, but symptoms have only occurred 3 days — 1 month

adjustment disorder

anxious and/or depressive reactions that develop within 3 months of life stressor, clinically significant distress but does not persist longer than 6 months after exposure to stress

things to keep in mind when looking at PTSD statistics

most people who undergo traumatic events do NOT develop PTSD

how to assess for PTSD

all criterion must be met; clinical interviews, self-report questionnaires, initial screening, comprehensive assessment

factors that increase likelihood of developing PTSD

genetic predispositions (prone to anger, emotional outbursts, HPA axis), demographic variables (women, undocumentation, LGBTQ+)

treatments for PTSD

medications for anxiety and panic attacks, cognitive behavioral treatment (CBT), prolonged exposure therapy, cognitive processing therapy (CPT), eye movement desensitization & reprocessing (EMDR)

difference for PTSD between DSM and ICD

DSM is used in US and does NOT include PTSD; ICD is used internationally, includes re-experiencing of traumatic event(s), avoidance, persistent perceptions of heightened current threat and Complex PTSD includes affect dysregulation, negative self-concept, disturbed relationships

mind set bias

privy to certain biases depending on the clientele you are used to working with

example of mind set bias in the Depp v. Heard trial

Curry: worked with military & civilian clients

Hughes: worked with victims of truama

example of an ethical challenge in the trial

regularly providing testimony in court cases reduces your credibility

hallmark of BPD

instability in interpersonal relationships

difference between memories and flashbacks

memories are more conscious and controlled; flashbacks are involuntary and are a re-experiencing of the event

fear

uncontrollable survival emotion

stress

sense of apprehension about the future

internal avoidance

avoidance of memories, thoughts, or feelings

external avoidance

avoidance of people, places, objects, activities

cognitive-behavioral treatment (CBT)

increases positive coping skills, social support; highly effective talk therapy that helps individuals identify and challenge harmful thought patterns and behaviors

cognitive processing therapy (CPT)

instead of talking about trauma, an individual writes about it