PSYC 353 - Week 4 Tue - Assessment (intro)

Assessment & Diagnosis

• Importance of Assessment

  • Assessment involves collecting and interpreting relevant information about a client.

  • Aids in understanding the individual’s problems which includes predicting behavior, treatment planning, and evaluating treatment response.

  • Provides evidence of a disorder leading to diagnosis while ruling out alternatives.

The 3 P’s of Assessment

• Predict

  • Understand likely future functioning or the course of the disorder (e.g., work performance may indicate stability).

• Plan

  • Involves treatment planning, including identifying essential treatment components and providers (e.g., psychiatry).

• Progress

  • Monitors treatment progress by comparing current symptoms as treatment continues.

Assessment and Treatment Process

1. Intake Interview/Assessment

2. Diagnosis

3. Treatment

Case Examples of Misdiagnosis

• Misdiagnosis examples highlight the importance of thorough assessments:

  • Deafness mistaken for intellectual developmental disorder.

  • Epilepsy misdiagnosed as schizophrenia.

  • Medication reactions misinterpreted as depression.

  • Brain tumors misreported as anorexia nervosa.

  • Externalizing behaviors and depression misdiagnosed as bipolar disorder particularly in people of color.

Assessment Considerations

• After data collection, significance interpretation is crucial for coherent treatment planning.

• Key factors to consider include:

  • The theoretical orientation of the clinician.

  • Potential overemphasis on external situations.

  • Risks of inaccurate data or premature evaluations.

  • Possible cultural bias of the assessment tools or the clinician.

Social Identity Wheel

• Different aspects of identity include:

  • Religious or Spiritual Affiliation

  • Age

  • Physical, Emotional, Developmental (Dis)Ability

  • Race and Ethnicity

  • Socio-Economic Status

  • Gender

  • National Origin

  • Sexual Orientation

• Prompts for reflection:

  1. Identities you think about most and least often.

  2. Identities you want to learn more about and their impact on your self-perception.

In-Class Participation Activity

• Activity on Canvas Quizzes related to the social identity wheel.

• Followed by breakout group discussions to reflect on the experience and insights gained.

Breakout Discussion Prompts

• Discuss experiences of completing the identity wheel, surprises, reflections on visibility and value of identities, and future learning aspirations related to identity.

• Explore relationships with salient identities and perceptions by others based on identity.

The Case of Henry

• Henry, a 19-year-old college student, exhibited odd behavior and preoccupation in class, raising suspicion among peers and faculty.

• His beliefs regarding his classmates and external perceptions reflect deeper psychological concerns.

Cultural Formulation Interview (CFI)

• A structured 16-item interview designed to uncover cultural influences on mental health during assessments.

• Aims to develop an understanding of the client’s narrative of illness and their social context.

Cultural Assessment Interview Protocol (CAIP)

• Involves 9 categories of questions focused on a client’s cultural relationship and its relevance to their concerns.

• Encourages clinicians to reflect on their own assumptions prior to assessments.

Basic Elements of an Intake

• Key aspects to address during an intake:

  • Presenting problem and its context (e.g., situational vs. pervasive symptoms).

  • Prior treatments and their effects.

  • Short-term treatment goals based on future expectations.

Key Assessment Concepts

• Reliability: Consistency of results.

• Validity: Accuracy; matches "truth".

  • Possible scenarios:

    • Reliable and valid.

    • Reliable but not valid.

    • Neither reliable nor valid.

Standardization in Assessment

• Scores more than 2 standard deviations from the mean are considered significantly different.

• Standardization enables normative and self-referent comparisons.

Types of Assessment

• Clinical Interviews: Forms include structured, semi-structured, and unstructured formats.

  • Mental Status Exam: Inquiries and observations assessing psychological functioning (e.g., awareness, mood, behavior).

Important Assessment Types

• Specific instruments for adults, such as the Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5) and the Clinician Interview Schedule.