Assessing Psychological Disorders

Clinical assessment: systematic evaluation and measurement * Psychological * Biological * Social
Diagnosis: degree of fit between symptoms and diagnostic criteria
Purpose: understanding the individual, predicting behavior, treatment planning, evaluating outcomes

Reliability: degree of consistency of a measurement
Validity: does the test measure what it’s supposed to? * Concurrent: comparison between results of one assessment with another measure known to be valid * Predictive: how well the assessment predicts outcomes
Standardization: consistent use of techniques * Provides normative population data

Clinical interview: asses multiple domains * Presenting problem * Current and past behavior * Detailed history * Attitudes and emotions
Most common clinical assessment method
Structured vs semistructured

Components of mental status exam: appearance and behavior, thought processes, mood and affect, intellectual functioning, and sensorium * Appearance and behavior: overt behavior, attire, posture, expressions * Thought processes: rate of speech, continuity of speech, content of speech * Mood and affect: predominant feeling state of the individual, feeling state accompanying what individual says * Intellectual functioning: type of vocabulary, use of abstractions and metaphors * Sensorium: awareness of surroundings in terms of person (self and clinician), time, and place

Physical examinations can be helpful in diagnosing mental health problems * Understand and rule out physical etiologies * Toxicities * Medication side effects * Allergic reactions * Metabolic conditions

Identification and observation of target behaviors * Target behavior: behavior of interest
Direct observation conducted by assessor or by individual or loved one
Goal: determine that factors that are influencing target behaviors
The ABCs of observation: antecedents, behavior, consequences
Self-monitoring: when an individual observes themself
May be informal or formal
The problem of reactivity: simple observing a behavior may cause it to change due to the individual’s knowledge of being observed

Specific tools for assessment of cognition, behavior, and emotion
Include specialized areas like personality and intelligence
Projective tests: project aspects of personality onto ambiguous test stimuli * Rooted in psychoanalytic tradition * Used to assess unconscious processes * Require high degree of inference in scoring and interpretation
Objective tests: tests stimuli are less ambiguous * Rooted in empirical tradition * Requires minimal clinical inference in scoring and interpretation
Personality tests * Minnesota Multiphase Personality Inventory (MMPI) * Extensive reliability, validity, and normative database
Intelligence tests: nature of intellectual functioning and IQ