chapter 3 - assessment & diagnosis classification = ordering & grouping
TRANSCRIPT
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Chapter 3 - Assessment & Diagnosis
• Classification = ordering & grouping
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Advantages of Classification
• Means of communication
• Labels help to condense & order info
• To guide treatment strategies
• To facilitate research
• Etiology & progression of disorder
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Disadvantages of Classification
• Self-fulfilling prophecies & stigma
- Rosenhan (1973)
- Pygmalion in the classroom (“bloomers”)
• Overlooking other important problems
- aspects not typical of a diagnosis
e.g., CD & depression
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Disadvantages, cont.
• Automatically label those who seek help
• Focus on weaknesses vs. strengths
• Categories = less individual information
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DSM-IV-TR
• The most widely used system
• Pros
- reliable
- based on research (validity)
- communication
- atheoretical
- multiaxial
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DSM axes
I. Clinical disorders
II Personality/enduring problems
III. Medical problems
IV. Environment/psychosocial
V. Global assessment
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DSM Cons• Disorders created by committee• Labels => stigma• Culture-bound• No treatment suggestions• No causes• Focus on problems• Most axes rarely used-> reduces person to one disorder
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Reliability & Validity
Reliability - consistency
1. Internal consistency
- over all the items
2. Test-retest reliability
- over time
3. Interrater reliability
- over raters
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Validity - test measures what it purports to1. Content - covers much of the trait2. Concurrent - correlates with other
measures of the trait3. Predictive - predicts other measures of
the trait{Concurrent & Predictive are both criterion}
4. Construct - test supports theory5. Face - looks like what it measures
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Interviews Clinical interview
• First step
• Talk to client
• Not reliable across examiners
• Valid
• Good for rapport
• Nonverbal behavior
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• Structured Interviews - decision trees
- for diagnosis
• Mental Status Exam - brief measure ofcognitive functioning
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Intelligence Tests
Reasons to use
• Mental abilities affect other problems?
• Strengths & weaknesses
• General functioning
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Problems
• Cultural bias
• IQ = small part of intelligence
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Personality Tests
Objective & Projective
Objective Tests
• unambiguous
• reliably interpreted
• usually self-report
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Multi-Trait Scales
MMPI - 567 items
• normed on psychiatric patients
• items distinguished patient groups
• 10 clinical scales & 3 validity scales
• patterns suggest disorders & malingering
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Other multi-trait scales
• MCMI (personality disorders)
• Child Behavior Checklist
• Strong Vocational Interest Test
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Single-trait self-report scales
• Many scales
ex. BDI
• Face-valid
• Good reliability & validity
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Projective Tests • Ambiguous stimuli
-> responses reflect person• “Project” psyche onto stimuli• Given by trained person• Interpretations differ (? reliability)• ?Validity• Difficult to research• Used for getting ideas
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Rorschach Inkblot Test
• Scoring system (reliability)
• More validity research
• Good for psychosis
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Thematic Apperception Test -TAT
• Ambiguous scenes
• Pattern of responses
• Scoring system seldom used
• Not reliable (subjective)
• Suggests ideas
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Neuropsychological Tests
• Brain damage & deterioration
• Measures cognitive processes perception, memory, attention
• Includes IQ testing
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Behavioral Assessment
Focus on problem behavior
• Antecedent conditions
• Problem description
• Person’s response
• Result of response
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Leads to treatment
• Self-rating
- person monitors own behavior
• Analogue Measures
- simulate the problem in clinic/laboratory