chapter 3 clinical assessment slides & handouts by karen clay rhines, ph.d. seton hall...
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Chapter 3Chapter 3
Clinical Assessment
Slides & Handouts by Karen Clay Rhines, Ph.D.Seton Hall University
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Clinical AssessmentClinical Assessment
• ______________: to determine how and why a person is behaving abnormally
• tools:– ____________– Tests– _________________
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Clinical InterviewsClinical Interviews• Face-to-face encounters • personal history• Conducting the Interview
– Focus depends on _______________– _________ interviews: open-ended
questions– structured interviews: ______
questions– May include __________________
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Mental Status Examination:Mental Status Examination:
Appearance and Appearance and BehaviorBehavior
Hyperactivity Psychomotor agitation Psychomotor retardation Catatonia Compulsions
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Mental Status ExaminationMental Status Examination
Content of ThoughtContent of Thought
• _______________• Delusions• _______________• ______ Thinking
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Mental Status ExaminationMental Status Examination
Affect and MoodAffect and Mood
• Affect: _________________________o Inappropriateo Blunted or Flato Exaggerated, Heightened, or
Overdramatico Decreased Mobilityo Excessive Mobilityo Restricted Range
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Mental Status ExaminationMental Status Examination
Affect and MoodAffect and Mood
• Mood: ________________________Euthymic = _____________________________ = Unpleasant feelings_______ = Cheerful, elated, possibly even ecstatic
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Mental Status ExaminationMental Status Examination
Perceptual Perceptual ExperiencesExperiences
• Hallucination: _________________
Auditory Command
Visual Olfactory Somatic Gustatory
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Mental Status ExaminationMental Status Examination
OrientationOrientation
Clip art copyright © 2005 www.clipart.com. Used with permission.
• Time• Place• Identity
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Mental Status ExaminationMental Status Examination
Thinking Style & Thinking Style & LanguageLanguage• incoherence: speech that
is ____________________.• loosening of
associations: flow of thoughts that is ___________________________________.
• _______ thinking: thinking characterized by contradictions and erroneous conclusions.
• _______________: going completely off track and never returning to the point.
• _____________: speech that is indirect and delayed in reaching a point because of irrelevant and tedious details.
• ________: the experience in which a person seemingly “loses” a thought in the midst of speaking, leading to seconds or minutes of silence
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• __________: sound, rather than word meaning, determines content of individual’s speech.
• ____________: fabricating facts or events to fill in voids in one’s memory; not conscious lies but attempts to respond with approximations of the truth.
• ___________: persistent repetition of someone else’s words or phrases, as if mocking or sarcastic.
• ____________: fact-paced speech marked by acceleration, abrupt changes of topic, and plays on words.
• _________ of speech: speech rapid and driven, as if individual is compelled to utter stream of nonstop monologue.
• perseveration: _________ of the same idea, word, or sound.
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Mental Status Mental Status ExaminationExamination
o Motivationo impairment can
make even ordinary life tasks seem insurmountable.
• Sense of Self (sense of who I am)– Depersonalization – Identity confusion
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Mental Status ExaminationMental Status Examination
Cognitive Functioning:
• Level of ___________ evidenced by details such as memory and abstract ability.
• Problems might include __________ impairment
Insight and Judgment:
• ____________________________________.
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Characteristics of Assessment Characteristics of Assessment ToolsTools
• _______________ : performance serves as a common standard (norm)
• Reliability – _______________• _________ – accuracy of results
– measures what it is supposed to be measuring
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Clinical TestsClinical Tests
Intelligence Tests assess both verbal and non-verbal
skills Generates an intelligence quotient
(IQ) Most popular: Wechsler (WAIS,
WISC)
I.Q. I.Q. =Mental Age
Chronological Age
Mental Age
Chronological Age X 100
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Clinical TestsClinical Tests Personality Inventories
– measure broad personality characteristics– Minnesota Multiphasic Personality Inventory
(MMPI)• Derives ten clinical scales:
– Hypochondriasis (HS)– Depression (D)– Conversion hysteria (Hy)– Psychopathic deviate (PD)– Masculinity-femininity (Mf) Paranoia (Pa)– Psychasthenia (Pt)– Schizophrenia (Sc)– Hypomania (Ma)– Social introversion (Si)
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Clinical TestsClinical Tests
Response Inventories – ________________________________
• Affective inventories (Ex. BDI)• Social skill inventories• Cognitive inventories
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Clinical TestsClinical Tests
• Projective tests– ______________________________________
__________________________•Rorschach Inkblots•Thematic Apperception Test•Sentence Completion•Drawings
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Rorschach InkblotRorschach Inkblot
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Behavioral Behavioral Assessment Assessment
• Behavioral Self-Reports– Behavioral
Interviewing– ________________– Behavioral
Checklists and Inventories
• Behavioral Observation – ________– _______
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Environmental Environmental AssessmentAssessment
Environmental Assessment:
A form of measurement examining the _________________________________________________.
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Physiological Physiological AssessmentAssessment
Many psychological disorders occur in the presence of ______________________________
Disturbances may be:– localized in brain, perhaps as _________________ or– _______________ (e.g., diabetes, AIDS) that may alter
psychological functioning.
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Physiological AssessmentPhysiological Assessment
• Psychophysiological techniques
– Measure ______________ response•HR, BP,
temperature, etc.• Most popular =
_______________________________)
• Physiological Techniques (_______ assess brain function) – Brain Imaging:
•EEG, CT, MRI, PET
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Neuropsychological Neuropsychological AssessmentAssessment
Neuropsychological assessment:
____________ assess brain function by assessing cognitive, perceptual, & motor functioning– Most widely used =
Bender-Gestalt