Abnormal Psychology Chapter 3

Front 1

Assessment

Back 1

Is the process of gathering information about people symptoms and causes of symptoms? .

-fist we use interviewing as a tool.

2types:

- interviewing consists of unstructured open-ended questions.

-- Allow us to respond to the client and get information.

- Also structured set of questions / standardized. Mini / mental status exam. Structure diagnostic interview.

--decrease biase. Make sure that we Hit eats topic or question with the client.

Front 2

Sample of clinical review / structured prompts and information gathering

Back 2

● symptoms and presenting complaint:

- Functioning, positive and negative ways of coping, family history and current social support, social cultural context and access to resources, history of SMI, head injury, Hi, SI, ask psychiatric TX or hospitalization, physical health status / most recent physical health exam.

- the more specific The Prompt the more it is a structured interview.

Front 3

Intelligence test

Back 3

• intelligence test

- WAIS, WISC.

- achievement tests for learning disability

• G Factor vs. Multiple intelligences: We base intelligence off of One's knowledge of vocabulary. When there are multiple different types of intelligences that aren't considered.

- In the US, you generally come up with a full-scale IQ and then and IQ for overall verbal and overall performance.

Front 4

Assessment tools / neurological

Back 4

• physiological and neuropsychological Test to detect brain activity or injury.

- psysiological tests: EX: EEG / electrical activity along the scalp

-bendrt-gestalt Showing people simple shapes and having them Try to replicate them. If it's not the same Its an indactor.

-neroimaging: CT-3D, enhance x-ray of brain structure. Pet, picture of activity in brain. MRI, less dangerous no radiation or injections and more detailed images of brain anatomy structural or activity functional.

Front 5

Assessment tools, clinical tests, questionnaires, and inventories

Back 5

symptom questionnaire / self-report scales. Quick assessment of symptoms and severity of distress or impairment.

EX: BSI- brief symptom inventory, BDI- Beck depression inventory. PLC- post-traumatic stress disorder.

- We do use symptom questionnaires to give us a quick snapshot of someone symptoms, levels and thier distress.

Front 6

Self-report tools pros and cons

Back 6

•pros:

- standardized with Norm's from large samples of different populations.

- quick to administer

•Cons:

- Self-report accuracy is questionable.

- perception of individual versus clinician.

Front 7

Assessment tools / personality inventories and projective tests

Back 7

•Personality inventories are used to assess people's typical ways of thinking, feeling, and behaving. Often used for. Forensic evaluations.

-MMPI: structured / standardized. Mmpi-2 567 True or fauls items , mmpi-2- FR- 338 items.

- 10 clinician scales, for validity scales.

• projective tests are ambiguous stimuli / unconscious response.

-Rorschach (inknlot test)

-thematic aptitude testl

Front 8

Chemical test / questionnaire / inventories

Back 8

Validity: Does this tester tool measure what it is intended to measure?

-face: the idea that the test measures what it supposed to measure.

-content: Is that assesses all the aspects of that construct. Includes an affective component and behavioral component

-concurrent: Is whether the test gives the same results as other tools that measure the same thing.

-predictive: predicting future Behavior.

-construct: That this really is measuring the idea.

Reliability: Is it consistent? If we measure this in different ways, do we get the same answer?

- test reset: seeing the score or answers or results From one week to the next week are the same or close to the same. Testing one week and then testing again the next week.

-alternate form: an alternative test to see if the outcome will be similar.

-internal interrater or interjudge: Is do all those items on the measure hang together?

Front 9

Behavioral observations and self-monitoring The clinician would observe.

Back 9

- appearance:

- energy level:

- Speech rate.:

- insight into thier problem:

Front 10

Problems in assessment

Back 10

- Being thoughtful about who you are evaluating.

Ex: evaluating childre: difficulties in communication, reporting. parent reporting Maybe inaccurate. Over and under report.

- cultural biases / language barrier. Different cultures Express different psychological disorders differently. May or my not effect the willingness to talk about emotions.

Front 11

Diagnosis continued DSM ICD

Back 11

-1841- one category- idiocy / Insanity for purpose of CENSUS KEEPING: People being labeled as sane or insane.

- Subsequently to that we have seven different categories of Mental Health. Conditions and where we really saw that get bra in what's after World War II.

- categories brought in by the Army after World War II.

- After that is when we saw our first DSM and ICD.

--- the DSM-5 Was published in 2013? And had 265 diagnosis.

--- International classification of disease ICD-11 release June 2018 for testing. And is now in current used by most countries.

Front 12

Diagnosis

Back 12

• Is a label that we attach to a set of symptoms that tend to co-worker with one another. / syndrome.

• the diagnostic and statistical manual DSM:

- DSM-5 2013: clinically significant disturbance in an individual's cognition, Emotion regulation, or behavior that reflects a dysfunction in the psychological, biological or developmental processes underlying mental functioning.

- ICD- 2018: can you please significant disturbance in an individual's cognitive, emotional regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes that underlie mental and behavioral functioning. These disturbances are usually associated with distress. Or impairment in personal, Family, Social, educational, occupational, or other important areas of functioning. ICD is used in most of the world.

Front 13

ICD vs. DSM

Back 13

ICD:

- The International System was produced. Or is produced by a global health agency that has a public health mission.

- And to Global, it's multidisciplinary, So it is not informed. So Lyon. Psychiatry and psychology, it's much broader than that.

- multilingual so they're taking multiple languages into account.

- is approved by the World Health assembly with health ministers from the different countries.

- Meant to be affordable and is it free online

DSM:

- the document reuse, is produced by a single National professional association, the American psychiatrists, so those are people with MDs who focus on Mental Health?.

- predominantly determined by us psychiatrist.

- They create task force for each disorder and there are psychologists included. On that and social workers, but the decision makers are the US psychiatrist.

- approved by the Assembly of the American Psychiatric Association.

- meant to be profitable / not free.

- most popular in the United States.

Front 14

DSM diagnosis/ multiaxial system

Back 14

- in 1980, DSM developed the multiaxial system for diagnosis and health, current stressors, and level of functioning. Was in place until 2013 when it was moved from the DSM-5.

• axis 1: most disorders, list primary disorder first / reason for visit.

• axis 2: personality disorders and mental retardation / chronic conditions.

• axis 3: General medical conditions.

• access for psychological and environmental problems.

• axis 5: Global assessment of functioning (GAF)

-- Because of the lack of reliability they went to a different way of trying to communicate impairment of functioning.

* This is not used anymore, but there are people who are trained in it and still use it.

Front 15

WHODAS impaired functioning

Back 15

World Health Organization disability assessment schedule. (WHODAS) 2.0.3 assess ability to perform in 6 domains:

• domain one cognition / understanding and communicating.

•Domain 2: Mobility / moving and getting around.

•Domain 3: self-care / hygiene, dressing, eating, staying alone, Etc. •Domain 4: getting along / interacting with others.

•Domain 5: life activities / domestic responsibilities, Leisure, work, and school.

•Domain 6: participation / joining and community activities, participating in society, Etc.

○ The severity is then rated.

1. no impairment.

2. mild impairment

3. moderate impairment

4.severe impairment

5. extreme impairment / unable to function

Front 16

Things to consider in diagnosis

Back 16

• categorical symptoms versus continuum: Looks kind of symptoms are on a continuum. The extent of sadness, difficulty sleeping,... rather than yes / no.

•Comorbility:

• research bias for disorders: every research vs. light research that need to be considered.

• variations in presentation of symptoms across cultures:need to be thoughtfull about culter variations.

Front 17

Pros and cons of diagnosis

Back 17

PROS:

- With diagnosis you can get services.

- children need a diagnosis to get an IEP for an individual education.

- need to get their health insurance to cover treatment whether it's Psychotherapy or medication.

- If we group of people together with a label, we may be able to better understand that diagnosis.

* people serve a purpose often times in creating access to services.

CONS:

- The stigma that comes along with being labeled with a diagnosis.

- the validity.

Front 18

Alternative classification approaches

Back 18

• Research Dynamic criteria is a research framework for studying mental illness. A proposed by the NIMH. Focuses on studying dysfunction and biological psychological systems.

• study domains of human behavior and functioning.

- negative valence systems: Responses to adverse of situations or context, such as fear, anxiety and loss.

- positive valence systems: Responses to positive motivational situations or context, such as reward seeking, and reward / habit learning.

- cognitive systems: awareness, cognitive control / goal-directed Behavior, working memory.

- systems for social processes: attachment, processing of social cues, motivation.

- arousal / regulatory systems: circadian rhythm, sleep / wakefulness.

- sensorimotor systems: motor control, development and refinement.

Front 19

RDoC

Back 19

Study domains of human behavior and functioning across the levels of analysis. Strong biological part.

• units of analysis

- Gene's

-molecules

-cells

- circuits

- psychology

- Behavior

-self-reports

-paradigms