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Clinical Assessment and Diagnosis Flashcards

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7303889605Clinical assessmentSystematic evaluation and measurement of psychological, biological, and social factors in an individual presenting with a possible psychological disorder0
7303889606DiagnosisProcess of determining whether the particular problem afflicting the individual meets all criteria for a psychological disorder, as set forth in the fifth edition of DSM; degree of fit between symptoms and diagnostic criteria1
7304002350ReliabilityThe degree to which a measurement is consistent; "agreement" between two different testing times or between two different evaluators2
7304002351ValidityWhether something measures what it is designed to measure; does the test measure what it's supposed to?3
7304002352Concurrent/ descriptive validitycomparison between results of one assessment with another measure known to be valid,4
7304002353predictive validityhow well the assessment predicts outcomes5
7304002354StandardizationProcess by which a certain set of standards or norms is determined for a technique to make its use consistent across different measures6
7304002355Mental status examorganize information obtained during clinical interview, appearance/behavior, thought process, mood/affect, intellectual functioning, sensorium7
7304002356delusions of persecutionsomeone thinks people are after him and out to get him all the time8
7304002357delusions of grandeurindividual thinks she is all-powerful in some way9
7304002358ideas of referenceeverything everyone else does relates back to the individual10
7304002359Halls cinationsthings a person sees or hears when they aren't really there11
7304002360SensoriumRefers to our general awareness of our surroundings12
7304050714Anxiety and Related Disorders interview schedule for DSM-5interview schedule to asses anxiety in a patient13
7304050715Behavioral assessmentUsing direct observation to formally assess an individuals thoughts, feelings, and behavior in specific situations or contexts14
7316085527What is the purpose of assessing psychological disorders?understanding the individual, predicting behavior (best predictor of future behavior is past behavior), treatment planning, evaluating outcomes15
7316092180What is the funnel analogy of how to do an assessment?broad multidimensional start, narrows to specific problems in sessions16
7316104057Interrater reliability?consistency of raters to get the same assessment on a patient, ensure two or more raters will get the same answers17
7316107276Test-retest-reliability?consistency of tests across time, the test should give a similar result on Tuesday and Thursday o the same week etc.18
7316129616construct validitydegree to which test or item measures the unobservable construct it claims to measure19
7316134986Discriminant validitymaking sure you are measuring something different then opposite tests; example making sure IQ and depression test are different because they want to measure different things20
7316143737What is face-validity?does the test appear to measure what is is trying to measure? can suck because patients can figure out how to cheat the system21
7316158601What are things kept constant for standardization?consistent techniques (administration procedures), scoring, and evaluation data22
7316160613What is population normative data?a lot of tests correct for age, education, race; data specific for Caucasian, female, 20 years old, educated etc to compare patients data too23
7316171034What does a clinical interview focus on? Listed?presenting problem, current and past behavior, detailed history, attitudes/emotions24
7316178522What is the first thing to tell a patient that comes in your office?informed consent, that defines the limits of confidentiality, HIPPA etc.25
7316181505What are the reasons a psychologist will release notes?court ordered (can sometimes squash), danger to self/others (have to go further and warn people), child or elder abuse, insurance codes for coverage as well26
7316192744What should you ask about the presenting problem?Why did you come in?, chronic/acute onset, constant/fluctuating symptoms, previous diagnosis?, past trauma?,27
7316201349What kind of history do you want on a patient?family history of problems, location of living, work history (good idea of everyday), sleep/medical history, medication (even herbal supplements), social interactions, substance use **** maybe more ****28
7316234589What should you look for in appearance/behavior in mental status exam?notice hygeine, dress (appropriate or not), notice body language for rapport (harmonious connection), eye contact29
7316243104How should you look for thought processes in Mental Status Exam?is it goal-oriented, language is fluent?30
7316246156What is mood/affect in Mental status exam?mood is what somebody reports feeling and affect is how you observe their feelings, if they report feeling depressed and they are crying their mood and affect are congruent; if they say they are feeling sad and are laughing then their mood is incongruent31
7316257428How can you judge intellectual functioning in Mental Status Exam?look at their grammar, syntax, use of language etc; want to make sure y'all are understanding each other32
7316260999How do you judge sensorium in Mental Status Exam?person, place, time, situation (why they are here?); it is their understanding of the orientation in that instant33
7316280435What is a physical examination needed?mostly left to medical provider, understand toxicities (asbestos), medication side effects, allergic reactions, and metabolic conditions; to help rule out physical etiologies with mental health34
7316291529What is behavioral observation focused on?identification and observation of target behaviors; goal is to determine the factors that are influencing target behaviors , usually done by direct observation35
7316298248What are the ABC's of observation?antecedents- what precedes behavior; behavior- what are they doing?; and consequences- what is the reinforcement, etc that happens after behavior36
7316308767What is self-monitoring method in behavioral observation?patient itself looks to notice what happens before, during, and after a particular behavior to understand better; usually conjoined with some coping mechanism from therapist37
7316313830What is the problem of reactivity?simply observing a behavior may cause it to change due to the individual's knowledge of being observed38
7316323534What are assessment of psychological testing of?cognition, emotion, behavior39
7316326801What areas of specialty are psychology testing include?personality and intelligence40
7316329981What is projective tests?psychological testing, rooted in psychoanalytic tradition, used to assess unconscious processes, project aspects of personality onto ambiguous test stimuli, requires high degree of inference though; example is Rorschach inkblot test, and Thematic apperception test41
7316337926What is a Rorschach test?inkblot test, not used as much because people can prepare for them, idea is you project personality to what you see in inkblots, there is an objective scoring system that is tedious, issue is interrater validity42
7316347643What is a Thematic apperception test?project tests, look at a picture and try to understand what it shows, ask the person to tell a dramatic story about the picture; social cognition and object relations scale for results,43
7385716535How are IQ tests scored?Mental age was determined and divided by chronological age44
7316354029What are two projection tests that are used a lot with kids?incomplete sentence tests, and house/tree/person drawings45
7316357461What are the strengths and criticisms of projective tests?strength is a useful icebreaker, one way to gather qualitative data; but it is hard to standardize, reliability and validity data tend to be mixed46
7316365890What are objective tests?roots in empirical tradition, test stimuli are less ambigious, require minimal clinical interference in scoring and interpretation47
7316368459What personality test is mostly used now?Minnesota Multiphasic Personality Inventory (MMPI), extensive reliability, validity, and normative database; 567 items on test, true/false responses, and interpretation has individual scales and profiles48
7316377897What is an intelligence test?nature of intellectual functioning and IQ, originally developed as a measure of children's performance diverged from others in grade; psychological objective test; has Weshler scale; usually measure working memory49
7316383981What is deviation IQ?compare a person's scores against those of other people who are the same age, has verbal and performance domains50
7316390944What is Neuropsychological Testing?used to assess a broad range of skills and abilities, goal is to understand brain-behavior relations51
7316399139What is the Luria-Nebraska and Halstead- Reitan batteries?neuropsychological testing designed to assess for brain damage, test diverse skills ranging from grip strength to sound recognition, attention, concentration52
7316407068What are the problems with neuropsychological tests?false positives: mistake show problem; and false negatives: fails to detect problem; has to do with IQ of person53
7316411743What are two objectives of neuroimaging?to understand brain structure, understand brain functioning54
7316413513What is a CT scan?computerized axial tomography, utilizes X-rays55
7316415895What is an MRI?utilizes strong magnetic fields, better resolution than CT scan; excite hydrogen atoms in the brain and watch as they fall back to normal spn,56
7316419916What is a PET?positron emission tomography, injected with tracer substance attached to radioactive isotopes, or groups of atoms that react distinctively (blood,oxygen, glucose) expensive but can show metabolic problems with disorders57
7316419917What is a SPECT?single photon emission computed tomography, almost used too freely, looks ab absorption in brain and try to determine if anything is damaged etc.,58
7316426220What is fMRI?functional MRI, brief changes in brain are detected and correlated to activity in brain59
7316433106What is the advantages of neuroimaging and disadvantages?DTI (diffusion tensor imaging, no good controls, doesn't know purpose and effect of plate sheering), still not well understood, expensive, lack adequate norms, limited clinical utility, but ADVANTAGES are yield detailed information, lead to better understanding of brain structure and function60
7334744062What is a diagnostic classification?classification central to all sciences, assignment to categories based on shared attributes or relations61
7334748485What is idiographic strategy of diagnosis?specifically about individual features; what is unique about an individual's personality, cultural background, or circumstances in their classificatoin62
7334754730What is nomothetic strategy?often used when identifying specific psychological disorders, to make a diagnosis; it is common attributes within large groups of people63
7334762733What is the classification strategy from higher to lower of psych disorders?taxonomy is classification in scientific context; then nosology which is taxonomy in psychological/medical phenomena; then nomenclature which are labels in nosological system64
7334770014What is a classical categorical approach for diagnosis?strict categories of you either have it or you don't for diagnosis65
7334773144What is dimensional approach to diagnosis?classification along dimensions, different people have varying amounts of anxiety in social situations66
7334778100What is a prototypical approach to classifying disorders?identify common features of a disorder so it can be classified and then understood; combines classical and dimensional views67
7334782104What is a DSM?diagnostic and statistical manual of mental disorders; updated every 10-20 years, current edition is DSM 5 released in May 2013, previous was DSM-IV-TR68
7334789107What is the ICD?international classification of diseases ICD-10, published by world health organization, newer system and it is more medical classifications of diseases and disorders69
7334796634What were diagnosis based on before DSM?prior to 1980, diagnoses were made based on biological or psychoanalytic theory70
7334800253What did DSM-III revolutionize?classificatoin newly relied on specific lists of symptoms, improving reliability and validity71
7334802405What was the Axes of diagnosis?1. mental disorder 2. personality and intellectual disorders- separate because they are unlikely to benefit from psychotropic medications and are more developmental in nature 3. contributory medical conditions 4. psychosocial factors- history of abuse, problems with relationships, called B codes 5. GAF- global assessment functioning, scale from 0-100 arbitrary to how much the psych disorder is impairing function72
7334820387What was the original DSM for?it was in 1952 and it was made during WWII to help treat soldiers especially PTSD, it was a statistical manual that considered homosexuality, personality disorders due to parent child relationships73
7334827265What is DSM II?1968, dichotomous things based on neurosis (neurotic like anxieties) and psychosis, had passive-aggressive personality disorder, inadequate personality disorder74
7334835022What was DSM III?started 5 Axes classification, 1987, PMDD was considered a problem, concerned with masochists, sadists etc.75
7334840428What was DSM IV?introduced 1994, things needed to be clinically significant to the point that it effects multiple levels of functioning, eliminated the previous distinction between psychological versus organic mental disorders, reflected appreciation that all disorders are influenced by psychological and biological factors76
7334852594What was DSM-IV-TR?text revision of DSM-IV, incorporated new research and slightly altered criteria accordingly77
7334855869What is DSM-5?removed axial diagnosis system, clear inclusion and exclusion criteria for disorders, disorders are categorized under broad headings, empirically-grounded, prototypical approach to classification; got rid of Asburgers and made it a little harder to classify for autism; some proven biological disorders were removed like RETTS78
7334871015How do you add new diagnoses?new disorder labels are created when groups of individuals are identified whose symptoms are not adequately explained by existing labels; example was premenstrual dysphoric disorder79
7334878264What is PMDD?example of new disorder in DSM-5, relatively rare and severe emotional disturbance present during the majority of premenstrual phases80
7334885221What is a new disorder that did not make it to DSM-5?mixed anxiety-depression, insufficient research to justify the creation81
7334888836What are unresolved issues in DSM-5?problem of comorbidity- two or more disorders for the same person; high comorbidity is a problem, emphasizes reliability maybe at the expense of validity; was supposed to move to a more dimensional approach but critics say it does not improve much from DSM-IV; labeling issues and stigmatization82
7334894690What does labeling a disorder sometimes do?some labels have negative connotations and may make patients less likely to seek treatment83
7334909264What does clinical assessment and diagnosis rely on?reliable, valid, and standardized information84
7385561251EquifinalifyWe must consider a number of paths to a given outcome85
7385716536Brief Psychiatric Rating Scale18 general areas of concern, behavior rating scale 0-6 on symptoms86
7385755986Bender Visual Motor Gestalt TestGive child a series of cards with drawing and ask them to copy them, compare number of mistakes with average of kids their age, neurophysiological test87
7385883967Psychophysiological assessmentmeasurable changes in the nervous system that reflect emotional or psychological events; may be taken from brain directly or from other parts of the body88
7385900199What are alpha waves?brain wave activity determined by EEG that shows these waves are present in waking activities of a normal adult; associated with relaxation and calm,89
7385910741What are delta waves?sleeping pattern of brain waves, 1-2 hours after falling asleep,90
7385920582galvanic skin response?GSR, electrodermal responding, measure of sweat gland activity controlled by the peripheral nervous system91
7390455810Biofeedbacklevels of physiological responding, such as blood pressure readings, are fed back to the patient by meters or gauges so that the patient can try and regulate these responses92
7390485333nomothetic strategyattempt to name or classify the problem93
7390517989What is the classical (or pure) categorical approach?Emil Kraepelin's work, biological tradition, assumes every diagnosis has a clear underlying pathophysiological; useful in medicine especially for treatment94
7390544662What is the dimensional approach?note the variety of cognitions, moods, behaviors with which the patient presents and quantify them on a scale; can be unsatisfactory95
7390557784What is prototypical approach?combines features of classical and dimensional approach, identifies certain essential characteristics of an entity that you (and others) can classify it, but also allows certain nonessential variations that do not necessarily change the classification; DSM-5 based on this approach96
7390603814familial aggregationextent to which the disorder would be found among the patient's relatives97
7390932674Culturerefers to the values, knowledge, and practices that individuals derive from membership in different ethnic groups, religious groups, or other social groups may affect the individual's perspective on their experience with psychological disorders98

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