1
Q
Clinical assessment
A
- systematic evaluation and measurement of psychological, biological, and social factors in an individual presenting with a possible psychological disorder
2
Q
Diagnosis
A
- process of determining whether the particular problem meets the criteria for a psychological disorder
3
Q
assessing psychological disorders
reliability
A
- degree to which a measurement is consistent
4
Q
assessing psychological disorders
validity
A
- whether something measures what it’s supposed to measure
5
Q
assessing psychological disorders
standardization
A
- structured administration, scoring, and evaluation procedures
- creates the “norms” that allow for the clinician to make comparisons based on demographic criterias
6
Q
Clinical interview
A
- most important interview
- first interview with patient
- gathers history of individual’s life in general and of the presenting problem (see if there may be connections)
7
Q
What are some topics covered in a clinical interview?
7
A
- past/present family life
- any children?
- where they are currently living
- siblings?
- religious attitudes
- cultural concerns ex. discrimination
- educational history
8
Q
Mental status exam
A
- used to organize info obtained during an interview
- systematic observation of someone’s behaviour
- includes 5 categories
- gives a clearer look on what needs to be looked at in more detail - helps narrow it down
- evaluate how people think, feel, and behave and how these actions might contribute or explain their problems
9
Q
categories of mental status exam
Appearance and behaviour
A
- observes any overt physical behaviours (ex. leg twitch, facial expressions, etc)
10
Q
categories of mental status exam
Thought processes
what kinds of things are they looking for?
A
- speech patterns (ex. slow or fast)
- do thoughts make sense? do they flow well?
- are they saying weird things that could suggest something like schizophrenia?
11
Q
categories of mental status exam
Mood and affect
A
mood - predominant feeling state of the individual (ex. depressed or elated?)
affect - feeling state that accompanies what we say at a given time (ex. laughing after saying something disturbing could mean inappropriate affect)
12
Q
categories of mental status exam
Intellectual functioning
A
- reasonable vocab?
- can they talk in abstractions and metaphors?
- how is their memory?
- do they seem above or below average intelligence
13
Q
categories of mental status exam
Sensorium
what is it and why is it a concern?
A
- general awareness of our surroundings
- could suggest something like brain damage
- is their sensorium clear and oriented times three (to person, place and time)
14
Q
is the presenting problem typically what it ends up being?
A
- not always
- usually patients have a general understanding of how they’re feeling but after a clinical interview the doctor may decide that there are underlying issues that the patient isn’t realizing
15
Q
Semistructured interviews
A
- made up of questions that have been carefully phrased and tested to elicit useful information in a consistent manner, so clinicians can be sure they have inquired about the most important aspects of particular disorders
- they don’t have to follow exactly how it’s written - if they want to dig deeper into certain areas (semi-structured)
16
Q
Advantages to semi-stuctured interviews
A
- clinicians can be sure they are covering all the topics
- been tested
17
Q
disadvantages to semistructured and structured interviews
A
- may stop the client from offering up info that isnt directly connected to any of the questions
- may miss out on info that would only really come up in casual conversation
18
Q
ex. OCD
persistence-distress measure
A
- how often an obsession occurs and how much distress it causes
19
Q
ex. OCD
resistance measure
A
- types of attempts the patient makes to get rid of the obsession and their frequency
20
Q
why are physical examinations sometimes administered if the patient hasn’t had one in a year +
A
- some disorders ex. anxiety may have symptoms that closely resemble symptoms to other physiological problems
- ex. thyroid issues may look like depression
- ex. hallucinations could be indicative of a brain tumor
- ex. withdrawal from cocaine could look like panic attacks but most people are reluctant to offer up a drug issue
21
Q
Behavioural assessment
A
- like a mental status exam but using direct observation to formally assess an individual’s thoughts, feelings, and behaviour in specific situations or contexts
- this info should explain why this person is having difficulties *at this time *
- useful when people may not be able to express everything in a clinical interview (ex. children)
- might go observe the child at school or set up a simulation to see how they would act in certain situations/environments
22
Q
what is the goal of a behavioural assessment?
A
- identify target behaviours and determine factors that seem to influence those behaviours
- understand what others may not be able to accurately describe or what they may not even understand (ex. your son throwing glass when you asked him to put his cup in the dishwasher likely isn’t just an issue of him “not listening” to you)
23
Q
behavioural assessments
Observational assessment
A
- focuses on the here and now
- relatively informal observation because it relies on the clinicians perspective and recollection of events
24
Q
behavioural assessments
ABC’s of observational assessment
A
- Antecedents (what happened just before the behaviour)
- Behaviour (immediate)
- Consequence
25
formal observation
- identifying specific behaviours that are observable and measurable
26
# behavioural assessment
self-monitoring
- people observe their own behaviour to find patterns
- ex. quitting smoking, going to the gym
- goal is to help patients monitor their behaviours and recognize what influences them
- especially important when working with behaviours that typically only happen in private (ex. purging)
27
why is self-monitoring useful
- people will typically respond better when they are the ones observing their own behaviour
28
# advantages of self-monitoring
reactivity
- your presence may influence someone's behaviour
- when you're self-monitoring the same effect tends to happen - you change your behaviour because you're being "watched"
29
Psychological tests
- specific tests to determine cognitive, emotional, or behavioural responses that might be associated with a specific disorder
30
# psychological tests
Projective tests
- ambiguous stimuli are presented to a patient - ex. photos of people or things
- people are asked to describe what they see
- based in psychoanalytic theory - controversial as to whether these tests work
- ex. inkblot test, thematic apperception test (TAT)
31
# psychological tests
what is the idea behind projective testing?
- that people will project their own personality and unconscious thoughts/fears onto other things
- they'll interpret things differently based on their own personality
32
# Psyhological tests
personality inventories
| Minnesota Mutiphasic Personality Inventory (MMPI)
- based on an empirical approach unlike projective testing which rely on clinical interpretation
33
how does MMPI work
- people answer the questions and then their pattern of responses is compared to the pattern of responses of groups of people with certain disorders
34
IQ tests (intelligence testing)
| what do they compare?
- mental age and chronical age compared
- used to see how people's scores deviate from others of the same age group
35
neuropsychological testing
- measures abilities in areas such as receptive and expressive language, attention, concentration, memory, motor skills, perceptual abilities, learning, and abstraction
- assesses brain dysfunction by observing its effects on the person's ability to perform certain tasks
- determining things like alzheimer's
36
Neuroimaging
- taking pictures of the inside of the brain
- looks at structure, and function (ex. by mapping blood flow)
37
why is brain imaging useful?
- helps find neurobiological factors that may be involved in psychological disorders
- ex. areas of brain activation in people with PTSD, suididal thoughts, etc.
38
psychophisiological assessment
- measures changes in the nervous system that reflect emotional or psychological events
39
# psychophysiological assessment
electroencephalogram (EEG)
- measures electrical activity in the head related to the firing of a specific group of neurons reveals brain wave activity
- assesses brain waves and the reaction they have to certain psychological things (ex. hearing a meaningful message)
- often affected by psychological or emotional factors
- some therapies can work to regulate these waves
40
# diagnosing psychological disorders
classification
- any effort to construct groups or categories and to assign objects or people to these categories on the basis of their shared attributes or relations
41
# diagnosing psychological disorders
taxonomy
- classification of entities for scientific purposes (ex. rocks and insects)
42
# diagnosing psychological disorders
nosology
- applying a taxonomic system to psychological or medical phenomena or other clinical areas
- ex. anxiety or mood disorders
43
# diagnosing psychological disorders
nomenclature
- names or labels of the disorders that make up the nosology
44
why is classification important
- so we all have a shared system of understanding disorders
- makes it easier for doctors to communicate
45
# Kraepelin
classical categorical approach to classification
- assume that every diagnosis has a clear and underlying pathophysiological cause
- criteria doesn't overlap with other disorders and in order to be diagnosed the person has to meet all of the set criteria
46
dimensional approach to classification
- uses a scale to quantify the variety of cognitions, moods, and behaviour that a patient presents with
47
prototypical approach to classification
- identifies certain essential characteristics so that it can be classified but also allows for certain non-essential variations that don't necessarily change the classification
- should meet most criteria but doesn't need to meet all of them
- more flexible but lines can be blurry
- ex. describing dogs in general instead of describing each individual breed
- allows for a more personalized diagnosis
48
# criticisms of the DSM5
comorbidity
- individuals are diagnosed with more than one psychological disorder at a time
- so many options and overlap from so many different possible diagnoses
- makes it harder to treat effectively if you're dealing with more than one disorder
49
why is labelling a concern in diagnosis
- people may identify with the negative connotations around a disorder/label
50
classification and naming system for medical and psychological phenomena
nosology
51
classification method founded on the assumption of clear-cut differences among disorders, each with a different cause
classical categorical approach
52
brain circuit in the limbic system that responds to threat signals by inhibiting activity and causing anxiety
behavioural inhibition system (BIS)
53
in a naming system, the actual labels or names that are applied
nomenclature
54
assessment of brain and nervous system functioning by measuring an individual's performance on behavioral tasks
neuropsychological test
55
assignment of objects or people to categories on the basis of shared characteristics
classification
56
system of naming and classification (e.g., of specimens) in science
taxonomy
57
measurement of changes in the nervous system reflecting psychological or emotional events, such as anxiety, stress, and sexual arousal
psychophysiological assessment
58
what is the goal of a clinical assessment?
- to understand the individual, predict behaviour, plan treatment, and evaluate outcome
59
what makes a good clinical assessment?
- multidimensional (not based on only one piece of info/data)
- reliable
- valid
60
why is standardization important?
- ensures consistency in the use of a technique
- very specific rules to follow (ex. sit 6 feet away, etc.)
61
# standardization
normative data
- provides benchmarks for comparisons
62
why is a clinical interview so important?
- builds rapport with the patient
- need to make them feel like it will help them so they come back
63
what are some criticisms of the DSM-5?
- too many possible diagnoses - so many options
- are we labelling too many things as disorders?
- pathologizing things benefits big pharma
- why can't people just be quirky?
- labelling issues and stigmatization
64
comorbidity
- meeting criteria for multiple disorders at once
- 2 or more co-occuring disorders threatens the validity of separate diagnoses
- makes it difficult to be reliable when diagnosing
Psychopathology
flashcards
Decks in class (20)
# Cards
-
154
-
364
-
567
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6 - Somatic Symptom and Related Disorders25
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6 - Obsessive-Compulsive and Related Disorders35
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7 - Trauma and Stressor Related Disorders15
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7 - Dissociative Disorders19
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8 - Structure of Mood Disorders30
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8 - Prevalence, Causes, and Treatment of Mood Disorders21
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9 - Overview of Eating Disorders18
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9 - Causes of Eating Disorders2
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9 - Treatment of Eating Disorders1
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10 - Sleeping47
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13 - Personality14
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13 - Cluster A Personality Disorders18
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13 - Cluster B Personality Disorders39
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13 - Cluster C Personality Disorders16
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14 - Psychosis37
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14 - Prevalence and Causes21
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14 - Treatment15
