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Lec2: Diagnosis & Assessment (Diagnosis (Adv (Research, Clinical…
Lec2: Diagnosis & Assessment
Diagnosis
Adv
Research
Clinical practice
Facilitate communication
Tools to get diagnosis
Interviews
Structured (script)
Semi-structured (clinicians)
Not structured (eg. intake interviews)
Observations
go school/home visits, or set up a lab, see how children interact with others and how they play
Tests
Psychological testing
Neurobiological testing
Classification of disorders
Standardization
test administered to a large group->individual scores compared with the norm
Same procedure in administration, scoring, interpretation
Use a representative sample eg. IQ
DSM-5
Nonaxial approach
this system dropped in DSM-5
DSM 1-4 had a 5-axis system
Improvements
More extensive descriptions
Associated features
Differential diagnosis
Essential features
Possible diagnostic categories in need of further study ->eg. caffeine use disorder, internet gaming disorder etc.
Specific diagnostic criteria, more explicit & concrete
Increasing number of diagnostic categories BUT comorbidity problem
features
Describes criteria for diagnoses (key clinical features)
Comorbidity
ppl can be diagnosed with multiple disorders
about 300 disorders
Ethnic & Cultural considerations
DSM includes & attempts to
enhance cultural sensitivity
Appendix of culture-bound syndromes
Running Amok in DSM-IV
Episode in which there is a period of brooding followed by a violent outburst - >related to "evil tiger spirit"
Koro in DSM-IV
Intense fear that one's penis/nipples will recede into body & lead to death
Shenjing Shuairuo
Fatigue, dizziness, headaches, pain, poor concentration, sleep problems, memory loss
According to Kleinman, views it to be 87% like depression but no conclusion to date
(neurasthenia)China
Taijin Kyofusho TKS
very specific social phobia but NOT social phobia
(japan) fear that one could offend others through inappropriate eye contact, blushing, or body odour
Ataque de nervios
neurotic/anxiety attack
Hispanic/Latino culture
intense emotional upset, screaming or shouting uncontrollably
Criticisms of Classification
Labelling & stigma against mental illness
Difficulty of finding a job
treated differently by others
Misdiagnosis perpetuates
Categories do not capture uniqueness of person ie. it's an individual who has schizophrenia, not a schizophrenic
Culture can influence
Types of symptoms experienced
Willingness to seek help
Risk factors
Availability of treatments
Psychological assessments & Tests
Psychological/Clinical Tests
Gathering info abt specific topics
Tests, scales, inventories, surveys, questionnaires
3 major categories
Personality Inventories
Strengths
Standardised
Higher validity than projective tests
Easier, cheaper & faster to administer
Weaknesses
May not always get truthful responses
Cultural differences
How it's constructed
Criterion keying
724 normal subjects & 800 hospitalised mental patients
Select items that differentiate the 2 groups
how it works
Measure broad personality/characteristics
Wide range of questions total 550 self-statements
Self-report->Asking clients to assess themselves
assesses careless responding & lying
Cognitive (Intelligence) Tests
Most popular Wechsler
Key role in diagnosing mental retardataion, learning disabilities
Intelligence Quotient (IQ) M=100 SD= 15
Strengths & weaknesses
Strengths
very high reliability & validity
Standardised on large groups of subjects
among the most carefully produced tests
Weaknesses
Can be influenced by non-intelligence factors
eg. motivation, anxiety, test-taking experience
Cultural biases
Stereotype threat
African americans on IQ test
beliefs that certain groups do poorly may influence performance
Less cultural experiences/less comfortable with tests
Projective Tests
types
Rorschach Inkblot
Interpretation
Thematic context
Scoring system: Exner's book
look out for perceptual & cognitive pattern of the response
code whatever the person describes like shapes, mvt, colour etc.
10 cards of symmetric inkblots,
Keep asking qns like "What might this be?"
TAT
ask what's happening in pic & look for themes
30 black & white drawings
Draw a Person Test
take note of details, shape, solidity of lines, location on paper
Sentence-completion
Weaknesses
low inter-rater reliability
Low validity
Rationale ->reflect unconscious processes
ambiguous stimuli
Other Types of Tests
Neurobiological testing
Brain imaging
Computerised Axial Tomography
Positron Emission Tomography
Magnetic Resonance Imaging
Neurotransmitter assessment
Psychophysiological testing
Neuropsychological testing
Assess cognitive, perceptual & motor functioning
Serves as screening tool for stroke, head/brain damage etc.
battery of tests
paper/pencil->to infer dysfunctions in brain
few examples
Tactile Performance Test
Bender Gestalt Test (visual-motor)
Psychophysiological tests
Use physiological reactions to infer psychological states eg. anxiety/fear
Other measures
ECG
EEG
assumption
psych problems->emotional dysregulation->reflected in physiological responses
Polygraph/Lie Detector
measures HR, BP, breathing pattern
Sweating, skin conductance
Limitation
Machines can be intimidating due to noise in data
"Habituation" limits its effectiveness
many emotional states can't be clearly differentiated
Psychopaths don't show any reactions