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Assessment and Diagnosis - Coggle Diagram

- - - - Situational (problem only occurs during specific situations) or pervasive (problem occurs across different situations and environments)?
      - Duration? How long have the problems persisted? If they have been persisting for a long time, what coping mechanisms were used?
      - Prior attempts to help or treat?
      - Self-defeating or resourceful? Is the person motivated to change (resourceful) or more resigned and feels stuck in their situation (self-defeating)
      - How does problem impact social roles?
      - Does the problem match any DSM-5 disorder criteria?
  - - - Awareness of increasing population diversity. What may be considered acceptable in the past may be acceptable today. Values and beliefs may change over time
      - APA Ethical code related to cultural competence. Learn about the client and their values.
      - Cultural variables inclusion
    - - Note that trust and rapport, as well as its impact on assessment processes, can affect each other. Trust and rapport can lead to more honest reports in assessments. This can then lead to more improvement in clients just from gaining a more informed perspective. This can also feedback into the trust and rapport
      - Clients: Trust psychologists
      - Psychologists: Trusts the client to provide truthful information
  - - - General physical examination: Medical history, major systems of body are checked
        
        Medical problems can produce behavioural symptoms that can mimc those of mental disorders
      - Neurological examination: Assessing the integrity of the brain
        
        Electroencephalogram (EEG): Measure and record electrical activity in the brain using electrodes
        
        Significant diversions from normal pattern of brain activities: Tumors, lesions, electrical dysrhythmia
        
        Good temporal resolution
        
        Computed Tomography Scan (CT Scan): X-ray measurements taken at various angles, and then combined to provide more detailed information than regular X-ray. For enlarged brain areas
        
        Magnetic Resonance Imaging (MRI): Painless, non-invasive
        
        Good spatial resolution, for enlarged brain areas
        
        Functional MRI (fMRI): Tells us about the working brain (brain mapping) by checking which areas of the brain are more active. Relatively poor temporal resolution
        
        Positron Emission Tomography (PET): Organic processes
      - Neuropsychological Examination: Assessing whether a person's brain is functioning correctly
        
        Using an array of testing devices to measure cognitive, perceptual, and motor performance
        
        Provides clues to the extent and location of brain damage
    - - Clinical Interviews
        
        Structured interviews: Predetermined format. Each question is structured in a manner so as to allow responses to be quantified or clearly determined. Can be used by clinicians or lay interviewers, can maximise reliability.
        
        Semi-structured interviews: Interviewer asks questions in a specific order and way, but depending on the answer can follow up with another question for more information. Only for trained people. Greater validity than structured interviews.
        
        Unstructured interviews: Do not follow predetermined set of questions. Important information may be overlooked. Responses are difficult to quantify or compare.
      - Clinical Observation of Behaviour: learn more about a person's psychological functioning by attending to their behaviour in various contexts
        
        Clinical observation in natural environments
        
        Clinical observation in therapeutic or medical settings: Analogue situations (designed to yield information about adaptive strategies) that might involve role-playing, event reenactment, family interaction assignments, think-aloud procedures
        
        Self-monitoring: Self-observation and objective reporting of behaviour, thoughts, and feelings
        
        Rating scales: Rater indicating the presence or absence, and degree of a behaviour. (e.g.Brief Psychiatric Rating Scale (BPRS))
    - - Intelligence tests
        
        Wechsler Intelligence Scale for Children-Revised (WISC-IV) for children
        
        Wechsler Adult Intelligence Scale-Revised (WAIS-IV) for adults
        
        Stanford-Binet
      - Personality tests
        
        Projective personality tests: Unstructured, subjective; through interpretation of ambiguous stimuli, people may reveal information about their personalities as they project their own problems, motives, and wishes into the situation in interpreting the stimuli
        
        Rorschach Inkblot Test: 10 inkblot pictures for clients to see and then interpret. Can be unreliable because of subjective interpretations
        
        Thematic Apperception Test (TAT): Presenting a series of simple pictures (some highly representational and others more abstract) and getting subjects to make up stories. Pictures tend to depict people in various contexts that are ambiguous, leading subjects to project their own worries onto it.
        
        Sentence Completion Test: Asking clients to complete the beginning of sentences
        
        Objective personality tests: Structured, with questionnaires, rating scales, etc.
        
        Neuroticism-Extroversion-Openness Personality Inventory (NEO-PI): Information on major dimensions of personality
        
        Cost effective, highly-reliable, objective. However, too mechanistic to portray the complexity of human beings, test-takers can "fake" results
        
        Minnesota Multiphasic personality Inventory (MMPI-2): 10 clinical scales compared to normal population + validity scales to measure if a person has answered honestly
- - - - Human behaviour can be sorted into categories of "healthy" and "disordered"
      - There are non-overlapping sub-classes or disorders that have a high degree of within-class similarity in symptoms and underlying organisation of the disorder
      - Problems
        
        Are disorders really discrete and distinct entities?
        
        How many categories?
        
        Comorbidity: Presence of two or more disorders in the same person (may be giving multiple labels to different variants of the same underlying condition)
        
        Mild, moderate, and severe forms of disorder all grouped together
    - - Typical behaviour is the product of the differing strengths or intensities of definable dimensions
      - Advantages
        
        Preserves information about variability
        
        Cut-points can be used to define mild, moderate, or severe levels of dysfunction
    - - Advantages
        
        Fits the way people actually think
        
        Can include dimensional perspective
  - - - More comprehensive and more subtypes of disorders
      - Allows for gender related differences in diagnosis
      - Cultural Formulation Interview (CFI): Provides structured interview regarding cultural influences
      - Criticism: Criteria for several disorder relaxed -> over-medicalising behaviour
    - - Symptoms: Client's subjective reporting of what is wrong
      - Signs: Objective and visible indicators of a problem
    - - Label only captures a behavioural pattern
      - Creates assumptions among clinicians
      - Creates social stigma