Transcript September 9, 2002 Lecture - Oklahoma State University

Power Point and Syllabus
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h3443.html
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Assessment and Diagnosis in Abnormal
Psychology
Chapter 3
Objectives
 What are the purposes of assessment in abnormal
psychology?
 What are important characteristics of assessment
approaches?
 How would one use interviews and testing to assess
psychological disorders?
 How are diagnoses made for psychological disorders?
Assessing Psychological Disorders
 Purposes of Clinical Assessment
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To
To
To
To
understand the individual
predict behavior
plan treatment
evaluate treatment outcome
 Analogous to a Funnel

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Starts broad
Narrow to specific problem areas
 Multidimensional in approach
Characteristics of Assessment
 Reliability
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Consistency in measurement
Examples include test-retest, inter-rater reliability
 Validity
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What the test measures and how well it does so
Examples include content, concurrent, discriminant,
construct, and face validity
Sensitivity and specificity
Sensitivity and Specificity
Does the person truly have
the disorder?
What does the test say?
No
Negative
Positive
800
100
Specificity
800/(800+100) = 88.9%
Yes
true negatives
false positives
10
90
false negatives
true positives
Sensitivity
90/(90+10) = .90
Characteristics of Assessment
 Standardization

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Standards and norms help ensure consistency in the use of
a technique
Examples include administration procedures, scoring, and
evaluation of data
Domains of Assessment:
The Clinical Interview
 Clinical Interview
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Most common clinical assessment method
Structured or semi-structured
 Purposes of interview
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Explore presenting problem
Associated problem(s),
History
Biopsychosocial context
Diagnose
Domains of Assessment:
Clinical Interview (cont.)
 Mental Status Exam
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Appearance and behavior
Thought processes
Mood and affect
Intellectual functioning
Sensorium
 Mini Mental State Examination (MMSE)

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Assesses for cognitive functioning
Useful for screening for dementia or other
neuropsychological deficits
Domains of Assessment:
Behavioral Assessment and Observation
 Behavioral Assessment
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Focus on here and now
Tends to be direct and minimally inferential
Purpose is to identify problematic behaviors and situations
Identify antecedents, behaviors, and consequences
 Behavioral Observation and Behavioral Assessment
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Can be either formal or informal
Self-monitoring vs. others observing
Problem of reactivity using direct observation methods
Domains of Assessment:
Psychological Testing and Projective Tests
 Psychological Testing

Must be reliable and valid
 Projective Tests
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Project aspects of personality onto ambiguous test stimuli
Roots in psychoanalytic tradition
Require high degree of clinical inference in scoring and
interpretation
Examples include the Rorschach Inkblot Test, Thematic
Apperception Test
Reliability and validity data tend to be mixed
Domains of Assessment: Psychological
Testing and Objective Tests
 Objective Tests
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Test stimuli are less ambiguous
Roots in empirical or scientific tradition
Require minimal clinical inference in scoring and
interpretation
 Objective Personality Tests
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Minnesota Multiphasic Personality Inventory (MMPI, MMPI-2,
MMPI-A)
Over 549 true or false items
Extensive reliability, validity, and normative database
 Objective Intelligence Tests
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Nature of intellectual functioning and IQ
The deviation IQ
Verbal and performance domains
Diagnosing Psychological Disorders:
Foundations in Classification
 Clinical Assessment vs. Psychiatric Diagnosis
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Assessment – Idiographic approach (individual)
Diagnosis – Nomothetic approach (norms)
Both are important in treatment planning and intervention
 The Nature and Forms of Classification Systems
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Classical (or pure) categorical approach – Strict categories
Dimensional approach – Classification along dimension
Prototypical approach – Combines classical and dimensional
views
 DSM-IV and ICD-10
Purposes and Evolution of the DSM
 Purposes of the DSM System

Aid communication, evaluate prognosis, need for
treatment, and treatment planning
 Basic Characteristics
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Five axes describing full clinical presentation (person and
environment)
Clear inclusion and exclusion criteria for disorders,
including duration
Disorders are categorized under broad headings
Prototypic approach to classification; one that is
empirically grounded
The DSM-IV
 The Five DSM-IV Axes
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Axis I – Most major disorders
Axis II – Stable, enduring problems (e.g., personality
disorders, mental retardation)
Axis III – Medical conditions related to abnormal behavior
Axis IV – Psychosocial problems affecting functioning or
treatment
Axis V – Global clinician rating of adaptive functioning
Be sure to….
 Read second half of Chapter 3, Research Methods