CLINICAL ASSESSMENT AND DIAGNOSIS

Multimethod & MultimodalMultimethod & Multimodal Multimethod & MultimodalMultimethod & Multimodal

Like a FunnelLike a Funnel Like a FunnelLike a Funnel

Start BroadStart Broad Start BroadStart Broad

More SpecificMore SpecificMore SpecificMore Specific

Value Depends On

ReliabilityReliabilityConsistency of our Assessment

ValidityValidityWhat are we measuring?

StandardizationStandardization

Application of Standards to Ensure Consistency

StandardizationStandardization

Application of Standards to Ensure Consistency

Clinical InterviewClinical Interview– Structured vs. SemistructuredStructured vs. Semistructured– Mental Status ExamMental Status Exam

– Behavioral Observation

Clinical InterviewClinical Interview– Structured vs. SemistructuredStructured vs. Semistructured– Mental Status ExamMental Status Exam

– Behavioral Observation

Clinical InterviewClinical Interview Clinical InterviewClinical Interview

Physical ExamPhysical Exam Physical ExamPhysical Exam

Behavioral AssessmentBehavioral Assessment Behavioral AssessmentBehavioral Assessment

Clinical InterviewClinical Interview Clinical InterviewClinical Interview Physical ExamPhysical Exam Physical ExamPhysical Exam

CsCsCsCs

Psychological TestingPsychological Testing– Projective vs. Objective

Projective TestsProjective Tests Projective TestsProjective Tests

Thematic Thematic Apperception Test (TAT)Apperception Test (TAT)Thematic Thematic Apperception Test (TAT)Apperception Test (TAT)

Projective TestsProjective Tests Projective TestsProjective Tests

Rorschach Inkblot TestRorschach Inkblot TestRorschach Inkblot TestRorschach Inkblot Test

Class lectures would be more stimulatingwith more _______ and lots of ____.

Other Projective TestsOther Projective Tests Other Projective TestsOther Projective Tests

Sentence Completion Methods:Sentence Completion Methods:- - - -

Draw a PictureDraw a PictureDraw a PictureDraw a Picture

Objective TestsObjective Tests Objective TestsObjective Tests

Minnesota Multiphasic Personality Minnesota Multiphasic Personality Inventory (MMPI, MMPI-2)Inventory (MMPI, MMPI-2)

Objective TestsObjective Tests Objective TestsObjective Tests Minnesota Multiphasic Personality Minnesota Multiphasic Personality

Inventory (MMPI, MMPI-2) Inventory (MMPI, MMPI-2)

Minnesota Multiphasic Personality Minnesota Multiphasic Personality Inventory (MMPI, MMPI-2) Inventory (MMPI, MMPI-2)

Intelligence TestsIntelligence Tests– Stanford-Binet IQ Test:

Intelligence Quotient– Wechsler IQ Tests

Intelligence TestsIntelligence Tests– Stanford-Binet IQ Test:

Intelligence Quotient– Wechsler IQ Tests

Neuropsychological TestingNeuropsychological Testing Neuropsychological TestingNeuropsychological Testing

Psychological TestingPsychological Testing Psychological TestingPsychological Testing

Neuropsychological TestingNeuropsychological Testing Neuropsychological TestingNeuropsychological Testing Assess Broad AbilitiesAssess Broad Abilities Infer Brain DysfunctionInfer Brain Dysfunction Empirically DerivedEmpirically Derived ProblemsProblems

– False Positives and False Negatives– Long Time to Administer

Assess Broad AbilitiesAssess Broad Abilities Infer Brain DysfunctionInfer Brain Dysfunction Empirically DerivedEmpirically Derived ProblemsProblems

– False Positives and False Negatives– Long Time to Administer

NeuroimagingNeuroimaging NeuroimagingNeuroimaging

Neuropsychological TestingNeuropsychological Testing Neuropsychological TestingNeuropsychological Testing

Structural AbnormalitiesStructural Abnormalities– Computerized Axial Tomography Computerized Axial Tomography

(CAT)(CAT)

– Magnetic Resonance Imaging Magnetic Resonance Imaging

(MRI)(MRI)

Structural AbnormalitiesStructural Abnormalities– Computerized Axial Tomography Computerized Axial Tomography

(CAT)(CAT)

– Magnetic Resonance Imaging Magnetic Resonance Imaging

(MRI)(MRI)

Functional AbnormalitiesFunctional Abnormalities– Positron Emission Tomography (PET)Positron Emission Tomography (PET)

– Single Photon Emission Computed Single Photon Emission Computed Tomography (SPECT)Tomography (SPECT)

– fMRIfMRI

Functional AbnormalitiesFunctional Abnormalities– Positron Emission Tomography (PET)Positron Emission Tomography (PET)

– Single Photon Emission Computed Single Photon Emission Computed Tomography (SPECT)Tomography (SPECT)

– fMRIfMRI

Psychophysiological AssessmentPsychophysiological Assessment Psychophysiological AssessmentPsychophysiological Assessment

Neuropsychological TestingNeuropsychological Testing Neuropsychological TestingNeuropsychological Testing NeuroimagingNeuroimaging NeuroimagingNeuroimaging

Measure Nervous System ActivityMeasure Nervous System Activity

Some Problems and LimitationsSome Problems and Limitations

Measure Nervous System ActivityMeasure Nervous System Activity

Some Problems and LimitationsSome Problems and Limitations

Psychophysiological AssessmentPsychophysiological Assessment Psychophysiological AssessmentPsychophysiological Assessment

NosologyNosology____________________________________________________________

Nomenclature Nomenclature ____________________________________________________________________________________________________________________________________________________________________________________________________________

Two widely used classification systems: ICD-10 & DSM

NosologyNosology____________________________________________________________

Nomenclature Nomenclature ____________________________________________________________________________________________________________________________________________________________________________________________________________

Two widely used classification systems: ICD-10 & DSM

DSM-I (1952) DSM-II (1968) DSM-III (1980) DSM-III-R (1987) DSM-IV (1994) DSM-5 (2013)

Classical or CategoricalClassical or CategoricalClassical or CategoricalClassical or Categorical

DimensionalDimensionalDimensionalDimensional

PrototypicalPrototypicalPrototypicalPrototypical

Thresholds for Diagnosis of DisordersThresholds for Diagnosis of Disorders Multiaxial FormatMultiaxial Format

– Axis I:Axis I: Most Major Disorders

– Axis II:Axis II: Personality Disorders / MR

– Axis III:Axis III: Medical Diseases or Conditions

– Axis IV:Axis IV: Psychosocial / Environment Problems

– Axis V:Axis V: Global Assessment of Functioning

Some Problems With the DSM-IVSome Problems With the DSM-IV

Thresholds for Diagnosis of DisordersThresholds for Diagnosis of Disorders Multiaxial FormatMultiaxial Format

– Axis I:Axis I: Most Major Disorders

– Axis II:Axis II: Personality Disorders / MR

– Axis III:Axis III: Medical Diseases or Conditions

– Axis IV:Axis IV: Psychosocial / Environment Problems

– Axis V:Axis V: Global Assessment of Functioning

Some Problems With the DSM-IVSome Problems With the DSM-IV

The general consensus is that DSM-5 is largely unchanged from DSM-IV although some new disorders are introduced and other disorders have been reclassified

– Divided into three main sections How to use the manual Disorders Description of disorders

Most notable change: ____________________________ More emphasis on ______________________________

• Continuing criticisms & controversies:

___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CLINICAL ASSESSMENT AND DIAGNOSIS

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