PSYCHOSOCIAL ASSESSMENT OF MENTAL DISORDERS

1
PSYCHOSOCIAL ASSESSMENT OF MENTAL DISORDERS

• Defining a mental disorder
• Interviewing basics and skills
• The assessment process
• Diagnosis

2
DEFINING A MENTAL DISORDER

• A clinically significant behavioral or
  psychological syndrome or pattern that occurs in
  a person
• There can be significant distress or disability
  with significant risk of pain or death, or loss
  of freedoms
• The syndrome or pattern is considered to be a
  manifestation of behavioral, psychological or
  biological dysfunction in the individual
• Conflict with the surrounding social structure is
  often a result

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ETIOLOGICAL CONSIDERATIONS

• Psychodynamic perspective There is intra-psychic
  conflict between id, ego and superego. This
  conflict overwhelms defense mechanisms producing
  symptoms of anxiety, disorder thinking and
  obsessive behaviors.
• Medical model perspective Brain and central
  nervous system abnormalities produce symptoms
• Cognitive Behavioral perspective Learned
  patterns of behavior produce symptoms

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ECOLOGICAL CONSIDERATIONS (CONT)

• Interactionism (ecologic) perspective
  Environmental factors and the subjective
  perception the environment and interactions with
  others.
• Humanistic perspective Where there is disorder
  and stress and the absence of positive regard
• Genetic perspective Organism is waiting for the
  right environmental stressor
• Sociocultural perspective Culture bound
  definitions which change over time

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SIX CRITERIA FOR DEFINING NORMAL FUNCTIONING

• Efficient perception of reality (events and
  personal ability)
• Self knowledge and self awareness (understanding
  ones own behavior and motivation)
• Ability to exercise voluntary control over
  behavior (control of impulsivity)
• Self esteem and acceptance (feelings of self
  worth and individuation)

6

• Ability to form affectionate and meaningful
  relationships (empathy with autonomy in
  interpersonal relationships)
• Productivity (energy, motivation and focus)

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DEFINING NORMAL

• Statistical norms based on deviation from the
  average person
• Subjective alteration in functioning while in
  distress
• Legal definition (risk to self and others and the
  inability to care for ones self)
• Cultural or social norms with specific ideas
  about what acceptable behavior is and is not
• Moral components
• Maladaptive behaviors interfere with ability to
  live a productive and peaceful life.

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TYPICAL SIGNS AND SYMPTOMS FOUND IN DISABILING
EMOTIONAL DISORDERS

• Consciousness Disturbances in levels of
  consciousness (orientation, clouding, delirium).
  Disturbances in attention and processing
  (distractibility, selectivity). Disturbances in
  suggestibility.
• Affect Inappropriate presentation of affect
  (disharmony of affect and ideation) Examples
  include euphoria, depression, anxiety,
  agitation, panic, apathy, aggression and mood
  swing.

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SIGNS AND SYMPTOMS (CONT)

• Psycho-motor behavior Disturbances in conation
  (echolalia, echopraxia, tics, compulsions,
  ritualism)
• Thinking Disturbances in the form (autistic,
  concrete). Disturbances in the structure of
  association (Circumstantiality, tangential).
  Disturbances in the rate or speed of
  association (Flight of ideas, pressured speech,
  blocking). Disturbances in content of thought
  (Delusions, obsessions, phobias)

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SIGNS AND SYMPTOMS (CONT)

• Perception Disturbances in processing reality
  (Auditory, visual, tactile, olfactory
  hallucinations)
• Memory Disturbances in recall and restoration
  (Long term, short term, false recognition,
  confabulation)
• Intelligence Organic brain syndrome, dementia,
  developmental delay, injury