DIAGNOSIS AND CLINICAL ASSESSMENT

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CLINICAL ASSESSMENT AND
DIAGNOSIS
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Basics of Clinical Assessment

• Multimethod Multimodal

• Like a Funnel

Start Broad
More Specific
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Determining the Value of Clinical Assessment
Value Depends On

• Reliability
• Consistency of our Assessment

• Validity
• What are we measuring?

Standardization Application of Standards to
Ensure Consistency
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Methods of Clinical Assessment

• Clinical Interview
• Structured vs. Semistructured
• Mental Status Exam
• Behavioral Observation

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Methods of Clinical Assessment

• Clinical Interview

• Physical Exam

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Methods of Clinical Assessment

• Clinical Interview

• Physical Exam

• Behavioral Assessment

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Methods of Clinical Assessment

• Behavioral Assessment

A
Cs
B
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Methods of Clinical Assessment

• Clinical Interview

• Physical Exam

• Behavioral Assessment

• Psychological Testing
• Projective vs. Objective

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Methods of Clinical Assessment

• Projective Tests

Thematic Apperception Test (TAT)
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Methods of Clinical Assessment

• Projective Tests

Rorschach Inkblot Test
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Methods of Clinical Assessment

• Other Projective Tests

Sentence Completion Methods - -
Class lectures would be more stimulating with
more _______ and lots of ____.
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Methods of Clinical Assessment

• Other Projective Tests

Draw a Picture
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Methods of Clinical Assessment

• Other Projective Tests

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Methods of Clinical Assessment

• Objective Tests

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

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Methods of Clinical Assessment

• Objective Tests

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

• Intelligence Tests
• Stanford-Binet IQ Test Intelligence Quotient
• Wechsler IQ Tests

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Methods of Clinical Assessment

• Clinical Interview

• Physical Exam

• Behavioral Assessment

• Psychological Testing

• Neuropsychological Testing

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Methods of Clinical Assessment

• Neuropsychological Testing

• Assess Broad Abilities
• Infer Brain Dysfunction
• Empirically Derived
• Problems
• False Positives and False Negatives
• Long Time to Administer

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Methods of Clinical Assessment

• Clinical Interview

• Physical Exam

• Behavioral Assessment

• Psychological Testing

• Neuropsychological Testing

• Neuroimaging

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Methods of Clinical Assessment

• Neuroimaging

• Structural Abnormalities
• Computerized Axial Tomography (CAT)
• Magnetic Resonance Imaging (MRI)

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Methods of Clinical Assessment

• Neuroimaging

• Functional Abnormalities
• Positron Emission Tomography (PET)
• Single Photon Emission Computed Tomography
  (SPECT)
• fMRI

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Methods of Clinical Assessment

• Clinical Interview

• Physical Exam

• Behavioral Assessment

• Psychological Testing

• Neuropsychological Testing

• Neuroimaging

• Psychophysiological Assessment

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Methods of Clinical Assessment

• Psychophysiological Assessment

• Measure Nervous System Activity
• Some Problems and Limitations

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From Assessment to Diagnosis
and Classification
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Diagnostic and Statistical Manual of
Mental Disorders

• Nosology__________________________________________
  __________________
• Nomenclature _____________________________________
  __________________________________________________
  _______________
• Two widely used classification systems ICD-10
  DSM

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Development of the DSM

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

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Approaches to Classification
Classical or Categorical
Dimensional
Prototypical
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DSM-IV A Prototypical --Dimensional
Approach

• Thresholds for Diagnosis of Disorders
• Multiaxial Format
• Axis I Most Major Disorders
• Axis II Personality Disorders / MR
• Axis III Medical Diseases or Conditions
• Axis IV Psychosocial / Environment Problems
• Axis V Global Assessment of Functioning
• Some Problems With the DSM-IV

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DSM-5

• 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 ______________________________

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The DSM-5

• Continuing criticisms controversies
• __________________________________________________
  __________________________________________________
  __________________________________________________
  __________________________________________________
  __________________________________________________
  _________