Abnormal Psychology Chapter Four Notes Introduction Psychological assessment refers to a procedure by which clinicians using psychological tests observations and interviews develop a summary of the client s symptoms and problems Clinical diagnosis the process through which a clinician arrives at a general summary classification of the patient s symptoms by following a clearly defined system The Basic Elements in Assessment pages 104 108 First thing that a clinician needs to do is identify the presenting problem major symptoms and behavior the client is experiencing Taking a Social or Behavioral History o An adequate assessment should include a diagnostic label an individual s personality traits behavior patterns and environmental demands all together integrated into a consistent and meaningful picture is referred to as a dynamic formulation because it not only describes the current situation but also includes hypotheses about what is driving the person to behave in maladaptive ways Then decisions about treatment are made collaboratively with the consent and approval of the individual in severe cases they may have to be made without their participation Ensuring Culturally Sensitive Assessment Procedures o Cultural competence critical for psychologists to be informed of the issues involved in multicultural assessment The Influence of Professional Orientation o How clinicians go about the assessment process often depends on their basic treatment orientations they focus on the type of assessments that their professions entail Assessment of the Physical Organism pages 108 111 Sometimes medical evaluation is necessary to rule out the possibility that physical abnormalities may be causing or contributing to a mental disorder The Neurological Examination o Electroencephalogram EEG used to asses brain wave patterns in awake and sleeping state a graphical record of the brain s electrical activity o Dysrhythmia irregular brain pattern o Computerized axial tomography CAT scan reveals images of parts of the brain that might be diseased provides rapid access without surgery to accurate information about the localization and extent of anomalies in the brain s structural characteristics Only reveals anatomical features such as shape or a particular internal structure o Magnetic resonance imaging MRI replacing CAT scans involves the precise measurement of variations in magnetic fields that are caused by the varying amounts of water content of various organs and parts of organs Reveals brain structure Sensitive to instrument errors or inaccurate observations as a result of slight movements of the person being evaluated o Positron emission tomography PET scan allows for an appraisal of how an organ is functioning Reveals functioning better from of CAT scan o Functional MRI fMRI measures changes in local oxygenation blood flow of specific areas of brain tissue that in turn depend on neuronal activity in those specific regions Revels brain activity better form of fMRI Results are difficult to interpret Sensitive to instrument errors or inaccurate observations as a result of slight movements of the person being evaluated o Aphasia a loss of ability to communicate verbally The Neuropsychological Examination o Neuropsychological assessment involves the use of various testing devices to measure a person s cognitive perceptual and motor performance as clues to the extent and location of brain damage o Halstead Reitan battery test composed of several tests and variables from which an index of impairment can be computer provides specific information about a subject s functioning in several skill areas Composed of Halstead Category Test measures subject s ability to learn and remember material and can provide clues as to his or her judgment and impulsivity number presented guess correct number doorbell wrong number buzzer person is required to determine form the pattern of buzzers and bells what the underlying principle of the correct choice is Tactual Performance Test measures a subject s motor speed response to the unfamiliar and ability to learn and use tactile and kinesthetic cues test surface with board with 10 different shaped spaces have to place blocks in correct grooves asked to draw blocks and board from tactile memory Rhythm Test measures attention and sustained concentration through an auditory perception task 30 pairs of rhythmic beats played on recorder asked if pairs are same or different Speech Sounds Perception Test determines whether an individual can identify spoken words and measures subject s concentration attention and comprehension nonsense words presented on recorder subject asked to identify word from list of four printed words Finger Oscillation Task measures the speed at which an individual can Psychosocial Assessment pages 111 124 depress a lever with the index finger Attempt to provide a realistic picture of an individual in interaction with his or her social environment Brief Psychiatric Rating Scale BPRS provides a structured quantifiable format for rating clinical symptoms such as over concern with physical symptoms anxiety emotional withdrawal guilt feelings hostility suspiciousness and unusual thought patterns contains 18 scales that are scored from ratings made by a clinician following an interview with a patient Psychological Tests o More indirect means of assessing psychological characteristics standardized sets of procedures or task for obtaining samples of behavior often more precise and more reliable than interviews or some observational techniques o Wechsler Adult Intelligence Scale Revised commonly used test for measuring adult intelligence includes verbal and performance materials and consists of 15 subsets Vocabulary verbal subset that consists of a list of words to define that are presented orally to the individual designed to evaluate knowledge of vocabulary Digit Span performance test of short term memory sequence of numbers is administered orally and the individual is asked to repeat digits in the order administered Task two involves the individual s remembering the numbers holding them in memory and instructed to say them backwards o Projective personality tests unstructured in that they rely on various ambiguous stimuli such as inkblots or vague pictures rather than on explicit verbal questions and in that the person s responses are not limited to the true false or cannot say variety Rorschach Inkblot Test uses 10 inkblot pictures and the subject is