Assessment

• Psychological assessment


  The process of evaluating an individual's mental health, cognitive abilities, personality, and other psychological characteristics
• Psychological functioning is a dimensional process, not functional or dysfunctional but more on a spectrum of more or less functional
• Reasons categories are helpful

  • Communication with patient, other doctors/care providers, third party payers
  • Put a name to an individual's suffering
  • Allow for study of causes and treatments
  • Allow for prescription to alleviate
• DSM (Diagnostic and Statistical Manual of Mental Disorders)


  A manual published by the American Psychiatric Association that provides a common language and standard criteria for the classification of mental disorders
• History of the DSM

  • Emil Kraepelin recognized that not all psychiatric disorders are the same and suggested a system of classifying them
  • First edition of the DSM published in 1952, with many revisions since then
  • Current edition is the DSM-5, published in 2013
  • Includes 237 diagnoses and some dimensional characteristics like severity ratings
• Comorbid


  The presence of more than one disorder in an individual
• Differential diagnosis


  The process of differentiating between more than one diagnosis to capture which most accurately reflects the current symptom presentation
• Etiology


  The cause or origin of a disorder
• Prevalence


  The number of cases of a disorder that are present in the population at a given time
• Incidence


  The number of new cases that develop in a period of time
• Types of assessment/data


  • Clinical interview (structured vs unstructured)
  • Objective self-/observer-reports
  • Projective assessments
  • Task-based measures
  • Neuropsychological testing
  • Behavioral observation
  • Intelligence Testing
• Considerations in assessment


  • Standardization (comparing to a "normal" group)
  • Reliability (test-retest, interrater agreement)
  • Validity (measuring what it's supposed to measure, predictive validity, face validity)
  • Utility (worth using for the information gained, ease of use)
• Factors to consider in assessment

  • Biological (genetics, sex)
  • Environmental (family relation, physical environment, cultural)
  • Psychological (thoughts, emotions, beliefs, personality)
• The Mental Status Exam is the mental health professional's "lab test"
• Components of the Mental Status Exam

  • General Presentation (appearance, behavior, attitude)
  • State of consciousness
  • Attention and Concentration
  • Speech
  • Orientation
  • Mood and affect
  • Thought Content
  • Thought Process
  • Insight and judgement
  • Ability to think abstractly
  • Memory
• Types of personality tests

  • Objective (MMPI, PAI, MCMI)
  • Projective (Rorschach Inkblot, Thematic Apperception Test, House-Tree-Person, Incomplete Sentences Blank)
• Types of self-report assessments

  • Barkley Deficits in Executive Function Scale (BDEFS)
  • Behavior Assessment System for Children
  • Beck Anxiety Inventory (BAI)
  • Beck Depression Inventory (BDI)
• Types of neuropsychological tests

  • Beery Visual Motor Integration Task
  • Delis-Kaplan Executive Function System
  • Tower of Hanoi
• Types of intelligence/cognitive assessments

  • Wechsler Scales (WAIS, WISC)
  • Stanford-Binet
• Intelligence Testing/Cognitive Assessment


  Attempt to measure stable underlying cognitive processes often linked to academic, occupational, and life successes (attention, processing speed, nonverbal reasoning, vocabulary)
• Neuropsychological Tests


  Tap "neurocognitive skills" like working memory, perceptual reasoning, visual-motor coordination
• Personality Tests


  Attempt to measure stable, latent constructs through responses to a set of stimuli (questions/prompts)
• Clinical interviews can be structured (follow a set of prescribed questions) or unstructured (freedom for asking follow-up questions)