NETA POWERPOINT

PRESENTATION TO ACCOMPANY

ABNORMAL
PSYCHOLOGY
An Integrative Approach
Sixth Canadian Edition
BY BARLOW/DURAND/HOFMANN/LALUMIÈRE
 Chapter 3

Clinical Assessment and

Diagnosis

2
 Chapter 3 Outline
• Assessing Psychological Disorders
• Diagnosing Psychological Disorders

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Assessing Psychological
Disorders

4
Assessing Psychological Disorders
• Clinical assessment and diagnosis
• DSM-5
• Value of assessments determined by:
– Reliability
– Validity
– Standardization
– See Figure 3.1

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Assessing Psychological Disorders

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Assessing Psychological Disorders
The Clinical Interview
• The Mental Status Exam
– Systematic observation of behaviour
– Clinicians get enough information to
determine presence of a psychological
disorder
• The mental status exam covers five
categories
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Assessing Psychological Disorders
The Clinical Interview: Mental Status
Exam
• Five categories of mental status exam:
– Appearance and behaviour
– Thought processes
– Mood and affect
– Intellectual functioning
– Sensorium
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Assessing Psychological Disorders

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Assessing Psychological Disorders

The Clinical Interview

• Semistructured Clinical Interviews
– Clinical interviews can be unstructured or
semistructured
Physical Examination
– Conducted to lead to proper diagnosis and
proper treatment

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Assessing Psychological Disorders
Behavioural Assessment
• Target behaviours identified and
observed
• ABCs of observation
– Antecedents, behaviours, and
consequences

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Assessing Psychological Disorders

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Assessing Psychological Disorders
Behavioural Assessment
• Informal observation
– Subject to observer’s interpretation
• Formal observation
– Behaviours are observable and measurable
– Observe a pattern of behaviour
– Design treatment based on these patterns

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Assessing Psychological Disorders
Behavioural Assessment
• Self-monitoring or self-observation
– Checklists used to observe behaviour
– Behaviour rating scales
• Reactivity

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Assessing Psychological Disorders
Psychological Testing
• Determine cognitive, emotional, or
behavioural responses
– Responses might be associated with a specific
disorder
• Intelligence tests determine cognition
• Neurobiological procedures determine brain
damage or dysfunction to patient’s condition

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Assessing Psychological Disorders
Psychological Testing
Projective Testing
• Psychoanalytic tradition
• Rorschach inkblot test
– Questionable reliability and validity
• Thematic Apperception Test (TAT)
− These tests widely used
• See Figures 3.4 and 3.5
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Assessing Psychological Disorders
Psychological Testing
Personality Inventories
• Minnesota Multiphasic Personality
Inventory (MMPI)
• See Table 3.1 and Figure 3.6
• Revised Psychopathy Checklist (PCL-R)
– Assesses psychopathy

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Assessing Psychological Disorders

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Assessing Psychological Disorders
Psychological Testing
Intelligence Testing
• Intelligence Quotient (IQ) =
– Mental age Chronological age 100
• Popular tests:
– Stanford-Binet, Wechsler Scales (for adults [WAIS-
IV] and children [WISC-5])
• Verbal scales
• Performance scales

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Assessing Psychological Disorders
Neuropsychological Testing
• Pinpoint the location of brain
dysfunction; common tests:
– Bender Visual-Motor Gestalt Test
– Halstead-Reitan Neuropsychological Battery
• Issue of false positives
• Issue of false negatives

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Assessing Psychological Disorders
Neuroimaging: Pictures of the Brain
• Neuroimaging: pictures of brain structure
and function
• Categories:
– Brain structure images
– Brain function images

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Assessing Psychological Disorders
Neuroimaging: Pictures of the Brain
Images of Brain Structure
• CAT scan
• MRI

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Assessing Psychological Disorders
Neuroimaging: Pictures of the Brain
Images of Brain Functioning
• PET scan
• Single photon emission computed
tomography
• fMRI

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Assessing Psychological Disorders
Psychophysiological Assessment
• Electroencephalogram (EEG)
– Event-related potential (ERP)
– Evoked potential
• Electrodermal response (skin
conductance)

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Diagnosing Psychological
Disorders

27
 Diagnosing Psychological
Disorders
• Classification
• Taxonomy
• Nosology
• Nomenclature
• DSM-5, ICD-10

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 Diagnosing Psychological
Disorders
Classification Issues
• Subject of classifying human behaviour is
controversial
• Distinctions between “normal” and
“abnormal” unclear

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 Diagnosing Psychological
Disorders
Classification Issues
Categorical, Dimensional, and Prototypical
Approaches
• Classical categorical approach
• Dimensional approach
• Prototypical approach

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 Diagnosing Psychological
Disorders
Classification Issues
Reliability
• Personality disorder classification is
unreliable and biased
Validity
• Getting the label for a disorder right

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 Diagnosing Psychological
Disorders
Classification Issues
Diagnosis Before 1980
• Early classification had biological foundations
of disorders
– Identified by Emil Kraepelin
• 1948: WHO added section of mental disorders
to ICD
• 1952: DSM-I published by APA
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 Diagnosing Psychological
Disorders
Classification Issues
DSM-III and DSM-III-R
• Atheoretical approach to diagnosis
• Specific and detailed criteria for identifying disorders
DSM-IV and DSM-IV-TR
• 1994: compatible with ICD-10
• Multiaxial format
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 Diagnosing Psychological
Disorders
DSM-5
• Some new disorders introduced,
reclassifies some
• Relatively uniform rating for dimensional
axes of
– severity, intensity, frequency, or duration

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 Diagnosing Psychological
Disorders
DSM-5
Social and Cultural Considerations in the
DSM-5
• Cultural formulation
Criticisms of the DSM-5
• Comorbidity

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 Diagnosing Psychological
Disorders
DSM-5
A Caution about Labelling and Stigma
• Labelling is categorizing people as individuals
with psychological disorders.
• Stigma is a negative connotation attached to
individuals with impaired cognitive abilities or
behavioural functioning.

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 Diagnosing Psychological
Disorders
Creating a Diagnosis
• Mixed anxiety-depression
• Premenstrual dysphoric disorder (PMDD)
Beyond DSM-5: Dimensions and Spectra
• Autism spectrum disorder

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