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CLINICAL ASSESSMENT AND DIAGNOSIS

CLINICAL ASSESSMENT AND DIAGNOSIS. Basics of Clinical Assessment. Multimethod & Multimodal. Like a Funnel. Start Broad. More Specific. Determining the Value of Clinical Assessment. Value Depends On. Reliability

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CLINICAL ASSESSMENT AND DIAGNOSIS

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  1. CLINICAL ASSESSMENT AND DIAGNOSIS

  2. Basics of Clinical Assessment • Multimethod & Multimodal • Like a Funnel Start Broad More Specific

  3. 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

  4. Methods of Clinical Assessment • Clinical Interview • Structured vs. Semistructured • Mental Status Exam • Behavioral Observation

  5. Methods of Clinical Assessment • Clinical Interview • Physical Exam

  6. Methods of Clinical Assessment • Clinical Interview • Physical Exam • Behavioral Assessment

  7. Methods of Clinical Assessment • Behavioral Assessment A Cs B

  8. Methods of Clinical Assessment • Clinical Interview • Physical Exam • Behavioral Assessment • Psychological Testing • Projective vs. Objective

  9. Methods of Clinical Assessment • Projective Tests Thematic Apperception Test (TAT)

  10. Methods of Clinical Assessment • Projective Tests Rorschach Inkblot Test

  11. Methods of Clinical Assessment • Other Projective Tests Sentence Completion Methods: - - Class lectures would be more stimulating with more _______ and lots of ____.

  12. Methods of Clinical Assessment • Other Projective Tests Draw a Picture

  13. Methods of Clinical Assessment • Other Projective Tests

  14. Methods of Clinical Assessment • Objective Tests • Minnesota Multiphasic Personality Inventory (MMPI, MMPI-2)

  15. Methods of Clinical Assessment • Objective Tests • Minnesota Multiphasic Personality Inventory (MMPI, MMPI-2) • Intelligence Tests • Stanford-Binet IQ Test: Intelligence Quotient • Wechsler IQ Tests

  16. Methods of Clinical Assessment • Clinical Interview • Physical Exam • Behavioral Assessment • Psychological Testing • Neuropsychological Testing

  17. Methods of Clinical Assessment • Neuropsychological Testing • Assess Broad Abilities • Infer Brain Dysfunction • Empirically Derived • Problems • False Positives and False Negatives • Long Time to Administer

  18. Methods of Clinical Assessment • Clinical Interview • Physical Exam • Behavioral Assessment • Psychological Testing • Neuropsychological Testing • Neuroimaging

  19. Methods of Clinical Assessment • Neuroimaging • Structural Abnormalities • Computerized Axial Tomography (CAT) • Magnetic Resonance Imaging (MRI)

  20. Methods of Clinical Assessment • Neuroimaging • Functional Abnormalities • Positron Emission Tomography (PET) • Single Photon Emission Computed Tomography (SPECT) • fMRI

  21. Methods of Clinical Assessment • Clinical Interview • Physical Exam • Behavioral Assessment • Psychological Testing • Neuropsychological Testing • Neuroimaging • Psychophysiological Assessment

  22. Methods of Clinical Assessment • Psychophysiological Assessment • Measure Nervous System Activity • Some Problems and Limitations

  23. From Assessment to Diagnosis and Classification

  24. Diagnostic and Statistical Manual of Mental Disorders • Nosology____________________________________________________________ • Nomenclature ______________________________________________________________________________________________________ • Two widely used classification systems: ICD-10 & DSM

  25. Development of the DSM • DSM-I (1952) • DSM-II (1968) • DSM-III (1980) • DSM-III-R (1987) • DSM-IV (1994) • DSM-5 (2013)

  26. Approaches to Classification Classical or Categorical Dimensional Prototypical

  27. 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

  28. 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 ______________________________

  29. The DSM-5 • Continuing criticisms & controversies: • ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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