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Clinical Assessment . Psychological Approaches Biological Techniques Issues in Assessment. Five steps to diagnosis. Collect relevant patient information Verify diagnostic criteria Assess the patient’s psychiatric history Apply multiaxial criteria Establish the prognosis.
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Clinical Assessment Psychological Approaches Biological Techniques Issues in Assessment
Five steps to diagnosis • Collect relevant patient information • Verify diagnostic criteria • Assess the patient’s psychiatric history • Apply multiaxial criteria • Establish the prognosis
Psychological Approaches 1 • Clinical interviews • Intake and follow-up • Structured (SCID) and open-ended • Paradigmatic influence: You look for what you expect to find. • Situational influence: Compare cross-cultural interviewing
Psychological Approaches 2 • Psychological tests: Standardized • Self-report inventories • Projective techniques • Intelligence tests • Behavioral observation: SORC • Description and analysis • Checklists and time studies • Reactivity effects: Graph and display
Psychological Approaches 3 • Cognitive methods • Self-report inventories • Articulation of thoughts • Schema analysis: Beck’s characteristic logical errors • Arbitrary inference • Selective abstraction
Biological Approaches • Imaging techniques • Computerized EEG • CT scan • MRI and PET • Neurochemical analysis • Postmortem studies • Metabolite studies
Combined methods • Neuropsychological tests • Tactile Performance Tests • Category Test: Concept formation • Trailmaking test • Halstead-Reitan and Luria-Nebraska • Psychophysiology • Measure bodily responses to thoughts & feelings
Behavior Checklist • Behavior Time Observation :30 1:00 1:30 2:00 2:30 1. Eye contact 2. Note taking 3. Raised hand 4. Sleeping 5. Talking 6. Smoking
Appearance Behavioral disturbance, verbal and non-verbal Orientation Memory, long-term and recent Sensorium Perceptions Mood or affect Intelligence Thought: Form and content Insight Judgment The Mental Status Exam
Structured Interview • Demographic information • Reason(s) for diagnostic visit • History of this and other complaints • Psychiatric and medical • Range of social activity and level of adjustment before the presenting problem • Family history