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Clinical Assessment Purposes To understand the individual

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Presentation on theme: "Clinical Assessment Purposes To understand the individual"— Presentation transcript:

1 Clinical Assessment Purposes To understand the individual
To predict behavior To plan treatment To evaluate treatment outcome

2 Clinical Assessment Issues
Reliability Validity Standardization Clinical Utility or Clinical Significance

3 Diagnostic Reliability
Present Absent Disorder Present Diagnosis Given

4 Methods of Clinical Assessment
Clinical Interview Structured vs. Semistructured Behavioral Observation Mental Status Exam Testing Objective Tests Projective Tests

5 Additional Methods Physical Examination Neurological Examination
Neurological Imaging CT, PET, MRI, fMRI Neuropsychological Examination Tasks that reveal brain function (or dysfunction)

6 Diagnosis Idiographic vs. Nomothetic Classification Categories
Dimensions Threshold Model Prototype Model

7 Diagnostic and Statistical Manual
Evolving Document Currently DSM-IV-TR DSM-V expected in 2013 Purpose? Utility? Real world reliability and validity?

8 DSM-IV-TR Multiaxial System Axis I – Clinical Syndromes
Axis II – Personality and Developmental Disorders Axis III – Medical Conditions Axis IV – Psychosocial Stressors Axis V – Global Assessment of Functioning (GAF; scale )

9 Unresolved Issues in the DSM-IV
Thresholds for Diagnosis? For example, level of distress, impairment, number of required symptoms Somewhat Arbitrary Time Periods Should Other Axes Be Included? Such as premorbid history, treatment response, family functioning, GARF Optimal for Designing Treatments or Research? The Problem of Comorbidity

10 Issues of Diagnosing Reliability, Validity, and Comoribity Problems
Cause Reification Treatment Cure Relief Labeling Stigma Self-fulfilling prophecy Social Constructions

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