Module 3 - Assessing and Diagnosing Abnormality

ASSESSING AND DIAGNOSING
ABNORMALITY
The Importance of
Classification System
• The goal of having a classification system for abnormal
behavior is to provide distinct categories, indicators
and nomenclature for different patterns of behavior,
thought processes and emotional disturbances.
1. It helps to clarify the therapist’s “picture” of the client’s
mental state.
2. It can lead the therapist to possible treatment programs.
3. The categories within the classification scheme provide
concise descriptions of or references to symptoms and
disorders.
4. The use of classification scheme has the effect of
standardizing psychological assessment procedures.
Problems with Early Diagnostic
Classification System
• The first effective scheme for mental disorder
was devised by Emil Kraepelin and had a distinct
biological slant, using biological factors to
categorize disorders.
• Classification was based on symptoms exhibited
by the patient as in the case in medicine.
• It was hoped that disorders evidence by similar
groups of symptoms would possess a common
etiology (the cause of disordes) and would
require similar treatments.
ASSESSMENT
• Is the process of gathering
information and drawing conclusions
about the traits, skills, abilities,
emotional functioning, and
psychological problems of the
individual, generally for use in
developing a diagnosis.
Informed
Consent
• Every individual has rights governing the circumstances
pertinent to how he/she can helped with his problem
through assessment and therapy. The provisions of
informed consent according to Pedersen (2005) include
the following:
 Every adult person has the right to decide what can and
cannot be done to his or her own body.
 Assumes a person is capable of making and informed
decision about own health care.
 State regulations vary, but mental illness does not mean
that a person is should be assumed incapable of making
decisions related to his or her own care.
 Patients have a right to:
a. Information about their treatment and any
procedures to be performed.
b. Know he inherent risks and benefits.
 Without this information (specific information,
risks, and benefits) a person cannot make an
informed decision. The above also hold true for
those who might participate in research. (Laben
and Crofts Yoker, 1998).
• The alternative model of behavioral
assessment treats tests results as sample
of behavior that occurs in specific
situations rather than signs of underlying
personality types or traits. Direct
observation may be used to assess
interactions between clients and
relatives.
• The behavioral interview poses
questions to learn more about the
history and situational aspects of
problem behavior. Non-verbal behaviors
are assessed together with cognitive
factors that affect the problem behavior.
• Analogue or contrived measures are
intended to simulate the actual
setting in which the behavior
naturally takes place but they are
carried out in laboratory or
controlled settings.
COMMONLY USED
ASSESSMENT TOOLS
CLINICAL
INTERVIEW
• A clinical interview provides opportunity for
observation of the subject as well as for the
collection of data about person’s life situation
and personality. It covers the following:
 Identifying data
 Description of the presenting problem(s)
 Psychological history
 Medical/Psychiatric history
 Medical problems/Medication
MENTAL STATUS
EXAMINATION
• The mental status examination is based on
observation of the client’s behavior and self-
presentation, and the client’s response to
questions that probe various aspects of cognitive
functioning. The factors being assessed include:
Appearance Mood and Affect
Behavioral Observations Intelligence

Orientation Thought processes/content
Memory Insight
Speech and Language Judgment
Perceptual Processes/Disturbances
O B S E R VAT I O N
• Observation of overt behavior provides the
most basic method of assessing abnormal
behavior.
1. Direct observation or behavioral observation is
the hallmark of behavioral assessment, through
which the clinician can observe and quantify
problem behavior.
 Controlled observation – made in laboratory, clinic, or
contrived settings.
 Naturalistic observation – made in natural setting
(classroom, office, hospital ward, or home)
• In self-monitoring, clients assume
the primary responsibility for
assessing the problem inventory.
They record important incidents and
their own behaviors.
BEHAVIORAL RATING
SCALE
• Is a checklist that provides
information about the frequency,
intensity, and range of problem
behaviors.
P SYC H O LO G I C A L
TESTS
• Psychological tests
have been used to
assess maladaptive
behavior,
development of social
and emotional skills,
intellectual abilities,
vocational interest,
and brain damage.
I. Projective
Personality Test
• One in which the test taker is presented with
ambiguous stimuli. The goal of projective
testing is to obtain a multi-faceted view of the
total functioning of a person, rather than a
view of single facet dimension of personality.
– Rorschach technique
– Thematic Apperception Test (TAT)
– Draw A Person Test (DAP)
II. Objective Personality
Inventories
• Characteristically contain short-
answer items for which the
client's task is to select one
response from two or more
provided. The scoring is done
according to set of procedure.
– Minnesota Multiphasic Personality
Inventory
– Basic Personality Inventory
– NEO-PI
III. INTELLIGENCE
TESTS
• Used to obtain an estimate of a person’s
current level of cognitive functioning. It is
also used to assess intellectual
deterioration in organic or functional
psychotic disorders. An individually
administered intelligence test may yield
additional useful data for the clinician.
• The most commonly used are Standford
Binet and Wechsler intelligence scales,
WAIS-R, WISC-III and WPPSI-R
NEUROPSYCHO
LOGICAL
ASSESSMENT
• Neuropsychological assessment is done to evaluate
whether or not psychological problems reflect
underlying neurological damage or brain defects.
• Neuropsychological tests not only suggest whether or
not clients are suffering from brain damage, but many
also suggest which parts of the brain may be involved.
Some neuropsychological used tests are:
– The Bender Visual Motor Gestalt Test
– The Halstead-Reitan Neuropsychological Battery
– The Luria Nebraska Test Battery
PHYSIOLOGICAL MEASUREMENT
• Studying people’s physiological responses can
also help learn about abnormal behaviors.
– People sweat more heavily when they are anxious.
Sweating can be measured through the Electrodermal
Responses or Galvanic Response
– Electroencephalogram (ECG) – measure brain waves
by attaching electrodes to the scalp
– Electromyography (EMG) – which monitors meuscle
tension through sensors attached to targeted muscle
groups. Changes in muscle tension are associated with
anxiety.
DIAGNOSIS
DIAGNOSIS
• Is a label attach to a set of symptoms that tend
to occur together. This set of symptoms is called
a syndrome.
• A Psychological Diagnosis is a classification or
labeling of a client's stated and perceived
difficulties following a formal assessment by a
psychologist or trained professional.
Issues on DSM
• Although the recently introduced
DSM-5 was meant to reflect the
developments in our
understanding of mental disorders
over the last decade or so, debates
continue over important questions
about the classification and
diagnosis of disorders.
 Reifying Diagnoses
 Category or Continuum
 Differentiating mental Disorders from
one Another
 Addressing Cultural Issues
The Social-Psychological Dangers of
Diagnosis
• People in power use psychiatric diagnoses to
label and isolate people who do not “fit in”
(Szasz, 1961). (Stigmatization)
• Rosenhan (1973) concluded that it is difficult to
distinguish between the sane and insane, and
shows that neither can be detected by
professionals. Furthermore, once being labeled
insane, it's extremely difficult to remove that
label, even when completely sane.

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ASSESSING AND DIAGNOSING

Behavioral Observations Intelligence

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