chapter 3 classification and assessment. classification: categories of maladaptive behavior...
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CHAPTER 3
CLASSIFICATION AND ASSESSMENT
CLASSIFICATION: CATEGORIES OF MALADAPTIVE BEHAVIOR
ADVANTAGES OF CLASSIFICATION Bridges gap between research and treatment. Allows communication between clinicians. Valuable for statistical purposes. Categories contribute to planning of treatment
programs and facilities. DISADVANTAGES OF CLASSIFICATION
Labeling may result in stigma. Diagnostic categories are imperfect.
CHARACTERISTICS OF A GOOD CLASSIFICATION SYSTEM
1. Provides information about the cause or causes of a condition.
2. Provides a common language for communication among clinicians and researchers.
3. Enables clinicians to give patients and their families a short- and long-term outlook.
4. Indicates possible treatment.5. Suggests paths to prevention.
THE DSM-IV
Axis I Most disorders except personality disorders and
mental retardation. Axis II
Personality disorders and mental retardation. Axis III
Relevant general medical conditions. Axis IV
Psychosocial and environmental problems. Axis V
Global assessment of psychological, social, and occupational functioning.
MAJOR AXIS I DIAGNOSTIC CATEGORIES
Disorders first diagnosed in infancy and childhood
Delirium, dementia, amnestic, and other cognitive disorders
Mental disorders due to a general medical condition
Substance-related disorders
Schizophrenia and other psychotic disorders
Mood disorders
Anxiety disorders Somatoform disorders
Factitious disorders Dissociative disorders
Other conditions that are the focus of clinical attention
Eating disorders
Sexual and gender identity disorders
Impulse-control disorders
Adjustment disorders Sleep disorders
CLINICAL OBSERVATIONSAND SYMPTOMS USED
IN DSM-IV CLASSIFICATION
RESEARCH ON CLASSIFICATION
RELIABILITY Is system reproducible? Kappa statistic
VALIDITY Is system appropriate?
CLINICAL JUDGMENT Does system produce reliable
diagnoses? CULTURAL CONTEXT
Is system culture-bound?
THE ASSESSMENT PROCESS
Interview Mental Status Examination Structured Interview Diagnostic Interview Schedule
(DIS) Structured Clinical Interview for
DSM (SCID)
FOUR COMPONENTS OF THE CLINICAL INTERVIEW
Rapport How interviewer and client relate to each
other. Technique
Select techniques to build rapport. Mental Status
Evaluate client answers to questions. Diagnosis
A continuing, fluid process of formulating client’s problems and personality.
KEY FEATURES OF CLIENT BEHAVIOR OBSERVABLE IN MENTAL STATUS
EXAMINATION
Appearance Consciousness or alertness Psychomotor behavior Attention and concentration Speech Thought patterns Orientation Memory Affect and mood Energy Perception Judgment and insight
INTELLIGENCE TESTS
Binet Tests Alfred Binet IQ= MA/CA x 100
Wechsler Tests Wechsler Adult Intelligence Scale (WAIS-III) Wechsler Intelligence Scale for Children
(WISC-III) Wechsler Preschool and Primary Scale of
Intelligence (WPPSI-R) Full Scale IQ=Performance IQ+Verbal IQ
Kaufman Assessment Battery for Children (K-ABC)
NEUROPSYCHOLOGICAL TESTSMeasure cognitive, sensorimotor, and perceptual
consequences of brain abnormality
PERSONALITY ASSESSMENT
Personality Inventories Minnesota Multiphasic Personality Inventory
(MMPI-2) Million Clinical Multiaxial Inventory (MCMI)
Rating Scales Behavior Rating Scale for Children Visual Analogue Scale (VAS)
Projective Techniques Rorschach Inkblots Thematic Apperception Test (TAT) Word Association Test Sentence Completion Test
THE MMPI-2: CLINICAL AND VALIDITY SCALES
ASSESSING AXIS II PERSONALITY DISORDERS
THE THEMATIC APPERCEPTION TEST (TAT)
VISUAL ANALOGUE SCALES
OTHER FORMS OF ASSESSMENT
Behavioral Assessment Information about behaviors
Cognitive Assessment Information about thoughts and thought
processes Relational Assessment
Information about key relationships, especially family.
Bodily Assessment Physiological functioning Polygraph, galvanic skin response (GSR), brain
imaging
BODILY ASSESSMENT – BLOOD PRESSURE
BODILY ASSESSMENTTHE POLYGRAPH