Chapter 3 Clinical Assessment Slides & Handouts by Karen Clay Rhines, Ph.D. Seton Hall University.

Chapter 3Chapter 3

Clinical Assessment

Slides & Handouts by Karen Clay Rhines, Ph.D.Seton Hall University

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Clinical AssessmentClinical Assessment

• ______________: to determine how and why a person is behaving abnormally

• tools:– ____________– Tests– _________________

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Clinical InterviewsClinical Interviews• Face-to-face encounters • personal history• Conducting the Interview

– Focus depends on _______________– _________ interviews: open-ended

questions– structured interviews: ______

questions– May include __________________

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Mental Status Examination:Mental Status Examination:

Appearance and Appearance and BehaviorBehavior

Hyperactivity Psychomotor agitation Psychomotor retardation Catatonia Compulsions

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Mental Status ExaminationMental Status Examination

Content of ThoughtContent of Thought

• _______________• Delusions• _______________• ______ Thinking

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Mental Status ExaminationMental Status Examination

Affect and MoodAffect and Mood

• Affect: _________________________o Inappropriateo Blunted or Flato Exaggerated, Heightened, or

Overdramatico Decreased Mobilityo Excessive Mobilityo Restricted Range

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Mental Status ExaminationMental Status Examination

Affect and MoodAffect and Mood

• Mood: ________________________Euthymic = _____________________________ = Unpleasant feelings_______ = Cheerful, elated, possibly even ecstatic

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Mental Status ExaminationMental Status Examination

Perceptual Perceptual ExperiencesExperiences

• Hallucination: _________________

Auditory Command

Visual Olfactory Somatic Gustatory

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Mental Status ExaminationMental Status Examination

OrientationOrientation

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• Time• Place• Identity

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Mental Status ExaminationMental Status Examination

Thinking Style & Thinking Style & LanguageLanguage• incoherence: speech that

is ____________________.• loosening of

associations: flow of thoughts that is ___________________________________.

• _______ thinking: thinking characterized by contradictions and erroneous conclusions.

• _______________: going completely off track and never returning to the point.

• _____________: speech that is indirect and delayed in reaching a point because of irrelevant and tedious details.

• ________: the experience in which a person seemingly “loses” a thought in the midst of speaking, leading to seconds or minutes of silence

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• __________: sound, rather than word meaning, determines content of individual’s speech.

• ____________: fabricating facts or events to fill in voids in one’s memory; not conscious lies but attempts to respond with approximations of the truth.

• ___________: persistent repetition of someone else’s words or phrases, as if mocking or sarcastic.

• ____________: fact-paced speech marked by acceleration, abrupt changes of topic, and plays on words.

• _________ of speech: speech rapid and driven, as if individual is compelled to utter stream of nonstop monologue.

• perseveration: _________ of the same idea, word, or sound.

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Mental Status Mental Status ExaminationExamination

o Motivationo impairment can

make even ordinary life tasks seem insurmountable.

• Sense of Self (sense of who I am)– Depersonalization – Identity confusion

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Mental Status ExaminationMental Status Examination

Cognitive Functioning:

• Level of ___________ evidenced by details such as memory and abstract ability.

• Problems might include __________ impairment

Insight and Judgment:

• ____________________________________.

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Characteristics of Assessment Characteristics of Assessment ToolsTools

• _______________ : performance serves as a common standard (norm)

• Reliability – _______________• _________ – accuracy of results

– measures what it is supposed to be measuring

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Clinical TestsClinical Tests

Intelligence Tests assess both verbal and non-verbal

skills Generates an intelligence quotient

(IQ) Most popular: Wechsler (WAIS,

WISC)

I.Q. I.Q. =Mental Age

Chronological Age

Mental Age

Chronological Age X 100

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Clinical TestsClinical Tests Personality Inventories

– measure broad personality characteristics– Minnesota Multiphasic Personality Inventory

(MMPI)• Derives ten clinical scales:

– Hypochondriasis (HS)– Depression (D)– Conversion hysteria (Hy)– Psychopathic deviate (PD)– Masculinity-femininity (Mf) Paranoia (Pa)– Psychasthenia (Pt)– Schizophrenia (Sc)– Hypomania (Ma)– Social introversion (Si)

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Clinical TestsClinical Tests

Response Inventories – ________________________________

• Affective inventories (Ex. BDI)• Social skill inventories• Cognitive inventories

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Clinical TestsClinical Tests

• Projective tests– ______________________________________

__________________________•Rorschach Inkblots•Thematic Apperception Test•Sentence Completion•Drawings

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Rorschach InkblotRorschach Inkblot

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Behavioral Behavioral Assessment Assessment

• Behavioral Self-Reports– Behavioral

Interviewing– ________________– Behavioral

Checklists and Inventories

• Behavioral Observation – ________– _______

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Environmental Environmental AssessmentAssessment

Environmental Assessment:

A form of measurement examining the _________________________________________________.

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Physiological Physiological AssessmentAssessment

Many psychological disorders occur in the presence of ______________________________

Disturbances may be:– localized in brain, perhaps as _________________ or– _______________ (e.g., diabetes, AIDS) that may alter

psychological functioning.

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Physiological AssessmentPhysiological Assessment

• Psychophysiological techniques

– Measure ______________ response•HR, BP,

temperature, etc.• Most popular =

_______________________________)

• Physiological Techniques (_______ assess brain function) – Brain Imaging:

•EEG, CT, MRI, PET

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Neuropsychological Neuropsychological AssessmentAssessment

Neuropsychological assessment:

____________ assess brain function by assessing cognitive, perceptual, & motor functioning– Most widely used =

Bender-Gestalt