1. Diagnostic Testing: Clinical Applications
PSY 614
Fall 2007
Instructor: Emily E. Bullock, Ph.D.

2. Clinical Assessment & Diagnosis
Clinical Assessment – systematic evaluation and measurement of psychological, biological, and social factors in someone with a possible psychological disorder
Diagnosis – process of determining whether a presenting problems meets the criteria for a mental disorder in DSM-IV-TR

3. Goals of Clinical Assessment
Description
Understand the individual
Decision-Making (Prediction)
Predict behavior
Plan treatment
Evaluate treatment outcome

4. Multiaxial Diagnosis Using DSM-IV-TR
Axis I – clinical disorders and conditions that may be the focus of clinical attention
Axis II – personality disorders and mental retardation
Axis III – general medical conditions
Axis IV – psychosocial stressors
Axis V – global assessment of functioning (GAF)

5. The Role of Diagnostic Testing
Diagnosis is generally made based on an interview and a review of the client’s history
Tests provide a norm-referenced supplement to these procedures
May help guard against interviewer bias

6. Common Approaches to Diagnostic Testing
Rationally-derived tests (symptom checklists)
Empirically-derived tests (MMPI-2)
Hybrid tests that use a combination of rational/theoretical and empirical procedures (MCMI-III, PAI)

7. Rationally-Derived Tests
High face validity
Symptom checklists
OQ-45.2
Evaluation
Advantages
Disadvantages

8. OQ-45.2: An Overview Description and rationale Administration Scoring
45-item symptom checklist designed to track therapeutic progress and outcome
Administration
Adults
6th grade reading level
Takes about 5 minutes
Scoring

9. OQ-45.2: Interpretation
Not intended for diagnostic purposes but as quick screen for severity of distress
Step 1: Review critical items (8, 11, 26, 32, and 44)
Step 2: Examine each scale score
Total
Symptom Distress
Interpersonal Relations
Social Role Performance

10. OQ-45.2: Interpretation cont.
Clinical
Cutoff
Normal
Adults
Couns. Center
Outp. Clinic
RCI SD 36
25 (11)
41 (15)
49 (15) 10 IR 15
10 (5)
19 (4)
20 (6) 8 SR 12
10 (4)
15 (4)
14 (5) 7
Tot 63
45 (18)
75 (17)
83 (22) 14

11. OQ-45.2: Report Writing
Start with the Total score and note whether any scales exceeded the cutoff
“Mr. Johnson’s total score of 65 on the OQ-45 exceeded the clinical cutoff, indicating that his report of overall distress was clinically meaningful.”
Indicate which norms are being used
“Compared with college undergraduates, Mr. Johnson exceeded the 84th percentile on Symptom Distress.”

12. OQ-45.2: Report Writing cont.
Provide the reader with item-level examples so they know what is producing scale elevation
“Mr. Johnson reported that he is frequently bothered by feelings of loneliness, hopelessness about the future, and difficulty sleeping.”
Be sure to note any critical items that were endorsed