1. Heidi Combs, MD Julie Lord, MD Colin Dauria, MD

2. By the end of the session, you should be able to: Assess a patient’s level of psychological functioning on a spectrum from low to high functioning.

3.  Major deficits in one or more of the following: reality testing, affect regulation, relationships with others, ability to sustain work, impulse control.

4.  The patient’s level of functioning helps to determine what type of treatment is indicated.  Functioning ranges from low to high.  Level of function can be determined by looking at interpersonal relationships and work histories

5.  Does your pt have at least one give-and-take relationship? Are relationships stable?  Can your patient sustain effort at things such as work or long-term projects?  Can your patient delay gratification and control impulses? Adapt to changes?  How does your patient handle anxiety or painful emotions?

6.  People with major deficits in reality testing, affect regulation, poor relationships with others, inability to sustain work, poor impulse control  People who can think realistically, have durable relationships, lead productive lives, and enjoy a range of activities

7.  Review the sample cases  Complete the Psychopathology Spectrum Worksheets for the cases. You may not be able to answer every question for each patient.  Determine whether the patient is low functioning (highly impaired,) moderate, or highly functioning (minimally impaired.)