1. Clinical Assessment Purposes To understand the individual
To predict behavior
To plan treatment
To evaluate treatment outcome

2. Clinical Assessment Issues
Reliability
Validity
Standardization
Clinical Utility or Clinical Significance

3. Diagnostic Reliability
Present
Absent
Disorder Present
Diagnosis Given

4. Methods of Clinical Assessment
Clinical Interview
Structured vs. Semistructured
Behavioral Observation
Mental Status Exam
Testing
Objective Tests
Projective Tests

5. Additional Methods Physical Examination Neurological Examination
Neurological Imaging
CT, PET, MRI, fMRI
Neuropsychological Examination
Tasks that reveal brain function (or dysfunction)

6. Diagnosis Idiographic vs. Nomothetic Classification Categories
Dimensions
Threshold Model
Prototype Model

7. Diagnostic and Statistical Manual
Evolving Document
Currently DSM-IV-TR
DSM-V expected in 2013
Purpose?
Utility?
Real world reliability and validity?

8. DSM-IV-TR Multiaxial System Axis I – Clinical Syndromes
Axis II – Personality and Developmental Disorders
Axis III – Medical Conditions
Axis IV – Psychosocial Stressors
Axis V – Global Assessment of Functioning (GAF; scale )

9. Unresolved Issues in the DSM-IV
Thresholds for Diagnosis?
For example, level of distress, impairment, number of required symptoms
Somewhat Arbitrary Time Periods
Should Other Axes Be Included?
Such as premorbid history, treatment response, family functioning, GARF
Optimal for Designing Treatments or Research?
The Problem of Comorbidity

10. Issues of Diagnosing Reliability, Validity, and Comoribity Problems
Cause
Reification
Treatment
Cure
Relief
Labeling
Stigma
Self-fulfilling prophecy
Social Constructions