1. Chapter 4 Clinical Assessment and Diagnosis
ABNORMAL PSYCHOLOGY SIXTEENTH EDITION James N. Butcher/ Jill M. Hooley/ Susan Mineka
Chapter 4
Clinical Assessment and Diagnosis
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2. Assessing Psychological Disorders
Purposes of psychological assessment
To understand the individual
To predict behavior
To plan treatment
To evaluate treatment outcome
Clinical diagnosis – the process of determining whether the individual meets the criteria for a psychological disorder

3. The Basic Elements in Assessment
Identification of presenting problem
Situational or pervasive?
Duration?
Prior attempts to help or treat?
Self-defeating or resourceful?
How does problem impact social roles?
Does problem match any DSM-5 disorder criteria?
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4. The Relationship Between Assessment and Diagnosis
Classification of presenting problem
Treatment planning
Knowledge of range of diagnostic problems
Insurance payment
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5. Taking a Social or Behavioral History
Good assessment includes social history noting:
Personality factors
Social context
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6. Ensuring Culturally Sensitive Assessment Procedures
Awareness of increasing population diversity
APA ethical code related to cultural competence
Cultural variables inclusion
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7. Influence of Professional Orientation
May determine assessment techniques
Does not limit clinician to one type of assessment
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8. Reliability, Validity, and Standardization
Psychological Assessments are:
Reliable
Valid
Standardized
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9. Key Concepts in Assessment
Standardization
Ensures consistency in the use of a technique
Provides population benchmarks for comparison
Examples include structured administration, scoring, and evaluation procedures

10. Trust and Rapport Between the Clinician and the Client
Importance of trust and rapport
Impact on assessment process
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11. Assessment of physical organism incorporates:
General physical examination
Neurological examination
Neuropsychological examination
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12. General Physical Examination
Many psychological problems have physical components either as
Causal factors
Symptom patterns
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13. Neurological Examination
Neurological tests aid in determination of
site of organic brain disorder
extent of organic brain disorder
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14. Peeking Inside the Brain
Electroencephalograph(EEG)
Positron emission
tomography(PET)
fMRI
Computed tomography(CT)
Magnetic resonance
Imaging (MRI)

15. Neuropsychological Examination
Involves use of expanding array of testing devices
Measures cognitive, perceptual, and motor performance
Provides clues to extent and location of brain damage
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16. Neuropsychological Examination
Halstead-Reitan Battery
Halstead Category Test
Tactual Performance Test
Rhythm Test
Speech Sounds Perception Test
Finger Oscillation Task
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17. Psychosocial Assessment
What role does psychosocial assessment attempt to provide?
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18. Psychosocial Assessment
Three procedures commonly used in psychosocial assessments include:
Assessment interviews
Clinical observation of behavior
Psychological tests
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19. Assessment Interviews
Face-to-face interaction
Structured interviews
Unstructured interviews
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21. The Clinical Interview and Physical Exam
Mental status exam
Appearance and behavior
Thought processes
Mood and affect
Intellectual functioning
Sensorium
Semistructured clinical interviews (DICA, ADIS - IV)
Physical exam

22. Clinical Observation of Behavior
Clinical observation in natural environments
Clinical observations in therapeutic or medical settings
Use and purpose of rating scales
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23. ABC Chart

24. Behavioral Assessment and Observation
Behavioral observation and behavioral assessment
Can be either formal or informal
Self-monitoring vs. being observed by others
Problem of reactivity using direct observation
Behavior Rating Scales
Expanded Brief Psychiatric Rating Scale

25. Psychological Tests
Two general categories of psychological tests for use in clinical practice are
Intelligence tests
Personality tests
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26. Psychological Tests WPPSI – IV, WISC-IV, Stanford-Binet V and WAIS-IV
Most commonly used intelligence tests include:
WPPSI – IV, WISC-IV, Stanford-Binet V and WAIS-IV
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27. Projective personality tests
Psychological Tests
Projective personality tests
Unstructured stimuli are presented
Meaning or structure projected onto stimuli
Projections reveal hidden motives
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28. Projective personality tests include:
Psychological Tests
Projective personality tests include:
Rorschach Inkblot Test
Thematic Apperception Test
Sentence Completion Test
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29. Rorschach Inkblot Test
10 inkblots - designed by Hermann Rorschach.
Rorschach tests began in 1911.

31. Thematic Apperception Test (TAT)
Developed by Henry Murray ( ),

32. Psychological Tests Advantages and limitations Examples
Objective personality tests
Examples
Advantages and limitations
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33. Psychological Testing and Objective Tests
Roots in empirical tradition
Test stimuli are less ambiguous
Require minimal clinical inference in scoring and interpretation
Personality tests
Minnesota Multiphasic Personality Inventory (MMPI)
Extensive reliability, validity, and normative database

36. Integration of Assessment Data
Developing integrated, coherent working model
Utilizing individual or team approach
Identifying definitive picture vs. discrepancies
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37. Ethical Issues in Assessment
Potential cultural bias
Theoretical orientation of clinician
Under-emphasis on external situation
Insufficient validation
Inaccurate data or premature evaluation
Ethical issues in assessment include:
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38. Classifying Abnormal Behavior
Benefits of classification include:
Introduction of order
Communication establishment
Prevalence rates
Clarification of insurance issues
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39. Differing Models of Classification
Three basic approaches include:
Categorical approach
Dimensional approach
Prototypal approach
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40. Formal Diagnostic Classification of Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders (DSM)
International Classification of Disease (ICD)
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41. Formal Diagnostic Classification of Mental Disorders
The DSM-5
More comprehensive and more subtypes of disorders
Allows for gender related differences in diagnosis
Provides structured interview regarding cultural influences
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42. Formal Diagnostic Classification of Mental Disorders
Need for diagnosis
Disadvantages of labeling
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