Introduction

• Clinical assessment: systematic evaluation and measurement

  • Psychological

  • Biological

  • Social

• Diagnosis: degree of fit between symptoms and diagnostic criteria

• Purpose: understanding the individual, predicting behavior, treatment planning, evaluating outcomes

Key Concepts in Assessment

• Reliability: degree of consistency of a measurement

• Validity: does the test measure what it’s supposed to?

  • Concurrent: comparison between results of one assessment with another measure known to be valid

  • Predictive: how well the assessment predicts outcomes

• Standardization: consistent use of techniques

  • Provides normative population data

Clinical Interview

• Clinical interview: asses multiple domains

  • Presenting problem

  • Current and past behavior

  • Detailed history

  • Attitudes and emotions

• Most common clinical assessment method

• Structured vs semistructured

Mental Status Exam

• Components of mental status exam: appearance and behavior, thought processes, mood and affect, intellectual functioning, and sensorium

  • Appearance and behavior: overt behavior, attire, posture, expressions

  • Thought processes: rate of speech, continuity of speech, content of speech

  • Mood and affect: predominant feeling state of the individual, feeling state accompanying what individual says

  • Intellectual functioning: type of vocabulary, use of abstractions and metaphors

  • Sensorium: awareness of surroundings in terms of person (self and clinician), time, and place

Physical Examination

• Physical examinations can be helpful in diagnosing mental health problems

  • Understand and rule out physical etiologies

    • Toxicities

    • Medication side effects

    • Allergic reactions

    • Metabolic conditions

Behavioral Assessment

• Identification and observation of target behaviors

  • Target behavior: behavior of interest

• Direct observation conducted by assessor or by individual or loved one

• Goal: determine that factors that are influencing target behaviors

• The ABCs of observation: antecedents, behavior, consequences

• Self-monitoring: when an individual observes themself

• May be informal or formal

• The problem of reactivity: simple observing a behavior may cause it to change due to the individual’s knowledge of being observed

Psychological Testing

• Specific tools for assessment of cognition, behavior, and emotion

• Include specialized areas like personality and intelligence

• Projective tests: project aspects of personality onto ambiguous test stimuli

  • Rooted in psychoanalytic tradition

  • Used to assess unconscious processes

  • Require high degree of inference in scoring and interpretation

• Objective tests: tests stimuli are less ambiguous

  • Rooted in empirical tradition

  • Requires minimal clinical inference in scoring and interpretation

• Personality tests

  • Minnesota Multiphase Personality Inventory (MMPI)

  • Extensive reliability, validity, and normative database

• Intelligence tests: nature of intellectual functioning and IQ