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Psychological Assessment of Patients with Behavioural Symptom

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					Psychological Assessment of
       Patients with
   Behavioural Symptoms
Psychiatric Evaluation
 Taken as part of Medical History
 Personality chararterestics
 Relationships with others
 Sources of Stress
                     together with
Chief complaints
History of illness
 Evaluation of patients who show abnormal behaviour
 normally occurs in the context of clinical interview.

 Psychiatric History
 MSE
 Self Report inventories
      Mental Status Examination (MSE)
 MSE - comprehensive survey used to evaluate an individuals
  current state of Mental Functioning.
                           Assesses:-
 General Presentation (Appearance , behavior, attitude
  toward the examiner, and level of consciousness)
 Cognition (orientation, memory, attention and
  concentration, cognitive ability, and speech)
 Emotional state (mood and affect)
 Thought and perception (form or process, content, and
  perception)
 Judgment and Insight
 Reliability and Impulse control
Assessment Approaches

 Self Report Measures = Questionnaires
 Interviews
 Observational Ratings
 Objective Tests
 Projective Tests
                      Self Report inventories
 Evaluation instruments can be administered to an individual
  or to a group of individuals at one time.
 Individually administered tests allow careful observation and
  evaluation of that person.
 Tests given to a group of people simultaneously have the
  advantages of efficient administration, grading, and
  statistical analysis.
 Tests used in the psychological evaluation of patients: 3 main
  categories:
              Intelligence
               Achievement
             Personality/psychopathology
Questionnaires

 Most common method for personality
 Great for detailed self descriptions in bigger
  samples
 Rely on the info the participant is willing & able to
  give
 “Faking good” can be assessed
 Controlled testing situation
 Interpretation is exclusively on behalf of the
  applicant, not the interviewer
 Objectivity guaranteed
  Interviews
 Uses verbal interaction to determine personality

 Structured, semi-structured or unstructured

 Involves many information processes for interviewer and
  interviewee

 Not particularly reliable or valid for personality
  assessment

 Less accurate than people believe
      Psychometric approach

 Focuses on how well people perform on standardized
  mental tests and with what the scores correlate

   Achievement tests - based on learning


   Aptitude tests--measure the ability to acquire skills in the
   future

      ---the difference is really one of degree and intended use
   since all are based to some extent on experience with words,
   objects, etc.
   Intelligence
 Intelligence is a measure of individual’s innate potential for
  learning
                 It includes Quantification of :


 Ability to reason: to think logically and come to a
  conclusion
 To understand abstract concepts
 To assimilate, recall, analyze
 Organize information
 To meet the special needs of new situations.
    Determinants of Intelligence
                             Genetic Factors
                 Biological Factors ( -ve effect)
 Poor Nutrition
 Illness, early in life
                      Environmental Factors
 Exposure to education Enrichment
                              Social Factors
 Good Parent -Child Relationship
                            Emotional Factors
 Positive response to a testing Situation
  Invention of IQ Tests

 Alfred Binet:   1904        Mental Age

 Lewis Terman: 1916          Stanford     IQ

Divided child’s mental age by the child’s chronological age
 to yield an Intelligence Quotient (IQ): MA/CA x 100

All average children, regardless of age,would have an IQ of
 100
           IQ tests
 Weschler Adult intelligence scale – revised (WAIS-R)
  – adults (16-75 yrs)

 Weschler intelligence scale for children –revised – for
  testing children b/w 6 & 16 ½ (WISC-R)

 Weschler preschool and primary scale of
  intelligence – 2.5 yrs to 7 yrs and 3 months (WPPSI)

 Vineland social maturity scale – evaluates skills for
  daily living in mentally retarded and other challenged
  people (Eg. Visually impaired)
              Achievement tests
 Achievement is culture specific measure of knowledge
 and skills achieved from education and Experience

 Scholastic aptitude test (SAT)


 Medical college admissions test (MCAT)


 US medical licensing examination (USMLE)


 Wide range achievement test (WRAT) – evaluate
 arithmetic, reading, and spelling skills in patients
  Achievement tests in schools
 Evaluate individual student performance
 Monitor effectiveness of teaching program, teachers &
  administrators
 Compare with other school systems


 Eg. California, Iowa, Stanford & Peabody achievement tests
 PERSONALITY TESTS
Objective Personality Tests
 Participant could be unaware what is tested


 Result can’t be faked


 Based on easily scored & statistically analyzed


 May be administered without special training
   Objective tests
 Minnesota Multiphasic Personality Inventory (MMPI)
   the most widely researched and clinically used of all personality
    tests
   developed to identify emotional disorders

 MMPI: examples
 “Nothing in the newspaper interests me except the
  comics.”
 “I get angry sometimes.”
 Million Clinical Multiaxial inventory -2 (MCMI-2)
   generates scores directly compatible with personality disorders
    and other DSM-4 disorders
   Separates clinical syndromes into more severe and less severe
    disorders
  Projective Personality Tests

 Idea: reaction to ambiguous material shows more about
 you than about the material

 Rorschach Inkblot
 Thematic Apperception Test (TAT)



 Objectivity, reliability & validity doubtful
 Main problem: subjective interpretation of answers
  Assessing the Unconscious

 Projective Tests
    Used to assess personality (e.g., Rorschach or TAT tests)


    How? provides ambiguous stimuli and subject projects his or
     her motives into the ambiguous stimuli
Rorschach Ink Blot Test

                          used to identify
                          people’s inner
                          feelings by
                          analyzing their
                          interpretations
                          of the blots
 The most widely used projective test
 A set of 10 inkblots designed by Hermann Rorschach
Assessing the Unconscious--TAT
                  Thematic Apperception Test
                           (TAT)
                   people express their inner
                  motives through the stories
                  they make up about ambiguous
                  scenes
     Sentence completion test
 Used to identify patient’s worries & problems by verbal
  associations
 Patient is told to complete non-structured sentences started
  by the examiner

 My father…
 I wish…
 Most People………………

				
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Description: Lecture slides on behavioral sciences, psychology.