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Psych 410 Chapter 3

by: Molly Hart

Psych 410 Chapter 3 PSYC 410 002

Molly Hart

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These notes are from chapter 3!
Survey of Abnormal Psychology
Jeffrey C. Schatz
Class Notes
psych, Abnormal psychology, Assessment of mental health
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This 9 page Class Notes was uploaded by Molly Hart on Wednesday February 10, 2016. The Class Notes belongs to PSYC 410 002 at University of South Carolina taught by Jeffrey C. Schatz in Spring 2016. Since its upload, it has received 31 views. For similar materials see Survey of Abnormal Psychology in Psychlogy at University of South Carolina.


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Date Created: 02/10/16
Psych 410 notes Chapter 3 Clinical Assessment for Mental Health Concerns:  What to do when symptoms arise? o People start to go in to the doctor when mental health symptoms start  affecting their life in a big way o Physical exam/ General Health check up o Recommendation for specialist  Ex: Neurologist  Does this specialist help the condition?  Does the treatment work?  The Clinical Process o Assess what is going ontreatmentAssess the treatmentAlter  treatment Asses altered treatment  What is assessment? o Methods of gathering information  How to get information  Not enough to get good quality assessments  It isn’t straight forward o Methods of organizing information  Taking what you gathered and put it together for diagnosis or  treatment  Pick what is important and what isn’t  o Key concepts  Reliability­Something that can be used over and over again and is  reliable to other doctors or scientists.  Consistency   Validity­The results are correct due to the correct experiment or  assessment  Cant have validity without reliability  Results can’t be correct   Standardization­ How a assessment thing should be done and  should be the same from one person to the next.  EX: IQ test has a standard IQ of the world   Types of Assessment o I. Biological Assessments  o II. Psychosocial Assessments  US Mental Health Care Systems o Mild­moderate conditions  Private pay  Health insurance  “Indemnity insurance”  This caused health care professionals to continuously make  money as long as they diagnosed and treated people, which  led to corruption.  Health maintenance organizations (HMO’s)  Corporate wellness programs o Severe conditions  Asylums/Inpatient care  They were like warehouses for people  Most people were in and out all the time  May be a stressful environment for people who need a stress free environment.  It’s like jail where they can’t get by in the world by  themselves again when released.  Homelessness  Community mental health movement  HMO’s  Day treatment centers  Not enough beds for severe mental illness  Homelessness  Many have serious mental illness  Hospital Emergency rooms  If no one else will take you, hospitals have to take you.  Jails/Prisons  Many people have mental illness in jail and prisons.  Assessment Biological Factors o Physical Exam/ General health check­up  Clinical interview and history  Doctor takes your history  What are your concerns?  Talks about life, medications, history  Physical exam  Physical problems and mental problems may be connected  Blood work  Looks for organ dysfunction  Metabolites of neurotransmitters o Neurological Exam  Issues: emphasizes lower systems  Tries to rule out other causes like neurologic problems  History  Mental status a way of assessing cognitive functions by  observing behavior  Cranial nerves are the parts of the nervous system intact  Motor tone  Sensory  Coordination  Reflexes o Brain imaging used to rule out neurological problems  Electroencephalogram (EEG)  Measures electrical activity  Primary in clinical practices  Sensors on scalp  Temporal sensitivity electrical activity over time (time  course).  Relatively poor spatial sensitivity o Might not know where the source is.  Clinically used to rule out seizure disorders  Structural Imaging (CT, MR)  Water/hydrogen concentration inside of thing (started with  rocks).  Good spatial resolution (very detailed)  Differentiates types of tissue  Clinically used for brain damage (stroke or tumor)  Functional Imaging (PET, fMR)  The things that seem more active, are actually taking up  more blood, which can be used to identify a response from  a cognitive activity.   Measure changes in blood flow or oxygen use (vascular  supply  Good spatial resolution entire brain  Relatively poor temporal resolution  Clinically used to rule out medical causes o Can’t be used to make inferences about individual  people. o Neuropsychological Assessment  A combination of behavioral neurology and psychological  assessment  WWII veterans brain /head injuries  Problems with higher level cognitive functions  Problems with emotional states  Brain functioning as a cognitive profile higher mental functions  Mapping process  Sensitive, but not very good at localizing dysfunction  Describes functional capabilities.  Clinically used for functional abilities  EX: problems with memory  Assessment of Psychosocial factors o Clinical interview  Includes mental statues exam  Organizing observations of a patient  3 types  Unstructured free flowing, open­ended o High efficiency but low reliability  Semi­structured set questions with freedom to modify the  follow­up  o Medium efficiency and medium reliability  Structured set questions, closed­ended o Next question is predetermined o Low efficiency but high reliability o Behavioral assessment  ABC’s  A Antecedents (something that happens before a key  behavior)  O Organismic variable (Other things that are important)  B Behavior (The key behavior that is watched)  C Consequences   Behavioral observation  Try to understand environment, look for before and after of  key behaviors.   Behavioral interviewing/questionnaires   People in the room tell us about the behavior  Frequency of different behaviors.  Self­monitoring  The person themselves will give the assessment.  o Personality test  Projective  Rorschach Inkblot Test  Rooted in psychodynamic tradition  Ambiguous stimuli  Make people come up with a situation to fill in the blank  People project out their thoughts   Objective  MMPI­2  Most commonly used personality measure  Measures self­reported psychopathology and personality  features  Originally designed through criterion validity  Clear cut answers  Validity scales  Advantages o Number of scales and their utility o Validity scales o Reliability o Validity   Disadvantages o Poor test construction process o Cultural validity is poorly understood o Awkward to administer o Good enough is the enemy of better o Symptom Questionnaires  Have you felt sad or down recently?  Do you have difficulties sleeping?  Is it hard for you to concentrate  Yes/no answers o Cognitive/Intelligence Tests  Cognitive abilities (attention skills, language skills)  Cognitive style/problem solving  How people approach problems  Behavioral sample with cognitive challenges  Difficult behaviors may come out during challenging times.  o Cultural differences in Assessment  People thought things were universal and nothing was different  between cultures  Cultural validity  Intelligence is different from culture to culture.   Communication/language barrier  Might not translate from one language to another  Cultural constraints on behavior  Some cultures may think it is taboo to seek mental help but  others it may be the norm  Lack of trust/credibility  Stereotypes  Generating it in your head   Doesn’t affect your work  How to minimize the negative impact of cultural difference for  assessment  Awareness be aware of how culture affect people and the  environment  Knowledge get information of different cultures  Dynamic sizing don’t make categories/assumptions  Flexibility in methodsmore flexible in assessments. Diagnosis and Classification of Abnormal Behavior o Diseaseabnormal condition with identified cause, symptoms, and method of diagnosis o Syndromea common set of symptoms that co­occur frequently. Causes  may be partially understood. PSYCHOLOGY uses it.  EX:   Alzheimer’s disease is due to brain atrophy from senile  plaques and neurofibrillary tangles. (autopsy).  Syndrome is Probable DAT general declines in memory  and other areas of cognitive ability.  When diagnosing, you can group symptoms together  Can have more than one way to divide things up/organize it  Core symptoms are most important for diagnosis  Associated problems are not that important but may be  around the other symptoms  Then you need to label things  Equifinality  Syndromes may have multiple causes  EX: The flu and Ebola have many of the same symptoms  Symptoms may fall under the same category/ different  illnesses o Classification systems  I. Diagnostic and Statistical Manual of Mental Disorders (DSM­V)  Mostly in America  Goals of DSM o INCREASE RELIABILITY OF DIAGNOSIS  Doesn’t tell you the treatment that will work for certain  people!!!!!!  Field trials did not apply to people that well at first o Still not that impressive o Moderate reliability o May not agree on a specific disorder but may think  it is all a mood disorder.  Definition of Mental Disorder o Clinically significant disturbance of cognition,  emotion, or behavior in an individual. o Cause significant distress or disability o Not an expected or culturally approved response to  a common stressor o Not primarily a conflict between the individual and  society  DSM diagnosis o Categorical system EX: mood disorders  Have something or don’t have something o Tries to be atheorteical (not based on/ concerned  with theory).  Don’t want people fighting on theoretical  views.  o Does not address specific etiology  Nothing about what caused the syndrome o May or may not aid in treatment planning  Take the best guess on what the diagnosis is  statistically    Major Depressive Episode o 5 symptoms for at least 2 weeks o One symptom must be depressed mood or loss of  interest  o NOT GRIEF  The symptoms o Depressed mood o Markedly diminished interest or pleasure in all or  almost all activities  o Significant weight loss or gain, or increase or  decrease in appetite. o Insomnia or hypersomnia o Psychomotor agitation or retardation o Fatigue or loss of energy o Feelings of worthlessness or inappropriate guilt o Diminished concentration or indecisiveness o Recurrent thought of death or suicide  Dimensional systems o Concerned with the amount or degree of a problem o Requires quantifying the problem on a scale  Dimensional approach o A group at a level of severity that are considered  abnormal for treatment.  II. The International Classification of Diseases (ICD­10)  Internationally  III. Dimensional Approaches  Not that different from ICD­10  Key research paradigms for mental health research o Experimental designs  Randomized control trials (RCTs)  Demonstrates the efficacy of a treatment o DOES THE TREATMENT WORK?  Random assignment to groups  At least two conditions  Compare groups on primary and secondary outcomes as  defined a priori.  Randomization o Bias in assignment  Blind experiments? o Unknown confounds/variables  Can’t tell participants which group is which  Conditions o Control conditions  Keep doing what you’re doing o Treatment conditions  Something more like education or placebo  Outcomes o A priori  Looking retrospectively at the outcome  which can influence the actual results o Single or multiple?  How many outcomes do you measure?  How likely you are to get an outcome?  Analogue studied/models  Experimental induction that mimics a clinical condition o Mood o Beliefs o Brain function  Correlational designs o Epidemiological research methods  Incidence  Prevalence Determine how important  diseases are.   Distribution more may occur in different  genders (Biological?)  Correlates as potential causal factors o Single case experimental designs  Withdrawal designs (A­B­A­B)  See if first treatment even works  A baseline over a meaningful period  of time  Implement a treatment and see if it  works  Does the symptom go down?  Remove treatment and see if they get worse to see if the treatment actually  works.  Multiple baseline designs


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