Lecture
The Diagnostic Process
The goal of clinical-psychological assessment – is to provide a psychological evaluation of a personality or behavioral problem (mental disorder) in order to subsequently decide on ways of providing professional help.
The Diagnostic Process
The main tasks of conducting a clinical-psychological assessment (from a medical perspective) are:
differential diagnosis of disturbances in mental activity,
analysis of the structure and determination of the degree of mental disturbances,
determining the level of the patient's mental development ,
determining the characteristics of his/her personality,
assessing the dynamics of mental disturbances over time,
solving expert (forensic) tasks
The diagnostic process – is the process of distinguishing between normalcy and pathology.
It is carried out through the analysis of various information about a person's development and life with the aim of drawing conclusions about the nature and causes of the existing problem. It concludes with a diagnosis – a determination of the nature of the disorder.
A distinction should be made between a medical diagnosis and a clinical-psychological diagnosis.
A medical diagnosis focuses on formally assigning the visible psychological problem to a specific taxonomic unit – the most suitable name included in the accepted classification system. Correctly identifying the name of the disorder automatically predetermines the possible range of its causes and the corresponding way of addressing them through specific treatment.
A clinical-psychological diagnosis represents a psychological analysis of the problem (an assessment of behavior, mental functions and emotions, personality state, and the external circumstances of the disturbance).
In fact, a clinical-psychological diagnosis is not simply the correct recognition and selection of a suitable name for the disorder, but a description of the features of the behavior, thoughts, and feelings characteristic of a particular mental disorder in a specific individual.
Components of clinical-psychological diagnostics:
description of the problem or disorder (main and accompanying features; degree of severity – duration, intensity, frequency of occurrence, and depth of the problem; the circumstances under which the pathological condition arises or worsens);
formal classification of the problem or disorder (determining the type);
explanation of the possible causes and conditions giving rise to the problem or disorder;
prognosis for the development of the problem or disorder (formulating assumptions about how the pathological condition will develop under certain circumstances);
overall psychological assessment (allows one to draw up a further action plan and then evaluate its effectiveness by comparing the assessment before and after the therapeutic interventions).
Two opposite approaches can be distinguished in diagnostics: the explanatory and the understanding approach.
the explanatory approach is connected with the nosological paradigm of clinical-psychological diagnostics,
the understanding approach – with the descriptive-phenomenological one.
In the nosological paradigm, the psychologist relies on general conclusions applicable to broad groups of people.
In the descriptive-phenomenological paradigm, the psychologist places emphasis on the unique developmental situation of a specific child or family.
The Nosological Principle
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The leading nosological principle of diagnosis is the principle of explanation, which is based on whether a person's behavior and the features of their mental activity are comprehensible or incomprehensible to an outside observer (a psychologist or physician).
The main emphasis in nosologically oriented clinical-psychological diagnostics is placed on distinguishing individual features of the disorder and determining their connection with the pathological process. Pathological features are denoted using a system of symptoms.
The use of the concepts of symptom and syndrome makes it possible to describe the patient's condition in a strictly formalized way, since it breaks down holistic mental activity into separate typical units, which is important for recognizing the essence of the disturbance.
The descriptive-phenomenological paradigm
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