Clinical psychology series: Diagnostics in psychology

Discover how official ICD/DSM diagnoses differ from descriptive diagnoses, and how the interview, cognitive assessment, and personality tests—MMPI, NEO, TAT—guided by the psychodynamic diagnostic manual, build clinical understanding.

Examine structured, semi-structured, and unstructured interviews, with examples like the SCID and the adult attachment interview. Understand diagnostic framing, session duration options, and note-taking practices.

Acquire interviewing strategies for clinical psychology through empathy, active listening, open-mindedness, and a non-judgmental stance, using exploratory, clarifying, and reflective questions in unstructured interviews.

Explore presenting problem, onset, duration, triggering events, prior treatment, demographics, and psychiatric history; then examine mental status, medical and family histories, social development, and coping strengths.

Explore social and developmental history by asking about childhood, key life events, present-day functioning, and personal strengths using natural or direct questioning and a strengths-based wrap.

Avoid leading and negative questions, be precise about meanings and timeframes, and manage emotions, interruptions, and hostility, while considering involuntary patients, with attitude and personal touch.

Present a collaborative formulation that summarizes the presenting problem in the patient’s words, links interview findings, notes effects and traits, and invites patient input for a changeable plan.

Explore a case study of John Miller, a 34-year-old with anxiety, and examine formulation, pharmacotherapy, and therapy to build coping skills and relaxation strategies.

Assess cognitive abilities: intelligence, memory, attention, language, and executive functioning to guide diagnosis. Note when thorough assessment is needed for brain trauma, stroke, or dementia, and use MoCA and MMSE.

Compare the Mini-Mental State Examination and the Montreal Cognitive Assessment as short cognitive screening tools for dementia, detailing scoring, items, and education norms, with screening implying risk, not diagnosis.

Explore the main cognitive assessment domains—language (semantics, pragmatics, prosodics), attention, memory, IQ, and executive functioning—and the tools used to analyze and diagnose cognitive function.

Explore why IQ matters in clinical assessment, compare the Wechsler Adult Intelligence Scale and Raven's Progressive Matrices, and discuss controversies and interpretations of intelligence as adaptability to new tasks.

Explore memory assessment using Luria's ten words test and Benton visual retention test to map fixation, retention, and reproduction, and to evaluate short-term and long-term memory for brain pathology.

Explore executive functioning and core processes—planning, inhibitory control, cognitive flexibility, working memory, attention, and problem solving—and review tests like the Wisconsin Card Sorting Test, Stroop, and Tower of London.

Explore personality diagnostics through the PDM two framework, focusing on personality styles and their traits, emotions, and central conflicts, with interviews and three tests including the thematic apperceptive test.

Depressive personality centers on self-criticism and preoccupation with loss or relationships, with sadness, guilt, and shame, and beliefs of inherent inadequacy and fear of rejection.

Explore dependent personality, where the conflict is keeping versus losing relationships; individuals fear abandonment, feel inadequate, rely on others for care, and show submissiveness, subtypes: counter dependent and passive aggressive.

Explore anxious avoidant and phobic personalities, focusing on safety versus danger, the belief that others protect or threaten, and how onset timing distinguishes anxious patterns from avoidant or phobic coping.

Examine obsessive compulsive personalities, their authority struggles, emotional rigidity, and need to control, and distinguish egosyntonic traits from ego dystonic OCD in therapy.

Explore schizoid personality: the conflict between fear and longing for closeness, the split between emotion and cognition, emotional pain and suppression, and how early development shapes relationships.

Explore somatizing personalities through alexithymia, where the body speaks while mirroring shapes fragile self-views and the sense that others are healthy and indifferent.

Examine hysteric-histrionic personalities, their gender-based conflicts, attention-seeking and seductive behaviors, and how fear of overstimulation and jealousy of the opposite gender shape neurotic and borderline patterns.

Explore narcissistic personalities across a spectrum from malignant to grandiose, driven by self-esteem fluctuations, external affirmation, and early relationship influences.

Paranoid personalities involve fear of attack and the belief that the world is dangerous. They use projective identification to disown dependency and other impulses, fearing hostility, humiliation, and being attacked.

Analyze psychopathic personalities within antisocial disorders, including criminal and parasitic, marked by manipulation, risk taking, and lack of remorse, with roots in childhood attachment and biology; therapy is seldom effective.

Explore the sadistic personality's central conflict—suffering versus inflicting it—driven by domination, with hatred, contempt, and glee, a detached, dehumanizing view of others, rarely amenable to therapy.

Explore borderline personality traits, focusing on self-fragmentation, intense emotions, and dissociated self states. Compare DSM and PDM concepts, discuss borderline personality organization versus disorder, and outline etiology and treatment.

Compare the MMPI-2, the Neo Pi-3, and the Thematic Apperception Test to assess personality structure and clinical insight, and discuss the five-factor model and pros and cons.

Explore the 12 personality styles and their main themes, and review MMPI, the Neo Pi three, and the t.a.t. to understand patient personalities in clinical practice.