Richard A. Bryant
There is significant change in acute stress reactions in the weeks after exposure to a traumatic event, which raises challenges for assessing the responses in the acute posttraumatic period. This chapter reviews the assessment tools and strategies that are appropriate in the acute period. It focuses initially on acute stress disorder (ASD) as a description of acute posttraumatic stress and as a predictor of subsequent PTSD. Psychometrically-validated scales are reviewed for both diagnostic and symptom responses in the acute period, with a critique of the limited ability of these measures to identify most people who are at high risk for subsequent PTSD. Finally, this chapter identifies mechanisms that may enhance our ability to identify maladaptive responses in the acute phase, and specific populations that need particular attention in the immediate period following trauma exposure. The weeks following exposure to a traumatic event are often characterized by considerable distress, fluctuating emotions, and changing environmental factors. This lack of emotional and contextual stability raises significant challenges for assessment of psychological states shortly after trauma. This chapter aims to provide an overview of assessment of psychological responses in the weeks after trauma. It commences with a review of the current evidence about the nature of acute posttraumatic stress reactions and discusses the different goals of assessment at this stage. Established psychometric instruments are then reviewed, including structured clinical interviews, self-report measures, and other tools relevant to acute reactions. The review then turns to other factors that can be assessed, including cognitive and biological factors, occurring in the acute posttraumatic period. Finally, the chapter outlines other procedural issues that need to be considered when assessing trauma survivors in the acute phase.
Ken Winters, Tamara Fahnhorst, Andria Botzet, Randy Stinchfield, and Ali Nicholson
This chapter addresses several assessment and measurement issues relevant to adolescent drug abuse. Both researchers and clinicians working with youth suspected of problems associated with drug involvement are considered as the following topics are discussed: principles of assessment, validity of self-report, clinical domains of interest, instrumentation, clinical considerations when assessing youth, and assessing treatment outcome. Despite some research gaps, the field consists of several psychometrically sound screening and comprehensive assessment tools to assist researchers and clinicians when measuring drug use, drug problems, symptoms of substance use disorders, and behavioral problems that commonly coexist with drug involvement. Future research needs are also discussed, including the need for more psychometric data on sub-populations of young people defined by age and ethnicity/race.
Dustin B. Hammers, Kevin Duff, and Gordon J. Chelune
This chapter describes methods of evaluating cognitive change over time using evidence-based practices in the field of clinical neuropsychology. While doing so, a description of cognitive changes during the ‘normal’ ageing process is undertaken, followed by a brief review of cognitive trajectories for a few syndromes associated with abnormal decline. A discussion of the practice of clinical neuropsychology ensues, accompanied by concerns arising when using traditional single time-point assessments. The benefits of and challenges to using serial assessments are also discussed, as well as a basic review of the statistical methods available to identify reliable change over time. The chapter concludes with proposed research directions for the field to better tailor the use of cognitive trajectories to monitor predicted decline in the individual patient.
Obsessive compulsive disorder (OCD) is a complex and debilitating disorder that has a high degree of comorbidity and functional impairment, and significant impact on the family. The purpose of this chapter is to provide a brief overview of comorbidity, family, insight, and quality of life issues, and to review assessment and treatment implications of those issues. Measures for assessing relevant constructs are described.
Douglas K. Snyder, Richard E. Heyman, and Stephen N. Haynes
Couple distress has a high prevalence as well as high comorbidity with a broad range of emotional, behavioral, and physical health problems. Marriage and relationship problems also influence individuals' response to treatment for a wide range of psychological disorders. Hence, clinicians need to be skilled in conducting clinical assessment involving relationships in order to provide effective interventions, whether working primarily with individuals, couples, or the broader family system. This article first introduces brief screening measures and clinical methods for diagnosing couple distress in clinical as well as research applications. It then conceptualizes and assesses couple distress for the purpose of planning and evaluating treatment. The article also reviews empirical findings regarding behavioral, cognitive, and affective components of couple distress, and specific techniques derived from clinical interviews, behavioral observations, and self-reports. Finally, it considers emerging technologies for assessing intimate relationships and makes recommendations for future research.
Jessica R. Grisham and Alishia D. Williams
The assessment of hoarding has evolved over the past two decades to more appropriately capture its key features and associated phenomena. The authors describe a comprehensive and multimethod approach to assessment, which includes questionnaires, pictorial assessment, interview-based measures, behavioral tasks, and the incorporation of reports of family members and clinicians. It begins by reviewing self-report and interview-based measures of hoarding symptoms and providing relevant psychometric information and clinical-cut off scores. It then provides information regarding the assessment of clinical features commonly associated with hoarding, such as hoarding-related beliefs, excessive acquisition, and comorbid psychopathology. It concludes the chapter by noting specific clinical considerations when assessing an individual with hoarding problems and suggesting future directions in the assessment of hoarding, including the incorporation of more standardized behavioral measures of discarding, acquiring, and categorizing.
Nicole M. Dorfan and Sheila R. Woody
This chapter describes methods and tools for assessing obsessive compulsive disorder (OCD). The chapter outlines the purposes of assessment and discusses special challenges presented by OCD, such as shame associated with socially unacceptable obsessional content. Several types of assessment tools are discussed, including structured diagnostic interviews, semistructured clinician interviews to assess OCD symptom profile and severity, self-report instruments, behavioral assessment and self-monitoring, assessment of appraisals and beliefs relevant to OCD, and functional impairment. The importance of linking assessment findings to an evidence-based treatment plan is discussed.
Michelle J. Bovin and Frank W. Weathers
Posttraumatic stress disorder (PTSD) is a serious and prevalent mental disorder that poses a number of significant challenges for accurate assessment and diagnosis. In this chapter we describe some of the most widely used PTSD assessment tools for adult trauma survivors, including structured interviews, self-report measures, and psychophysiological methods. We also discuss several key issues in PTSD assessment, including identifying an index traumatic event for symptom inquiry, linking symptoms to the index event, and detecting exaggerated symptom reporting. We conclude with a brief discussion of future directions for research on PTSD assessment.
Darren W. Holowka and Brian P. Marx
Previous research has shown that PTSD is associated with impairments in functioning across a variety of domains and decrements in quality of life. In this chapter, we review the literature on the assessment of PTSD-related impairments in functioning and quality of life. We first discuss the importance of assessing PTSD-related impairments in quality of life and functioning. We then review some important methodological concerns related to the assessment of these constructs. Finally, we review some of the most commonly used assessment tools and discuss recent efforts to develop and validate a new assessment tool to assess PTSD-related functional impairment.
Sonja March, Alexandra De Young, Belinda Dow, and Justin Kenardy
The literature concerning the assessment of posttrauma reactions is well developed for adults, but this is not so for children and adolescents, especially young children. This chapter covers some key trauma-assessment issues in the child and adolescent population, which includes derivation and validation problems, the influence of developmental factors, applicability of current diagnostic classification, and the use of multiple informants. The range of available assessment measures is then reviewed, including semi-structured and self-report measures of posttraumatic stress disorder, acute stress disorder, and dissociation. Available screening measures and physiological measures are also reviewed. Directions for future work in this area are made.