Lesson 4 - Assessment and the DSM-V

Clinical Interviews

Assuming that physical disease or illness has been ruled out, the first thing that many psychologists do with respect to assessment is a clinical interview. Clinical interviews examine current behaviours -- what people are doing in their daily lives, what their attitudes are concerning themselves and others, and what sort of problems they describe regarding themselves and their lives. Psychologists must be aware, however, that personal biases may affect how they perceive a particular patient. Using guidelines, structure, and a standardized set of questions may help reduce potential bias.

Some clinicians use mental status exams to guide their assessments. With this type of exam, a psychologist can better determine the mental health of individuals. This test may also assist the psychologist in forming an hypothesis about a person’s pathologies. Perhaps the first area that an interviewer observes is appearance and behaviour. Are patients well-groomed with clean clothes? Have they bathed in the last six days? How is their posture? What is their behaviour like – are they tense, upset, or calm? The next area of interest may be thought processes. Do they have continuity of thought? Do they speak slowly or rapidly? What do they speak about?

The patients’ mood and affect also are areas of concern to the psychologist. What is the overall mood from day to day? Is the affect of a person congruent with the content of what he or she is saying? For example, is the person recounting a tragic event while smiling? Of equal importance, is the person recalling an emotionally charged event without emotion of any sort – is he or she just sitting there? Psychologists also like to understand the intellectual functioning of their patients. Do they use multi-syllable words? Do they use metaphors, similes, and abstractions? Can they clearly explain memories? Finally, are patients aware of their situation? Are they aware of their surroundings? Do they know their names, the date, or where they live?