According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), a Major Depressive Disorder is a severe Mood Disorder that is characterized by a pervasive clinical depression and a series of associated symptoms. In order to diagnose this disorder correctly, the patient must present with either 1) depressed mood, or 2) markedly diminished interest or pleasure in all, or almost all, activities. In addition, both criterion 1 and/or 2 must be present “most of the day, nearly everyday.” If the doctor has not provided information in their report indicating that the patient had criterion 1 and/or 2 “most of the day, nearly everyday” then the patently obvious conclusion is the there is no agreement between the doctor’s history of the patient’s symptoms or complaints and the DSM criteria for a Major Depressive Disorder.
Friday, April 28, 2017
Instructions for Finding out if an MMPI-2 T-Score is Possible - Cross-Examining Psych Doctors, TIp #77
Pathological anxiety can be observed in a variety of ways during a face-to-face interview. Specifically, pathologically anxious individuals typically can be observed to exhibit a variety of narrative statements that express danger, threat, unpredictability, uncertainty and/or terror. Moreover, on direct observation their behavior is often characterized by jumpiness, restlessness, hand wringing, a strained voice, tremulousness, tension, motor hyperactivity, fidgeting, autonomic hyperactivity, vigilance, scanning and/or poor reality testing. In assessing the credibility of a psych report, you should check to see if the doctor provided a description of any such observations or any of the patient’s narrative statements supporting a pathological anxiety in their report.
Friday, April 14, 2017
The Symptom Checklist-90-Revised (SCL-90-R) is simply a symptom checklist in which the individual is presented with a list of symptoms or complaints that they can either endorse or deny. However, this test has no method for detecting an individual who is attempting to embellish or simulate their complaints. Further, the use of a symptom checklist is inappropriate in a medical-legal examination where the presentation of the list itself can be an encouragement to endorse items that do not reflect the individual’s status.
Wednesday, April 12, 2017
When reading a psych report you may find that the doctor provided “Rule Out” diagnoses. “Rule Out” diagnoses are used only when there is diagnostic uncertainty. With all due respect to the psych doctor who authored the report with “Rule Out” diagnoses, this indicates that they are unsure whether these diagnoses truly exist. Accordingly, it is unclear why a doctor would chose to write a comprehensive report without obtaining sufficient information to be certain about their diagnosis. However, it is clear that by adding “Rule Out” diagnoses to their diagnostic categories, the doctor has clouded the issue concerning the patient’s psychological state.