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Deel I: Fundamentele aspecten van de diagnostiek...................................................................9
H1: Het diagnostisch proces........................................................................................................9
Inleiding...................................................................................................................................9
1.2 Stappen van diagnostisch onderzoek...............................................................................9
1.3 Vijf basisvragen in de klinische psychodiagnostiek........................................................11
1.3.1 Onderkenning bevat:...............................................................................................11
1.3.2 Verklaring bevat:......................................................................................................11
1.3.3 Predictie...................................................................................................................11
1.3.4 Indicatie....................................................................................................................12
1.3.5 Evaluatie...................................................................................................................12
1.4 De diagnostische cyclus (Empirische cyclus, De Groot)..................................................13
1.5 Het diagnostisch proces: van aanmelding tot verslag....................................................13
1.5.1 Aanmelding:.............................................................................................................13
1.5.2 Reflectie van de diagnosticus...................................................................................13
1.5.3 Diagnostisch scenario...............................................................................................14
1.5.4 Het diagnostisch onderzoek.....................................................................................14
1.6 Diagnose Behandel Combinaties (DBC’s):.......................................................................16
1.7 Besluit:.............................................................................................................................16
Oefenvragen H1:...................................................................................................................17
Deel II: Diagnostische methoden en rapportage van diagnostiek............................................18
H3: Het gesprek.........................................................................................................................18
3.1 Inleiding...........................................................................................................................18
3.2 De plaats en functie van het gesprek in de diagnostische cyclus...................................18
3.3 Voorwaarden voor het gesprek......................................................................................20
3.3.1 De omgeving............................................................................................................20
3.3.2 Kennis van de gespreksleider...................................................................................20
3.3.3 Vaardigheden van de gespreksleider.......................................................................20
3.4 Inhoud van het gesprek..................................................................................................21
3.4.1 De aard van de gegevens.........................................................................................21
3.4.2 De invloed van de leeftijd van de onderzochte op de inhoud van het gesprek......21
3.4.3. De wijze van informatieverzameling.......................................................................22
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, 3.5 Beoordelingsschalen en gestructureerde interviews.....................................................23
3.5.1 Structured Clinical Interview for DSM Disorders (SCID-S en SCID-P)......................24
3.5.2. Mini International Neuropsychiatric Interview (MINI)...........................................24
3.5.3. Overige (semi)gestructureerde interviews.............................................................24
3.5.4. Schedule for Clinical Assessment in Neuropsychiatry (SCAN)/ Present State
Axamination (PSE).............................................................................................................25
3.5.5. Health of the nation Outcome Scales (HoNOS)......................................................25
3.5.6. Overige beoordelingsschalen..................................................................................25
3.6 De feitelijke uitvoering van het gesprek.........................................................................26
3.6.1. De voorbereiding....................................................................................................26
3.6.2. Tijdens het gesprek.................................................................................................26
3.7 Mogelijke obstakels tijdens het gesprek.........................................................................26
3.7.1 Obstakels bij de gespreksleider...............................................................................26
3.7.2 Obstakels bij de cliënt..............................................................................................26
3.7.3 Obstakels in de interactie........................................................................................27
3.8 overige gesprekken tijdens de intakefase.......................................................................28
3.8.1 crisisinterventie........................................................................................................28
3.8.2 het adviesgesprek....................................................................................................28
3.8.3 Slechtnieuwsgesprekken..........................................................................................28
3.9 Verslaglegging.................................................................................................................28
H4: Gedragsobservatie..............................................................................................................30
4.1 Inleiding...........................................................................................................................30
4.2 Ongestandaardiseerde observatie..................................................................................31
4.3 Gestandaardiseerde observatie......................................................................................31
4.3.1 De inhoud van de observaties..................................................................................31
4.3.2 De context waarin de observaties plaatsvinden......................................................32
4.3.3 De tijdschaal waarop wordt geobserveerd..............................................................33
4.3.4 De observator...........................................................................................................33
4.3.5 De betrouwbaarheid................................................................................................33
4.4 Gestandaardiseerde observatie bij specifieke verschijnselen........................................33
4.4.1 Angst........................................................................................................................33
4.4.2 Psychische functiestoornissen.................................................................................35
4.4.3 Ernstige psychopathologie.......................................................................................35
2
, 4.4.4 Oudere cliënten.......................................................................................................36
4.4.5 Overige observatie-instrumenten............................................................................37
H5: Indirecte methoden............................................................................................................38
5.2 Kenmerken van indirecte methoden..............................................................................38
5.3 Soorten indirecte methoden...........................................................................................38
5.3.1 De Rorschachtest:....................................................................................................39
5.3.2 De Thematische Apperceptie Test (TAT).................................................................39
5.3.3 De Zinaanvultest (ZAT).............................................................................................40
5.3.4 Tekeningen...............................................................................................................40
5.4 Interpreteren en interpretatieprocessen.......................................................................41
5.5 Evaluatie en gebruik van indirecte methoden................................................................41
Oefen vragen H3+4+5...........................................................................................................42
H6: Intelligentie en intelligentietests........................................................................................45
6.1 Inleiding...........................................................................................................................45
6.1.1 Definitie en geschiedenis.........................................................................................45
6.1.2 Theorieën.................................................................................................................45
6.1.3 Het meten van intelligentie.....................................................................................46
6.2 Intelligentietests..............................................................................................................46
6.2.1 Wechsler Adult Intelligence Scale-IV (WAIS-IV-NL).................................................46
6.2.2 Groninger Intelligentie Test-2 (GIT-2)......................................................................48
6.2.3 Kaufman Intelligentietest voor Adolescenten en Volwassenen (KAIT)...................50
6.2.4 Raven’s Progressive Matrices..................................................................................50
6.2.5 Nederlandse Leestest voor Volwassenen (NLV)......................................................51
6.3 Intelligentietests in de praktijk.......................................................................................51
6.3.1 Het IQ als ‘absoluut getal’........................................................................................51
6.3.2 Intelligentie en opleidingsniveau.............................................................................52
6.3.3 Neuropsychologische stoornissen...........................................................................53
6.3.4 Profielanalyse...........................................................................................................54
Appendix 6A: Samenvatting COTAN-oordelen voor de in dit hoofdstuk besproken tests
...........................................................................................................................................54
Oefenvragen H6....................................................................................................................55
H7: Neuropsychologische vragen en methoden.......................................................................57
7.1 Inleiding...........................................................................................................................57
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