The Assessment of Object Relations Phenomena in Adolescents: Tat and Rorschach Measures

By Francis D. Kelly | Go to book overview

1
Diagnostic Difficulties in Adolescent Psychiatry: Limitations of DSM-IV and the Role of Projective Tests in Developmental Assessment

A large part of the clinician's work with adolescents continues to involve assessment and diagnosis. Differential diagnosis reveals a multifaceted procedure in which data is collected from an array of external and internal sources, and is then ordered into a conceptual schema designed to generate a profile or comprehensive composite representative of a syndrome or disorder. The clinician has to rely on direct and indirect sources of material with which to facilitate an ongoing, oscillating, inductive-deductive process that should suggest what the problem is and what can be done about it in order to facilitate optimal developmental functioning.

Increasingly, psychiatrists, psychologists, and clinical social workers tend to rely on devices that generate actuarial data in order to arrive at quick and accurate diagnostic impressions with adolescents. Data may be gathered from a variety of sources, some of the more frequently utilized being briefly referenced here.

The interview is the most commonly relied on procedure used to obtain an initial diagnostic picture. Structuring and standardizing interview procedures resulted in significant effort directed at developing more objective approaches to the interview process with adolescents. Attempts to provide standardization, reliability, and validity in the diagnostic process resulted in the development of a variety of structured interview procedures including: the Diagnostic Interview for Children and Adolescents (DICA), developed by Herjanic and Reich ( 1982); the Kiddie-SADS (K-SADS) written by Puig-Antich and Tabrizi ( 1983); and the Child Assessment Schedule (CAS) developed by Hodges and colleagues ( Hodges, McKnew, Cytryn, Stern, & Kline, 1982).

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