An intake is a clinical interview with a referred client who requests help with certain complaints to find out the client’s presenting problem and to get acquainted with the client. This allows for the building of a working relationship and is an important source for hypothesis building.

The intake categorizes the information about the client:

1. Problem
   This includes the presenting problem which consists of cognitive status complaints (1), emotional status complaints (2), suicidal ideation (3) and aggressive ideation (4).
2. Content
   This includes symptomatic evaluation which consists of developmental history (1), psychiatric history (2), alcohol- and substance history (3), medical history (4) and family medical and psychiatric history (5).
3. Context
   This includes psychosocial evaluation which consists of family history (1), educational and vocational history (2), criminal and legal history (3), social history (4), psychosexual history (5) and multicultural evaluation (6).
4. Behavioural observations via mental state evaluation
   This includes all behavioural observations during the intake which consists of appearance and behaviour (1), speech and language (2), mood and affect (3), thought processes and content (4), cognition (5) and prefrontal functioning (6).

The predisposing- (1), explanatory- (2), perpetuating- (3) and protective factors (4) need to be taken into account when assessing the complaints and the impaired functioning.

Recognizing patterns in behaviour and complaints in order to apply a classification system is called a classifying diagnosis. Cause-effect relationships and seeing a diagnosis as an individual theory is a descriptive diagnosis.

The presenting problem refers to determining in what way a client’s functioning is impaired. This includes whatever complaint the individual identifies as the reason for assessment. The symptomatic evaluation refers to the symptomatic and medical features of what may be impairing the client’s functioning.

Behavioural observations are added to the intake’s observations because self-report is limited (1), it adds information on complaints and personality (2), double-checks the information given by the client (3) and not observing deviations is informative too.

The mental status evaluation refers to a method of organizing clinical observations data.

Receptive language refers to language comprehension. Expressive language refers to the individual’s use of language. Mood refers to the current emotional state of an individual as reported by the individual. Affect refers to the observed emotional state of an individual. Mood can be incongruent with the situation and with the affect.

Hypotheses should be generated for all likely causes of impairments. One hypothesis always states that the individual’s functioning is normative and functional. This requires all impairments in functioning to be mapped. Impairment in functioning due to medical illness or substance-related disorders need to be ruled out.

There are several additional biases of an intake:

1. Availability heuristic
   This is the tendency to overuse information that is recent or striking.
2. Halo effect
   This is the

General intelligence (g) explains a person’s performance on intellectual tests according to Spearman. However, the idea that there is only one factor explaining intelligence is contested. Crystallized intelligence refers to the knowledge of facts. Fluid intelligence refers to the ability to solve new problems and reason.

Fluid intelligence is not stable over time and is disrupted by several factors (e.g. brain damage, age). Crystallized intelligence is relatively stable over time.

The general intelligence test is a method of assessing someone’s intelligence and consists of several sub-tests which assess specific intellectual skills. IQ reflects a person’s overall performance on all subtests in comparison with a group of peers.

There are several forms of the Raven’s Progressive Matrices, including the Standard Progressive Matrices (1), the Coloured Progressive Matrices (2) and the Advanced Standard Progressive Matrices (3).

A lot of consequences (e.g. special education or not) depend on the results of IQ test scores and these consequences treat IQ test scores as absolute numbers. One problem with a classification system is that intelligence tests often do not properly differentiate between participants on the extreme scale of the measure. The Flynn effect also needs to be taken into account when interpreting intelligence tests.

Intellectual tests can provide powerful diagnostic information. However, intelligence tests are not useful for a localized disorder or localized brain damage. There are three levels in intelligence tests in neuropsychological questions:

1. Level of test performance
   This involves the level of performance on the intelligence test. This is related to a person’s background and at this level, the intelligence test can be used for its original purpose.
2. Inventory of disorders
   This level involves employing the intelligence test as a neuropsychological test battery to make an inventory of potential disorders.
3. Statement about abnormal performances on IQ tests
   This level involves abnormal performance on parts of the IQ tests with the goal of distinguishing localized brain damage.

The test administrator needs to communicate clearly (1), be sensitive to the client’s feelings and perceptions (2) and make sure the logistics are in order (3) at the day of the test.

Norm data provides support for making good quality decisions (e.g. generating the cut-off scores for personnel selection). It is imperative to select norm groups with which to compare the client’s raw scores. The accuracy of conclusions depends on the reliability of the test. It is necessary to standardize scores to compare scores of two different constructs (e.g. verbal intelligence and motor skills).

People with lower intelligence have a higher risk of complaints. However, mental health care is aimed at people with average intelligence. It is useful to conduct an intelligence test on everyone but this is expensive so it is more useful to use an intelligence screening. The Screener for Intelligence and Learning Disabilities (SCIL) consists of 14 items aimed at

Risk assessment is important in the social (1), political (2), clinical (3) and ethical (4) domain. It has several goals:

• It can be used to gain insight into heterogeneous groups of offenders.
• It can be used to prevent recidivism.
• It can be used to provide guidelines for treatment.
• It can be used to structure discussions among professionals (e.g. judges, practitioners).
• It can be used to protect the rights of the person and protect society.

The risk depends on the situation and the risk assessment is never certain. The quality of risk assessment depends on the available information regarding the individual (1), the instrument that is used (2) and the professional (3).

Risk assessment refers to assessing the risk of future violent or non-violent behaviour. It estimates the likelihood that someone will exhibit a certain behaviour (e.g. violence) in the near or distant future. The purpose is to increase the ability to detect true positive and true negative cases and keep the false positives and false negatives to a minimum. The base rate refers to the prior probabilities in an outcome domain (e.g. recidivism rate in sex offenders).

Risk assessment can be used to gain insight into heterogeneous groups of offenders through gaining information regarding risk factors that are related to recidivism. Denial of the crime and the severity of the crime is not predictive of sexual recidivism. Impulsive, anti-social tendencies and sexual deviance and preoccupation are predictive of sexual recidivism.

The structured professional approach uses systematic collection (1), reviewing (2), combining (3), weighing (4) and integrating (5) information on risk factors. Treatment aimed at reducing violent recidivism should focus on reducing risk factors and reinforcing protective factors.

There are several approaches to risk assessment:

1. Unstructured clinical judgement
   In this method, the risk factors are determined using experience and knowledge of the expert. The decision making is based on personal choice and is unstructured. It is more flexible and tuned to the individual. This method has low interrater reliability and low predictive value, making this method suboptimal.
2. Actuarial risk assessment
   In this method, the risk factors are determined using a fixed list of risk factors. This list is based on empirical research. The decision making is based on the sum score of the risk factors. The estimation of risk is based on a comparison with norm groups.
3. Structured clinical judgement
   In this method, the risk factors are determined using a fixed list of risk factors but there is the possibility to add risk factors based on clinical experience. The decision making is based on the presence of a risk factor (1), clinical experience (2) and clinical insight (3). This method does not employ comparison with norm groups.

In the structured clinical judgement method, only the presence of a risk factor matters. The absence of a risk factor

Clinical neuropsychology studies the relations between the brain and behaviour. It makes use of modern diagnostic tools such as interviews (1), personality questionnaires (2), complaint lists (3), neuropsychological tests (4) and neuroimaging research (5). The most important tool is knowledge of different cognitive and emotional domains.

Localization refers to the theory that focuses on the specific behavioural effects of selective disorders on specific parts of the brain (i.e. a specific disorder is localized in a specific area in the brain). Holism focuses on the general behavioural effect of the brain as a whole.

There are several requirements for the intake interview:

1. Environment
   The environment must not distract (1), must be neutral but pleasant (2) and must be comfortable (3).
2. Interviewer’s knowledge
   The interviewer must have extensive knowledge of his subject area (1), must be up-to-date on the current classification systems (e.g. DSM-5) (2) and must have appropriate knowledge of epidemiology (3).
3. Interviewer’s skills
   The interviewer must be empathetic (1), needs to provide unconditional positive acceptance (2) and needs to be authentic (3).

The organization’s attitude towards the client must be respectful. The interviewer must dress appropriately. The interviewer must keep an appropriate emotional and physical distance from the client. Age influences the topics that are discussed during the intake interview.

Advantages of structured interviews are better and higher reliability (1), a fairer estimation of the severity of complaints (2), a greater comprehensiveness (3) and a reduction in both information variance and criterion variance (4). Disadvantages of structured interviews are that they are time-consuming (1), the interviewers need to be regularly trained (2) and the interviewer may conduct the interview too routinely (3). There are several structured interview instruments:

1. Structured Clinical Interview for DSM disorders (SCID-S and SCID-P)
   This is a semi-structured interview for the classification of mental disorders according to the DSM. It has satisfactory interrater reliability.
2. Mini-International Neuropsychiatric Interview (MINI)
   This is a structured interview for both DSM-5 and ICD-10 classifications. The administration time is relatively short and the psychometric properties are sufficient.
3. Diagnostic Interview Schedule (DIS)
   This is a structured interview to assess most common mental disorders. It is very time consuming but requires less specialized knowledge of psychopathology.
4. Composite International Diagnostic Interview (CIDI)
   This is a highly structured interview to establish classifications according to the ICD and the DSM.

There are several potential obstacles during the interview:

1. Interviewer obstacles
   The interviewer may avoid topics he is not comfortable with. This can be solved by being self-aware.
2. Client obstacles
   The obstacles that originate with the client are often the result of psychopathology.
3. Interaction obstacles
   There may be obstacles in the interaction between the client and the psychologist (e.g. client does not accept psychologist’s authority).

The referrer question is not always the same as the general practitioner question.

Therapeutic assessment refers to personality assessment that aims to have direct therapeutic influence on patients. In therapeutic assessment, the client develops highly personalized questions together with the therapist.

The holistic theory focuses on what is known and what is not yet known. It also focuses on what is understood and what is not yet understood. It pays attention to inconsistencies and recurring themes.

Self-report cannot always be used because some people have introspective limitations (1), are ambivalent about changing (2) or may want to present themselves in a particular manner (3). This makes the multi-method approach useful.

The MMPI-2 measures psychiatric symptoms (1), personality (2) and test attitude (3).It measures what friends can see and may report about the person. The Rorschach measures the level of personality organization (1), level of object relations (2), the capacity and style of affect management (3), the cognitive and affective style (4), the accuracy of perception (5) and self-perception (6). It measures what is ‘under the surface’.

Incremental validity refers to extra knowledge coming from additional instruments.

A treatment plan should be based on the best science available. The clinical hermeneutics error refers to the therapist losing track of the actual degree of pathology due to adopting the patient’s perspective. High-level depth of processing or interpreting and explaining the behaviour leads to a loss of normative judgement.

The Neo-Kraepelinian diagnostic rubrics consist of ascertainment of facts to determine the presence or absence of relatively explicit diagnostic criteria (1), the making of differential and multi-axis diagnoses (2) and the differential selection of treatment guided by differential diagnosis (3).

A high degree of comorbidity may be the result of manifestations of the same few maladaptive personality traits (e.g. negative emotionality) which are interpreted as symptoms. The features a diagnostician focuses on may be consequences of extreme levels of personality traits (1), problematic configurations of trait levels (2) or extreme adaptations to personality traits (3).

Personality traits influence how individuals interpret and construe life events. Trait levels refer to an individual’s specific dispositions. There are three trait dimensions:

1. Extraversion
   This is an aspect of the broader dimension of positive emotionality (PE).
2. Neuroticism
   This is an aspect of the broader dimension of negative emotionality (NE).
3. Constraint
   This is related to reversed psychoticism and reversed sensation-seeking.

Treatment planners should know about four things:

1. Heritability of personality traits
   This is the proportion of variance in a trait that is attributable to genetic influences.
2. Initial findings on the source of personality trait stability
   A lot of stability of personality stems from genetic factors whereas change arises primarily from unshared environmental factors.
3. Gene-environment correlations
   This is the tendency of people to seek and create trait-relevant environments, leading to personality stability.

Individuals with certain genotypes select environment that provides stability for their personality