Table Of ContentCONCISE GUIDE TO
The Psychiatric Interview of
Children and Adolescents
American Psychiatric Press
CONCISE GUIDES
RobertE.Hales,M.D.
SeriesEditor
CONCISE GUIDE TO
The Psychiatric Interview of
Children and Adolescents
ClaudioCepeda,M.D.
ClinicalAssociateProfessor
DepartmentofPsychiatry
UniversityofTexasHealthScienceCenteratSanAntonio
SanAntonio,Texas
Washington,DC
London,England
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LibraryofCongressCataloging-in-PublicationData
Cepeda,Claudio,1942–
Conciseguidetothepsychiatricinterviewofchildrenand
adolescents/ClaudioCepeda.
p. cm.—(Conciseguides/AmericanPsychiatricPress)
Includesbibliographicalreferencesandindex.
ISBN0-88048-330-X
1.InterviewinginchildpsychiatryHandbooks,manuals,etc.
2.InterviewinginadolescentpsychiatryHandbooks,manuals,etc.
I.Title. II.Title:Psychiatricinterviewofchildrenand
adolescents. III.Series:Conciseguides(AmericanPsychiatric
Press).
[DNLM:1.Interview,Psychological—methods—Adolescence
Handbooks. 2.Interview,Psychological—methods—ChildHandbooks.
3.Interview,Psychological—methods—Child,PreschoolHandbooks.
4.Psychiatry—methods—AdolescenceHandbooks. 5.Psychiatry—
methods—ChildHandbooks. 6.Psychiatry—methods—Child,Preschool
Handbooks. WS39C399c2000]
RJ503.6.C46 2000
618.92′89—dc21
DNLM/DLC
forLibraryofCongress 99-26053
CIP
BritishLibraryCataloguinginPublicationData
ACIPrecordisavailablefromtheBritishLibrary.
Thisbookisdedicatedtomywife,Rosalba;
tomychildren,Rene,Adrian,andJoe;
and
tothememoryofmynieceYvonne(“Bombis”),my
nephewEdgarHernando,andmydearfriend
HectorTejada,M.D.,allofwhompassedaway
whilethisbookwasbeingwritten.
This page intentionally left blank
CONTENTS
ListofTables. . . . . . . . . . . . . . . . . . . . . . . xi
ListofCaseExamples. . . . . . . . . . . . . . . . . xiii
IntroductiontotheAmericanPsychiatric
PressConciseGuides . . . . . . . . . . . . . . . . . xix
Foreword . . . . . . . . . . . . . . . . . . . . . . . . xxi
Introduction. . . . . . . . . . . . . . . . . . . . . . xxiii
Acknowledgments . . . . . . . . . . . . . . . . . . xxxi
1 GENERAL PRINCIPLESOF
INTERVIEWING. . . . . . . . . . . . . . . . . 1
InterviewSetting . . . . . . . . . . . . . . . . . . . . . . 1
PreparationforthePsychiatricExamination. . . . . . . . 2
InterviewProcess . . . . . . . . . . . . . . . . . . . . . . 3
QualitiesofthePsychiatricExamination . . . . . . . . . 16
PhasesofthePsychiatricExamination . . . . . . . . . . 20
ModalitiesofthePsychiatricExamination . . . . . . . . 38
StrategiesforEvaluatingPreadolescents . . . . . . . . . 41
StrategiesforEvaluatingAdolescents. . . . . . . . . . . 50
ProcessInterviews. . . . . . . . . . . . . . . . . . . . . 53
PhysicalContact. . . . . . . . . . . . . . . . . . . . . . 55
Activity,Structuring,andSupportDuringthe
PsychiatricExamination . . . . . . . . . . . . . . . . 59
LimitSettingDuringthePsychiatricExamination . . . . 61
CarryingthePsychiatricExamination. . . . . . . . . . . 62
EnactmentsDuringthePsychiatricExamination. . . . . 63
ProspectiveInterviews. . . . . . . . . . . . . . . . . . . 64
References . . . . . . . . . . . . . . . . . . . . . . . . . 67
2 NONVERBAL TECHNIQUESFOR
INTERVIEWINGCHILDRENAND
ADOLESCENTS. . . . . . . . . . . . . . . . 69
DrawingTechniques. . . . . . . . . . . . . . . . . . . . 70
PlayTechniques . . . . . . . . . . . . . . . . . . . . . . 78
References . . . . . . . . . . . . . . . . . . . . . . . . . 88
3 USEOFTHEAMSITINDOCUMENTING
THECHILDANDADOLESCENT
PSYCHIATRICEXAMINATION. . . . . . . . 89
Appearance,Behavior,andSpeech . . . . . . . . . . . . 92
MoodandAffect . . . . . . . . . . . . . . . . . . . . . 104
Sensorium. . . . . . . . . . . . . . . . . . . . . . . . . 105
IntellectualFunction . . . . . . . . . . . . . . . . . . . 108
Thought. . . . . . . . . . . . . . . . . . . . . . . . . . 108
References . . . . . . . . . . . . . . . . . . . . . . . . 121
4 EVALUATIONOF
INTERNALIZINGSYMPTOMS . . . . . . . 123
EvaluationofSuicidalBehaviors . . . . . . . . . . . . 123
EvaluationofDepressiveSymptoms. . . . . . . . . . . 130
EvaluationofAnxiousSymptoms . . . . . . . . . . . . 138
EvaluationofObsessive-CompulsiveBehaviors . . . . 144
EvaluationofPsychoticSymptoms . . . . . . . . . . . 149
EvaluationofSchizoidSymptoms. . . . . . . . . . . . 161
References . . . . . . . . . . . . . . . . . . . . . . . . 165
5 EVALUATIONOF
EXTERNALIZINGSYMPTOMS . . . . . . . 169
EvaluationofHyperactiveandImpulsiveBehaviors . . 169
EvaluationofChildrenWhoHave
Attention-Deficit/HyperactivityDisorder. . . . . . . 172
EvaluationofAggressive,Homicidal,and
Self-AbusiveBehaviors . . . . . . . . . . . . . . . . 173
EvaluationofBipolarSymptoms. . . . . . . . . . . . . 182
EvaluationofOppositionalBehaviors. . . . . . . . . . 193
References . . . . . . . . . . . . . . . . . . . . . . . . 199
6 EVALUATIONOFOTHERSYMPTOMS. . . 201
EvaluationofSymptomsofAbuse. . . . . . . . . . . . 201
EvaluationofRegressiveBehavior. . . . . . . . . . . . 210
AssessmentofTruthfulnessinAbusedChildren . . . . 211
References . . . . . . . . . . . . . . . . . . . . . . . . 216
7 THENEUROPSYCHIATRICINTERVIEW
ANDEXAMINATION. . . . . . . . . . . . . 219
ElementsoftheNeuropsychiatricHistory. . . . . . . . 222
NeuropsychiatryandPsychosocialFactors . . . . . . . 225
PerformingtheAMSITonaChildWhoHasa
NeuropsychiatricDisorder. . . . . . . . . . . . . . . 226
ElementsoftheNeurodevelopmentalEvaluation . . . . 226
IndicationsforConsultationandTesting. . . . . . . . . 236
IndicationsforNeuropsychologicalTesting. . . . . . . 238
SpecificNeuropsychiatricSymptoms . . . . . . . . . . 244
InterviewingChildrenWhoHaveLearningDisabilities
orOtherNeuropsychiatricDeficits . . . . . . . . . . 270
References . . . . . . . . . . . . . . . . . . . . . . . . 279
8 COMPREHENSIVEPSYCHIATRIC
FORMULATION . . . . . . . . . . . . . . . 283
ReviewofChildandAdolescentPsychiatric
Literature. . . . . . . . . . . . . . . . . . . . . . . . 284
TheoryoftheComprehensivePsychiatricFormulation
Process. . . . . . . . . . . . . . . . . . . . . . . . . 286
AssessmentofInternal(Intrinsic)Factors. . . . . . . . 287
AssessmentofExternal(Extrinsic)Factors . . . . . . . 295
PragmaticsofaComprehensivePsychiatric
Formulation . . . . . . . . . . . . . . . . . . . . . . 298
Description:Not long ago, child psychiatrists rarely conducted Mental Status Examinations on their patients for fear of nosological labeling. Due to an increasing recognition that childhood psychiatric syndromes often continue into adulthood, direct and systematic interviewing of pre-adolescents has become more
