Clinical Diagnosis and Assessment
CHAPTER 3 Clinical Diagnosis and Assessment
J
eannette Walls had an unusual childhood. She and her three
siblings—Lori, Brian, and Maureen—had smart, engaging
parents who taught them each to read by the time they
were 3, explained and demonstrated to them scientifi c princi-
ples, instilled a love of reading and appreciation for the arts,
and made their children each feel that they were special. As
Jeannette Walls recounts in her memoir, The Glass Castle
(2005), her father, Rex, was an intelligent man who was a
skilled electrical engineer. Her mother, Rose Mary, was an
artist and had been trained to be a teacher. Yet Rex had dif-
fi culty holding onto jobs, and most of the time Rose Mary
didn’t have a paying job. However, she wasn’t as busy rais-
ing her children as you might think: Both parents gave their
children enormous freedom to explore and experiment; they
also often left the children to fend for themselves.
Rex and Rose Mary would uproot and move the family in the
middle of the night, sometimes giving the kids 15 minutes to pack their
things and pile into the car. They’d leave town in order to avoid bill
collectors or child welfare offi cials, moving to whatever small town
caught Rose Mary’s and Rex’s fancy. Neither parent spent much time
fulfi lling the many daily responsibilities of parenting, such as prepar-
ing meals. For instance, even at the age of 3, if Jeannette was hungry,
she knew not to ask her parents for something to eat, but to make
it herself. She fi gured out how to make hot dogs: put water in a pot
and boil the dogs, standing on a chair by the gas stove in order to
do it. During one stint of hot dog making when she was 3, her dress
caught on fi re. She was so severely burned that she was hospitalized
for 6 weeks and had skin grafts. Her hospital stay ended when her fa-
ther had a fi ght with her doctor about whether her bandages should
remain on; her father carried Jeannette from her hospital room in the
middle of the night and out to the car, where her family was waiting
for her. They headed out of town to wherever the road took them;
Jeannette’s scars never properly healed.
The family referred to this and other late night moves from one
dusty town to another as doing “the skedaddle.” A few months after
taking Jeannette out of the hospital, the family did the skedaddle
again. During Jeannette’s early childhood, Rex would get a job as
an electrician or an engineer (often making up stories about previous
jobs he’d had or degrees he’d earned). When they left a town, RexChapter Outline
Diagnosing Psychological Disorders
Why Diagnose?
A Cautionary Note About Diagnosis
Reliability and Validity in Classifi cation Systems
Systems
The Diagnostic and Statistical Manual
of Mental Disorders
The People Who Diagnose Psychological
Disorders
Assessing Psychological Disorders
Assessing Neurological and Other Biological
Factors
Assessing Psychological Factors
Assessing Social Factors
Assessment as an Interactive Process
Diagnosing and Assessing Rose Mary
and Rex WallsMichael Gillette/Heart Agency 71