Plugging the Science-Practice Gap: Getting Evidence-Based Assessment Past the Tipping Point

Current healthcare trends have emphasized the urgent need to expand mental healthcare outside of clinics and increase service efficiency. A ready-made upgrade that would improve current practice in clinical assessment is available in the form of evidence-based assessment (EBA). EBA is a clinical decision-making approach that uses diagnostic probability as a way of guiding clinical decisions. While the assessment of psychological disorders could benefit from EBA, it is important to consider conceptual differences between them. It is crucial to analyze the ability of assessment measures in discriminating between these disorders by examining their psychometric properties. Study 1 compared two rating scales with different manic symptom items on diagnostic accuracy for detecting BPSDs in outpatient mental health clinics. Findings suggest that both scales were equally valid; with one being able to be used as part of an assessment battery to screen for BPSDs, and the other being able to be used as more of a broadband measure screening for other psychopathology. Study 2 investigated the diagnostic efficiency of the Dimensional Obsessive-Compulsive Scale (Abramowitz et al., 2010) and subscales for distinguishing obsessive compulsive disorder (OCD) from other DSM-IV anxiety disorders in adults from mental health outpatient clinics. Findings suggest that the DOCS-Contamination subscale was the most helpful in ruling in OCD from other anxiety disorders, while the DOCS-Total scale was most helpful in ruling out OCD. Study 3 analyzed the clinical utility of the Anxiety Sensitivity Index (ASI-3; Taylor et al., 2007) and subscales for distinguishing adults with a diagnosed anxiety disorder (AD) from other mental disorders who presented to an outpatient substance use/abuse clinic. We measured any incremental value in combining subscales, after controlling for age and gender and race. As a set, the combination of these three studies illustrated the applicability of EBA methods to multiple psychological disorders and across a broad range of ages.