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Themenschwerpunkt/Theme Articles

Ambulantes Assessment in der Klinischen Psychologie und Psychiatrie

Published Online:June 11, 2008https://doi.org/10.1024/1661-4747.56.3.169

Abstract

Viele diagnostische Verfahren in der Klinischen Psychologie und Psychiatrie stützen sich auf retrospektive Selbstberichte. Solche retrospektiven Selbstberichte sind häufig beeinträchtigt durch Erinnerungsfehler und eignen sich kaum, um kurzfristige Veränderungen des Verhaltens über die Zeit oder verschiedene Situationen hinweg abzubilden. Ambulantes Assessment bezeichnet diagnostische Verfahren, die das Verhalten und Erleben von Personen in ihrer natürlichen Umgebung unmittelbar oder mit minimaler zeitlicher Verzögerung erfassen. Mit diesen Verfahren lassen sich Erinnerungsfehler vermeiden und detaillierte Informationen über Symptome sowie deren Antezedentien und Konsequenzen in der natürlichen Umgebung von Patienten gewinnen. Der Beitrag gibt eine Übersicht über Ambulante Assessment Methoden, die sowohl für die Forschung als auch für die Diagnostik und die psychotherapeutische Praxis von Nutzen sind. Vorgestellt werden systematische Selbstbeobachtungs- und Tagebuchverfahren, Methoden des Verhaltensmonitorings (Registrierung der Bewegungsaktivität, Körperhaltung und Sprechaktivität), des psychophysiologischen Monitorings sowie der Registrierung von Umweltmerkmalen. Ferner werden ambulante Experten- und Feedbacksysteme besprochen. Abschließend werden sowohl die Grenzen als auch das zukünftige Potenzial des Ambulanten Assessments diskutiert.


Ambulatory Assessment in Clinical Psychology and Psychiatry

Assessment in clinical psychology and psychiatry relies to a large extend on retrospective self-reports. However, such self-reports are impaired by recall biases and are not appropriate for assessing short term changes of behavior across contexts and over time. Ambulatory Assessment refers to different diagnostic methods, which have in common that they capture people’s behavior and experience in their usual daily life, without or with only minimal latency. Ambulatory Assessment methods avoid recall biases and provide detailed information about symptoms, their antecedents and consequences in the natural context of patients’ daily life. This article gives an overview over current Ambulatory Assessment methods that are valuable for research, clinical diagnostic and psychotherapy. We introduce electronic diaries, behavior monitoring (recording of physical movement, posture, and speech activity), psychophysiological monitoring, and methods to record features of the physical and social environment. In addition, we review ambulatory feedback and expert systems. Finally, we discuss the limits and potentials of Ambulatory Assessment in clinical psychology and psychiatry.

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