Comparing different methods of measurement in psychiatry and clinical psychology: The diagnostic power of the new neurophysiology techniques

The present challenge is to assess the best tools to measure psychological and psychopathological processes underlying clinical external observations. An interesting approach about is to make reference to a multilevel systemic modeling, where clinical rating scale, self completed questionnaires, neuropsychology and event related electroencephalography may be matched. 13 subjects with an history of child abuse and 14 controls with no history of psychopathology were studied. Clinical data and self descriptions of maltreated people showed a higher psychological discomfort, a lower social functioning and a lower quality of life of such subjects. Neuropsychological data highlights a lower response control and a valence attribution bias of these subjects but not a dysfunction in selective attention. Neurophysiological data evidenced different $\text{P}_{\mathbf {3\, }}$activation patterns in brain cortex between the two groups: a higher frontal versus lower temporal activation in selective attention task and a higher left hemisphere activation versus a lower right hemisphere activation in affective attribution tasks. All the measurement methods appeared highly discriminating by their own, but neuropsychology. However the best methods resulted in adopting an integrative approach where neurophysiological data were integrated with neuropsychology and external clinical observations. Using this new approach the initial two groups were better discriminated in three groups where a new group of masked maltreated subjects was identified. This better discrimination is possible using a two dimension discriminating function in which the inner distortion in $\text{P}_{\mathbf {3}}$ activation pattern is compensated by another $\text{P}_{\mathbf {3}}$ activation pattern, sensitive to social relationship top down behavioral modulating effect. Using this method, self completed questionnaires resulted useless to add more information, while neurophysiology plus neuropsychology resulted in a sufficient reliable first line screening method.