PSYCH257 Lecture Notes - Lecture 3: Thematic Apperception Test, Inter-Rater Reliability, Concurrent Validity

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Chapter 3: Clinical Assessments and Diagnosis
I. Why Asses patients?
To know what type of medication, Prognosis, course of ailments, what type of disorder
needed
1. Characteristics of assessment tools
Reliability
- Consistency is measurement; most basic
Validity
- What the test measures and how well it does so
Standardization
- Standards and norms help ensure consistency in the use of a technique
Reliability is the consistency of a test
- Two main types:
a. Testretest reliability retest of the certain disorder the next months later
b. Interrater reliability e.g.: a student not convinced with a psychologists’
method, then went to another psychologist because not convinced but the
other psychologist has different diagnosis low interrater reliability
- Suggests that the instrument is not reliable
- The instrument itself even though used by the same psychologists, could give
different diagnosis
Validity is the accuracy of a test’s results
- A good test must accurately measure what it is supposed to be measuring
- Some types of validity:
a. Predictive validity how well your assessment tells you what will
happen in the future
e.g.: GRE’s predict performance of students going to graduate schools. If
GRE doesn’t correlate with the students’ performance, there’s a low
predictability
b. Concurrent validity comparing the result of one test to another
c. Discriminative validity
d. Construct validity -
2. Assessment tools
The specific tools used in an assessment depend on the clinician’s theoretical
orientation
Hundreds of clinical assessment tools have been developed
- Interviews (patient and family)
- Physical Exams
- Behavioral Observations
- Psychological Tests
3. Clinical Interviews
Face-to-face encounters
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- Often the first contact between a client and a therapist/assessor
Used to collect detailed information, especially personal history, about a client
Allow the interviewer to focus on whatever topics they consider most important
Can be either structured or unstructured
- In unstructured interviews, clinicians ask open-ended questions, let the client
discuss whatever they want to talk about, let them determine the flow of
session
- In structured interviews, clinicians ask prepared questions, often from a
published interview schedule
- Semi- structureD combination of structured and unstructured; include
detailed questions and ask follow up questions
II. Strengths and weaknesses of Clinical Interviews
Strengths: a good path way to reach diagnosis
Weakness: unstructured interviews are not highly reliable
1. Behavioral Assessment and Observation
Behavioural Assessment
- Focus on here and now
- Tends to be direct and minimally inferential
- Purpose is to identify problematic behaviours and situations
- Identify antecedents, behaviours, and consequences
Behavioural Observation and Behavioural Assessment
- BEHAVIORAL OBSERVATION: Can be either formal or informal
- Self-monitoring vs. others observing
- Problem of reactivity using direct observation methods: people behavior
changing as the function of being observed
2. Psychological Testing
Projective tests developed by individuals who inherited psychodynamic process
- Require that subjects interpret vague and ambiguous stimuli or follow open-
ended instruction
- Mainly used by psychodynamic practitioners
- Most popular:
i. Rorschach inkblots
ii. Thematic Apperception Test
iii. Sentence completion
iv. Drawings
Clinical Test: Rorschach Inkblot
Clinical Test: Thematic Apperception Test
III. Projective tests: Strengths and Weaknesses
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Document Summary

To know what type of medication, prognosis, course of ailments, what type of disorder needed: characteristics of assessment tools. What the test measures and how well it does so. Standards and norms help ensure consistency in the use of a technique. Reliability is the consistency of a test. Two main types: test retest reliability retest of the certain disorder the next months later. Interrater reliability e. g. : a student not convinced with a psychologists" method, then went to another psychologist because not convinced but the other psychologist has different diagnosis low interrater reliability. The instrument itself even though used by the same psychologists, could give different diagnosis. Validity is the accuracy of a test"s results. A good test must accurately measure what it is supposed to be measuring. Some types of validity: predictive validity how well your assessment tells you what will happen in the future e. g. : gre"s predict performance of students going to graduate schools.

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