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Lecture 3

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

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Uzma Rehman

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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
1. Characteristics of assessment tools
- Consistency is measurement; most basic
- 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:
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
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
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
- 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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