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Lecture 3

PSYB32H3 Lecture 3: Lecture-3

Course Code
Konstantine Zakzanis

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Chapter 3 Clinical Assessments
Evidence-Based Assessment of Mental Health
Background Data
o Examples:
o Family history is there any history of psychiatric disorder?” to determine any genetic predisposition
o Age to determine base rates
o Medical History addiction
What could go wrong if you ask an individual “What brings you here?”
- It is subjective
o they might think but they may not have the symptoms that they are suggesting they have
- Sometimes the patient is not comfortable to share everything, so they omit certain kinds of problems
Positive Impression Management (saying that there is nothing wrong with them)
o This is done sometimes because they are uncomfortable, for cultural reasons, or
because of brain injury Anosognosia (unawareness of mental illness)
- Negative Impression management overexaggerating the symptoms
- Solution: Reach out for a collateral interview with somebody who knows the person
o Career someone that is working in a lab may have a neuropathological alteration
o Childhood Experiences this can shape the way we behave/misbehave later on in life
“did you grow up in an abusive environment?”
o Complications during birth
An anoxic event (disruption of oxygen to the brain) give long-term consequences with respect to
memory such as cognitive problem
o Educational background the more education you have, the more you can handle failings
Cognitive-reserved hypothesis the more we use our brains throughout our life, the more we
have to fall later on in life. If we have a traumatic brain injury or dementia, we have more to lose
before the deficits are obvious
o Socioeconomic status poverty
o Developmental History
Syrian refugees
o Culture
o Gender women and man see the world in very different ways
could also affect base rates there are diseases that are more common in women than men such
as eating disorder
Behavioural Observations
o Examples:
o Tone of their voice are they angry? agitated?
o Whether or not there is hesitation in their speech
o Body language
o Facial expressions
What make clinical psychologists unique is that they employ tests. These tests allow you to determine in a quantifiable
manner what this person’s symptoms are like in terms of breadth, severity, and veracity.
Quantitative Data
Qualitative Data

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In Search of Madness: Is it evidence-based opinion or mere fairytale?
The Crystal Ball Approach to Assessment
Evidence-Based Assessment
BAI (Beck Anxiety Inventory) one of the most widely used psychology test measures
Similarity of BAI and Multi-krypton Psychometric Inventory of Superheroism: Self- report
For a test to be meaningful, it has to be standardized and the score that you garner from the patient in front of you has to
be compared to the standardization sample (test norms) that has been established.
Neuro|Psychological Tests
o Responses of person being assessed are compared to test norms that have been established
Test Norms
o The test is administered to many people and the responses are analyzed to establish how a group of people
tend to respond
o Provides a comparison context which is used to interpret an individual’s score
How to Standardize a Score
Example: A patient scores 9/50 on a depression inventory. Are they depressed?
o How would we answer this question?
o We first need to compare this score to the normative sample
Percentile allows you to determine how abnormal the score is compared to the standardized sample
Interpreting Scores
What are some issues that can arise when trying to interpret standardized scores?
o We know why we want to standardize scores, improves interpretation, comparability across people and
across tests
o What are some issues when the tests are normed on different samples?
Let’s say you perform two memory tests, and both tests have different normative samples.
One test is normed on a sample of individuals over the age of 65
The other is normed on a sample of young healthy individuals.
On one memory test you might perform far above average and the other you might perform at
o Let’s say you administer a test battery to a patient in the hopes of uncovering some sort of cognitive
profile. But each test is normed on a different sample of people. Because of this, you may be introducing
error into your interpretation if the normative sample isn’t appropriate.

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Selecting Appropriate Normative Data
Selecting the normative dataset should be done a priori
Large samples are ideal (at least n=200)
Date of norming (usually have a lifespan of 15-20 years)
2 schools of thought when selecting norms:
o Norms should be as representative of the general population as possible
Stratified General Population Norms
When you are interested in comparing an individual to every one of the same age
o Norms should represent the specific subgroup to which the individuals belong
Demographically corrected norms (within-group norms)
When you’re interested in comparing an individual’s score to a group of people of the
same age, gender, education, handedness, ethnic group, geographic location, etc.
Psychological Tests
Screening Measures
o Beck Scales
Projective Measures
o Rorschach Inkblot Test
o Thematic Apperception Test (TAT)
Specific Inventories
o Pain Inventories (e.g., P-3; Multidimensional Pain Inventory)
o Traumatic Symptom Inventory
Omnibus Inventories
o Personality Assessment Inventory/Personality Assessment Screener
o Minnesota Multiphasic Personality Inventory -2 (MMPI-2)
Psychological Screening MeasuresLimitations?
When can Screening Measures be useful?
o If the score is elevated it can allow you to triage (send the people for full assessment) people
Measure Efficacy
o To check if the person is getting better with the drug
Projective Techniques
Projective Hypothesis
o The notion that highly unstructured stimuli are necessary to bypass defenses in order to reveal
unconscious motives and conflicts.
Projective Techniques
o Tests of personality that involve use of unstructured stimulus materials. Use of such materials maximizes
the role of internal factors such as emotions and motives in perception.
Rorschach Inkblot Test
o A projective test in which the subject is instructed to interpret a series of ten inkblots (monochromatic and
coloured) reproduced on cards.
o Technique consists soliciting a number of responses, and then afterwards asking the person to explain
their answer(s)
o Scored on a variety of elements including number of responses, “popularity” of response, response to
colour = indicative of emotional control, shading = anxiety, focus on space = hostility
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