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Lecture 4

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Konstantine Zakzanis

Lecture 4: Assessment Procedures: - Real importance of psychologists (in terms of what they can bring into the medical community or practitioners) is their ability to test - Most psychologists spend most of their time assessing than doing anything else - A lot of science that go into the tests (assessment procedures) - All sorts of people (judges) who rely on expert opinions, rely on psychologists because of the kinds of tests that they are able to employ and use in their clinical practice. o Ex: task, patient psychotic or not (do they get to keep child or not) children’s aid case. Psychiatrist = only clinical interview, psychologists= clinical interview and psychological testing o Only clinical interview  biases (disadvantage) - High value of these tests because they are reliable and valid as well  Reliability- consistency of measurement. When you give a measure, is it consistently measuring the same thing? o Test-retest reliability- administer test once, and again after a certain period of time passes, will the same results be produced? Same result= reliable  Doesn’t work for all psychological tests, example tests based on mood (someone at time one may score really high for depression, but at time 2 may not as things may have changed or may have sought out counselling) BUT if you give a person a test measuring depression and they show that they aren’t depressed and at time 2 they claim they aren’t depressed, you would expect the same result as test one in that scenario.  Test-retest reliability= dynamic  IQ = pretty stable after a certain age, so you would see a high test-retest reliability o Alternate-form reliability- sometimes it’s impt to have a test that is an alternate form of the original test. Eliminates practice effects. Prevents subject from scoring better as a result of familiarity or memorization of answers.  If there were 2 diff kinds of depression test scales, the person given to must score the same on both tests to ensure the reliability of the alternate test form. o Internal consistency reliability- whenever we have a test measure, we want to make sure all the items on the test are measuring the same thing  Ex: 20 item test, 1 10 items asked about personal failures but the 2 items asked about shoe size and favourite subject at school and o/ such things  Not consistent with the other items which measured depression.  When we look at internal consistency, we split test in ½ and make sure subject is filling out q’s in a consistent & reliable manner.  Validity – if a test is not reliable then it is NOT valid o Content validity- if we are going to measure something, only valid if we measured as much of the construct that exists. Want to sample the content of the disorder.  Ex: given depression inventory but only asks about 2 of the many symptoms. Not valid in terms of content because there are many other symptoms as well (sadness, loss of appetite etc) o Criterion Validity- when we develop a test we need to make sure it measures what we say it measures  Aka convergent reliability. Result on one test converges w/ result on a/o test. Both have same results. (ex: depression is present)  Predictive validity- if the criterion is that the 1 measure measures depression, then it should be predictive of that in the real world (does the person look depressed?) o Construct Validity- most diff to understand b/c psychological disorder= constructs (not tangible)  To measure: take a group of ppl w/ anxiety and measure their level of anxiety against a group of ppl who don’t have anxiety. If there’s a difference b/w the groups then we know that the measure is measuring anxiety (a construct that is not tangible)  Psychological assessment: o Clinical interview= essential part  Asking questions to help figure out what is wrong with you and how best to help  Ex: Neuropsychologist works w/ a biological paradigm – ask q’s about family illness history, if any physical injuries to the head, any current or past medications?  Type of psychologist and paradigm used influences type of questions. o Structured Interviews:  Ask a series of question in a certain order, one after another  Look at the skid in txtbook o Semi-structured views:  Don’t systematically follow everything. Jump around as things come up. But have notes in front of them as well. o Behavioural observations- ex: facial expressions  Behavioural observations can be diagnostic in and of themselves at times (Ex: person w/ severe memory loss left clinician to go to washroom but never came back & forgot that they were ever with the clinician)  Limitations of clinical interviews: o Are they telling the truth? Any evidence of negative impression management. Are they exaggerating? We don’t know if all we r doing is asking q’s. Some psychological tests have imbedded validity indexes (lie scales) o What if you have a person with no insight? o Person who engages in positive impression management not willing to admit to any minor faults or any symptoms that may be present (consciously doing this)  Beyond clinical interviews= psychological tests: o Screening Measures- these are checklists of symptoms a patient may or may not have.  Beck Scales (Beck Anxiety inventory)  Screening measures very subjective (prof doing anxiety test) could be exaggerating or feigning.  Some psychologists base diagnosis on only screening tests  bad practice  What they should be doing is employing measures that omnibus  Have good construct validity but also have scales to tell us if person is exaggerating or if person has no insight o Personality Inventories  Personality Assessment Inventory/ Personality Assessment Screener (PAI)  344 item questionnaire w/ validity scales  Statistical infrequency: all tests are normed (standardized) before tests are published they are administrated to a variety of ppl. Have something to compare against.  T-scores  Anything above 70- statistically infrequent (healthy ppl don’t get scores above 70)  ICN= Inconsistency, INF= infrequency (healthy ppl wouldn’t never endorse ex: fav sprt = high jump) , NIM= negative impression management (exaggerating or feigning), PIM= positive impression management (not wanting to admit probs), SOM= somatic complaints, ANX= anxiety, DEP= depression, PAR= Paranoia, MAN= Manic, SCZ= schizo, BOR= borderline, ALC= alcohol use, ANT= Antisocial, DRG- drug use, AGG- aggressiveness, SUI= suicidal  Anything above 0 for suicidal= bad  Minnesota Multiphasic Personality Inventory- 2 (MMPI-2) o Projective Measures (omnibus techniques are what most clinicians rely on today, but beyond that is projective measures, more common in the 50’s 60’s and 70’s. Not common at all for diagnostic purposes, but still use it to explore diff kinds of things in the context of therapy (after diagnosis is already known))  Projective Hypothesis: the notion that highly unstructured stimuli are necessary to bypass defenses in order to reveal unconscious motives and conflicts (paradigm= psychodynamic paradigm)  Rorschach Inkblot Test  missing reliability (won’t get the same answer) try to score this test based on commonality (test-retest reliability pretty shitty)  Thematic Apperception Test (TAT)  look at pic and tell story o Specific Psychological Inventories  Thousands of measures assessing every type of psychopathology  Ex: Pain Inventories (eg. P-3 Multidimensional Pain Inventory) measures person’s perception of pain..does it affect sleep, diable person etc.  Ex: Trauma Symptom Inventory  sensitive to someone w/ post traumatic stress disorder. Asks specific questions relating to it o Intelligence tests (been around for a while)  Wechsler Adult In
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