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Lecture

PSY240H1 Lecture Notes - Psychopathology, Minnesota Multiphasic Personality Inventory, Thematic Apperception Test


Department
Psychology
Course Code
PSY240H1
Professor
Martha Mc Kay

Page:
of 5
Psy240- chapter 4: Assessing and Diagnosing Abnormality
Assessment: the process of gathering information about people’s symptoms and the
possible causes of those symptoms. Information is gathered in an assessment is used to
determine the appropriate diagnosis for a person’s problems
Diagnosis: the label attached to a set of symptoms that tend to occur together.
In gathering information, we would want to look at the symptoms and history,
physiological and neurophysiological factors and sociocultural factors that guide the
information of a diagnosis.
1. Current symptoms. 2. Ability to function. 3. Coping. 4. Recent events. 5. History of
psychological problems.
Many disorders appear to have genetic roots, so knowing that an individual has a family
history of a particular disorder can assist in diagnosing that disorder.
Psychological disorders don’t have definitive biological test. They can tell whether a
medical disease is causing psychological symptoms as side effects.
Drugs can induce distressing psychological symptoms as side effects during use or
withdrawal from the drugs
Differential diagnosis: a determination of which of several possible disorders an
individual may have.
Sociocultural factors
Social resources: the number of friends and family members they have contact with
and the quality of their relationships with these people.
Social isolation can make it much more difficult for people to overcome psychological
problems.
Sociocultural background: specific culture in which they were raised, the number of
years they have been in this country, the circumstances that brought them to this
country.
Also very useful to know as much as possible about client’s socioeconomic status and
occupation in their homeland.
Acculturation: extent to which people identifies with his or her group of origin and its
culture or with the dominant, mainstreams culture.
Some members of ethnic minority groups retain as much of their culture of origin as
possible and reject the dominant, mainstream culture.
Bi-cultural: they continue to identify with their culture of origin and celebrate it but also
assimilate as necessary into the dominant culture.
We need to understand this because it can affect how clients talk about and present
their problems, the kinds of stresses clients will be exposed to etc.
Clinical interviews
Intake interview/mental status exam: Information is gathered for an assessment in
an initial interview.
Unstructured interview: with only a few open ended questions.
Structured interview: series of questions about symptoms he or she is experiencing or
has experienced in the past. Format of the questions and the entire interview is highly
structures and standardized, uses concrete criteria to score each answer.
Resistance: sometimes individuals being assessed does not want to be assessed or
treated.
Validity: the accuracy of a test in assessing what it is aiming to measure. The test would
yield the same information every time as what it is supposed to measure.
Psy240- chapter 4: Assessing and Diagnosing Abnormality
Face validity: face value, items seem to be measuring what the test is intended to
measure.
Content validity: test assesses all important aspects of a phenomenon.
Predictive validity: test predicts the behavior it is supposed to measure
Construct validity: test measure what it is supposed to measure, not something else
Concurrent validity: test yields the same results as other measure of the same
behavior, thoughts, or feelings.
Reliability: indicator of the consistency of a test in measuring what it is supposed to
measure.
Test-retest reliability: how consistent the results of a test are over time.
Alternative form reliability: develops two or more forms of a test. These different
forms of test are similar.
Internal reliability: when people’s answers are similar in different parts of the same
test.
Inter-rater reliability: two or more raters or judges who administer and score a test
come to similar conclusions.
Neuropsychological test: useful in detecting specific cognitive and fine-motor deficits,
such as attentional problem or a tendency to ignore items in one part of the visual field.
Bender-Gestalt test: assesses clients’ sensorimotor skills by having them reproduce a
set of nine drawings.
Good at differentiating people with brain damage from those without brain damage, but
it does not reliably identify the specific type of brain dame a person has.
Computerized tomography (CT): an enhancement of X-ray procedures. CT scan can
reveal brain injury, tumours and structural abnomalities.
Cons: exposes patients to X-rays which can be harmful and provides only the image of
the structure, and not the activity of the brain
Positron-emission tomography (PET): provide a picture of activity in the brain.
Assesses brain activity by measuring movement of photons through the injection of a
radioactive isotope.
Pros: can show differences in the activity level of specific areas of the brain between
people with a psucological disorder and people without a disorder.
Magnetic resonance imaging (MRI): Provides finely detailed pictures and does not
expose the person to radiation. Relies on magnetically affecting hydrogen atoms in a
way that provides 3D images of the brain.
Intelligence test: used to get a sense of client’s intellectual strengths and weaknesses,
particularly when mental retardation or brain damage is suspected.
Tests were designed to measure basic intellectual abilities, such as ability for
abstract reasoning, verbal influency, and spatial memory.
Cons: Assesses verbal and analytical abilities but do not assess other talents or skills,
such as artistic and musical ability.
Psychologists argue that both social skills and other talents influence success in life.
Biased in favour of middle- and upper-class.
Symptom questionnaire: cover a wide variety of symptoms, representing several
different disorders. Others focus on symptoms of specific disorders.
Psy240- chapter 4: Assessing and Diagnosing Abnormality
Allow for the mass screening of large numbers of people to determine self-reported
symptoms.
Beck depression Inventory (BDI): has 21 items, each of which describes four levels of
a given symptom of depression.
Cons: does not clearly differentiate between clinical syndrome of depression and the
general distress that may be related to an anxiety disorder or several other disorder.
Also does not indicate whether the respondent would qualify for a diagnosis of
depression
Pros: extremely quick and easy to administer, good test-restest reliability. Widely used.
Personality inventories: questionnaires that are meant to assess people’s typical ways
of thinking, feeling and behaving. These inventories are used as part of an assessment
procedure to obtain information on people’s well-being, self-concept attitudes and
beliefs, way of coping, perceptions of their environment and social resources and
vulnerabilities.
Minnesota multiphasic personality inventory (MMPI): more than 150 languages and
used in more than 50 countries.
Pros: large groups of possible items were given to people without psychological
disorder and to people with various psychological problems. The items on the MMPI
cluster into ten scales, measure different types of psychological characteristics or
problems. An additional of 4 scales are addled to assess vulnerability
4 validity scales also determine whether the person tends to respond to the items on
the scale in an honest and straightforward manner or tends to distort answers in a way
that might invalidate the test.
Ability of MMPI to identify or catch individuals who may be faking their good or bad
response has made it an especially valuable tool in clinical contexts, respondents
exaggerates.
Re-test reliabiilites for MMPI is high.
Cons: do not reflect variations across cultures in what is considered normal or
abnormal.
Projective test: when people are presented with an ambiguous stimulus, they will
interpret the stimulus in line with their current concerns and feelings, their
relationships with others, their conflicts or desires.
As to project these issues as they describe the content of the stimulus
Pros: useful in uncovering the unconscious issues or motives of a person or in
assessing a person who is resistant or heavily biasing the information he or she
presents to the assessor.
Four most frequent used projective test are:
o The Rorschach Inkblot test, the Thematic Apperception Test (TAT), the sentence
completion test, and the Draw-a-person test.
All of these test are for assessing the underlying conflicts and concersn that clients
cannot or will not report directly
Cons: validity and reliability of all projective test have not proven strong in research
because they rely greatly on subjective interpretations by clinicians, thus open to
biases.
Behavioural observations: assess deficits in their skills or ways of handling situations.
Helps clients learn new skills, stop negative habits and change the way he or she reacts
to certain situations.
Pros: does not rely on clients reporting and interpretation of their behaviours.