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Lecture 4

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PSYC 3140
James Alcock

January 28 , 2013 Tahreem Mahmood Lecture 4 Abnormal Psychology -Psych 3230 Lecture 4: Assessment and Research Scientist-Practitioner Model  Clinical psychology is about 100 years old  Grounded in psychological research  1949, Boulder Conference on Graduate Education in psychology o Developed a model of training o Clinical psychologists to be trained BOTH as scientists and as practitioners  Clinical psychologist should use their training as scientist researcher to guide their practice o Evaluate client progress o Apply critical thinking o Employ empirically – supported techniques o Practice is formed by research literature Clinical Vs. Statistical Prediction  Statistical (actual) method – classify the individual in terms of similar cases (nomothetic) – as in testing.  Clinical method – attempting to understand the individual apart from other cases (idiographic) o Advocates argue that psychological causation is always personal and never actuarial o Gordon Allport in the 1940s;  We should discard all predictions based on class membership, e.g., actuarial predictions o Example (G. Allport, 1942, p.157):  Is 80 percent of delinquents from broken homes are recidivists, it does not follow that a single delinquent from a broken home as an 80% probability of becoming a recidivist  Probability is based on frequencies obtained across repeated trials. However, a particular delinquent represents only a single trial  If we know all the variables that are related to recidivism then we would be able to predict the delinquent’s outcome with certainty.  Paul Meehl (1954) Clinical verses Statistical Prediction argued against this view: o We can use statistical predictors, based on categories; why not use them if they give 70 or 80% certainty? o For Allport, only if all predictors were known should we use category membership, for then, we would predict with reasonable (near 100%) certainty. January 28 , 2013 Tahreem Mahmood Lecture 4 Abnormal Psychology -Psych 3230  Meehl reviewed empirical comparisons of statistical (actuarial) and clinical predictions of outcomes: o Success in training programs o Recidivism o Recovery from psychosis  Meehl (1954) found 16 studies o “in all but one , predictions made actuarially were either approximately equal or superior to those made by a clinician” (p. 119)  We know now that for example, interviews even by highly skilled interviewers are not as accurate as when tests are used or when interviews are supplemented by tests  Similarly for diagnosis  Yet there often seems to be something disturbing about using a statistical approach o E.G. – Likelihood that an offender will reoffend.  The temptation is always to let the experience take over statistical (actuarial factors) o E.G. – likelihood an individual will become violent  Nobody can predict violence – we shouldn’t pretend that we can o E.G. – For admission to graduate school.  You have to take a balanced approach – Not depend a lot on GRE’s (graduate examination) Methods of Assessment  Interviews  Objective tests  Projective tests – there is no evidence that they are still useful  Physiological measures – these aren’t used too often – e.g. galvanic skin response or finger temperature Clinical interview  Can be structured, semi-structured, or unstructured  What do we want to find out? o Life history -- find out how the person’s life has been so far (getting some information about their life is critical) o Apparent problem o Stresses o Mental status examination January 28 , 2013 Tahreem Mahmood Lecture 4 Abnormal Psychology -Psych 3230  Mental status examination -- a semi structured part of clinical interview o Clinical observes and asks questions  Appearance – does it appear that this person isn’t looking after themselves  Behaviour  Sensorium (five senses working properly?)  Orientation – does the person look in your eye  Affect – emotion  Memory, intelligence, thought process and content  Insight, judgement Test Construction  Reliability concerns o Internal consistency – degree of reliability within a test o Temporal stability (test-retest reliability) o Inter-rater reliability – is the test independent of the rating of the person?  Validity concerns o Content validity – does it tap a representative sample of behaviours we consider important o Criterion validity  Concurrent validity: does it distinguish between groups – e.g. depressed and
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