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University of Toronto St. George
Hywel Morgan

Psychological assessment refers to the systematic gathering and evaluation of information pertaining to an individual for whom a specific question about psychological functioning needs answering. Assessment requires the clinician to place and interpret scores and other data within the context of the person’s history, referral information, behavioral observations and life story of that person in order to provide a comprehensive understanding of that individual. Assessment can be carried out with a wide variety of techniques, typically including a clinical interview and a number of psychological tests. • Test-retest reliability = the degree to which a test yields the same results when it is given more than once to the same person • Alternate-form reliability = the degree to which two alternate forms of a test agree (provide similar results) • Internal consistency = the degree of reliability within a test • Split-half reliability = a measure of internal consistency; often evaluated by comparing responses on odd- and even-numbered test items • Coefficient alpha = a measure of internal consistency; calculated by averaging the intercorrelations of all the items on a given test • Face validity means that the items on a test resemble the characteristics associated with the concept being tested. • Content validity is one step beyond face validity in requiring that the test's content include a representative sample of behaviours thought to be related to the construct the test is designed to measure • Criterion validity is said to have been achieved when the test results match what is known in the population (i.e., a depression test has criterion validity if it discriminates between depressed and non- depressed people) • Construct validity is concerned with the importance of a test within a specific theoretical framework; especially useful for abstract constructs Rorschach Inkblot Test: created by Rorschach; asked to describe what they see in the blot; Exner system developed to increase reliability and validity by standardizing scoring ThematicApperception Test: created by Murray and Morgan; drawings on cards of ambiguous social interactions which individuals create stories about; questions about the reliability and validity of scoring techniques THERAPIES-CH 17 Treatment 2 ways: different paradigms within. Psychopathology-faulty ways of thinking. Theoretical perspectives. Behavioural-way of looking how mind works. Etc. main approaches they lead to different types of therapy. Theoretical approach: •Psychological therapies- •Somatic/biological therapies-problem in biological make up, imbalance of distortion of some kind. Gestalt argument: im greater than the sum of my parts. People feel they have an entity inside of them, a spirit, separate from biology, a soul. Its dilemma the mind brain dilemma, not clear. We have clear gestalt examples, clear example in our environments ie/ film. What are the parts of a film, a motion picture. They are static pictures of the parts, unmoving when put together really quickly there is movement. Greater than the sum of its parts, get movement. o Shock Therapy o Psychosurgery o Psychoactive Drug Therapy These therapies are used together, psychological-what you think and biological-make up. Both influence each other. What you think can affect your health, biology. Ex/ stress and anxiety can create ulcers. Distinct relationship between the two. Can do experiments on this not just correlational studies. Ulcers are actually bacterial infections but stress to which reduces immune system allowing to eat your stomach. Treatment was stress reduction, still is and anti biotic to reduce ulcers. They both interact for the development of psychopathology and the treatment. Psychological therapies Planned, ongoing interaction between a therapist and a client. Doesn’t have to be single client. • Psychoanalytical psychotherapies-dysfunction. Psychodynamic therapy. Method of this treatment was psychic conflict that originates from childhood. Freud said would not get to next stage. Free association is the tool.- lie and say whatever comes to mind because subconscious things arises-Freudian slips. Criticism: not easy to scientifically identify this. The Freudian slip is from subconscious or twist of the tongue-impossible to determine. • Cognitive therapies- apply learning theories to covert cognitive events. Psychoanalysis- address in mind. Behaviour-address movement. Cognitive appreciates thinking about what your doing. Cognitive behavioural therapies CBT- think about what your doing. Its psychological challenge whereas behavioural there is none just manipulating through conditioning. Cognitive asking you why you are doing that. Comes from the perspective that psychopathology comes from faulty thoughts or beliefs that were learnt incorrectly. Athough learned incorrectly- I am stupid or ugly, not capable of doing this. This theory that you learnt that somewhere and is not correct. Therapy used is to challenge those thoughts. Verbal challenge-would involve modeling. Usually gets positive results with anxiety, depression. • Behaviour therapies- reaction to psychoanalysis. Interested in overt behaviours not important in subconscious. Miller. Not interested in childhood, past thoughts, treating what may have originally caused the behaviour only in behaviour present. Behaviour modification is the approach used. Compulsive disorder. Pathological behaviour displayed presently is the only consideration. Methods derived from conditioning, classical and operant. Channeling behaviour through stimulus response- no conscious introspection, not interested in thinking and feeling about past. Simply a treatment method to modify your current behaviour. Conditioning principles to therapy. Treatment strategies derived from whether increase or decrease in behaviour. • Major treatment modifications: some strategies work better for some psychopathology but not others. o Behavioural therapies: • Systematic desensitization- treating phobias. Effective technique on anxiety disorder- drugs have sideffects so effective way is systematic desent. Ex/ phobia-irrational fear. Ie/ heights. Rational fear- falling. Common fears don’t require interventions. Learnt fear through conditioning. • Flooding or implosive therapy-spider in a room. Successful not ethical. Not used for phobias. Useful for compulsive disorder. Going to confront your obsessions and making you do those compulsions. • Modeling- useful for children, fear of dog. Model an interaction with a dog, watch me first. • Extinction- conditioning principles. Real easy, simply stop reinforcing a behaviour. Often will display can be abnormal behaviours because they get attention. Will display good and bad behaviours for attention.Attention is the most powerful reinforce, more powerful then cocaine and chocolate. • Positive reinforcement- extinguish a negative behavior and reinforce a positive behaviour. • Group therapies- involves non related members. Related involves family members. Social dysfunction. Advantage-same disorder, can be supportive of each other. Family therapy adtage: family dynamic is part of the cause. Group therapy is cost effective, is a place to practice relating to others, offers exposure to the experiences of others, and may lead to feelings of cohesion. Q: Briefly describe the focus of behavioural approaches and provide examples of techniques. A:At the heart of behavioural approaches are efforts to reinforce desirable behaviours and ignore undesirable behavoiurs. Response shaping is used to shape behaviour in gradual steps toward a goal, such as teaching a young child to get dressed independently. Behavioural activation is used to help patients develop strategies to increase their overall activity and to counteract their tendencies to avoid activities. In systematic desensitization, fear-inducing stimuli are arranged in a hierarchy, individuals are trained in techniques to achieve deep muscle relaxation. Clients imagine the items of the hierarchy one at a time while remaining relaxed.Assertiveness training is effective for treating anxiety in interpersonal situations, and is often offered to couples experiencing relationship problems or aggressive individuals. Drug Therapies • Anti-psychotics • Anti-depressants • Stimulants • Tranquilizers 5 potential risks of drug treatment 1. May have undesirable physiological effects 2. Maybe based on a faulty diagnosis 3. Encourages pill taking 4. Deprives people opportunity to control own behaviour 5. Maybe unethical to medicate a psychological problem *Many psychologists have argued for prescription privileges. They state that many major mental disorders are treated with medication, it might be more cost-effective for psychologists to prescribe medication rather than psychiatrists, and underserved groups might benefit from expanded opportunities to receive medication. Many physicians are concerned about the effects of psychologists having prescription privileges and argue that a great deal of training in biology is necessary. Psychopathology of adults and adolescents-CH 15 Child Disorders • Modern child psychopathology • DSM intially had two cateogries • DSM IV-10 major cateogries • Last disorder in each is "NOS" not otherwise specified, which is change on DSM V Intectual ability can tell right from childhood and autism can be diagnosed right from childhood-mental retardation and childhood schizophrenia now called autism. Some children lose touch with reality, as autism is recognized as-a psychiotic condition. These people don’t live in the same world or not responding int eh same way to stimuli compared with other infants. That term was abondoned because hallmarks for schizophrenia is halluciantions, dillusions so now abondoned and replaced with autsim. Mental retardation changed to intellectual ability. Intellectual disability only reffered to people with a deficit in intellect. DSM iv- two cateogries DSM V-not more categories of child disorders instead eliminated. DSM IV had a section on child disorders, meant that it first saw symptoms in childhood.Adults can show ADHD but is different then childrens. Categories have been reorganized into sections with similar sections in DSM V, autism is in psychiotic disorders.Age of concent is 12. adolence-still growing, when brain is fully developed that’s when reaches adulthood. Brain is continuing to grow until 23. adolesence same as 13-18. childhood is pre 13. after 3 brain stops working. At 18, you become an adult. Diagnosed in infancy 18-2 (toddler 2-4) , childhood 5-12, adolesence 13-18/19, adulthood. Not clear when adolesence ends and can show up post period. NOS: doesnt meet the same criteria as the disorder. DSM has eliminated NOS because if it doesn’t meet specific criteria then don’t have this disorder, combordity. They made the criteria less specific. To catch more people with that disorder. • Mental retardation Dsm iv- emphasized the intellectual disability. There are four cateogries in dsm iv Mild, moderate, severe, profound based on the level of intelligence. Below 40-severe, below 20-profound. How well can you adapt to the changing environment? Intellectual deficit includes adaptation. • Learning Disorders Reading Math Writing- split in dsm IV -controversial cateogry and redifined because a deficit where the child falls behind the developmental norms and deficits with extreme learning difficulties-dsm iv definition. Pathology is 2 stadard deviations 1. Motor skill disorders developmental coordination disorder. Must reach a milestone otherwise a concern. Further away a child chronigically, fromt eh milestone t, greater the concern. Easy to detect changes. This is statistical-a change in milestone. Further away from the statistical milestone, greater the concern which remains intact on dsm V 1. Communication disorders • Expressive disorder • Mixed expressvie-recpetive • Phonological • Stuttering -speaking and understanding disorders, prounications and stuttering. These disorders sometimes spontaneously remit- See in childhood and adulthood go away on their own, sometimes don’t require treatment. Unclear language, unusual for childs age, poor grammer, poor prounication. Doesn’t understand communication appropriatly. Diagnose comboridly in this cateogry for dyslexia. Phonological-substituting sounds and/or letter also corbid with dyslexia. Stuttering-inability to get the sounds out when expressing-neurological. When brain grows, stuttering goes away and stammering. Stuttering and stammering are treatable, cognitive beahvioural therapy. • Pervasive developmental disorders Cateogry called atusitic spectrum disorders, each of these disorders are eliminated, dsm V recognized they are all the same disorders on a continum/spectrum. They look like different from each other in terms of functioning but same symptoms. • Autism- dsm iv had different diagnostic cateogries but in dsm v has eliminated because same disorders on a spectrum. Loss of touch with reality. Extreme social isolation on dsm iv. Reality they have is not same as other people. Not interested in interaction with other people only themselves and inanimate objects. Can include any of those symptoms in varying degress on the spectrum. Mild-people intelligent but don’t interact well. • Rett's- a behaviour-hand ringing. Not interested in reality, social world only their hands. Rett's disorder. • Childhood disintegrative disorder- childhood schizophrenia, slow insidious progression from infancy to non responsive state. Non social.Atwo month old baby must have a social interaction with caregiver. Infants with autism you cant detect because looks normal but taken away from caregiver they are indifferent. • Asperger's - mildest form. Not doing the same thing as other people are doing. Not dressing, the same or same interest. They are functional, have friends but not fitting in. nerd. Doesn’t undertadn what other people tke for granted when effectively charged. Don’t understand sarcasm, take things literally. Nothing to do with intelligence. Lacking emotional valence, not on same terms with social interaction as other people are. Autism is often combobid with mental retardation others say a form of mental retardation. Category 6: Attention deficit and disruptive disorders. Dsm 5 has separated them, where in DSM 4 same category. • ÄD/HD- inability to focus on materials presented o you in extended periods of time.Attention wanders, seen right from childhood. School years-5 or 6, clearly seen by 10. fun stuff don’t have a problem with, focus on video games is no problem. It is mundane stimuli have trouble focusing on. Not attending to things they should be. Other symptom is impulsivity-cant stop themselves from doing those other things. Cant focus and cant help themselves. Key features odAD-impulsivity. It goes with disruptive disorders because disruptive leads to trouble. Hyperactivity- cant stop themselves from moving. Implies behavioural activity, busy, fidgety, moving around. • Conduct disorder-remains on dsm 5 as a separate section. Children behaving anti-social. Impulsive behaviour. Children who are delinquent in legal terms. Overlap between delinquency and conduct disorder. Significant overlap but not perfect between these two concepts so if deliquent not have conduct disorder.Aggressive, assulting others, stealing, setting fire. Conduct disorder is treatable until 18 years, and prosecuted under other rules. If not treated, this goes to manifest as a personality disorder that will not change.Aggression to people and animals: bullies, threatens, or intimidates others, initiates physical fights, physically cruel to people and/or animals; Destruction of property: fire-setting; Deceitfulness or theft: breaking into houses, lying to obtain goods or favours; Serious violations of rules: chronically truant from school, running away from home. • Oppositional defiant disorder- severe rejection of all authority,ADD. Not severe as conduct
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