Chapter 4- Clinical Assessment Procedures
! Two concepts that play a key role in assessment are reliability and validity.
! Psychometrics exists for the study of reliability and validity.
! Inter-rater reliability refers to the degree to which two independent observers or
! Test-retest reliability measures the extent to which people being observed twice or
taking the same test twice score the same way.
! Alternate-form reliability: the extent to which scores of two forms of the test are
! Internal consistency reliability assesses whether the items of a test are related to one
! The higher the correlation, the better the reliability.
! Validity is generally related to whether a measure fulfills its intended purpose.
! Content validity refers to whether a measure adequately samples the domain of
! Criterion validity is evaluated by determining whether a measure is associated is an
expected way with some other measure (the criterion).
! Predictive validity- the measure’s ability to predict some other variable that is
measure in the future.
! Construct validity is relevant when we want to interpret a test as a measure of some
characteristic or construct that is not simply defined. A construct is an inferred
attribute, such as anxiousness or distorted cognition, that a test is trying to measure.
! Clinical interview- the interviewer pays attention to how the respondent answers
! The paradigm within which an interviewed operates influences the type of
information sought, how it is obtained, and how it is interpreted.
! Structured interview is one in which the questions are set our in a prescribed fashion
for the interviewed.
! Psychological tests are standardized procedures designed to measure a person’s
performance on a particular takes or to asses his or her personality, or thoughts,
feelings and behaviour.
! Standardization - the same test is administered to many people, responses are
analyzed to indicate how certain kinds of people tend to respond, statistical norms for
the test are established.
! Three basic types of psychological tests:
! 1)self-repost personality inventories,
! " In a personality inventory, the person is asked to complete a self-report
questionnaire indication whether statements assessing habitual
tendencies apply to him or her. Most popular is MMPI- Minnesota
multiphasic personality inventory.
! 2) projective personality tests and
! " A projective test is a psychological assessment device in which a set of
standard stimuli- inkblots or drawings- ambiguous enough to allow
variation in responses in presented to the individual. Because the stimulus
materials are unstructured, the patient’s repsonses will be
determined primarily by unconscious processes and will reveal hir or her
true attitudes, motivations and modes of behaviour- the projective
! "Rorschach inkblot test - a person is shows 10 inkblots, one at a time and
asked to tell what figures or objects he or she sees in each of them.
! "Thematic Apperception Test (TAT)- a person is shown a series of black
and white pictures one by one and asked to tell a story related to each.
! 3) tests of intelligence.
! An intelligence test, often referred as an IQ test, is a standardized means of assessing
a person’s current mental ability.
! Scores on most IQ tests have 100 as the mean and 15 or 16 as standard deviation.
! Below 70 is sub average general intellectual functioning and about 130 is
! Alexithymia is a condition of reduced emotional awareness that is a risk factor for a
variety of adjustment problems.
! Behavioural and cognitively oriented clinicians use SORC:
! S stands for stimuli-environmental situations that precede the problem.
! O stands for organismic- under the skin factors.
! R stands for overt responses- intensity, frequency and form of problematic
! C stands for consequent variables- events that appear to be reinforcing or
punishing the behaviour in question.
! In formal behavioural observation, the observer divides the uninterrupted sequence
of behaviour into various parts and applies terms that make sense within a learning
! Children predicted their own anxious feelings and behaviour during the task better
than parents and teachers.
! Observe their own behaviour and to keep track of various categories of response-
! Self-observation a.k.a. ecological momentary assessment, EMA.
! The main reason for using EMA is that the retrospective recall of moods, thoughts, or
experiences may be inaccurate.
! The phenomenon of behaviour changing because it is being observed is called
! Dysfunctional Attitude Scale DAS.
! Articulated thoughts in simulated situations ATSS. A person pretends that they
are in a situation. During 30 seconds or silences, the person talks about whatever is
going through their mind in reaction to what they heard.
! In thought listening, the person writes down his or her thoughts prior to or following
an event of interest, such as entering a room to talk to a stranger, as a way to
determining the cognitive components of social anxiety.
! Videotape reconstruction involves videotaping the individual while he or she is
engaged in some task.
! It is important to assess current or previous types and levels of family functioning
before implementing the various forms of treatment.
! Equifinality is the notion that the same goal or endpoint can result from many
different starting points.
! Family environment scale FES assesses three main themes:
! 1) the family relationship,
! 2) personal growth and
! 3) system maintenance.
! The family adaptation and cohesion evaluation scale FACES-III has two
! degree of cohesion (Togetherness) and
! degree of adaptability )able to adapt to the rules that are changed)
! The parental bonding inventory PBI assesses the level of care or parental warmth
and the level of controlling parental behaviours.
! Affectionless control is an overcontrolling parent who lacks warmth and caring.
! EMBU assess memories of parental rearing styles.
! Single photon emission computerized tomography (SPECT) allows assessment of
cerebral blood flow and is used increasingly in neuropsychiatry.
! MRI produces pictures of higher quality and does not rely radiation like CT scans.
! fMRI allows researchers to take MRI pictures so quickly that metabolic changes can
be measure, providing a picture of the brain at work rather than of its structure alone.
! PET scan allows measurement of brain function.
! A neurologist is a physician who specializes in medical diseases that affect the
nervous system, such as muscular dystrophy, cerebral palsy, or Alzheimer’s disease.
! A neuropsychologist is a psychologist who studies how dysfunctions of the brain
affect the way we think, feel and behave.
! Neuropsychological tests are based on the idea that different psychological functions
are localized in different areas of the brain.
! Four tests included in the Halstead-Reitan battery are the tactile performance test-
time, memory, category test and speech sounds perception test.
! The luria-Nebraska batter has 11 sections.
! Psychophysiology is concerned with the bodily changes that accompany
psychological events or that are associated with a person’s psychological
! Each heartbeat generates spreading changes in electric potential, which can be
recorded by an electrocardiography and electrocardiogram.
! A second measure of autonomic nervous system activity is electro dermal responding
or skin conductance.
! Brain activity can be measured by an electroencephalogram or EEG.
two concepts that play a key role in assessment are reliability and validity. psychometrics exists for the study of reliability and validity. inter-rater reliability refers to the degree to which two independent observers or judges agree. test-retest reliability measures the extent to which people being observed twice or taking the same test twice score the same way. alternate-form reliability: the extent to which scores of two forms of the test are consistent. internal consistency reliability assesses whether the items of a test are related to one another. the higher the correlation, the better the reliability. validity is generally related to whether a measure fulfills its intended purpose. content validity refers to whether a measure adequately samples the domain of interest. criterion validity is evaluated by determining whether a measure is associated is an expected way with some other measure (the criterion).