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Chapter 4

chapter 4

Course Code
Konstantine Zakzanis

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Chapter 4 - Clinical Assessment Procedure
Reliability - consistency of measurement
interrater reliability: degree to which two independent judges or observes agree
test-retest reliability: measures extent to which people being observed twice or tested twice with same test score the
alternative-form reliability: two forms of a test instead of same test used for people may remember answers if it was
the same test and see to extent in which people score on two forms of test and if the scores are consistent
internal consistency reliability: assesses whether items on test are related to each other
[correlation is measured on how closely related variables are, higher correlation, higher reliability]
Validity- whether measure fulfills its intended purpose
[validity is related to reliability, unreliable measures[inconsistent results] have low validity]
content validity: whether measure samples the domain of interest
criterion validity: determine whether measure is associated with another measure [also called concurrent validity
when two variables are measured at the same time] ---> [to predict other variables would measure in the future
known as predictive validity]
construct validity: interpretation of a test, measure of a characteristic eg. anxiousness or distorted cognition;
important for theory testing; ex. anxiety proneness
Clinical interview
interviewer uses language as a principal means of finding out about the client
attention the interview gives to the how the respondent answers or which he does not respond to
if person not upset about something they are talking about it may not be important but if the person shoes emotion
distress or ignoring of the topic then taken into consideration
eg. emotions a person displays when talking about a situation
the paradigm an interviewer uses will affect what information will be found, how it will be found, and how it will
be interpreted
for example a psychoanalytic clinician will inquire about clients history, don't think client knows why he or she is
coming to therapy, behavior clinician focus’s on environmental conditions related to changes in the persons behavior
and appreciate individuals distress
find information for only what they are looking for
clinicians emphasize the things to get the patient to bring them out in the open, encourage them to elaborate,
humanist may use specific empathy techniques
interviews are important to the study of abnormal, clinicians however overlook factors that they may be displaying
and influencing clients responses
reliability low, inconsistent results in interrator reliability, and other reliabilities
Structured Interview
questions are set out in a prescribed fashion for the interviewer
eg. structured clinical interview diagnosis [SCID] for Axis 1 of DSM
SCID is a branching interview that is clients response to one question determines the next question asked
contains details on when to probe and so forth, and when to go onto other questions on other diagnosis
most symptoms put on a three point scale with instructions on how to translate the rating into diagnoses
improvement in reliability
interrater reliability for structured interviews are good
structured interviews developed for personality disorders, and anxiety disorders
Psychological Tests
standardized procedures designed to measure a persons performance on a particular task or to assess their personality
if diagnostic interviews don't give all answers psychological test may give them
example patient with schizophrenia may not opening tell a clinical they have hallucination but may report it on the
psychological test
when data is collected statistical norms can be established process known as standardization
responses of a person then compared to statistical norms

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Personality inventories
person completes a self-report questionnaire
eg. Minnesota Multiphasic Personality Inventory (MMPI)
used to detect a number of psychological problems
has adequate criterion validity
has a series of statements that is a trap to identify faked responses eg lie scale
however people knowing about these questions can allow them to fake a normal response profile
MMPI-2 was established to increases reliability and validity by including factors of racial minorities, some items
were taken out due to their content and intrusiveness, and new scales on substance abuse, Type 1 behavior and
martial problems were added
can now be administered by computer and several commercial MMPI serves that score and give response to
65 is the norm, below or above to a great distance means there are certain problems that need to be addressed
Projective Personality Test
assessment device in which a set of standard stimuli such as inkblot or drawings are presented to an individual and
asked for them to be described
assuming that because the pictures are unstructured the responses gained will be primary by the unconscious
processes that will reveal their true attitudes, feelings and mode of behavior, referred to as a projective hypothesis
ex. if individual sees eyes in a inkblot may be leaning towards paranoia
Rorschach Inkblot test: best known projective technique
-------->individual sees picture, half are black and white and shades of gray, 2 have red spots, 3 are in pastel
Thematic Apperception Test (TAT): person shown black and white pictures and asked to tell a story related to each
projective tests are derived from psychoanalytic paradigm
using of these tests means that client will be unwilling to express his or her true feelings
psychoanalytically oriented clinicians like using such projective tests for they believe people repress their feelings in
the unconscious mind
content of persons answer was seen symbolic of internal dynamics, and also concentrate on the form of the persons
response; test considered a perceptual-cognitive task
Many people use the Exner’s system to score Inkblot tests but people feel that its validity is only high on some tests
but not all eg. high validity in finding people with schizophrenia
some believe an interview can simply find the answers behind the responses for the inkblots
Roberts Apperception Test for Children: projective tests developed with more standardized scoring assessment
Intelligence Test by Alfred Binet
often referred to as n IQ test, standardized means of assessing a persons current mental ability
Wechsler Adult Intelligence Scale WAIS
Wechsler Intelligence scale for Children WISC
all tests used to identify if individual will do well in future schooling
used to diagnose learning disabilities, identify individuals with mental retardation, identify gifted children, part of a
neuropsychological evaluation
IQ tap several functions asserted to constitute intelligence, including language skills and abstract thinking, visual
spatial skills, attention, concentration and so forth
Standardized mean is 100, and 15 or 16 is the standard deviation
65% b/w 85 and 115
below 70 have disorder
above 130 are gifted
2.5 percent of population fall in theses extremes
highly reliable and have good criterion validity
regarding construct validity: psychologist only test what they consider to be intelligent but we know that other
factors also play a role in our intelligence
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