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Chapter 4

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Department
Psychology
Course
PSYB32H3
Professor
Connie Boudens
Semester
Summer

Description
Chapter 4 – Clinical Assessment Procedures Exam Tips for Abnormal Psych Recognition tests – recognizing the content over memorizing. This means familiarizing with the content.  Look for stuff that the prof has focused on  Stuff that has been mentioned in both the lecture and the textbook usually are a good indication  Answers will be found in the book Most psychologists spend the majority of their time in assessment over treatment. Psychologists have the ability to test, which ends up helping society (criminal, medical, etc.) Reliability and Validity in Assessment Reliability – consistency of measurement. When you give a measure is it consistently measuring the same thing?  Test-retest reliability – if you administer a test to a person and then re-administer it awhile later and it gives the same result, it is reliable. o This may not work for all psychological testing – if you give someone a test then introduce treatment, you should get a different result on a test.  Alternate-form reliability – An alternate form of the test that you have administered before - this type of test is important so that, if you have administer the test before, there is no memorization of the content (practice effects)  Internal consistency reliability – Want to make sure that all the items on a test are measuring the same thing. You don‟t want half the test asking about a person‟s depression and half asking where they buy their shoes. o Validity – Without reliability, there is validity.  Content validity – if you are measuring something, it is only valid if you measure as much of the content as exists. o Given a depression inventory, you don‟t just ask about their appetite and sleeping. It needs to ask about all the symptoms that are associated with the disorder.  Criterion validity – The test needs to measure what it is said to measure. Could also be convergent validity. It also needs to be predictive. If the test says that the person is depressed, they must actually be depressed in the real world too not just on the test. o Two different tests need to state the same result in order for the disorder to be valid.  Construct validity – Psychological disorders are constructs, not physical objects. You can‟t actually touch anxiety but it has defined symptoms. o If you compare a group of anxiety patients and a group on non-anxiety people, the test must show a difference in the scores of the two groups. If there is a difference, it means that the anxiety is being measured. Psychological Assessment Clinical interviews  Characteristics of clinical interviews o What questions do you feel would be important to ask of a patient? This can be defined by the paradigms.  Neuropsychologist (biological) – Does your disorder run through the family? Are you using any medications? Have you hit your head recently?  Psychoanalyst – Dreams? Childhood?  Structured/Semi Structured interviews o Structured – following questions one after the other (SCID) o Semi-Structured – Will hit all of the domains but will address them as they come up  Behavioral Observations – Facial expressions, fidgeting, etc. These may be diagnostic in themselves. Limitations  Is the patient telling the truth? – Are there any indication of negative impression management? Are they exaggerating, lying?  What if these person has a lack of insight (inability to see the problems they have)?  Positive impression management – They aren‟t willing to admit that there is something wrong Screening Measures Typically checklists of symptoms that a person may have.  Beck Scales - The scales go from „Not at All‟ to „Severely‟ o The problem with the test is that it can be taken far too literally or at the moment. Someone can feel hot from wearing a jacket, not from an anxiety disorder = situation/context is important. o People can also screw up the test – they can exaggerate. A psychologist should employ measures that have validity so that they can find out if the person is trying to alter the assessment Beck Anxiety Scale General Personality Inventories Omnibus Measures  Extensive measures that attempt to cover a wide range of clinical psychopathology  Typically self-report measures  Contain clinical measures and validity measures  Can directly assess clinical psychopathology (i.e., the PAI), or assess mental and personality clusters and infer psychopathology from that profile (MMPI-2) The Personality Assessment Inventory (PAI)  The Personality Assessment Inventory (PAI) is a 344 item self-report questionnaire that attempts to understand an individual‟s personality traits and characteristics.  Renders diagnostic considerations based on the DSM-IV.  Diagnostic considerations involve Axis I and Axis II disorders  Provides clinical and validity scales  Has screening measure to make assessment more efficient, 22 items vs. 344 items Interpreting Test Results Normative Comparison – If a person is below the norm, in an intelligence test, this might indicate a learning disability/mental retardation. This is a PAI Output – plotting the scores according to standardization.  Anything above 70 is statistically infrequent.  The bottom are all the measures used to make the test valid o ICN=inconsistency  differently worded questions – for the question, “I feel very depressed”, they This is a normal test answered „very true‟. However, with “I am not depressed”, they should answer „false‟ not „very true‟ o Frequency - healthy people should not endorse certain things. If the person is answers questions in an manner that is infrequent from normal people, they may be lying. o NIM – Negative Impression Management (making things appear worse than they are) o PIM – Positive Impression Management (making things appear better than they are)  SOM – Somatic complaints  ANX – Anxiety  DNP – Depression  PAR – Paranoia  MAN – Mania  SCZ – Schizophrenia  BOR – Borderline  ALC – Alcoholism  ANT – Antisocial  DRG – Drug Use  AGG – Aggression  SUI - Suicidality Depression is above 70 While schizophrenia is the highest, this person has many other symptoms. This makes it difficult to have this as one single diagnosis. Projective Techniques Projective Hypothesis  The notion that highly unstructured stimuli are necessary to bypass defenses in order to reveal unconscious motives and conflicts. Projective Techniques  Tests of personality that involve use of unstructured stimulus materials. Use of such materials maximizes the role of internal factors such as emotions and motives in perception. This is from the psychodynamic paradigm. Rorschach Inkblot Test A projective test in which the subject is instructed to interpret a series of ten inkblots (monochromatic and coloured) reproduced on cards. Technique consists soliciting a number of responses, and then afterwards asking the person to explain their answer(s) Scored on a variety of elements including number of response, “popularity” of response, response to colour = indicative of emotional control, shading = anxiety, focus on space = hostility  Test retest is very difficult for this test  However, if person can expand from what they see, it may provide more information about the person. Thematic Apperception Test  A projective test consisting of a set of 31 black-and-white pictures reproduced on cards, each depicting a potentially emot
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