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
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,
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.
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.
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
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
Behavioral Observations – Facial expressions, fidgeting, etc. These may be
diagnostic in themselves.
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
Positive impression management – They aren‟t willing to admit that there is
Typically checklists of symptoms that a person may have. Beck Scales - The scales go from „Not at All‟ to
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
Extensive measures that attempt to cover a wide range of clinical
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
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
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
The bottom are all the measures
used to make the test valid
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
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.
The notion that highly unstructured stimuli are necessary to bypass defenses in
order to reveal unconscious motives and conflicts.
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
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