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Chapter 4

Psychology 2310A/B Chapter Notes - Chapter 4: Millon Clinical Multiaxial Inventory, Rorschach Test, Psychological Evaluation

Course Code
Rod Martin

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-Psychological assessment: A systematic gathering and evaluation of info pertaining to
an individual with suspected abnormal behavior
-Psychological assessment is not a single score but a series of scores placed within the
context of history, referral info, behavioral observations, and life of an individual in
order to provide a comprehensive understanding of that individual
-A test is only a sample of behavior- a tool to be used in the progress of assessment
-A good assessment tool depends on:
-An accurate ability to measure some aspect of the person being assessed
-Knowledge of how people in general fare on such a measure
Assessment Tools: Striving for The Whole Picture
- Sometimes patients cannot report on their own internal states, even when they can
accurately describe their observable behavior
-Psychological methods are available to fill many of the missing pieces
Reliability and Validity
- Test-test reliability: Degree to which a test yields the same results when it is given
more than once to the same person
-Can be measured by correlating a person’s score on a given test with the same
person’s score on the same test taken at a later time
-Problem: Person may have just improved on their second attempt
- Alternate-from reliability: Designers prepare 2 forms of the same test —> a high
correlation between scores demonstrates alternate-form reliability
-Internal consistency: Degree of reliability within a test (to what extent do different
parts of the same test yield the same results?)
-Split-half reliability: Evaluated by comparing responses on odd-numbered test
items with responses on even numbered test items —> if scores are highly
correlated, there is half-split reliability
-Coefficient alpha: Calculated by averaging the intercorrelations of all items on
a given test —-> the higher the coefficient, the higher the internal consistency
-A reliable measure is useless if it is not valid
-Face validity: The user of a test believes the items on that test resemble the
characteristics associated with the concept being tested for
-Content validity: Requires that a test’s content include a representative sample of all
behaviors thought to be related to the construct that the test is designed to measure
-Ex. The construct of depression includes features such as lack of energy,
sadness, etc. so to have content validity, these features should be addressed

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-Criterion validity: Some qualities are easier to recognize than to define completely
-Construct validity: Importance of a test within a specific theoretical framework and
can only be understood in the context of that framework
-Especially useful when the construct is abstract
Clinical vs. Actuarial Prediction
- Clinical approach: There is no substitute for the clinician’s experience and personal
-Prefer to draw on all available data in their own manner; they are guided by
intuition honed with professional experience rather than by formal rules
- Actuarial approach: A more objective standard is needed (unbiased and scientifically
-Rely on statistical procedures, empirical methods, and formal rules
-More efficient in terms of making predictions in relapse, dangerousness,
improvement in therapy, success in university (especially when many
predictions must be made and the base of the data is large)
-Problems: Many of the equations found in the literature do not generalize to
practice settings and there are no prediction rules for the bulk of our decisions
Brain Imaging Techniques
- Central nervous system has been the focus of considerable research in the attempt to
understand the causes of psychopathy
-EEG: Uses electrodes placed on various parts of the scalp to measure the brain’s
electrical activity
-Patients may carry out tasks to see how parts of the brain responds
-Computed tomography (CAT): A narrow band of X-rays is projected through the head
and onto scintillation crystals which are much more sensitive than X-ray film —> The
X-ray source then rotate and project another image —> the source rotates a total of 180
degrees producing a number of images from different angles
-Tomography: A 2D image or cross-section of the brain
-Has shown that schizophrenia and disorders such as Alzheimers involve cortical
atrophy (shrinkage of the # of brain cells)
-Static image
-Magnetic resonance imaging (MRI): Non-invasive technique that reveals both the
structure and the functioning of the brain
-A magnetic field is produced around the patient’s head
-Capable of discriminating small differences in water concentration
-Safe because it doesn’t use high energy radiation (X-rays) or injections
-Functional MRI: Provides a dynamic view of metabolic changes occurring in
the active brain (dynamic image)
-Static image

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-Positron emission tomography (PET): Combination of computerized tomography and
radioisotope imaging
-Generated by injected or inhaled radioisotopes (common elements or substances
that have had the atom altered to be radioactive)
-This process allows the scientist to measure biological activities as the processes
occur in the living brain
-Dynamic image
Neuropsychological Testing
- Used to determine the relationships between behavior and brain function
-Bender Visual-Motor Gestalt Test: Oldest and most commonly used
neuropsychological test
-Series of 9 white cards containing lines and shapes drawn in black
-Respondents copy the images on another card and then draw them from memory
-Errors in reproducing lines can be associated with neurological impairment
-Problem —> errors could be caused by a tremor in hand or nervousness
-Some people with impairment can still complete it
-Developmental differences (age)
-The most popular neuropsychological battery is the Halstead-Reitan which consist of 6
subtests (time-consuming):
-1. Category test: Measures abstract thinking —> choosing an image from the
screen that represents a given category
-2. Rhythm test: Concentration and attention —> listening to 30 pairs of
rhythmic beats and identifies which are the same and which are different
-3. Tactual performance test: Visual memory —> Fitting blocs of shapes into
their corresponding spaces then draws the board from memory
-4. Tapping test: Taps rapidly on a lever
-5. Grip strength test: Identify location of brain damage —> Grasps a
dynamometer which measures strength
-6. Auditory test: Identify aurally transmitted nonsense words
Clinical Interviews
- Most common assessment tool
-Interviewer asks about medical history, psychiatric history, age, marital status, family,
education, lifestyle and the reason they are seeking consultation
-Unstructured interviews:
-Open-ended affairs with no scripts
-Can follow the patient’s lead —> helpful when under stress
-Easy to avoid sensitive topics until patient is more at ease
-Facilitate rapport (mutual understanding), mutual trust, and respect
-Structured interviews:
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