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Chapter 4

PS280-Chapter 4 Lecture Notes.doc

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John Stephens

1 PS280: Abnormal Psychology Lecture Notes Chapter 4: Clinical Assessment Procedures Chapter Outline · Reliability and Validity in Assessment · Psychological Assessment · Biological Assessment o Interviews o Brain Imaging o Psychological Tests o Neurochemical Assessment o Behavioural-Cognitive o Neuropsychological Assessment Assessment o Specialized Approaches to o Psychophysiological Cognitive Assessment Assessment o Family Assessment · Cultural Factors in Assessment Reliability and Validity in Assessment · Reliability o Inter-Rater Reliability: refers to the degree to which two independent observers or judges agree o Test-Retest Reliability: measures extent to which people being observed twice (taking the same test) perhaps several weeks or months apart o Alternate-Form Reliability: extent to which scores on the two forms of the test are consistent o Internal Consistency Reliability: assesses whether the items on a test are related to one another · Validity o Content Validity: refers to whether a measure adequately samples the domains of interest o Criterion Validity: evaluated by determining whether a measure is associated in an expected way with some other measure (the criterion) o Construct Validity: relevant when we want to interpret a test as a measure of some characteristic (construct) Psychological Assessment 1. Interviews · Clinical Interviews o Initial assessment  First part of an interview, the initial process is usually done by the secretary  When a client calls and is seeking help from a professional o History of client and problem(s)  Build a perspective of the person’s life, past events, family life  How all of these aspects affect the clients mental health o Allows for direct observation of client 2  When you pose a question, you look for the reactions portrayed by the client  Must be observant; what the client prefers not to talk about is probably the root of their problem  Non-verbal leakage; are their expressions telling you how they really feel · Structured Interviews o SCID: Structured Clinical Interview Diagnosis  Candid of you; better results in terms of consistency; asking same questions over again  Structured Q&A, clients answer to previous questions determines what question is next  Answers determine whether the severity of symptoms results in a disorder or not · Rated on a 1-3 scale o Diagnosis of psychopathology; allow for direct observation of client 2. Psychological Tests · Psychological Tests o Standardized procedures designed to measure person’s performance on a particular task or to assess personality, or thoughts, feelings, and behavior o Structured aspect of research; tasks are standardized over a broad population o Good measures have good standardization · Personality Inventories o MMPI-2: Minnesota Multiphasic Personality Inventory  Measures about 15 elements that are associated with psychopathology  Meant to assess multiple disorder symptoms at once; less expensive method  Quick to do now because of advanced technology o Projective Personality Tests  Psychological assessment device in which a set of standard stimuli ambiguous enough to allow variation in responses is presented to the subject  Clients response to ambiguous stimuli will reveal their true attitudes, motivations, and mode of behviour 3  Rorschach Inkblot Test  One infers from what one observes from ink blots; your personality brings about the thoughts that come to mind  Thematic Apperception Test (TAT)  Subject is shown a series of black and white pictures one by one and asked to tell a story related to each  The content of persons responses are viewed as symbolic of internal dynamics · Intelligence Tests o Alfred Binet o Often referred to as IQ tests, standardized means of assessing a person’s current mental ability o WAIS: Wechsler Adult Intelligence Scale, WISC: Wechsler Intelligence Scale for Children o Good reliability and validity; very standardized, have high criterion validity o Language skills, abstract thinking, non-verbal reasoning, visual-spatial skills, attention/concentration and speed of processing o Correlations between IQ and school performance are statistically significant, however environmental factors also play a large role in future educational attainment o IQ test are used:  In conjunction with achievement tests, to diagnose learning disabilities  To help determine whether a person is mentally retarded or not  To identify the intellectually gifted  As part of neuropsychological evaluations o Emotional intelligence is new aspect being looked into; important to be sensitive to the needs of others; important for adjustment and higher levels of well being 3. Behavioural and Cognitive Assessment · Often a system that involves the assessment of four sets of variables is used (SORC) o S- refers to Stimuli  The environmental situations that precede the problem; what cause anxiety o O-refers to Organismic  Physiological and psychological factors assumed to be operating “under the skin”  Ex. Persons fatigue is caused by excessive use of alcohol, or thoughts as in “I never do anything right so what is the point in trying” 4 o R-refers to overt Responses  Receive most attention from behavioral clinicians  Must determine what behavior is problematic; its intensity, frequency, and form o C-refers to Consequent variables  Events that appear to be reinforcing or punishing the behaviour in question  When client avoids a feared situation, does his or her spouse offer sympathy and excuse therefore not allowing client to face their fears · Ex. Behaviour observed of a child; look at when does the child have a tantrum, what stimulated the tantrum, variables that contributed to actions · Cognitive-Behavioural Case Formulation: a process in which a C-B therapist attempts to determine how the various problems experienced by a client are related in order to pick out overt behaviours and underlying schemas that will become the focus of therapy o Play much greater emphasis on negative/problematic cognitions · Behavioural Observation: observed divides the uninterrupted sequence of behaviour into parts and applies terms that make sense within a learning framework o Often difficult to observe behaviour as it takes place; little control · Self-Monitoring o Researchers as patients to monitor their own behaviour, and keep track of various responses o Intended to get more information about moods, stressful experiences, coping behaviours and thought processes o Ecological Momentary Assessment (EMA), conducted in real-world situations  Instead of having people reflect back, have them assess situations in the moment · Ex. Keep a diary and write down what you are feeling as you are feeling it  Main reason for this method is because sometimes retrospective recall of moods, thoughts, and experiences can sometimes be inaccurate and biased  Useful in clinical settings, revealing info that traditional assessment might miss  However sometimes EMA is not as useful, due to Reactivity: the phenomenon of behaviour changing because it is being observed · Self-Report Inventories o Personality Tests (already mentioned^) o Some Depression and Anxiety tests o Use of vignettes describing a situation to resolve 5 o Assessment of wide-range of cognitions: “When you witness someone being unjustly punished, what comes through your mind?” 4. Specialized Approaches to Cognitive Assessment · Articulated Thoughts in Simulated Situations (ATSS) o One way to assess immediate thoughts in specific situations · Thought Listing o The person writes down their thoughts prior to or following an event of interest; a way to determine the cognitive components of social anxiety o These measures are useful when investigators know little about the participants and the cognitive terrain o Keep track of all the times the client says “I can’t” · Videotape Recording o Involves videotaping an individual while they are engaged in some task or an actual or role-played problematic situation o Participant watches the videot
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