3- Assessment & Research Flashcards
Psychological Assessment and Reliability/Validity
Systematic gathering and evaluation of info related to sme’s psychological sx and problems => Integrate knowledge of assessment into broader context
Purposes:
- Describe current functioning
- Dx
- Identify therapeutic needs
- Monitor tx over time
Reliability:
- Test retest (be mindful of what you measure ex: contract construct)
- Inter-rater
Validity:
- Face validity
- Content validity
- Construct validity
*Without reliability, validity is irrelevant
Approaches to Assessment
- Clinical: uses clinician’s exp and personal judment
- Actuarial: use of objective, empirical data (mostly in research)
Potential Biases in Assessment (3)
Theoretical orientation of the clinician
- Shapes types of assessment tools used
- Shapes interpretations of same beh
- Shapes treatment recommendations
Underemphasis on broader socialcultural context
- DSM places disorder within the individual
- What about the person’s environment?
Lack of cultural sensitivity
- Imposing Western perspectives on other cultures
- Beh mean different things in different cultures ex: eye contact (in Japan), belief in evil spirits
Clinical Interviews and Content
- Unstructured
- Semi-Structured => can skip a few sections if no sx ex: SCID, MSE (examination used in hospitals, etc)
- Structured ex: DIS
=> Diagnostic Interview Content
- Identifying features
- Reason for referral
- History of Present Illness (HPI)*
- Psychiatric history
- Medical history
- Habits (Substance use)
- Family history
- Social and developmental history
- Review of symptoms
- Mental status exam
Self-Report Rating Scales
Indicate presence/absence of trait/beh AND severity
ex: Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI)
Psychological Tests
Two main kinds used in clinical psychology:
- Intelligence Tests (ex: WISC/WAIS)
- Personality Tests: Projective or Objective
Projective Personality Tests (2)
Rooted in psychoanalytic principles => Person presented with ambiguous stimulus will project their unconscious motives, needs, drives, feelings, and defenses
- Rorschach Inkblot Test: 10 inkblots, lacking in reliability/validity, efforts to improve psychometrics (ex: performance assessment system) *got posted on wiki
- Thematic Apperception Test: project psychological needs onto characters, pro: might be able to tap into less socially desirable deb vs con: psychometrics
*Generally lack reliability/validity but continued use among clinicians who accept underlying psychodynamic theory
Objective Personality Tests
Standardized procedures => Established norms and Statistically validated methods of interpretation ex: MMPI, MCMI
=> MMPI:
- 567 questions (true/false/cannot say)
- Contrasted gr method to ascertain validity (compare item resp in disordered gr vs control gr)
Has clinical scales (ex: hypochondriasis, hysteria, paranoia, etc), Validity scales (Lie and Infrequency Scales), DON’T PROVIDE A DX BUT HELPUL TO GUIDE ONE
=> MCMI: 195 questions (true/false), validated on clinical samples, Complementary to MMPI, but more focused on personality dx (aligned with DSM-IV axis II dx) with 15 personality scales (ex: histrionic, schizoid, dependent) and 10 clinical syndrome scales (ex: dysthymia, anxiety, somatoform, bipolar)
Biological Assessment
=> Brain Imaging:
Electroencephalogram (EEG)
- Electrodes on scalp measure brain’s electrical activity
Computed Tomography (CT)
- Produces detailed cross-section of brain
Magnetic Resonance Imaging (MRI)
- Structural: brain volume
- Functional: connectivity*
Positron Emission Tomography (PET)
- Requires injection of radioactive tracer
=> Neuropsychological Testing:
- Cognitive/Executive/Visual/Motor functioning
- Attention/concentration/Memory
- Motivation
- Language/Somatosensory/olfaction
- Neurodevelopmental dx ex: ADHD, Intellectual Disability, Learning Disability
- Neurocognitive dx ex: due to Alzheimer’s or TBI
*Can rule out organic impairment in other disorders (ex: depression, anxiety)
Purpose of Clinical Research
- Describe clinical presentations
- Understand epidemiology
- Identify etiology
- Prediction of beh
Epidemiology
- Prevalence: % of people in a population with a dx at a particular point in time (ex: past month, year, lifetime)
- Incidence: % of people who develop a disorder for the 1st time during a specific period
Risk Factors:
- For epidemiologists, this is a correlate (most often demographic variables) associated with different dx
- Psychologists use this term to mean a predictor, or cause.
Case Studies
Case studies: Detailed account of single patient ex: Anna O case study by Freud
Problems:
- Biased reporting
- Generalizability
Experimental Methods
Experimental vs. control group => Manipulate IV and measure effect on DV *Key design used to assess tx outcomes
Things to consider:
- Random assignment
- Pre-test vs. Post-test
- Placebo
- Blinding
- Statistical significance: means it is extremely unlikely that the obtained results could have occurred by chance (p<.05)
- Clinical significance: refers to the treatment’s practical utility => Consider effect size, Cost of tx, Particular outcome
Pros and Cons of Experiments
- Allows us to determine causality (useful for determining if tx is beneficial)
- Potential ethical concerns: Withholding effective tx and Etiological questions that can’t be addressed
Correl/Cross-Sectional/Longitudinal Designs
Correlational: Psychopathology aims to establish causality BUT, core problem with research is use of correlational designs (Due to the nature of our etiological questions)
*Correlation does not equal causality!
Instead, try to:
- Rule out third variables
- Establish temporal precedence
Cross-Sectional: Many in clinical psychology, Makes it hard to establish temporal precedence
=> Often “control for” third variables:
- Control groups (often “healthy controls”)
- Include control variables in your analyses
Longitudinal: Can establish some temporal precedence by looking across time
Different types:
- Retrospective
- Follow-up
- High Risk
Longitudinal Studies (3)
Retrospective: Collect a sample of people with a dx => Try to determine what preceded it through:
- Self-report
- Existing archival data
Follow-Up: Typically studies follow only people with the disorder over time (Due to high resources required)
- See what happens to an “already-ill-sample”
- Downside: makes it difficult to derive etiological explanations
High Risk: Variant of follow-up => Identify people who are likely to develop a dx (Follow them over time)
- Offspring of people with a dx (genetic) => On the basis of a biological abnormality, Beh variable
Cons:
- Genetic: Need to find people who have the dx and also have children (hard to recruit and underrep)
- Biological: Associations not well-proven
- Behaviors: May be a risk factor, or may be early manifestation of the disease
