Assessment and Dx

Question 1

Name purposes of psychological assessment.

Answer 1

Screening, measuring specific traits, determination of risk, diagnosis, vocational planning, intervention planning, evaluating treatment outcomes.

Question 2

Define psychometrics.

Answer 2

Branch of psychology concerned with the quantification and measurement of psychological variables, as well as with the design, analysis, and improvement of measures.

Question 3

What was the Binet-Simon scale?

Answer 3

The first intelligence test developed for French school children to evaluate children for intellectual disability.

Question 4

What is behavioral assessment and ecological assessment?

Answer 4

Behavioral assessment relies on hypothesis-testing, is used to describe a particular behavior/pattern and identify what triggers and maintains the behavior.

Ecological assessment uses observational methods to examine physical (e.g., lighting, noise) and psychological variables (e.g., relationships with others) that influence behavior in a given environment. Helps to determine whether individuals behave differently in different environments.

Question 5

What is standardization?
What is a norm-referenced measure?
What is a criterion-referenced measure?

Answer 5

Standardization: Process of administering a measure to a representative sample and developing norms.
Norm-referenced measure: standardized measure that compares examinee’s performance to a reference population.
Criterion-referenced measure: Examines where person stands on a particular criterion (skill, knowledge area). A test that determine’s a person’s level of accomplishment of the material covered on the test according to some reference point (e.g., licensing exam).

Question 6

Describe narrative recording assessments, interval recording methods (aka time-sampling), and event-sampling methods.

Answer 6

Narrative recording assessments: running record of individual’s behavior througout the assessment.
Time-sampling methods (interval recording): operationally define target behavior, then record whether target behavior happens during each time interval. Good for frequent behaviors or those with no clear start/end.
Event-sampling methods: operationally define target behavior, then record frequency of behavior during whole observation. Good for less frequent behaviors.

Question 7

Describe rating recordings.

Answer 7

Examiner rates a behavior in terms of intensity or duration on a Likert scale. Inter-rater reliability not so good.

Question 8

Describe a functional behavioral assessment.

Answer 8

During an FBA, a problem/target behavior is identified, antecedents and consequences are identified (function of the behavior), intervention plan is formulated, intervention implemented, response to intervention is evaluated and intervention plan is adjusted accordingly.

Question 9

Describe assessment centers and work sample methods used in industrial and organizational (I/O) psychology.

Answer 9

In assessment centers, person is evaluated on job-related skills by doing behavioral simulation exercises that reflect job content and types of problems faced on the job. Also includes other tests like cognitive ability tests, personality tests, and job knowledge tests. At the end, raters meet to discuss candidate.

Work samples are used to assess job potential by asking people to do tasks that simulate the job (ex, give a presentation, role-play customer interaction, etc.)

Question 10

Describe classical test theory (CTT).

Answer 10

According to CTT, an individual’s observed score on a measure is composed of their true score plus measurement error. True score is the average score you would achieve given infinite administrations.

S = t + e
raw score = true score + error

Based on Spearman’s work.

Question 11

Describe Generalizability Theory (G Theory)

Answer 11

G Theory is based on CTT but goes further to identify specific sources of measurement error (test forms, test items, circumstances of testing, rater). Conduct a generalizability study to quantify individual sources of measurement error and to determine conditions under which observations will be consistent and applicable accross contexts.

Question 12

What is item response theory (IRT) and what three aspects of items does it focus on? What is the Item Characteristic Curve (ICC) or Item Response Function (IRF)?

Answer 12

Focuses on individual test items during test development, measures the relationship between individual items and construct being measured (latent trait). They look at item difficulty (% of people that get it correct), item discrimination (how the item discriminates between those who do well vs poorly on the test as a whole), and probability item is answered correctly by guessing.

ICC (or IRF) is a plot of the probability that a test item is answered correctly against the examinee’s underlying ability on the trait being measured. Also, percentage of individuals in different ability groups that answer it correctly. Ranges from 0-1.

Question 13

What is reliability (as defined by G theory)? What is a reliability coefficient?
What is test-retest reliability?
What is the alternate form reliability coefficient?

Answer 13

G theory defines reliability as the degree to which testing is free from measurement error.
Reliability coefficient = r; describes consistency of scores across contexts; 1.00 is perfect reliability, 0.00 is absence of reliability.
Test-retest reliability: stability of scores over time; calculated by administering same test twice.
Alternate-form reliablity coefficient: two forms of same test are administered, and examinees’ two scores are correlated. Alternate forms reduce practice effects.

Question 14

What is internal consistency reliability?
What is split-half reliability?
What is inter-item reliability?
What is inter-rater reliability?

Answer 14

Internal consistency reliability: degree of interrelationship among test items; are they consistent and measuring the same thing.
Split-half reliability: measures internal consistency of a test by dividing test in halves (odds & evens) and correlating each half.
Inter-item reliability: measures degree of consistency between multiple items measuring the same construct.
Inter-rater reliability: extent to which independent raters reach the same scores; expressed as a correlation coefficient. If it’s high, researcher knows that trained individuals produce similar scores.

Question 15

What is validity and validity coefficient?
What is face validity?
What is criterion validity?
What is content validity?
What is cosntruct validity?

Answer 15

Validity: the extent to which a test accurately measures what it’s supposed to measure.
Validity coefficient is a correlation coefficient between test scores and criterion indicator/other measure
Face validity: extent to which a measure appears appropriate to the examinee; impacts response behaviors.
Criterion validity: index of how well a test correlates with an established standard of comparison (i.e., a criterion). Includes concurrent and predictive.
Content validity: how well a test includes representative information about subject matter/behavior it’s measuring.
Construct validity: extent to which a test measures a trait, concept or other theoretical entity. Includes convergent and discriminant validity.

Question 16

What is the holy trinity of validity?

Answer 16

Criterion validity, content validity, construct validity.

Question 17

What is concurrent validity?
What is predictive validity?

Answer 17

Concurrent validity: correlation between measure of interest and established measure (criterion) administered at the same time.
Predictive validity: correlation between measure of interest and a later outcome measure (criterion).

Question 18

Define sensitivity and specificity.

Answer 18

Sensitivity: proportion of people accurately identified as having a trait.
Specificity: proportion of people accurately identified as not having a trait.

Related to type 1 error (false positive) and type 2 error (false negative)

Question 19

What is a multi-trait multi-method matrix?

Answer 19

Used to establish construct validity. Compares a new measure for a trait with an existing measure for the same trait that uses a different method, as well as a measure that uses the same method but measures a different trait. Yields convergent validity (correlation with other measures of same trait) and divergent validity (extent to which it does not correlate with measures of other traits, measured by the heterotrait monomethod coefficient).

Question 20

What is test bias?
What is test fairness?

Answer 20

Test bias: when there is systematic variation/error leading to impartial measurement across groups; over or underestimates performance for members of a specific group.
Test fairness: extent to which a test is used fairly, to classify a criterion. According to the Standards for Educational and Psychological Testing, you have test fairness as
* lack of bias
* equitable treatment in testing process
* equality in outcomes of testing
* opportunity to learn

Question 21

Broadly describe the psychometric properties of the BDI-II.

Answer 21

Good validity (content, divergent, concurrent) and reliability (test-retest, internal consistency)

Question 22

What does the State-Trait Anxiety Inventory (STAI) measure? What is state vs trait anxiety?

Answer 22

The State-Trait Anxiety Inventory measures state-associated anxiety x’s, as well as trait anxiety (stable personality traits consistent with anxiety).

Question 23

What are some clinician rating scales for mood used with adults?

Answer 23

• Hamilton Rating Scale of Depression
• Hamilton Rating Scale of Anxiety

Question 24

What model of intelligence are most current intelligence tests based on?

Answer 24

Cattell-Horn-Carroll theory of intelligence.

Question 25

Describe the Cattell-Horn Model of intelligence and Carroll’s Three Stratum Model of intelligence.

Answer 25

Cattell-Horn Model: two types of intelligence (crystallized and fluid) nested under general intelligence factor (g)
Carroll’s Three Stratum Model: set of narrow cognitive abilities, set of 8 broad factors (fluid & crystallized intelligence, memory, visual perception, auditory perception, retrieval capacity, cognitive speed, processing speed, ) and general intelligence factor.

Question 26

Name some common nonverbal intelligence measures.

Answer 26

Leiter International Performance Scale (Leiter-III)
Universal Nonverbal Intelligence Test (UNIT-2)

Question 27

What are the age ranges for the following tests of intelligence?
* WAIS-IV
* WISC-V
* WPPSI-IV
* WJ Tests of Cog Ability
* SB-5

Answer 27

• WAIS-IV: 16 - 89
• WISC-V: 6 - 16
• WPPSI-IV: 2:6 - 7:7
• WJ Tests of Cog Ability: 2 - 90+
• SB-5: 2 - 85

Question 28

What indeces are included in the younger WPPSI battery?

Answer 28

VCI, VSI, WMI

Question 29

What are some fixed battery approaches in neurospych for adults?

Answer 29

• Halstead-Reitan Neuropsychological Test Battery
• Neuropsychological Assessment Battery (examines attention, language, memory, spatial, EF)

Halstead-Reitan includes Weschler scales + Category Test, Tactual Performance Test, Speech-Sound Perceptions Test, Seashore Rhythm test, Finger Tapping Test, Trail Making Test.

Question 30

What are the six domains assessed by the NEPSY-II?
What is the age range of the NEPSY-II?

Answer 30

Domains: Attention/EF, language, memory & learning, sensorimotor, visual-spatial, social perception
Age range: 3-16 (form for 3-4, form for 5-16)

Question 31

Define ability vs aptitude vs achievement.

Answer 31

Ability: capacity to perform specific task, includes aptitude and achievment.
Aptitude: individual’s potential to learn a given task
Achievement: knowledge acquired in a specific setting

Question 32

Name three common achievement tests and their age/grade ranges.

Answer 32

• WIAT-III (or WIAT-IV); ages 4-50
• WJ Tests of Achievement; ages 2-90
• Kaufman Test of Educational Achievement (KTEA); ages 4 - 25:11

Question 33

What is curriculum-based measurement vs performance-based measurement?

Answer 33

Curriculum-based: measures mastery of a defined curriculum
Performance-based: measures specific skill or ability to perform specific task

Question 34

What are aptitude tests used for and what do they measure?
Name an example of an aptitude test.

Answer 34

Aptitude tests are used for job placement or vocational counseling and measure an individual’s potential to learn a specific skill or acquire knowledge. An example is the General Aptitude Test Battery or the Differential Aptitude Test (used with HS students)

Question 35

Describe the scales of the PAI.

Answer 35

Validity scales, clinical scales (DSM-IV-TR), treatment variable scales, interpersonal functioning scales.

Question 36

What are the validity scales of the MMPI-2 and MMPI-3?

Answer 36

MMPI-2: CNS (cannot say, non-reporting), VRIN (variable response inconsistency, random responding), TRIN (true response inconsistency, detects fixed responding), F scale (identifies overreporting from 60 rarely endorsed items), L scale (uncommon virtues, detects intentional underreporting), K scale (unintentional underreporting, social desirability), S scale (superlative self-presentation, identifies specific areas of defensiveness).

Question 37

Does research support MMPI-II for diagnostics?

Answer 37

No, used mainly for profile analysis.

Question 38

Describe the Millon Clinical Multiaxial Inventory.

Answer 38

It assesses personality patterns ranging from adaptive to maladaptive. It yields modifying indices (disclosure, desirability, debasement), random response indicators (invalidity & inconsistency), 12 personality profiles, 3 severe forms of personality pathology, 7 clinical syndromes, 3 severe syndromes.

Question 39

What is the most common scoring system for the Rorschach?
Are the Rorschach’s psychometric properties good or bad?

Answer 39

Exner’s scoring system is most common- looks at severa criteria including location, determinants, content, popularity of response, and special scores for rare responses.

The Rorschach’s reliability and validity are inconsistent.

Question 40

What is Holland’s theory of vocational interest? What vocational interest measure did he develop?

Answer 40

There are six dimensions of vocational interest (RIASEC): realistic, investigative, artistic, social, enterprising, conventional.
Holland developed the Self-Directed Search (SDS)- self report and self scored, identifies your top 3 domains.

Question 41

Name vocational interst measures other than the SDS.

Answer 41

• Strong Vocational Interest Inventory
• Kuder Occupational Interest Survey
• Campbell Interest and Skill Survey

Question 42

What is the focus of health behavior assessments? Name some examples of health behavior measures.

Answer 42

Health behavior assessments focus on understanding emotional and behavioral status of individuals with medical/health concerns. They usually measure a particular domain.
Some measures include
* EQ-5D
* PedsQL (Pediatric Quality of Life)
* McArthur Health and Behavior Questionnaire
* Behavioral Risk Factor Surveillance System and Youth Risk Behavior Surveillance System

Question 43

What is symptom validity testing?
Name some examples of measures.

Answer 43

Symptom validity testing assesses an examinees level of effort and investment during psychological testing.
Some measures include:
Test of Memory Malingering
Rey 15-item Test
Recognition Memory Test

Question 44

What is the difference between malingering and facticious disorder?

Answer 44

In malingering, symptoms are feigned to achieve a particular outcome (external motivator), such as an outcome in trial, a disability claim, etc.
Facticious disorder (DSM-IV-TR), patient feigns symptms to assume the ‘sick role’ (internal motivator).

Question 45

What is competency to stand trial?
What is insanity?
What is ‘not guilty by reason of insanity’?

Answer 45

Competency to stand trial is the defendants ability to understand and participate in legal proceedings, consult with an attorney, choose between different options. Established by the Dusky Standard.
Insanity: in law, a condition that makes a person incapable of being responsible for their ciminal behavior.
Not guilty by reason of insanity (aka insanity defense), that the defendent is ‘non compos mentis’ and thus not responsible for the crime they are charged with. Established by the Durham Rule, which became the American Law Institute Model Penal Code insanity test, AKA American Law Institute Test.

Question 46

What is the American Law Institute Test?
What is the Insanity Defense Reform Act?

Answer 46

The American Law Institute Model Penal Code Insanity Test is a legal standard for establishing criminal responsibility, person not guilty if crime was due to mental illness (inability to appreciate criminality of the act, or inability to conform behavior to the law).
Insanity Defense Reform Act passed in 1984, modified laws of insanity defense, inability to “conform one’s conduct to the requirements of the law” was no longer a factor in judging insanity. Another modification involved shifting the burden of proof (responsibility for convincing the court beyond a reasonable doubt of the truth of an allegation) in such cases from the prosecution to the defense. Adopts M’Naghten Rule,

Question 47

What is “guilty but mentally ill”?
What is “diminished capacity”?
What is “diminished responsibility”?

Answer 47

Guilty but mentally ill in some states, ruling can be made if defendant pleads insanity. Defendents are first treated in a mental health institution, then when “healthy” they serve remainder of sentence in a correctional facility.
Diminished capacity is a defense that limited mental capacity due to intoxication or mental defect limited the defendants ability to have true criminal intent.
Diminished responsibility: aka “limited responsibility”, a defense that mental abnormality reduces the responsibility for a criminal act (not all-or-nothing like the insanity defense)

Question 48

Describe retrospective and prospective assessments of aggression and the purpose of each.

Answer 48

Retrospective assessments of aggression evaluate aggression that occurred in the past to describe propensity for anger going forward. Used in treatment planning.
Prospective assessments of aggression examine “dangerousness”, which is a legal term meaning the individual’s propensity to commit dangerous acts. Psychologists are asked to assess for dangerousness for legal matters. Unfortunately, no structured assessments have strong predictive validity for this.

Question 49

What are some risk factors for aggression?

Answer 49

Risk factors: previous history of aggressive behavior, history of substance abuse, history of psychosis (specifically prior hospitalization), hx of antisocial personality disorder, borderline personality disorder, and personality disorder NOS, anger, difficulty showing empathy for others.

Question 50

What are the seven risk factors for suicide that have been identified?

Answer 50

• history of suicidal behavior
• types of current SI and symptoms
• precipitant stressors
• overall symptom presentation
• self-control and impulsivity
• predispositions
• (lack of) protective factors

Question 51

What are the components of a good suicide risk assessment?

Answer 51

Evaluate seriousness of the statement/threat, evaluate the level/type of ideation, whether there is a plan and if it is viable, access to means for completing the plan, motivating factors for the SI, any protective factors (reasons for wanting to stay alive).

Question 52

Name some structured suicide assessment measures.

Answer 52

Beck Scale for Suicidal Ideation
Suicidal Ideation Questionnaire
Suicidal Behavior History Form

Question 53

What should you consider when selecting an assessment measure?

Answer 53

Extent to which it can answer the referral question, psychometric properties, time and expense it takes to administer it.

Question 54

What is the International Classification of Diseases (ICD)?

Answer 54

the global standard for diagnostic classification of all health conditions as compiled by the World Health Organization (WHO). Per HIPPA, ICD codes are used for billing/insurance reimbursment in the USA. ICD also used for mortality and morbidity statistics by WHO member countries.
DSM has been developed in coordination with the ICD.

Question 55

What were some changes from DSM-IV to DSM-V?

Answer 55

• Removal of axial system
• NOS –> other specified disorder or unspecified disorder
• autism, asperger’s and PDD NOS –> ASDs
• elimitated subtypes of schizophrenia
• removed bereavement exclusion for depressive disorders
• gender identity disorder –> gender dysphoria
• added binge eating disorder
• cultural considerations are more prominent

Question 56

What are the 19 diagnostic classes of the DSM-5?

Answer 56

1. Neurodevelopmental disorders
2. schizophrenia spectrum and other psychotic disorders
3. bipolar and related disorders
4. depressive disorders
5. anxiety disorders
6. obsessive compulsive and related disorders
7. trauma and stressor related disorders
8. dissociative disorders
9. somatic symptom and related disorders
10. feeding and eating disorders
11. elimination disorders
12. sleep-wake disorders
13. sexual dysfunctions
14. gender dysphoria
15. dysruptive, impulse control and conduct disorders
16. substance related and addictive disorders
17. neurocognitive disorders
18. personality disorders
19. paraphilic disorders

Question 57

When should you make a provisional diagnosis versus defer a diagnosis?

Answer 57

Provisional diagnosis: When there is evidence that full criteria will be met, but more info needs to be gathered, OR when symptoms are present and do not seem like they will go away, but minimum time requirement has not been met.
Deferred diagnosis: inadequate info for diagnostic judgment

Question 58

Describe an evidence-based approach to diagnostic decision-making.

Answer 58

Integrates empirical research, clinician training and comprehensive data collection. Typically uses standardized assessments.

Question 59

What is the observer effect in behavioral analysis?

Answer 59

Knowledge that you are being observed impacts the target behavior.

Question 60

What is response to intervention (RTI) assessment and where is it most commonly done?

Answer 60

Response to Intervention (RTI) assessment measures progress frequently to determine efficacy of treatment and services. Uses short and long term discrete, measurable goals. Most often used in schools.

Question 61

How is a reliability index calculated?

Answer 61

Square root of reliability coefficient

Question 62

What are the five factors of the SB-5?

Answer 62

Fluid Reasoning, Knowledge, Quantitative Reasoning, Visual-Spatial Processing, and Working Memory.