Chapter 4 Flashcards
1
Q
Psychological assessment
A
- procedure by which clinicians, using psychological tests, observations, and interviews, develop a summary of a client’s symptoms and problems
2
Q
Clinical diagnosis
A
- process through which a clinician evaluates and classifies the patient’s symptoms according to a clearly defined diagnostic system (like DSM-5)
3
Q
Reliability (internal consistency, test-retest and inter-rater reliability)
A
- degree to which an assessment measure produces same result each time it is used to evaluate the same thing
- internal consistency (degree to which items on scale are assessing same construct)
- test-retest reliability (if test result gives similar value accross time)
- inter-rater reliability (measure of agreement between different raters who assess the same person)
4
Q
Validity
A
- extent to which measuring instrument actually measures what it is supposed to measure
- in testing/classification – degree to which a measure tells us something additional and meaningful ab person now or helps predict future course of disorder
- validity presupposes reliability
5
Q
Chronbach’s alpha
A
- how closely related a set of items are as a group
- measure of scale reliability
- score over 0.7 is acceptable (some suggest 0.9 to 0.95)
- larger number of items in test can result in larger alpha
- high alpha may indicate redundant questions
6
Q
Construct validity
A
- ensuring that method of measurement matches construct you want to measure
7
Q
Content validity
A
- content of test covers all relevant parts of subject it aims to measure
8
Q
Criterion validity
A
- how closely results of test correspond to results of a different test
9
Q
Standardization
A
- procedure for establishing the expected performance range on a test
- ex IQ test build to have mean of 100
- many psychological tests are standardized so we can compare results to reference population (normative sample)
10
Q
Presenting problem
A
- major symptoms and behavior the client is experiencing
11
Q
Cultural competence
A
- psychologist’s need to be informed of issues involved in multicultural assessment
- important to consider various test factors, test-taking abilities, and other characteristics of person being assessed
12
Q
Biologically oriented clinician focus
A
- typically psychiatrist or other medical practitioner
- assessment methods aimed at determining underlying biological factors that may be causing the maladaptive behavior
13
Q
Psychodynamic or psychoanalytically oriented clinician focus
A
- may use unstructured personality assessment techniques (like Rorschach inkblots or Thematic Apperception Test) to identity intrapsychic conflicts
- may simply continue with therapy and expect conflicts to emerge
14
Q
Behaviorally oriented clinician focus
A
- techniques like behavioral observation and self-monitoring to identify learned maladaptive patterns
- try to determine functional relationships between environmental events or reinforcements and the abnormal behavior
15
Q
Structured assessment interviews
A
- follow predetermined format
- questions structured to allow responses to be quantified or clearly determined
- can be used by clinicians or people with no clinical training
- maximizes reliability
16
Q
Cognitively oriented clinician focus
A
- determine functional relationships between thoughts, emotions, and abnormal behavior
17
Q
Limits on client-clinician confidentiality
A
- report intent to harm self or others
- behavior suggestive of child abuse
- (in some jurisdictions) if they threaten action that would be breaking the law
- not so much laws, but guidelines
18
Q
Sources of assessment information
A
- client file or chart
- referral letter
- family member reporting (children)
- client behavior during session
19
Q
Semi-structured assessment interviews
A
- interviewer asks questions in specific order and in specific way but asks own follow-up questions
- should only be done by those with extensive training
- diagnoses have greater validity
- longer and more training needed
20
Q
Unstructured assessment interview
A
- subjective, no predetermined set of questions
- can miss important info needed for DSM diagnosis
21
Q
Beck Depression Inventory
A
- self-report measure of depression
- questions about 2 week period
- statements have different numerical weights
- usually depression self-report scales ask about suicidal intention
22
Q
Hamilton Rating Scale for Depression
A
- clinician completes it, not self-report scale
23
Q
Center for Epidemiological Studies Depression Scale
A
- self-report depression scale
24
Q
Anxiety self-report scales
A
- Beck, State
- usually asks about degree and not frequency of symptoms (vs. depression)
25
PCL
- PTSD checklist
- self-report measure
- asks about extent to which person is bothered by symptoms
26
PHQ-9
- self-report questionnaire for depression
- 0-20 scale; 0-9 is subclinical, 20+ is severe depression
27
T-IEQ
- trait injustice experience questionnaire
- trait injustice: extent to which individuals experience injustice in relation to adverse life experiences
28
OCI-R
- self-report scale to assess OCD
- asks how bothered person felt by symptoms in last month
29
SPS
- social phobia scale
- self-report
30
Advantages and disadvantages of self-report questionnaires
- can get a lot of info very quickly (client can fill out outside of session time)
- yield high rate of false positive diagnoses (cannot use for diagnosis)
- best used as measures of symptom severity
31
FMPS
- Frost Multidimensional Perfectionism Scale
- risk factor for depression
32
SSDS-W
- self-report scale about dependency
- risk factor for depression
33
Real-time monitoring methods
- ie wearable devices that beep at random times to tell you to respond to questionnaire ab how you feel at that moment
34
MMPI-2
- multidimensional scale, Hathaway and McKinley, 1943
- used to be 550 items, now 366, can take more than 2h
- used to be most widely used test of personality
- looked at items that were typically linked to specific diagnoses (some patterns of responses more likely for certain groups of individuals)
- many questions are super random
35
Validity Scales of MMPI-2
- Cannot say score (?)
- Infrequency scale (F)
- Infrequency scale (FB)
- Lie scale (L)
- Defensiveness scale (K)
- Superlative Self-Preservation scale (S)
- Response inconsistency scale (VRIN)
- Response inconsistency scale (TRIN)
- these try to catch people who respond with specific motivations that could distort responses
36
10 Clinical scales of MMPI-2
1: Hypochondriasis (Hs)
2: Depression (D)
3: Hysteria (Hy), eg 'rose-coloured glasses' or tendency to develop physical problems under stress
4: Psychopathic deviate (Pd), antisocial tendencies
5: Masculinity-femininity (Mf), gender-role reversal
6: Paranoia (Pa)
7: Psychasthenia (Pt), anxiety and obsessive/worrying behavior
8: Schizophrenia (Sc), peculiarities in thinking, feeling, and social behavior
9: Hypomania (Ma), unrealistically elated mood state, impulsive
10: Social introversion (Si)
37
Thematic apperception test
- show images and ask someone what it is about/what is happening in the story
- pictures look like they are from old movies
- psychoanalytical perspective: self report is subject to bias/defence mechanisms, projective tests and thematic apperception tests look at subconscious
- reliability is pretty low (and therefore not valid)
38
Neuropsychological assessment
- measure cognitive, perceptual, and motor performance
- can help to identify brain damage
- standardized, performance compared to normative standards
39
WAIS-IV
- most commonly used adult intelligence scale
- Full-Scale IQ divides into Verbal IQ and Performance IQ
- Verbal IQ divides into Verbal Comprehension Index and Working Memory Index
- Performance IQ divides into Perceptual Organization Index and Processing Speed Index
40
Verbal Comprehension Index (WAIS-IV)
- part of verbal IQ
- vocabulary
- similarities
- information
- comprehension
41
Working Memory Index (WAIS-IV)
- part of verbal IQ
- arithmetic
- digit span
- letter-number sequencing
42
Perceptual Organization Index (WAIS-IV)
- part of performance IQ
- picture completion
- block design
- matrix reasoning
43
Processing Speed Index (WAIS-IV)
- part of performance IQ
- digit symbol-coding
- symbol search
44
Symptom
- patient's subjective description of what is wrong
45
Signs
- objective or visual indicators of a problem
46
Evolution of the DSM
- each new iteration is more evidence based
- DSM-IV relaxed thresholds for several disorders, increased number of diagnoses (concerns that normal behavior is becoming overmedicalized)
47
BPRS
- brief psychiatric rating scale
- 16 items in 1962, now 24 items
- assess symptoms like: anxiety, depression, emotional withdrawal, guilt feelings, hostility, suspiciousness, grandiosity, and unusual thought patterns
- items can be probed for using semi-structured interview
- useful for research and assessing symptom change over time
- not used for diagnosis
48
3 examples of intelligence tests used in clinical practice
- Wechsler Intelligence Scale for Children (WISC-IV)
- Stanford-Binet Intelligence Scale
- Wechsler Adult Intelligence Scale (WAIS-IV)
49
Projective personality tests
- use various ambiguous stimuli that subject is encouraged to interpret
- personality characteristics are analyzed based on responses
50
Halstead-Reitan Battery
- neuropsychological assessment
- category test, tactual performance test, rhythm test, speech sounds perception test, finger oscillation task
51
Electroencephalogram (EEG)
- electrical activity of brain measured w electrodes
- good temporal resolution
52
Computed tomography (CT)
- x-ray measurements from various angles combine to provide more detailed info than a conventional x-ray
- risks with radiation
- images less detailed for soft tissues
53
Magnetic resonance imaging (MRI)
- does not involve radiation and can be safely used w wide range of people
- machine is a hollow cylinder w a strong magnet
- magnetic pulse makes hydrogen atoms move
- good spatial resolution
- poor temporal resolution
- sMRI: structural
- fMRI: functional (measures neuronal activity via differences in how magnetic oxygenated vs deoxygenated blood is)
54
Positron emission tomography (PET)
- way to examine how the brain is functioning
- radioactive agents are injected and scanned
- danger of radioactive material, takes longer than MRI
- bad temporal resolution
55
5 ethics issues in assessment
- potential cultural bias of instrument or clinician
- theoretical orientation of clinician
- underemphasis of external situation
- insufficient validation (of assessment tool)
- inaccurate data or premature evaluation
56
Categorical approach to classification
- seeks to classify behavior into distinct categories
- black and white idea of healthy vs disordered behavior
- exemplified in DSM
- now more dimensional approaches are gaining acceptance
57
Dimensional approach to classification
- assumes that a person's typical behavior is a product of the differing strengths of definable dimensions (ie mood, emotional stability, aggressiveness, ect)
- preserved info about variability
- can be used to define degrees of dysfunction
58
Prototypal approach to classification
- conceptual entity that represents the 'perfect case'
- provides standards against which ppl are compared to assign them to a category
- also kinda used in DSM
- fits the way people actually think
- prototype ratings predict adaptive functioning better than DSM diagnoses
59
ICD-11
- International Classification of Diseases (WHO)
- uses clinical prototypes
