Chapter 4: Clinical Assessment and Diagnosis

Question 1

Clinical Assessment

Answer 1

is used to determine whether, how, and why a person is behaving abnormally and how that person may be helped. It also enables clinicians to evaluate people’s progress after they have been in treatment for a while and decide whether the treatment should be changed

Question 2

Standardization

Answer 2

the process in which a test is administered to a large group of people whose performance then serves as a standard or norm against which any individual’s score can be measured

Question 3

Reliability

Answer 3

a measure of the consistency of test or research results. A good assessment tool will always yield similar results in the same situation

Question 4

Validity

Answer 4

a measure of the accuracy of a test or study’s results

Question 5

Test-Retest Reliability

Answer 5

one kind of reliability, if it yields similar results every time it is given to the same people (to measure this, participants are tested on 2 occasions and the 2 scores are correlated)

Question 6

Interrater Reliability (Interjudge)

Answer 6

another kind of reliability, if different judges independently agree on how to score and interpret it. (e.g., a test that requires a person to draw a copy of a picture, which a judge then rates for accuracy. Different judges may give different ratings to the same drawing)

Question 7

Face Validity

Answer 7

a given assessment tool may appear to be valid simply because it makes sense and seems reasonable (this sort of validity does not by itself mean that the instrument is trustworthy)

Question 8

Predictive Validity

Answer 8

is a tool’s ability to predict future characteristics or behavior

Question 9

Concurrent Validity

Answer 9

is the degree to which the measures gathered from one tool agree with the measures gathered from other assessment techniques

Question 10

Clinical Interview

Answer 10

is just a face-to-face encounter. Clinicians collect detailed information about the person’s problems and feelings, lifestyle and relationships, and other personal history

Question 11

Structured Interview

Answer 11

clinicians ask prepared – mostly specific – questions. Sometimes they used a published interview schedule – a standard set of questions designed for all interviews. This method ensures that clinicians will cover the same kinds of important issues in all of their interviews and enables them to compare the responses of different individuals

Question 12

Unstructured Interview

Answer 12

the clinician asks mostly open-ended questions; the lack of structure allows the interviewer to follow leads and explore relevant topics that could not be anticipated before the interview

Question 13

Clinical Interview Strengths

Answer 13

Clinicians get to see patients react to what the clinician says or does, observe as well as listen as the patient answers, and generally get a sense of who they are

Question 14

Clinical Interview Weaknesses

Answer 14

• Lack of validity, or accuracy (e.g., individuals may intentionally mislead in order to present themselves in a positive light or to avoid discussing embarrassing topics)
• Interviewers may make mistakes in judgments that slant the information they gather
• Interviewers’ biases, including gender, race, and age biases, may also influence the interviewers’ interpretations of what a client says
• Lack of reliability (people respond differently to different interviewers)

Question 15

Projective Test

Answer 15

a test consisting of ambiguous material that people interpret or respond to

Question 16

Rorschach Test

Answer 16

• In 1911 Hermann Rorschach, a Swiss psychiatrist experimented with the use of inkblots in his clinical work
• Rorschach found that everyone saw images in these blots, the images a viewer saw seemed to correspond in important ways with his or her psychological condition
• Example: people diagnosed with schizophrenia, tended to see images that differed from those described by people experiencing depression

Question 17

Thematic Apperception Test

Answer 17

• Is a pictorial projective test
• People who take the TAT are commonly shown 30 cards with black-and-white pictures of individuals in vague situations and are asked to make up a dramatic story about each card
• Clinicians who use TAT believe that people always identify with one of the characters on each card,, the stories are thought to reflect the individuals’ own circumstances, needs, and emotions

Question 18

Sentence-Completion Test

Answer 18

The test-taker completes a series of unfinished sentences, such as “I wish…” or “My father…” the test is considered a good springboard for discussion and a quick and easy way to pinpoint topics to explore

Question 19

Drawings

Answer 19

• On the assumption that a drawing tells us something about its creator, clinicians often ask clients to draw human figures and talk about them
• Draw-a-Person (DAP) test, the most popular of the drawing tests, individuals are first told to draw “a person” and then are instructed to draw a person of the other sex
• Drawing tests are commonly used to assess the psychological functioning of children

Question 20

What is an MMPI?

Answer 20

• Minnesota Multiphasic Personality Inventory (MMPI); consists of more than 500 self-statements, to be labeled “true,” “false,” or “cannot say”
• Altogether the statements make up 10 clinical scales, on each of which an individual can score from 0 – 120 (when people score ~70 on a scale, their functioning on that scale is considered deviant)
• When the 10 scale scores are considered side by side, a pattern called a profile takes shape, indicating the person’s general personality

Question 21

What information is assessed in the MMPI?

Answer 21

• Hypochondriasis: concern with bodily functions
• Depression: extreme pessimism & hopelessness
• Hysteria: suggesting that the person may use physical/mental symptoms as a way of unconsciously avoiding conflicts & responsibilities
• Psychopathic Deviate: showing repeated & gross disregard for social customs & an emotional shallowness
• Masculinity/Femininity: thought to separate male & female respondents
• Paranoia: abnormal suspiciousness & delusions of grandeur or persecution
• Psychasthenia: obsessions, compulsions, abnormal fears, guilt, and indecisiveness
• Schizophrenia: bizarre or unusual thoughts or behavior
• Hypomania: emotional excitement, overactivity, and flight of ideas
• Social Introversion: shyness, little interest in people, and insecurity

Question 22

What is a response inventory?

Answer 22

• tests designed to measure a person’s responses in one specific area of functioning, such as effect, social skills, or cognitive processes. Clinicians can use the inventories to determine the role such factors play in a person’s disorder.
• Example: one such test may measure affect (emotion), another social skill, and still another cognitive process.

Question 23

Psychophysiological Test

Answer 23

• A test that measures physical responses (such as heart rate and muscle tension) as possible indicators of psychological problems
• The measuring of physiological changes has since played a key role in the assessment of certain psychological disorders

Question 24

Intelligence Test

Answer 24

• a test designed to measure a person’s intellectual ability
• Intelligence tests play a key role in the diagnosis of intellectual disability and they can also help clinicians identify other problems

Question 25

Intelligence Quotient (IQ)

Answer 25

• an overall score derived from intelligence tests
• IQ, short for intelligence quotient, is a measure of a person’s reasoning ability. In short, it is supposed to gauge how well someone can use information and logic to answer questions or make predictions. IQ tests begin to assess this by measuring short- and long-term memory

Question 26

Naturalistic Observation

Answer 26

clinicians observe clients in their everyday environments

Question 27

Analog Observation

Answer 27

they observe them in an artificial setting, such as a clinical office or laboratory (e.g., often aided by special equipment such as a video camera or one-way mirror)

Question 28

Self-Monitoring

Answer 28

clients are instructed to observe themselves. People observe themselves and carefully record the frequency of certain behaviors, feelings, or thoughts as they occur over time.

Question 29

Diagnosis

Answer 29

• a determination that a person’s problems reflect a particular disorder
• Clinicians can apply what is generally known about the disorder to the particular individual they are trying to help (e.g., better predict the future course of the person’s problem and the treatments that are likely helpful
• When clinicians decide, through diagnosis, that a client’s pattern of dysfunction reflects a particular disorder, they are saying that the pattern is basically the same as one that has been displayed by many other people, has been investigated in a variety of studies, and perhaps has responded to particular forms of treatment

Question 30

Syndrome

Answer 30

a cluster of symptoms that usually occur together

Question 31

Classification System

Answer 31

a list of disorders, along with descriptions of symptoms and guidelines for making appropriate diagnoses

Question 32

What is the DSM, and what information is given?

Answer 32

• The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the most widely used classification system in North America
• Lists more than 500 mental disorders. Each entry describes the criteria for diagnosing the disorder and the key clinical features of the disorder. The system also describes features that are often but not always related to the disorder. The classification system is further accompanied by background information such as research findings; age, culture, or gender trends; and each disorder’s prevalence, risk, course, complications, predisposing factors, and family patterns)

Question 33

What is the difference between the DSM and the Research Domain Criteria (RDoC)

Answer 33

• DSM: Lists more than 500 mental disorders. Each entry describes the criteria for diagnosing the disorder and the key clinical features of the disorder. The system also describes features that are often but not always related to the disorder. The classification system is further accompanied by background information such as research findings; age, culture, or gender trends; and each disorder’s prevalence, risk, course, complications, predisposing factors, and family patterns)
• Research Domain Criteria (RDoC): Neuroscience classification tool, that it expects will eventually be the primary classification guide used by researchers. Critics believe that the final version of this new tool, which is based on the premise that mental disorders are best viewed and studied as biological disorders, may minimize environmental and psychological factors in its classifications while focusing excessively on genetics, brain scans, cognitive neuroscience, and other such areas of study

Question 34

What is meant by “empirically based” or “evidence supported” treatment?

Answer 34

• Empirically Supported Treatment: therapy that has received clear research support for a particular disorder and has corresponding treatment guidelines, and to spread information to clinicians (A.K.A. evidence-based treatment)
• Proponents of this movement have formed task forces that seek to identify which therapies have received clear research support for each disorder, to propose corresponding treatment guidelines, and to spread such information to clinicians