Clinical Assessments Flashcards
1
Q
Describe the purpose of a clinical interview
A
- interpersonal, psychological method of assessment
- language: gathering info (questions depend on theoretical orientation; effects how info gained, interpreted and used in the treatment)
- interviewer = how the Q is answered
- consideration of appearance, emotions, history, problem presentation and motivation
Important:
- rapport and comfort
- trust
- empathise
2
Q
Give some limitations of a clinical interview
A
- reliability is low
- unstructured/ semi-structured (difficult to replicate)
- interviewer bias (primacy effect: stuck on first impressions) (or focus on negative, client demographics or irrelevant details)
- we don’t know if client is lying or intentionally trying to mislead the interviewer
3
Q
Describe examples of structured interviews
A
- more helpful in gaining info and demonstrates good inter-rater reliability
- S.C.I.D (axis 1, DSM-5) :
- clients response to a question determines the next question
- instructions for the interviewer
- high inter-rater reliability (kappa scores; proportion of agreement - show very good)
4
Q
What are some advantages of using psychological tests?
A
- questionnaire (easy delivery)
- assessment of specific characteristics/traits
- usually rigid response - allows scoring and statistical norm scoring
- standardised (allows comparisons and diagnostic)
- reliability and validity
5
Q
Describe the MMPI used in clinical tests
A
Minnesota Multiphasic Personality Inventory (MMPI)
- originally tested on 800 psychiatric and 800 non-psychatric
- includes Qs that differentiate between the two group
MMPI - 2
- updated by Butcher et al (1989): MMPI-2 - 567 self-statements with 3 point likert scale
- 10 clinical subscales with 4 validity scales
- above 70 (out of 120) = psychopathology indication
6
Q
Give pros and cons of the MMPI-2
A
- valid
- internal and clinical validity (maps onto diagnostic criteria)
- but… time-consuming to administer (but some shorter ones available now)
7
Q
What are validity subscales?
A
Testing for
- evasiveness/difficulty interpreting the question (by how many left unanswered)
- L scale: tendency to answer in a socially acceptable way (I approve of every person I meet)
- F scale: respondent trying to fake psychopathological symptoms (everything answered)
- K Scale: respondent defensive (trying to look competent; couldn’t be better)
8
Q
What are clinical subscales?
A
- using the inventory results to generate an individual profile
- working out symptoms patterns and interpersonal relations
- mapping onto DSM etc
9
Q
What are specific trait inventories?
A
- used to measure functioning in specific psychopathology
e.g. state trait (anxiety)
ED1 (eating disorder)
10
Q
What is the state trait anxiety inventory (STAI) and give pros and cons of these types of inventories?
A
Speilberg, 1970
- 4 point Likert
- specific trait inventory
- measures anxiety about events
- measures trait anxiety
- high scores are positively correlated with anxiety
Pros:
- useful as research tools
- valuable and good psychometric measure
Cons:
- some underdeveloped
- some have little diagnostic and theoretical value
- majority fail to include validity scales
11
Q
What is a projective test?
A
- fixed set of stimuli presented (which are ambiguous enough for interpretation)
- thought to reveal unconscious processes, attitudes and modes of behaviour
12
Q
Give three examples of projective tests
A
Rorschach Inkblots
- client reacts to inkblot
- projects personality onto the picture (free association phase)
- scored according to vagueness, quality, content
- provides specific details (inquiry phase)
- structured scoring compared with standardised norms
- bad: heavily focused on therapists interpretation of the response
Thematic Apperception Test
- 30 black and white pics of people in an ambiguous situation
- client asked to tell a story behind it (asks their own responses in the situations; to identify with character)
Sentence Completion:
- 1920’s
- provides initial part of incompleted sentence (“i like”)
- using own words to complete (in diff topics)
- understands how psychopathology biases thoughts
e. g. PTSD - Kimble - 33 sentences (could be completed in military and non-military contexts), those with PTSD had higher military sentence completion - biases in coding and retrieving info
13
Q
Give disadvantages of projective tests
A
- used less over the years
- based in revealing via psychodynamic (less popular now)
- low reliability (interpreted different depending on the clinician)
- culturally biases (TAT - no ethnic minority characters) - should develop more contemporary representations
- clinicians require extensive training (expensive and time-consuming)
- some projective tests infer psychopathology without other evidence (100 schoolkids - non with mental health issues - these tests showed almost all to have fault reasoning/SZ mood disorders) - Hamel et al
14
Q
What are intelligence tests and give an example (and issues)?
A
- used by clinicians
- identifying ability and gifted
- assessing those with difficulties (neuropsychological evaluation)
WAIS
- scoring on a range of abiltiies (verbal, digit span)
Issues:
- intelligence is a hypothetical construct (no definition)
- cultural biases
- snapshot of current knowledge - effected by mood etc (ignores the capacity to learn)
- does not measure other forms of intelligence (musical ability) - reductionist and narrow
15
Q
Describe types of clinical observation
A
- can supplement others tests
- Analogue observations: controlled environments, two-way mirrors (feeds into other means of assessment)
- Direct observation: in session, observing frequency of certain behaviours
- Self-observation: monitoring, and recording own behaviour (EMA = ecological momentary assessment; collecting up-to-date info in daily lives) - overcomes biased retrospective recall
- ABC charts - coding sheets (identifies the antecedents - spark behaviour - behaviour/belief and consequences of the behaviour)
