Lecture 13: Diagnostics and Assessment: Chapter 3 (70-86) Flashcards
What is important for a clinical interview?
Establishing rapport with a person who seeks their help and obtaining trust of the person
What is the main difference between unstructured and structured interviews?
Unstructured: less reliable
Structured: questions are set out in a prescribed fashion
What is the most commonly used structured interview? What does it look like?
Structured Clinical Interview (SCID)
It’s branching: interviewer asks questions about different diagnoses
How do most clinicians interview? What is a downside of this?
Unstructured and informal review of DSM symptoms
The interrater reliability is lower now
What is the most comprehensive interview measure of life stress? How does it work?
Bedford college life events and difficulties schedule (LEDS)
Semi-structured interview that covers 200 kinds of stressors. Making a timeline of stressors
Why is it important to assess life stressors?
They’re predictors of episodes of anxiety, depression, schizophrenia and even cold
What is standardization?
Statistical norms administered to tests, making it possible to compare a person’s results to a statistical norm
What are projective tests? Why isn’t it used that much?
Measuring unconscious personality processes by presenting unstructured stimuli, e.g. drawing and house-tree-person and than elaborate on the story
Validity issues
What is the MMPI-2 Restructured Format (MMPI-2-RF) test? How good is this test?
A personality test that is multiphasic. It’s designed to detect several psychological problems
It’s reliable and has good validity
What are 2 common measures used to assess the big 5 personalities?
- NEO PI
- BFI-2
What are 2 concerns about universality of big 5 personality testing?
- General low openness in asian cultures, creating more homogeneity compared to western people
- The correlation between big 5 and personality structures is high for western people, but not for Asian or African people
What does an intelligence test measure? What is an underlying assumption?
Assessing person’s current cognitive ability.
Assumption: detailed sample of a person’s intellectual functioning can predict school performance
What are the 2 most commonly administered IQ tests?
- Wechsler (WAS) (Child + adult)
- Standford-Binet
How good are IQ tests?
High reliability and high validity. It can identify gifted children and also intellectual disability
Why is stereotype threat relevant for IQ tests?
Calling attention to stereotypes actually interferes with performances on IQ tests. This is seen in women, but also in different ethnic groups
When are neuropsychological tests used? What idea is it based on?
Help pinpointing specific areas of cognitive functioning impairment. It’s based on the idea that different cognitive functions rely on different areas of the brain
What is the tactile performance test?
While blindfolded, a person tries to fit variously shaped blocks into spaces of a form board using the preferred hand and later the non preferred hand
What is the trail making test?
The person is asked to draw connecting lines between numbers or letters
What is the california verbal learning test?
Verbal memory, where a person hears a list of words and has to recall as many as possible
What is the rey complex figure test?
Visual memory test, in which an intricate figure drawing is shown and a person is asked to copy the figure
It’s difficult to observe most behavior as it actually takes place and little control can be exercised over where and when it may occur. How can this be accounted for?
Creating a somewhat artificial setting in the office of the mental health professional and observing how a person or a family acts under certain conditions
What is ecological momentary assessment (EMA)? How does it work?
Experience sampling: collection of data in real time as opposed to the more usual method of having people reflecting back over their lives.
It’s like a structured diary, where an app asks you multiple times a day where you are, what you’re doing and additional questions (e.g. drug use)
Why could EMA be handy?
It tells us something about temporal relations. It’s still in pilot phase though
What are differences between personality tests administered by a psychologist and self report questionnaires?
Similar, but self-report has fewer questions and are often more focused on 1 domain
What are 5 general categories of psychological assessment methods?
- Clinical interviews
- Personality/cognitive tests
- Direct observation of behavior
- Experience sampling
- Self-report questionnaires
What are 3 types of neurobiological assessment?
- Brain imaging
- Brain stimulation
- Psychophysiological assessment
Why are neurobiological assessment methods not often used? (3)
- Not enough expertise required to use them
- Too costly
- Too non specific
What is the benefit of SPECT compared to PET?
SPECT is less expensive, because the used isotope is more readily available
What are 2 methods for brain stimulation?
TMS and tDCS
What are psychophysiological assessment measures? Give 3 examples of tests
It measures bodily changes associated with psychological events
- Heart rate (electrocardiogram EKG)
- Electrodermal responding: skin conductance
- Measuring electrical brain waves
What are the 3 types of judgement?
- Layman judgement
- Clinical judgement
- Psychological assessment PA
What is layman judgement?
Judgements everyone can make based on perception and personal characteristics
What is the difference between clinical judgement and layman judgement?
Clinical judgement uses psychological constructs and theories
What is the difference between psychological assessment and clinical judgement?
PA uses instruments besides the clinical judgement and layman judgement
What is a danger of high use of clinical judgement among psychologists? (3)
- Clinicians tend to overestimate their ability
- Clinicians only evaluate 50% of key criteria of structured interviews
- Clinicians use their judgement often to form diagnoses by comparing clients to prototypes
What is the (un)availability bias in clinicians?
The fact that some classifications are more readily available in clinicians. Some classifications are underclassified, simply because they don’t think about it
What is the premature closure bias in clinicians?
Reaching a diagnostic conclusion to early or stop after 1 classification, which causes missed comorbidities
Why do we need PA?
To reduce bias in the decision making processes inherent to clinical judgement
When do you use an observational rating scale?
When it’s hard to get information from a client, e.g. kids or people with severe psychiatric or neurological problems
What is the illusory correlation bias?
Perceiving a relation between test findings and a conclusion which does not empirically exist
E.g. projective tests such as the house-tree-person test
What is the excessive data collection bias?
Large, unfocused data collection, often for only 1 hypothesis, leading to false-positive results.
E.g. by administering a lot of personality tests, there is a high chance of extreme scores. Since it’s the only hypothesis that is often tested, it may lead to false positives
What is the self-report/response bias?
Bias created by the respondent due to e.g. social desirability, self-perception, mood states etc.
What is confirmation bias and how can it occur in PA?
Tendency to search for, interpret, favor and recall information in a way that confirms or strenghtens one’s initial belief
Occurs because only 1 hypothesis is tested with only 1 test
What are 7 aspects of good PA?
- Multiple hypothesis noted before you have the results
- Don’t focus on verification, but also on falsification
- Use reliable instruments in focused manner
- Consider multimethod and multi informant (e.g. from parents) approach
- Base your conclusions on testable predictions
- Be honest about test results vs. interpretations
- Stay critical about your own reasoning and the limitations of the PA
What are the 5 steps of the empirical/diagnostic cycle?
- Observation/exploration
- Induction
- Deduction
- Testing
- Evaluation
Why doesn’t translating western PA tests work for all countries?
Translation doesn’t ensure that the meaning of those words will be the same across different cultures
What is the job of the ITC guidelines for translating and adapting tests?
The development and adaption of a test to a different language, administration and scoring interpretations
Why is there still a long way to go in reducing cultural, ethnic and racial bias in clinical assessment?
- Guidelines aren’t always followed
- Cultural assumptions/biases may cause clinicians to over- or underestimate psychological problems in other cultures
- Make mistakes based on wrong assumptions they hold about a culture and emotion
Give an example of mistakes made based on wrong assumptions that clinicians hold about a culture
Asian person says he doesn’t want to be happy, so the clinician thinks he’s depressed
But actually in asian cultures, happiness isn’t the main goal, calmth and harmony is
What is an indication that reducing cultural biases is a priority among clinicians?
Clinicians overwhelmingly report taking culture into account in their clinical work
What are 3 issues that should be taught to graduate students in clinical psychology in order to reduce cultural bias?
- Learn basic assessment issues
- Become informed about the ways culture, race or ethnicity may impact assessment
- Consider that culture, race or ethnicity may not impact assessment in every individual case
