Review Flashcards
- What is the scientist practitioner model?
an integrative approach to science and practice wherein each must continually inform the other.
- What do Scientist-Practitioner psychologists embody?
research orientation in their practice, practice relevance in their research
- What is the social context of the SP model?
Origins in history of clin psych practice in US, Freud & Jung introducing psychoanalysis, medical doctors believe they should be only practitioners, major problems managing WWII vets shell shock
- What is the political context of the SP model’s history?
Clin psych joined APA in 1919 but not welcome, clinicians had their own association for a while, 1944 APA accepted full responsibility for clin psych, 1949 when SP model became fully integrated into applied training through Boulder committee
- Why do we need the SP model?
To ensure that the therapies clinicians use have empirical evidence (i.e. that they actually work). To make sure that clinicians know the evidence, and that researchers do evaluations of therapies being used.
- What did Eysenck find about the efficacy of psychoanalysis?
Those treated by psychoanalysis improved by 44 percent, those treated eclectically improved by 64% and those just treated by general practitioners improved by 72%
The more psychotherapy, the smaller the recovery rate
- What are the merits of the SP model?
In practitioners: attainment of critical thinking skills, understanding of research findings, know how to best implement interventions, can empirically justify intervention choice, avoid harm and reduce unneccesary treatment
- What major criticisms of the SP model exist?
Claims that applied work is often incompatible with scientific work, not all research applies to practice
Few clin psychs publish after completing training
- What is the practitioner-scholar model?
Practitioners taught to be producers of small-scale clinical science rather than traditional research science
Applied scientist who uses theory, validated principles of assessment and treatment where they exist; applies scientific methods and hypothesis testing, improves existing ones
What is evidence-based practice?
Evidence-based practice is the integration of best research evidence with clinical expertise and patient values
Makes use of science, research and evidence to guide decision-making in applied and clinical settings.
- Why use EBP?
Healthcare and applied knowledge grows fast, and is vast already
Skills to integrate best available info with clin expertise, patient values, health care environment
Avoid uncritical acceptance of usual practice
- What are the five A’s of EBP
Ask the right question. Access relevant evidence. Appraise the evidence. Apply the evidence (e.g., intervention, assessment tool) Assess its effectiveness.
- What are the benefits of a well focused PICO question?
Head start in finding relevant info
Provides checklist for main concepts included in search strategy
Makes finding info fast
- What are the four parts of a PICO question?
Population/Patient/Problem
Intervention (Exposure in PECO)
Comparison
Outcome
- What are the best places to find evidence?
PsychInfo, Scopus, Cochrane, Cinahl, Medline
- What is the Cochrane Library?
Collection of evidence-based medicine databases, adhering to a strict process that minimises bias and ensures reliability, has a protocol for evaluations
- What is the hierarchy of evidence?
Pyramid of evidence based on how good it is likely to be
Systematic reviews/meta analyses (filtered information, analysis of large numbers of studies)
Randomised Controlled Trials (participants randomly assigned to at least two interventions, one must be a control)
Control trial without randomisation
Case control studies (using existing records to identify things, medical records, etc. always retrospective, doesn’t prove causality) same level as cohort
Cohort studies (examine groups based on variables, no random assignment)
Systematic review of qualitative or descriptive
Qualitative or descriptive
Opinion/consensus
- What are systematic reviews and meta-analyses?
Systematic review: Analysis of results, strengths and weaknesses of studies that relate to a particular (PICO) question.
Meta-analysis: statistical evaluation of all relevant studies, DV is effect size as common metric across studies, IV is study characteristics.
- Are systematic reviews and meta-analyses always the best evidence?
The value of these analyses is based on the value of the studies they review, a large, well-run RCT may be better than a review of many less powerful RCTs
- What is the purpose of RCTs?
Eliminate bias in treatment assignment Facilitates blinding (masking) of treatments to investigators, participants and assessors (including possible use of a placebo)
- What are the disadvantages of RCTs?
Require rigorous control of allocation
Often long and expensive
Can’t examine rare conditions or problems with long latency
Generalisability (screens out vulnerable groups)
Is it ethical to withhold treatment?
- What are case control studies?
Detemining whether exposure to something is linked to an outcome by use of existing records
Always retrospective
Useful to investigate rare diseases and disease outbreaks
Pros: quick simple and cheap
Cons: association not causal, vulnerable to bias and weaker evidence
- What are cohort studies?
Examine groups that are linked and follow over time, observe what’s happed to the group exposed to some variable. Can be prospective or retrospective. Better causal and generalisability than case control, as well as rare exposure but expensive and need large sample over long term.
- Describe the three questions (steps) of a decision tree to determine quality of studies
What was the aim of the study? To describe study pop (PO questions) or quantify relationship between factors (PICO)
If PICO, was the intervention randomly allocated? Yes experimental/RCT, No Observational
If observational, when were the outcomes determined? (after invention/exposure, it’s cohort-prospective. Simultaneous, it’s cross sectional. Before, it’s case control-retrospective or historic cohort).
- What three question must be asked when appraising evidence?
Is it valid?
Is it clinically significant/important?
Is the evidence applicable/revelant?
Do you know the CASP tools/questions for systematic reviews?
Screening: Did the review address a clearly focused question, did the authors look for the right type of papers
Detailed: Were all important, relevant studies included? Did authors do enough to assess quality of included studies? Was it reasonable to combine results? What are the overall results and how precise are they? Can the results be applied to the local population? Were all important outcomes considered? Are the benefits worth the harms and costs?
- What is the RAMMbo model of evidence appraisal?
Recruitment- are p’s representative of target pop
Allocation- random allocation? Similar groups at start of trial?
Maintenance- were individuals within groups treated equally? Were the outcomes analysed for most p’s?
Measurement- were both p’s and researchers blinded? Were measurements objective and standardised?
- What is the CONSORT checklist?
Consolidated Standards of Reporting Trials
evidence-based minimum set of recommendations for reporting RCTs. Standard way to prepare reports of trial findings, represented as a flow diagram
What is the difference between absolute risk and relative risk?
Absolute risk of a disease is the risk of developing the disease over a specific time period (ten years, life, etc.) can be represented as odds, percentage or decimal.
Relative risk is used to compare the risk in two different groups of people (smokers/non-smokers). How likely is Group Y to develop the disease relative to group X.
- What are the three calculations that show how often you find a good/poor outcome?
Event Rate: How often the outcome is observed in control and treatment conditions
Absolute and Relative Risk: To allow comparison between control and treatment conditions
Number Needed to Treat: The number you need to treat to prevent a bad outcome
- What is the event rate (ER)?
The event rate (ER) is the proportion of people in control/treatment conditions of an experiment who experience a particular event
CER: Control Event Rate
EER: Experimental Event Rate
- What is the absolute risk reduction? (AAR, risk difference)
the difference between event rates in two groups, or size of difference between 2 treatments.
CER-EER, calculated in percentages
- What is the Number Needed to Treat? NNT
Another way of expressing absolute risk reduction, is the number of patients that need to be treated in order to have an impact on one person (to avoid a bad outcome).
NNT = 1/ARR
- What is Relative Risk Reduction? RRR
difference in event rates between two groups expressed as a proportion of the event rate in the untreated group
RRR=(CER-EER)/CER (is percentage in decimal form).
The disease was reduced by RRR% in the treatment group compared with the control group
- What is the difference between ARR and RRR, and how do patients perceive this?
Explain same difference, in different ways. ARR is simple differences between rates, while RRR describes relative or proportional difference. A treatment phrased as reducing your relative risk of death by 25% is much more impressive than phrasing it as reducing your risk of death by 5%, even though they’re the same thing.
- What is an Odds Ratio OR?
The odds that an outcome will occur given a particular exposure, compared to the odds of an outcome occurring in the absence of that exposure
The cross product of the four square- (have disease and were exposed x don’t have it and weren’t exposed) divided by (don’t have disease and were exposed x have disease and weren’t exposed). Is the number of times, if you have the disease, that you are more likely to have been exposed than if you weren’t exposed.
Calculated for case control studies
- What is standard effect size?
Shows the practical size of treatment effects, becoming more commont.
Calculated by taking the mean difference between two treatments and dividing by pooled variance
0.2 is small effect size, 0.5 is moderate, 0.8 is large
- What questions should you ask when applying evidence to a case?
Do the results apply to my client?
What are my client’s values and preferences?
Can this practice be implemented in this setting?
How can I help my client make a decision?
- How do you apply the results to a client?
some assessment of their individual baseline risk
judgement about whether the evidence can be extrapolated to your client
understanding of factors that may increase the benefits or harm their experience
- How do you assess the efficacy of a treatment?
Clinical trial with highly controlled variables to unambiguously demonstrate relationship between treatment and outcome
Involves controlling for comorbidity and other differences between patients
Using manuals to standardise delivery
Training and monitoring therapists
Controlling number of treatment sessions
Random assignment to conditions and use of blinding
- How do you asses the effectiveness of a treatment?
is considered when intervention is implemented without same level of internal validity- is it useful in a clinical setting?
Similar to efficacy, but in real-world scenarios.
- Where do you go to find psychologically validated measurements/tests?
Comprehensive lists (Mental measurements Yearbook (Buros), ETS test collection)
Publishes’ catologues (via Buros listing)
Books about individual tests
Academic journals
Text books on psychological testing
Name the test, measurement and target pop for this abbreviation? 16PF
Cattel’s 16 Personality Factor Questionnaire, Personality (non-clinical), Adults
Name the test, measurement and target pop for this abbreviation? CBCL
Child Behaviour Checklist, problem behaviour, children
Name the test, measurement and target pop for this abbreviation? D-KEFS
Delis-Kaplan Executive Function System, Executive function, All people
Name the test, measurement and target pop for this abbreviation? EPI
Eysenck’s Personality Inventory, Personality (non-clinical), all (adult and junior versions)
Name the test, measurement and target pop for this abbreviation? Hayling and Brixton tests
Hayling and Brixton Clinical Assessment of Executive Functioning, Executive function, Adults
Name the test, measurement and target pop for this abbreviation? MMPI
Minnesota Multiphasic Personality Inventory, personality (clinical), Adults (has adolescent version)
Name the test, measurement and target pop for this abbreviation? Neale
Neale Analysis of Reading, Reading, All (children mainly)
Name the test, measurement and target pop for this abbreviation? NEO
NEO-PI-3 (Covers big 5), Personality (non-clinical), Adults
Name the test, measurement and target pop for this abbreviation? Peabody
Peabody Picture Vocabulary Test, Vocab, All (mainly children)
Name the test, measurement and target pop for this abbreviation? RPM
Raven’s Progressive Matrices, Intelligence, All
Name the test, measurement and target pop for this abbreviation? Stanford-Binet
Stanford-Binet Intelligence Scales, Intelligence, All
Name the test, measurement and target pop for this abbreviation? TEA
Test of Everyday Attention, Attention (-CH version for children)
Name the test, measurement and target pop for this abbreviation? WAIS
Wechsler Adult Intelligence Scale, Intelligence, Adults
Name the test, measurement and target pop for this abbreviation? WASI
Wechsler Abbreviated Scale of Intelligence, Intelligence, All
Name the test, measurement and target pop for this abbreviation? WIAT
Wechsler Individual Achievement Test, Academic Achievement, All
Name the test, measurement and target pop for this abbreviation? WISC
Wechsler Intelligence Scale for Children, Intelligence, Primary to High school
Name the test, measurement and target pop for this abbreviation? WPPSI
Wechsler Preschool and Primary Scale of Intelligence, Intelligence, Pre-school to primary
Name the test, measurement and target pop for this abbreviation? WRAML
Wide Range Assessment of Memory and Learning, Memory and Attention, All
- What are the five factors in the Cattell-Horn-Carroll model of intelligence (used in the Stanford Binet Intelligence Scale)?
Fluid intelligence Crystallized intelligence Quantitative reasoning Visual-spatial reasoning Working memory
- How is the Stanford Binet test administered?
1 on 1 examiner, p completes 10 core tests
Tests yield 5 factor scores, which can be combined to give an overall score for Spearman’s g
- What are the psychometric properties of the Stanford binet test?
Standardised on subjects, stratified by age, ethnicity, geographic region and socioeconomic level
Reliability: High internal consistency and inter-rater reliability
Valdiity: correlates with other IQ tests, factor analysis supported five factor structure
- What are the 4 Wechsler tests?
WPPSI-IV: Wechsler Pre-School and Primary Scale of Intelligence (4th edition). For 3-7 year olds.
WISC-V: Wechsler Intelligence Scale for Children (5th edition). For 6-16 year olds.
WAIS-IV: Wechsler Adult Intelligence Scale (4th edition). For 16 upwards.
WASI-II: Wechsler Abbreviation Scale of Intelligence (2nd edition) -30 min and 15 min versions.
- How is the WISC-V administered?
10 core subtest in 4 groups (verbal comprehension, working memory, perceptual reasoning, processing speed)
Can be combined into measure of general intellectual functioning (Full Scale IQ, FSIQ)
One on one session with highly trained examiner for 45-65 mins
- What are the psychometric properties of the WISC-V
Standardised on kids from 6-16
High test-retest reliability over 1 month, high interrater, high internal consistency
Convergent/discriminant validity, factor analysis confirms 4 groups, comparisons between clinical and non clinical samples
- How is Raven’s Progressive Matrices administered?
In a group Nonverbally Anyone over 5 Doesn’t require any one language Should be independent of education
- What are the psychometric properties of RPM?
Normed worldwide
High reliability: alternate forms, internal reliability, test-retest
Validity: correlates with other aptitude tests and with academic ability
- What is the PPVT?
Peabody Picture Vocabulary Test
- How is the PPVT administered?
people aged 2+
Multiple choice, only requires pointing
No reading ability (but must be able to hear)
Rough measure of IQ for those unable to do Binet or Wechsler (not a proper substitute)
- What are the psychometric properties of the PPVT?
Reliability: alternate forms, internal consistency, test-retest
Validity: Content validity (all words in dictionary), test scores increase with age as predicted, correlates well with other established vocab tests, measures of oral language + reading, clinical populations performed as predicted
- How is the Neale Analysis of Reading Ability administered
Measures oral reading, comprehension and fluency, 6-12yrs
Can be used to diagnose reading difficulties in older readers
Children read a selection of stories out loud and complete a comprehension test on story
Administrator notes errors and time taken, scored to measure reading accuracy, reading rate, reading comprehension
- How was the 16PF created?
lexical approach, Cattell reviewed 18000 names for personality traits in English, determined quarter were ‘traits’ others temporary. Tested just distinguishable differences which produced 171. Students asked to rate friends on these, factor analysis, reduced to 36. Further reduced to 16 by research
- How is the NEO-PI-3 related to the 16PF
16PF can be scored to yield the Big Five factors instead of 16
- What is the consensus of the best model for personality
Five factor model/big five
- What are the five factors of the Big Five?
Agreeableness, Neuroticism, Extroversion, Openness to experience/culture, conscioustiousness
- What does the NEO-PI-3 measure?
Big Five
- How is the NEO-PI-3 administered?
240 items, 30-40 minutes, uses T scores, has different self-report and observer versions
- What are the psychometric properties of the NEO?
5 factors correlate with many other personality factors, established personality tests, social outcomes and behaviours (conscientiousness predicts GPA of uni students)
- According to Eysenck’s personality theory, what is the underlying basis for individual differences in neuroticism?
Differences in cortical arousal
- The theoretical basis of Eysenck’s personality theory is at the _________ level.
Biological
- What did Eysenck argue to be a critical component of the mechanism underlying individual differences in extraversion-introversion?
Arousal
- How was the Eysenck Personality Inventory created?
Factor analytic and theoretical approach
Biologically based theoretical model that mapped onto a 3 factor solution generated by factor analysis
- What are the three factors of the EPI?
Extraversion – differences in cortical arousal
Neuroticism – differences n activation thresholds in the limbic system.
Psychoticism - antisocial tendencies.
- Which of the following is the closest description of someone who scores high on the MMPI scale known as psychasthenia?
OCD
- What is a major criticism of the MMPI-2?
Lack of a nationally representative control sample
related to demographic variables
- How was the MMPI created?
Reviewed large pool of items
gave preliminary questionnaire to several groups of psychiatric in-patients and a control group
Used item analusis to choose items with best discriminatory ability
Standardised using control group
- What are the features/description of the MMPI-2
Comprehensive personality test designed to diagnose abnormal groups
Most frequently used test by neuropsychologists
Used to differentiate between “organic” and psychiatric disorders, detecting personality changes post head injury, assessing the validity of a patient’s self-report
Uses empirical criterion keying
- What is empirical criterion keying using the item discrimination index and how does it work?
True false statements are given to people with and without a certain condition. The IDI for each item is calculated by finding the difference between the proportion of people who had the condition and answered ‘true’ (out of the total pop with condition) and the proportion of people who didn’t have the condition and answered ‘true’ (out of total pop without condition). This can be done with groups that rank highly and lowly on other scales, etc.
- What do hypochondriasis, psychastenia and hypomania mean?
hypochondriasis – exaggerate health issues
psychasthenia – roughly means OCD
hypomania – manic-depressive disorder
- What are the psychometric properties of the MMPI?
Reliability: test-retest and internal consistency
Validity: construct validity (>10000 studies mapped profiles onto specific behaviours) criterion validity (MMPI scores map onto ratings by spouses and professionals
- What are the weaknesses of the MMPI?
Item overlap
Response bias affects scored (not enough reversed items
Correlates with demographic variables
Not nationally representative samples
- What are the scales used by the MMPI to detect lies?
Missing responses/double marked
Lie scale – negative statements that apply to most people
Infrequency scale – eccentric statements with low endorsement rates
Correction scale – willing to admit deviacy
TRIN (true response inconsistency) – times two answers that should have opposite answers, but don’t
VRIN (Variable Response Inconsistency)
Back F – are later responses similar to earlier ones
- How were the lie scales for the MMPI validated?
Neurotypical people were asked to fake a disease, and were detected.
- What is a psychologist according to the APS?
A psychologist studies the way people feel, think, act and interact. Aim to reduce distress and enhance emotional wellbeing. Are experts in human behavior. Assist people having difficulty controlling their emotions, thinking behavior.
Must be registered with Psychology Board of Australia (AHPRA)
- What is the function of the APS?
Support from peers in psychology
Cheaper insurance rates
Professional development
Advocate on the behalf of psychologists
- What is the difference between a clinical and counselling psychologist?
Who knows?
Counselling psych say they do more holistically with the issue, person centred, integrative approach (multiple theories)
Clin psychs say they’re expert in assessment (major focus on diagnosis, medical model)
This is a problem, because Clin psychs get Tier 1 rebates (124 an hour) while everyone else gets Tier 2 (88)
- What is the best recommendation on seeing a psychologist for somebody with a mental health problem?
See either clin psych or counselling psych, no difference