Week 10 Mandy's notes Flashcards
What is Clinical Psychology?
Clinical Psychologists:
» Provide a wide range of psychological services to individuals
- across the LIFESPAN
- mental health conditions that range from mild to severe and
complex
» Assessment and diagnosis and treatment of major mental
illnesses and psychological problems
» DESIGN, IMPLEMENT, and EVALUATE TRMT strategies
The referral question
Starting point for assessment and testing
» Psychologists role to answer/respond to the referral question
» May be explicitly outlined in correspondence from referral source
» May be presented by the client if self-referral –may need to be formulated
» May need to be clarified –more realistic, answerable
A clear and specific referral question:
»facilitates HYPOTHESIS generation
» guides SELECTION of appropriate ASSESSMENT and TESTING
» guides INTERPRETATION of results
» guides generation of RECOMMENDATIONS
Describe the most commonly used methods of assessment used in clinical psychology contexts.
- Assessment of cognitive functioning
» e.g., WAIS IV - Assessment of personality and psychopathology
» Structured tests, e.g., MMPI-2
» Clinical interview - Assessment of current level of symptomatology and functioning
» Tests, e.g., DASS, BDI, BAI, STAI, WASC-A, etc.
» Clinical interview
» Mental status examination
4. Diagnosis » Semi-structured clinical interviews, e.g., SCID-5 (see Kaplan, 2013, pp. 218-223) » Structured tests, e.g., MMPI-2, PAI » Clinical interview » Reference to DSM5 criteria
- Behavioural functional analysis
- Case formulation
Describe the Minnesota Multiphasic Personality Inventory (MMPI-2)
Most widely used and researched standardised “personality” test
» Developed as a measure to:
» distinguish between “normal” and “abnormal” groups
» assist in differential diagnosis of major psychiatric disorders
» Developed using the empirical approach/criterion keying
Empirical approach/criterion keying
A way of constructing psychological tests
» Relies on COLLECTING and EVALUATING data about how each of the ITEMS from a pool of items DISCRIMINATES BETWEEN GROUPS of respondents
» Groups who are thought to show or not show the attribute the test is designed to measure
MMPI-2 structure
567 “Yes/No” questions
» 10 clinical scales
» 7 validity scales – assess test-taking attitude and truthfulness/accuracy
MMPI-2 Clinical Scales
» 1: Hs: Hypochondriasis » 2:D: Depression » 3: Hy: Conversion Hysteria » 4: Pd: Psychopathic Deviate » 5: Mf: Masculinity / Femininity » 6: Pa: Paranoia » 7: Pt: Psychasthenia » 8: Sc: Schizophrenia » 9: Ma: Hypomania » 10: Si: Social Introversion
MMPI-2 Validity Scales (7)
? (Cannot say)score
» Number of items left unanswered (if 10% + items are not answered, test is invalid)
F (Infrequency) Scale
» Atypical or deviant response style
» General indicator of pathology or faking bad
» No exact cut-off for suspecting an invalid profile – need to consider individual and context to interpret
FB (Back F) Scale
» Similar to F scale
Lie (L) scale
» Extent to which client is “faking good” or describing self in an overly positive manner
» Tendency to present self in an unusually favourable light
VRIN (Variable Response Scale)
» Scored using pairs of responses
» Measures inconsistency in responding to items that are SIMILAR or different
TRIN (True Response Inconsistency Scale)
» Scored using pairs of responses
» Measures inconsistency in responding to items that are OPPOSITES
K (Correction) scale (CLINICAL INPUT INTO THE INTERPRETATION)
» More subtle and sophisticated index of “faking good”
» Items that some people might want to DENY about themselves
» Needs to be evaluated in CONTEXT (might be responding truthfully)
» T scores above 65 or 70 are higher than expected
» Higher scores indicative of ego defensiveness and guardedness
» K correction is added to five of the clinical scales
» Needs to be evaluated in context
Levels of Interpretation
Acceptability of the scores in the profile as determined by the validity indicators
» Elevation of the clinical scales against T-scores
» The relative elevation of the clinical scales
» Derivation of a code
» Determining subscale scores contributing to the elevated
clinical scales
» Content scales aid interpretation
» Also other scales and critical items
MMPI-2
Strengths and one caution
» Adequate reliability
» Adequate construct validity
» Many studies demonstrate predictive validity
» MMPI-A for adolescents
» Refer to Shum, et al., 2017, pp. 203 -204 for further details about
psychometric properties
Caution:
» Need to take into account context, demographic factors in interpretation
Tests of current level of
symptomatology and functioning
Beck Depression Inventory (BDI-2)
» Beck Anxiety Inventory (BAI)
» State Trait Anxiety Inventory (STAI)
» Kessler Psychological Distress Scale (K-10)
» The Hospital Anxiety and Depression Scale (HADS)
» Depression Anxiety Stress Scales (DASS)
» The Westerman Aboriginal Symptom Checklist Adults (WASC-A)
» The Westerman Aboriginal Symptom Checklist Youth (WASC-Y)
Clinical Interview purpose
Purpose:
» Assessment method for collecting information about client
» Opportunity to establish rapport
» Opportunity to check client understanding of assessment (and therapy if
relevant)
Clinical interview Characteristics:
Can take many forms depending on the perspective of the clinician
» Can be unstructured, structured, semi-structured
» Clinician/interviewer asks questions of the client that are related to the
referral question
» Interviewing skills essential (as discussed in Week 5,6 & 7 topic)
Clinical Interview
Information usually covered
The purpose and nature of clinical testing and assessment
» What the client is expected to do
» Confidentiality of information collected during assessment
» The need for informed consent
» Who will have access to information collected and how used
» Demographic data
» Medical history (self and family)
» Family history
» Educational and vocational history
» Psychological history
» PLUS Mental Status Exam (based on questions and observations)
