Week 11 Assessment in Clinical Practice

Question 1

What is the definition of testing

Answer 1

a particular scale is administered to obtain a specific score and a descriptive meaning can be applied to the score on the basis of normative, nomothetic findings

Question 2

What is the definition of assessment

Answer 2

a clinician who takes a variety of test scores from multiple test methods + considers data in the context of history, referral information and observed behavior to understand the person being evaluated + then communicate findings to the patient

Question 3

What are reasons for assessment

Answer 3

• describe current functioning
• identify therapeutic needs
• monitor treatment
• manage risk

Question 4

Why do we use standardized tests?

Answer 4

clinicians are unreliable judges- standardized tests allow us to make valid and reliable judgments

Question 5

Why do clinicians often make errors in gathering data?

Answer 5

• tendency to see patterns where none exist
• tendency to seek confirmatory basis
• use of preconceived biases

Question 6

Why do clinicians often make errors in synthesizing data?

Answer 6

representatives- looking for data that matches out relevant data
availability anchoring
affect- clinicians mood
prototypes- past clients

Question 7

What are five types of tests used by clinicians

Answer 7

• diagnostic interviews: question & answer session b/w psychologist and client
• self report questionnaires
• questionnaires completed by sig others
• behavioral tests
• observational methods

Question 8

What are the types ways diagnostic interviews can be structured?

Answer 8

fully or semi

Question 9

Discuss semi structured interviews

Answer 9

provide standard qs that are initially asked by the clinician but then they use their knowledge for the follow up qs to gather more info. Have the same sort sof qs as unstructured/conversational interview but it makes sure you ask all the relevant qs.

Question 10

What is the benefit of using fully or semi structured interview

Answer 10

ensure coverage of the diagnostic criteria as specified by DSM-IV etc.

Question 11

What types of reliability are important for structured diagnostic interviews

Answer 11

excellent inter-rater agreement- we want to make sure two clinicians who both ask the same questions to the same client are getting the same diagnosis
adequate test-retest reliability- want to make sure the diagnosis we give remains stable when the individual themselves has not changed

Question 12

Discuss validity re structured diagnostic interviews

Answer 12

construct validity v important
procedural validity -use LEAD criterion- a standard made up by an expert who uses all the data available to them over a longitudinal over a period of time and compare this with the current test

Question 13

What do kappa coefficients do

Answer 13

quantify inter-rater reliability and procedural validity

Question 14

What is excellent kappa interpretation (inter rater agreement)

Answer 14

> .75

Question 15

what is fair kappa interpretation (inter rater agreement)

Answer 15

.4 to .59

Question 16

what is poor kappa interpretation

Answer 16

less than .4

Question 17

What is sensitivity

Answer 17

the probability that a person with a clinical diagnosis will receive the same diagnostic interview diagnosis

Question 18

what is specificity

Answer 18

probability that a person without a clinical diagnosis will not receive the same diagnosis via diagnostic interview

Question 19

what is positive predictive values

Answer 19

probability that a person with a diagnostic interview diagnosis is truly ‘ill’

Question 20

what is negative predictive values

Answer 20

probability that a person without a diagnostic interview diagnosis is truly well

Question 21

Discuss global v specific measures

Answer 21

global- assess multiple symptoms, provide an overall level of severity of psychopathology
specific- assess a limited set of symptoms, provide measures of the level of severity of a specific problem

Question 22

What is the brief system inventory

Answer 22

global measure
53 items describing psychiatric symptoms
items are rated on a five-point scale indicating level of distress
adequate reliability and validity 
9 primary symptoms dimensions
3 global indices of distress

Question 23

What are the three global indices of distress for the BSI

Answer 23

global severity index
positive symptom distress index
positive symptom total

Question 24

What is Beck Anxiety inventory

Answer 24

specific measure
21 item developed to assess severity of anxiety symptoms
aims to reliably distinguish anxiety from depression
rating scale
good reliability and validity

Question 25

what are behavioural tests most commonly used for

Answer 25

in assessment of anxiety disorders

Question 26

what is behavioural avoidance test

Answer 26

snake

Question 27

discuss statistical vs clinical significance

Answer 27

statistical- significantly statistically but may not have any meaningful changes to the patient. Clinical- individual level of analysis/meaningful changes.

Question 28

What two criteria are necessary for an individual to show clinically significant change

Answer 28

1. improvement- dependant measure must show a reliable change that is larger than the measurement error of the instrument (reliable change index)
2. recovery- the individuals score is more likely to be drawn from the distribution of a functional rather than a dysfunction population

Question 29

What does the reliable change index have to be greater than to show improvement

Answer 29

1.96

Question 30

what are 3 ways to show recovery to normal functioning

Answer 30

1. post-treatment score should fall outside range of dysfunctional pop. (2 sds beyond mean)
2. post-treatment score should fall within range of functional pop
3. post-treatment score is closer to the mean of the functional than of the dysfunctional pop