Assessment Flashcards
(166 cards)
1
Q
two key aspects of the adequacy of classification systems are…
A
validity and utility
2
Q
Classification Validity
A
refers to the extent to which the principles used in classifying an entity are effective in capturing the nature of the entity
3
Q
Classification Utility
A
refers to the usefulness of the resulting classification scheme
4
Q
categorical approach to classification
A
an entity is determined to be either a member of a category or not.
The assumption underlying categorical classification is that there is an important qualitative difference between entities that are members of a category and those that are not
5
Q
dimensional approach to classification
A
is based on the assumption that entities differ in the extent to which they possess certain characteristics or properties
This approach focuses on quantitative differences among entities and reflects the assumption that all entities can be arranged on a continuum to indicate the degree of membership in a category.
6
Q
Within a dimensional classification system, the different dimensions may or may not be related, but it is essential that the dimensions reflect
A
significant higher-order constructs rather than simple descriptive features (e.g., a construct such as neuroticism, rather than specific psychological phenomena such as sadness, nervousness, loneliness, poor self-esteem, or poor self-confidence).
7
Q
diagnostic system
A
a classification based on rules used to organize and understand diseases and disorders.
8
Q
diagnosis
A
the result of applying the decision-making rules of a diagnostic system to the symptoms of a specific individual
9
Q
prototype model
A
members of a diagnostic category may differ in the degree to which they represent the concepts underlying the category.
As an example, if you think of all the features pertinent to the category “mammals,” dogs are more prototypic of the category than are platypuses. Applying the prototype model to psychiatric diagnosis implies that not all people receiving the same diagnosis have exactly the same set of symptoms.
Accordingly, in contrast to strict neo-Kraepelinian assumptions, two people with the same diagnosis may not have exactly the same disorder (i.e., the same set of symptoms) and therefore may require somewhat different treatments
10
Q
developmental psychopathology
A
a framework for understanding problem behaviour in relation to the milestones that are specific to each stage of a person’s development
underlines that biological and psychological systems are constantly changing
emphasizes the importance of major developmental transitions (such as starting daycare, learning to speak, going to high school, or moving into a long-term care facility) as well as disruptions to normal patterns of development (such as loss of a loved one, the effects of poverty, or exposure to trauma)
11
Q
what is central to the developmental psychopatholpgy approach?
A
Central to this approach is a reliance on empirical knowledge of normal development. So, for example, in understanding problems in very young children, it is essential to be informed by research on a wide range of issues, including interpersonal attachment, cognitive development, and sleep patterns. Understanding difficulties that are evident in preschool-age children requires, in particular, knowledge of language development and of ways that adults promote children’s self-esteem and self-control. Problems in school-age children can be considered in the context of what we know about academic functioning, peer relationships, and harmonious families.
12
Q
No diagnosis is based on a…
A
single symptom
-Diagnostic criteria always include a cluster of symptoms that co-occur
13
Q
Unlike medical diagnostic systems, classification systems for mental disorders rely almost entirely on the…
A
observation of symptoms (mostly from self-report data).
14
Q
the diagnosis of a disorder does not just require the co-occurrence of a set of statistically rare symptoms or behaviours; it also requires that…
what was the concept originally referred to
A
there is something wrong or dysfunctional and that this dysfunction causes harm to the individual or to those around him or her
14
Q
the diagnosis of a disorder does not just require the co-occurrence of a set of statistically rare symptoms or behaviours; it also requires that…
what was the concept originally referred to?
A
there is something wrong or dysfunctional and that this dysfunction causes harm to the individual or to those around him or her
harmful dysfunction
15
Q
Widiger has suggested that the concept of dyscontrol should be part of the definition of mental disorder - what is it?
what is the problem with this concept?
A
the resulting impairment must be involuntary or, at least, not readily controlled. This addition is important, especially in legal contexts, because it means that someone who intentionally and willfully engages in unacceptable behaviour such as sexually abusing a child or shooting participants at a summer camp would not be considered to have a mental disorder.
is difficult to operationalize. After all, how can you accurately determine whether another person is unable to control a behaviour or is simply choosing not to control the behaviour?
16
Q
the WHO World Mental Health Survey collected data on the disability and treatment of mental and physical disorders Across countries, mental disorders were found to be…
A
more disabling than physical disorders such as chronic pain, heart disease, cancer, and diabetes. At the time of the interview, survey participants with mental disorders were much less likely to be receiving treatment for their disorders than were those with physical disorders, and this was especially true for lower-income countries
17
Q
Modern theories of the etiology of mental disorders are all based on what type of model?
A
biopsychosocial model
18
Q
in a longitudinal study of common fears, the impact of __________ factors that influenced fear intensity during childhood tended to diminish over time, whereas the impact of ___________ increased over time
A
genetic
life experiences
19
Q
Which edition of the DSM was described as changing the entire focus of the field?
A
third
First, the manual was explicitly atheoretical, which allowed for the possibility of greater acceptance within the mental health field and for the introduction of concrete behavioural descriptions of most disorders. Second, the diagnostic criteria were much more explicit than they were previously, with lists of symptoms provided for each diagnosis. Third, as a significant part of the effort to improve upon the reliability of psychiatric diagnoses, thousands of patients and hundreds of clinicians were involved in field trials of the diagnostic system.
20
Q
What approach does the DSM-5 use for classification?
A
largely based on a categorical approach to classification
However, because some disorders may be better represented by dimensional categorization, the classes of disorders were clustered with similar disorders
21
Q
How are disorders clustered in the DSM-5?
A
Using the concepts of internalizing and externalizing disorders, disorders with anxiety, depressive, and somatic symptoms were grouped together (i.e., internalizing features), as were disorders with impulsive, disruptive conduct, and substance use symptoms (i.e., externalizing features)
22
Q
What does it mean by a lifespan approach used in the DSM-5?
A
listing disorders more frequently diagnosed in childhood at the beginning of the manual, and disorders more frequently diagnosed among older adults at the end of the manual
23
Q
The DSM-5 includes how many main diagnostic classes?
A
20
24
Evidence-based assessment (EBA)
an approach to psychological evaluation that uses research and theory to guide
(a) the variables assessed,
(b) the methods and measures used,
(c) the manner in which the assessment process unfolds.
It involves the recognition that the assessment process is a decision-making task in which the clinician must repeatedly formulate and test hypotheses by integrating data obtained throughout the assessment
25
assessment-focused services
services conducted primarily to provide information on a person’s psychosocial functioning to provide information that can be used to address a person’s current or anticipated psychosocial deficits
psychologists must use EBA tools and must follow all ethical standards in providing these services
26
Psychological assessments are most commonly conducted in the context of...
intervention services
27
intervention-focused assessment services
the psychological assessment is not a stand-alone service but is conducted as a first step in providing an effective intervention. All intervention should involve some assessment.
28
screening
The purpose of screening for a disorder, condition, or characteristic is to identify, as accurately as possible, individuals who may have problems of a clinical magnitude or who may be at risk for developing such problems.
Individuals who are screened may not have sought out assessment services; rather, they are receiving the assessment as part of the routine operations of a clinic, school, hospital, or employment setting.
People may also actively seek out a screening assessment. In the United States, there are national screening days for a number of psychological disorders, including the National Alcohol Screening Day and the National Depression Screening Day.
29
How are screening and diagnosis different?
Although screening is useful in identifying those at risk, it is important to remember that screening tools are not the same as tools used in diagnosis. So, for example, if you score high on a depression-screening instrument, it does not mean that you would necessarily meet diagnostic criteria for depression.
30
What is diagnosis currently called?
case formulation
is now more commonly used to describe the use of assessment data to develop a comprehensive and clinically relevant conceptualization of a patient’s psychological functioning. Typically, a case formulation provides information on the patient’s life situation, current problems, and a set of hypotheses linking psychosocial factors with the patient’s clinical condition.
31
Whether or not it is stated explicitly, psychological assessment always implies what?
some form of prediction about the patient’s future.
For example, recommendations that the person seek psychotherapy to address bulimic symptoms or that special academic tutoring is needed to compensate for a learning disability imply that, without some form of intervention, the present problems will either continue or worsen
32
Prognosis
predictions made about the future course of a patient’s psychological functioning, based on the use of assessment data in combination with relevant empirical literature.
33
base rate
the frequency with which a problem or diagnosis occurs in the population
34
the less frequently a problem occurs (the lower the base rate is), the more likely...
a prediction error will occur
35
sensitivity
proportion of true positives identified by the assessment
true positive = the situation in which the prediction is accurate and the event predicted (diagnosis) did, in fact, occur (was accurate)
Let’s assume that a psychologist conducted assessments on hospital inpatients in a patient care unit in order to predict who was at risk for future suicide attempts. In our example, sensitivity provides information on how well the assessment procedures were able to detect future suicide attempts
36
specificity
proportion of true negatives identified by the assessment.
true negative =occurs when the psychologist predicts that an event will occur, but in fact, it does not occur (e.g., the psychologist diagnoses ADHD in a child who does not have the disorder)
Let’s assume that a psychologist conducted assessments on hospital inpatients in a patient care unit in order to predict who was at risk for future suicide attempts. In our example,specificity provides information on how well the assessment procedures were able to identify individuals who would not attempt suicide
37
a decision about which assessment procedures to select should be informed by what two things?
a thorough consideration of the procedure’s sensitivity and specificity
the psychological and financial costs stemming from inaccurate clinical predictions
38
A useful treatment plan must cover three general areas:
problem identification, treatment goals, and treatment strategies and tactics
39
what is the difference between treatment strategies and treatment tactics?
a description of treatment strategies provides information on the general approach to addressing the clinical problems, whereas a description of treatment tactics provides details of specific tasks, procedures, or techniques that will be used in treatment.
To address Justin’s symptoms of depression and relationship conflict, for example, the treatment strategy may be to use individual interpersonal therapy or to use emotionally focused couples therapy (EFT) with both Justin and his partner Pat. The treatment tactics, however, would deal with the specific elements of treatment, such as, within EFT, having the couple work on emotionally reconnecting with each other and developing renewed trust in each other’s emotional availability
40
All clinicians have an implicit sense of how the patient is progressing, but treatment monitoring refers to...
explicitly tracking progress through the use of specific questions or psychological measures
41
Data gathered for treatment monitoring can affect treatment services provided to an individual client, but data gathered for treatment outcome purposes...
can yield information relevant to an entire psychological practice or service
42
although you may be able to quickly develop a questionnaire designed to measure some aspect of human functioning, it is not a psychological test until it has been demonstrated to have met the standards of what three things?
reliability, validity, and norms
43
difference between testing and assessment
testing can be part of an assessment but it must be considered part of the information gathered in the process of psychological assessment - No score should ever be interpreted in isolation
testing occurs when a particular device is used to gather a sample of behaviour from a client, a score is assigned to the resulting sample, and comparisons with the scores of other people are made in order to interpret the client’s score.
Assessment is more complex and multifaceted than testing and may or may not involve the use of psychological tests
The result from a test is a score that can be interpreted based on comparisons with the scores of others; the result from an assessment is a coherent, unified description of the client or selected aspects of the client’s experience
44
All mental health professionals conduct assessments, but compared with other mental health professionals, psychologists...
receive far more training in issues related to testing and are far more likely to use tests
45
assessment of children requires what different measures from the assessment of adults? why?
a much larger number and variety of tests and measures be used than is typically the case for adults
children are in a process of rapid cognitive, physical, and emotional development
The lives of children are best understood with reference to the contexts in which they are embedded—in families, schools, and peer groups
child assessment, by its very nature, involves the integration of information obtained from multiple methods (e.g., interviews, ratings, direct observations), informants (e.g., child, parent, teacher), and settings (e.g., home, classroom).
46
what are psychometric considerations?
standardization (of stimuli, administration, and scoring), reliability, validity, and norms
47
Standardization
consistency across clinicians and testing occasions in the procedure used to administer and score a test
Without standardization, it is virtually impossible for the psychologist to replicate the information gathered in an assessment or for any other psychologist to do so. Furthermore, without standardization, test results are likely to be highly specific to the unique aspects of the testing situation and are unlikely to provide data that can be generalized to testing by another psychologist, let alone to other situations in the person’s life.
48
How do test developers reduce variability in the testing situation?
provide detailed instructions regarding the nature of the stimuli, administrative procedures, time limits, and the types of verbal probes and permissible responses to the client’s questions. Instructions are provided for scoring the test.
49
what are the aspects of reliability of a test?
whether all aspects of the test contribute in a meaningful way to the data obtained (internal consistency)
whether similar results would be obtained if the person was retested at some point after the initial test (test-retest reliability)
whether similar results would be obtained if the test was conducted and/or scored by another evaluator (inter-rater or inter-scorer reliability)
50
test itself does not have reliability—reliability must be considered in a broader context that takes into account what two things?
the purpose for which the test is being used (there are numerous psychological tests for which one would not expect internal consistency or test-retest reliability to be very high - Take the example of a measure of stressful life events - if such a test was taken at the age of 18 and then again at the age of 25, one would not necessarily expect high test-retest reliability—such a test is not intended to measure a characteristic that is stable over time.)
the population it is being used with (So, simply because high levels of reliability have been found for an instrument when used with young adults, it should not be assumed that comparable levels of reliability will be found when used with older adults. )
51
How much reliability is necessary for a test?
this is a similar question to how high a ladder should be—the answer in both cases is that it depends on the purpose you have in mind. Nevertheless, there is a clear consensus that the level of acceptable reliability for tests used for clinical purposes must be greater than it is for tests used for research purposes
In considering internal consistency reliability, a number of authors have suggested that a value of .90 is the minimum required for a clinical test - For research purposes, values greater than .70 are typically seen as sufficient, with lower values being unacceptable
reliability influences how much error there is in a test score. This can be extremely important in clinical work where precise test cut-off scores are used
52
what does validity of a test tell us?
we are evaluating both the degree to which there is evidence that the test truly measures what it purports to measure and the manner in which the test results are interpreted - A standardized test that produces reliable data does not necessarily yield valid data, because a test purporting to measure one construct may in fact be measuring a different construct or may be misinterpreted
53
what are the aspects of validity?
ensuring that the test includes items that are representative of all aspects of the underlying psychological construct the test is designed to measure (evidence of content validity)
that it provides data consistent with theoretical postulates associated with the phenomenon being assessed (evidence of concurrent validity and evidence of predictive validity)
that it provides a relatively pure measure of the construct that is minimally contaminated by other psychological constructs (evidence of discriminant validity)
54
evidence of incremental validity
the extent to which a measure adds to the prediction of a criterion above what can be predicted by other sources of data (Hunsley & Meyer, 2003; Sechrest, 1963). It is not necessarily a case of “the more data the better” in clinical assessment. As described previously, there are costs associated with the collection of assessment data. The collection of excessive amounts of data can lead to both unnecessary costs and the introduction of unnecessary error creeping into the assessment. Despite the clear importance of incremental validity in conducting clinical assessments, there is currently very little research available to guide clinical psychologists in their selection and use of tests.
55
Fernandez, Boccaccini, and Noland (2007) outlined a four-step process psychologists can use in identifying and selecting translated tests for Spanish-speaking clients (and which is applicable to translated tests in other languages). what are the steps?
First, the range of translated tests should be identified by reviewing the catalogues and websites of test publishing companies. Next, research evidence for each relevant translated test, not just the original English-language versions, must be examined. Third, the nature of the Spanish-speaking samples used in the studies should be examined to determine if the results are likely to be relevant to the client (e.g., research conducted in Spain may not be generalizable to a client who recently emigrated from Ecuador). Finally, the strength of the validity evidence must be weighed in determining whether the test is likely to be appropriate and useful in assessing the client.
56
what are norms?
To meaningfully interpret the results obtained from a client, it is essential to use either norms or specific criterion-related cut-off scores
Without such reference information, it is impossible to determine the precise meaning of any test results. So, if you were told you had a score of 44 on a test of emotional maturity, it would provide no meaningful information unless you knew the range of possible scores and how most other people score. In psychological assessment, comparisons must be made either to criteria that have been set for the test (e.g., a certain degree of accuracy, as demonstrated in the test, is necessary for the satisfactory performance of a job) or to some form of norms.
As with validity considerations, it may be necessary to develop multiple norms for a test based on the group being assessed and the testing purpose (i.e., norms relevant for different ages and ethnic groups).
57
what is a common issue with norms?
It is very common to find tests that have norms based on samples of convenience—in other words, data were obtained from a group of research participants in a specific location and may not be representative of scores that would be obtained by others. Common convenience samples include undergraduate students, hospital inpatients, or patients in a single psychology clinic. Such norms should be treated very skeptically
58
People considering a psychological assessment should ensure that they receive sufficient details about the assessment to be able to make an informed decision about participation. They require information about...
the nature and purpose of the assessment, the fees, the involvement of other parties in the assessment, and any limits to confidentiality.
59
whatever is in a client file, with very few exceptions, can be seen by the client, and clients can authorize the release of file information to others such as teachers, lawyers, or other health care providers. This poses a potential challenge for psychologists, as they are also required to protect the security and copyright of test materials. As a result, it is becoming standard practice among psychologists to distinguish between...
test data and test material per se. Test data, like other parts of a client file, may be released to others upon the request of the client (or the client’s guardian or legal representative). Test material, including actual test questions and manuals, are not part of the file and must not be released.
60
in addition to stand-alone assessment services, psychological assessment can be used in...
screening, diagnosis and case formulation, prediction, treatment planning, and monitoring the effectiveness of interventions
61
What are the most commonly used strategies in clinical assessments?
interviews and observations
Interviews are the most common strategy to gather information necessary to make a diagnosis and serve many additional purposes. They are also used to obtain information for case formulation, problem definition, and goal-setting. Interview data include material that cannot be easily assessed in psychometric tests and that is important in generating hypotheses and elaborating on themes that have been identified in other assessment strategies
62
Structured interviews are typically used in what circumstances?
population surveys or other situations where the interviewer is not expected to have clinical training
63
Differences between social conversations and clinical interviews
Can take place anywhere / Usually in an office
May be overheard by others / Private
Variable duration / Usually 50 minutes to an hour
Details may be repeated in other conversations / Confidential, except to protect safety or with client’s written permission
Purpose is relationship maintenance /Purpose is to both gather information and establish a collaborative relationship
Free-flowing according to each person’s interest / Goal-directed, keeps to an agenda, clear sequence, keeps to relevant themes
Reciprocal: Something similar happened to me . . . That reminds me of the time when I . . ./ Focused on the client
Each person waits for an opening to make a comment: Now that you mention worries . . ./ Clinician interrupts and redirects conversation: Do you ever worry . . .
Maintenance of relationship usually takes precedence / May require persistent questioning over gathering information
Commonly avoids painful topics / Clinician raises painful topics such as abuse, violence, suicide
Participants rarely take notes / Psychologist may take notes
Not documented / Notes of session are kept by the psychologist
Not recorded / With client’s permission, may be audio or video recorded
64
advantages/disadvantages of open vs. closed questions
Open questions allow the client to give a more complex answer and do not suggest a particular response is required. However, open questions may invite the client to begin a long, tangential story that may be of limited relevance, in which case the psychologist must direct the client back to the topic at hand. Closed questions, on the other hand, yield brief, less ambiguous answers, allowing the rapid coverage of many topics. Many psychologists find it useful to begin discussion of a topic with an open-ended question and to follow up with closed questions that clarify details of the response.
65
a number of semi-structured interviews were developed to address what issue?
Researchers noted that although most mental health professionals agreed on the general features of a disorder, there was poor inter-rater reliability in assigning diagnoses; that is, there was low agreement between two interviewers about the precise diagnostic category.
They have a specific format for asking questions and a specific sequence in which questions are asked. Based on initial client responses, the interviewer is then directed to use follow-up questions that help confirm or rule out possible diagnoses.
66
what is the most widely used clinical interview in North America? what is it used for?
the Structured Clinical Interview for DSM-5 (SCID-5), - designed to permit diagnosis of a broad spectrum of DSM-5 disorders
67
Multiple versions of the SCID-5 have been developed. What are they? what are they for?
The Research Version is the most comprehensive interview, covering most of the DSM-5 diagnoses.
The Clinician Version is a somewhat shorter interview designed to cover the disorders most commonly encountered in clinical settings.
The Personality Disorders interview provides a detailed evaluation of all 10 DSM-5 personality disorders.
Finally, the Clinical Trials Version is tailored to the needs of treatment trials, covering only the diagnoses relevant to the inclusion and exclusion criteria for a clinical trial.
68
The SCID-5 Clinician Version begins with...
an open-ended interview on demographic information, work history, chief complaint, history of present and past psychopathology, treatment history, and assessment of current functioning. This less structured format is designed to develop rapport with the client prior to beginning the structured symptom-focused questions that are designed to yield diagnostic information.
69
what are some disadvantages of the SCID-5?
As the SCID-5 was only recently published, there are few studies on the psychometric properties of the interview.
To a very great extent, the validity of the SCID-5 versions is tied to the validity of the DSM-5 itself.
The strength of the SCID-5 lies in the breadth of the disorders it covers. The weaknesses, which may be related to the breadth of coverage, are the variable reliabilities that are obtained for different disorders and the lack of strong validity data.
Because the SCID-5 Clinician Version covers the most common diagnoses, it also can be very time consuming to administer—an important consideration in clinical use.
70
what is the ADIS-5? why would a clinician choose to use it over the SCID-5?
the Anxiety and Related Disorders Interview Schedule for DSM-5 is a semi-structured diagnostic interview that focuses on anxiety and related disorders, with additional coverage of disorders that are commonly comorbid with anxiety disorders (depressive disorders, substance-related disorders, and somatic symptom disorders)
Although there is only limited psychometric research available on the adult interview, its main advantage over more general diagnostic interviews lies in the depth of coverage of the disorders that are assessed.
71
what was introduced in adapting the ADIS for use with youth? why?
visual cues such as the Feelings Thermometer were introduced. On a Feelings Thermometer, respondents are asked to indicate on a picture of a thermometer how they are feeling. Zero might represent totally calm, and 100 might represent very afraid. The Feelings Thermometer is designed to enable children to better communicate different gradations of feelings when their vocabulary for expressing these distinctions is limited.
72
what features of diagnostic interviews are challenging for children? what has been done to address these problems?
These include the length of the interview, which often exceeds children’s attention capacity, and questions requiring a more precise response than children are capable of providing
Diagnostic interviews for children and adolescents usually have parallel versions that are completed by parents.
some creative interview formats have been developed. Ablow and colleagues have used puppets in the assessment of children aged 4 to 8 years - Children are presented with two identical puppets, Iggy and Ziggy, who describe themselves in different ways. So, for example, Iggy says, I am not shy when I meet new people, and Ziggy says, I am shy when I meet new people. Children are then asked to indicate which puppet they are similar to. - have reported encouraging test–retest reliability and discriminant validity for the interview
73
What is Dominic Interactive?
a diagnostic interview for children aged 6 to 11 years, which uses cartoon drawings as cues
The stimuli are available in different formats that vary in gender, age, ethnic background, and language.
Given children’s difficulties with the concept of time, there is no attempt to determine the frequency of behaviours, so the interview cannot yield full information required for diagnosis, nor does the information yield contextual data
have reported adequate test–retest reliability and criterion validity to support the use of the Dominic Interactive as an effective, brief screening instrument for mental disorders
74
The type of background information considered essential to an assessment depends on what 2 things?
the theoretical orientation of the psychologist as well as the type of services offered.
the challenge for clinical psychologists is to selectively focus on aspects that are most relevant for understanding the client’s problems and the personal resources that could be brought to bear on the problems
75
What is an important screening topic so that certain experiences are not overlooked in assessing/diagnosing?
Screening for exposure to violence
Psychological assessment must include routine screening to determine whether the person has been a witness to and/or a victim of violence. Questions must be phrased in a sensitive and open way that allows the client to acknowledge what he or she has experienced.
76
What guidelines/techniques have been developed around cultural sensitivity?
Both the Canadian Psychological Association and the American Psychological Association have developed guidelines for ethical practice with diverse populations
the American Psychiatric Association developed the Cultural Formulation Interview (CFI) to augment the information gathered to formulate a DSM-5 diagnosis
77
What are two examples of how psychologists can be culturally sensitive in their assessments?
eye contact - in the 1970s and 1980s, most clinical psychology training programs taught students to maintain eye contact with clients. Now, there is greater sensitivity that, in some cultures, too much eye contact may be perceived as intimidating. Similarly, it would be an error to interpret an averted gaze as evidence of avoidance, as it may simply represent a respectful stance toward an authority figure.
punctuality/attendance - In understanding the challenges the child faced in adjusting to the Canadian school system, it was very helpful to appreciate culturally based differences in the importance of time.
78
what are SMART goals?
specific, measurable, attainable, relevant, and time-bound
79
What sort of questions does a psychologist need to ask when assessing suicide risk? What should the psychologist's response to the levels of risk be?
Psychologists ask direct questions about suicidal thoughts, plans and their lethality, and access to the means to attempt suicide. Given the strong links between a history of suicidal behaviour and risk for future suicidal behaviour, questions must also focus on a history of suicide attempts. As some suicidal clients may make only a general statement about their level of unhappiness or hopelessness, it is the psychologist’s responsibility to follow up such comments with questions assessing the current risk
If the psychologist determines that a patient is at low risk for committing suicide, it would be appropriate to ensure that the person has emergency numbers for a suicide helpline and a local hospital. If the person appears to be at an elevated risk, the psychologist may need to accompany the patient to the emergency unit of the nearest hospital
80
In dealing with couples and family interviews, the psychologist must ensure what?
the psychologist ensures that, over the course of the interview, attention is devoted to each person. At the beginning of the interview, the psychologist tells family members explicitly that he or she would like to hear from each person. However, to put that into practice, the psychologist often must diplomatically cut off one family member to ensure each has a turn. The psychologist also conveys that it is normal for each person to have a different perspective. Although each person is invited to speak, each also has the right to be silent. It may be necessary to remind parents of this.
81
Things to take into account when assessing older adults:
cognitive impairment - the psychologist must pay particular attention to whether the person is capable of consent to services
cohort effects - For example, the current population of older adults who were born in the time of the economic depression of the 1930s, the Second World War, or the post-war recovery period. One developmental task of later life is to reminisce about one’s formative years, so the sociopolitical influences these older adults experienced may figure prominently in their discussions of their lives. The interviewer must also be sensitive to the impact such events may have had on the interviewee
knowledge of the physical challenges that may affect the person
possible effects of medication on client functioning
cooperation of both paid and unpaid caregivers
screening for maltreatment by family members or paid caregivers
82
Elements to a child interview
Like adults, children are entitled to know about confidentiality and its limits. The psychologist must explain the purpose of the interview. As children may associate interviews with adults as evaluative in nature, it is important to reassure the child that there are no right or wrong answers to the questions and that everyone has a different opinion. To engage the child in conversation, the psychologist maintains a varied voice tone and relaxed posture.
Interviewing techniques must be adapted when psychologists are interviewing children. Developmental considerations affect cognitive functioning and the young client’s understanding of what is being asked. Young children differ from adults in terms of their attention span and capacity to stay focused on the interview. Furthermore, children differ from adults in their style of interaction.
83
How is eye contact different between adults and children in assessment?
Although face-to-face contact and eye contact may be important ingredients of assessment interviews with most adults, we know that children and adolescents engage in some of their best conversations when they are not in eye contact
psychologists may invite child clients to play or draw while they are chatting to put the child at ease
84
Important aspects of observation
The psychologist notices the client’s activity level, attention span, and impulsivity. Careful attention is paid to the client’s speech, noting any difficulties or abnormalities. The psychologist observes the physical movements and behaviours of clients as well as the ease of interacting with them
85
why haven't observational coding systems that were originally developed in a research context been modified for use in clinical practice?
One major obstacle is expense. Some of the most useful research coding schemes require hours of coding to analyze a single hour of interaction. In a cost-conscious health care system, these costs are extremely difficult to justify. For this reason, researchers are developing observational approaches that require less coding time. The Disruptive Behavior Diagnostic Observation Schedule (DB-DOS), for example, is a brief observational system that has been shown to be helpful in the diagnosis of disruptive behaviour disorders and ADHD in preschoolers
86
To obtain accurate information as economically as possible, psychologists have developed a number of strategies for clients to observe their own behaviour, emotions and/or thoughts that collectively are known as...
self-monitoring strategies
87
how do self-monitoring strategies inform cognitive-behavioural psychologists?
obtaining information about the context in which these thoughts occur can provide useful information about factors that may provoke or maintain dysfunctional or non-productive behaviours
also provide a fuller picture of the client’s usual strategies, both successful and unsuccessful, for dealing with the symptoms
88
ambulatory biosensors
designed to measure physiological variables. These devices require virtually no effort on the part of the client, as data are recorded automatically, with no disruption in the daily activities of the person. A wide array of such devices is available, including those designed to assess cardiovascular activity, physical activity, and cortisol levels
89
Challenges of self-monitoring
Self-monitoring data are not always accurate, as the client may fail to record information at the appropriate time, may not have fully grasped the nature of the task given by the psychologist, or may be reluctant to report some undesirable thoughts or behaviours
90
reactivity
occurs in self-monitoring regardless of the client’s age. Reactivity refers to a change in the phenomenon being monitored that is due specifically to the process of the self-monitoring. This has been found for a surprisingly wide array of symptoms and problems, including hallucinations, substance abuse, worry, and insomnia (Korotitsch & Nelson-Gray, 1999). In almost all cases, such changes result in a decrease in the problem behaviour in question. Although this provides a therapeutic “bonus,” it does undermine efforts to obtain the most accurate data possible
91
Ecological momentary assessment
the term used for a set of strategies that allow research participants (and patients) to report repeatedly on what is occurring to them in real time
Using either electronic recording strategies or pencil-and-paper diaries, participants provide information on their experiences in event-based designs (e.g., describing their thoughts, behaviours, emotions, and interpersonal interactions around the time when they experienced a specific problematic event, such as a panic attack) and/or time-based designs (e.g., recording their mood and physical activity levels every hour in order to obtain an accurate sense of how fluctuations in mood and activity affect each other)
92
tests of intelligence and related cognitive abilities are among the ______________________ tests that psychologists have developed because...
psychometrically strongest
Because of the important implications of the results of intellectual and cognitive assessment, beginning in the latter half of the 20th century, test developers made great efforts to reduce test bias and measurement error.
93
Wechsler's definition of intelligence
a person’s global capacity to act purposefully, to think in a rational manner, and to deal effectively with his or her environment
94
Gottfredson’s definition of intelligence
involves the ability to reason, plan, solve problems, think abstractly, comprehend complex ideas, learn quickly and learn from experience. It is not merely book learning, a narrow academic skill, or test-taking smarts. Rather it reflects a broader and deeper capability for comprehending our surroundings—‘catching on,’ ‘making sense’ of things, or ‘figuring out’ what to do.”
95
three domains of theories of intelligence
factor models, hierarchical models, and information processing models
96
The earliest and probably most influential factor model of intelligence was developed by...
Charles Spearman
97
What were the two factors proposed by Spearman?
g: the general factor shared by all intellectual activities.
s: specific factors that are responsible for unique aspects in the performance of any given task (spatial, mechanical, verbal, arithmetic)
98
difference between factor model and hierarchical model of intelligence
The number of factors included in models of intelligence ranges from as few as 2 to well over 100 (Guilford, 1956). In an attempt to reconcile these different models, hierarchical model theorists have proposed that there are a small number of main factors that are comprised of subfactors.
99
One of the first and most influential of the hierarchical models was...
Cattell and Horn's general factor model
100
Cattell proposed what two general factors of intelligence? what do they represent?
fluid intelligence (g(F)) and crystallized intelligence (g(C)).
Fluid intelligence is the ability to solve problems without drawing on prior experiences or formal learning and is therefore best understood as representing one’s innate intellectual potential.
Crystallized intelligence is what we have learned in life, both from formal education and general life experiences.
101
Sternberg’s (1985) triarchic theory involves what three interrelated elements? what type of theory is this?
componential, experiential, and contextual.
The componential element deals with (a) the mental processes of planning, monitoring, and evaluating (referred to as executive functions); (b) performance, or the solving of a problem; and (c) knowledge acquisition, including encoding, combining, and comparing information.
The experiential element addresses the influence of task novelty or unfamiliarity on the process of problem-solving.
The third element, context, involves three different ways of interacting with the environment: adaptation, alteration of the environment, and selection of a different environment.
information processing model
102
What is Gardner's theory? why type is it? what does it argue?
A second information processing theory, Gardner’s (1983, 1999) theory of multiple intelligences also assigns less importance to g. According to Gardner, there are multiple forms of intelligence, including linguistic, musical, logical-mathematical, spatial, bodily-kinesthetic, intrapersonal, interpersonal, naturalist, spiritual, existential, and moral.
103
What is Gardner's theory? why type is it? what does it argue?
A second information processing theory, Gardner’s (1983, 1999) theory of multiple intelligences also assigns less importance to g. According to Gardner, there are multiple forms of intelligence, including linguistic, musical, logical-mathematical, spatial, bodily-kinesthetic, intrapersonal, interpersonal, naturalist, spiritual, existential, and moral.
Gardner argued that a culturally unbiased assessment requires recognition of the full range of different types of intelligence. His theory has been embraced by many educators and has led to the development of school curricula designed to maximize every student’s potential to learn (Hogan, 2014). According to Gardner’s model, instead of asking, “How intelligent are you?” a better question is “How are you intelligent?”
104
premorbid IQ
intellectual functioning prior to an accident or the onset of a neurological decline
psychologists have developed relatively effective strategies for making these estimates by consulting the client’s achievement records, testing with measures of ability that are relatively insensitive to decline, and paying close attention to the intelligence scale subtests that are least affected by neurological impairment
Progress has also been made in using demographic variables and scores for subtests of intelligence scales to predict premorbid IQ
105
Giftedness is defined in most jurisdictions as an intelligence test score in the top __% of the population (IQ ≥ ____)
2%
130
106
A diagnosis of intellectual disability requires that a person obtain an IQ score in the lowest __% of the population (IQ ≤ __) as well as...
2%
70
have impairments in functioning in areas such as self-care, social skills, home living, and work
107
the Wechsler Adult Intelligence Scale—Fourth Edition (WAIS-IV) is designed to assess individuals in the age range of ...
16 to 90 years
108
the Wechsler Intelligence Scale for Children—Fifth Edition (WISC-V) is designed to assess children and adolescents in the
6 to 16 age range
109
the Wechsler Preschool and Primary Scale of Intelligence—Fourth Edition (WPPSI-IV), designed to assess children in the age range from ...
2 years 6 months to 7 years 7 months
110
Wechsler translated raw IQ scores into ___________ scores based on a normal distribution with a mean of ____ and a standard deviation of ____, thus ensuring comparability in the meaning of IQ scores across ages
standard
100
15
111
Correlates of IQ
heritability - 40-80% but does not predict an individual's IQ
SES - children from lower SES backgrounds who are adopted by upper-middle-class parents will, in time, have an average increase of 12 IQ points
breastfeeding - increases IQ for both normal-weight infants and infants born prematurely
schooling - Good quality education, and in particular early schooling, affects intelligence. Children who are deprived of schooling for an extended period show substantial IQ deficits
no overall sex differences for intelligence. That being said, there is consistent evidence of slight advantages for females on measures of verbal abilities and for males on measures of visuospatial abilities
aerobic exercise can protect against declines in IQ
stereotype threat - can affect scores on a range of mental ability tests. For example, making women aware of the (inaccurate) stereotype that “girls aren’t good at math” has been found to suppress their scores on math tests by an average of one-fifth of a standard deviation
112
Full Scale IQ
the total score for an intelligence scale obtained by summing scores on verbal and non-verbal scales; usually referred to simply as the IQ
113
What are the four indexes (factors) of the WAIS-IV?
Verbal Comprehension (the ability to comprehend and use verbal material),
Perceptual Reasoning (the ability to use visually presented material),
Working Memory (the ability to do timed tasks that require the use of information in short-term memory), and
Processing Speed (the ability to quickly process and use new information)
114
the Wechsler scales reflect a ___________ model, with the FSIQ as a measure of _____ and the separate abilities represented by the ____________ scores
hierarchical
g
four index
115
representativeness - what is it? how good is it in relation to the Wechsler scales?
extent to which a sample reflects the characteristics of the population from which it is drawn (norms)
The most recent versions of the three scales have all used normative samples of at least 1,700 participants. For all scales, great care was taken to ensure that the demographic characteristics of the normative samples matched the most up-to-date American census data. Although this ensures the representativeness of the normative sample for testing in the United States, it does not guarantee that the norms are appropriate for testing in other countries
116
Starting with the work on the WISC-III, revisions to all Wechsler scales include a Canadian standardization component. Why?
This involves ensuring that test items are appropriate to the Canadian context (and altering the items when necessary) and then establishing Canadian norms using a large sample of participants whose demographic characteristics are representative of Canadian national census data.
117
What are some of the limitations of the Wechsler scales?
the tests are oriented to analytical forms of intelligence and do not measure abilities in the artistic, social, or emotional domains, among others. It also means that the focus of the Wechsler tests is on the examinee’s current ability or some of the products of intelligence, with little or no attention directed to the processes that underlie intelligence. A person’s performance on the Wechsler scales indicates a great deal about how well he or she can solve problems in a few important areas, but very little about exactly how he or she solves diverse problems
118
emotional intelligence (EI)
composed of related abilities that enable the person to perceive, understand, and regulate emotions.
119
A comprehensive review of the research using ability-based measures (Mayer, Roberts, & Barsade, 2008) summarized findings indicating that EI is associated with the following:
Better social relations for children (as reported by children, their family members, and their teachers)
Better social relations for adults (according to self-report)
Better family and intimate relations (reported by self and others)
More positive perceptions by others—high EI individuals are considered more pleasant to be around and more empathetic
Better academic achievement (reported by teachers)
Better social relations during work performance
Better psychological well-being (according to self-report)
120
The general interpretive strategy, recommended by almost every source on the Wechsler tests, is to move from ...
the general to the specific. Groth-Marnat & Wright (2016), for example, suggested that the FSIQ should always be interpreted first, followed by the factor/index scores (such as verbal comprehension and working memory). These steps allow the psychologist to understand the broad pattern of the examinee’s IQ and his or her general strengths and weaknesses.
121
The general pattern of intercorrelations among WAIS-IV subtest scores is very similar for the American and Canadian normative samples. However, the mean factor scores are higher in the ____________ samples than in the ___________ samples
what could a result be if the American norms?
Canadian
American
Canadian norms yield an accurate estimation of the cognitive impairment experienced by Canadian patients with substantial neuropsychological problems, whereas use of American norms leads to an underestimate of cognitive impairment
122
Because the WAIS can be administered across a large age range, from teenagers to older adults, it is important to note that raw scores on the test have ...
different standard score equivalents at different ages.
123
Does the WAIS-IV and previous versions have good or bad reliability values?
Previous versions of the WAIS were noted for their generally excellent reliability values. The WAIS-IV continues this trend, with the internal consistency coefficients derived from the normative sample for the FSIQ and the four index scores all equalling or exceeding .90
124
The Wechsler index scores correspond to the main constructs of the ...
Cattell-Horn-Carroll theory of intelligence
125
Flynn effect
the observed trend that IQ scores in developed countries have increased over the past few decades.
on average, there was an annual increase of .33 IQ score points in Western societies
an average undergraduate student today has an IQ that is approximately one standard deviation higher (i.e., 15 points) than that of the average undergraduate 40 years ago
Not all IQ measures or subtests are rising at the same rate. Flynn found that measures of visuospatial abilities—usually treated as measures of fluid intelligence —increased more than did measures of acquired knowledge (i.e., crystallized intelligence)
126
Why isn't the Stanford-Binet test used as much as Wechsler in Canada?
Although the Stanford-Binet has a long historical tradition, its value outside of the United States is limited due to the lack of content adaptations and norms necessary for the validity of the instrument when used in other countries
127
How do the Kaufman intelligence tests differ from the Wechsler intelligence scales?
Rather than focusing on content areas that measure intellectual functioning, they constructed process-based measures
In other words, the Kaufman Assessment Battery for Children, now in a second edition, and the Kaufman Adolescent and Adult Intelligence Test focus on how children and adults learn, and they assess styles of learning rather than knowledge or skill areas.
128
the Wechsler Memory Scale—Fourth Edition, a test that is typically used if...
there is a question of brain injury or brain dysfunction due to causes such as dementia, temporal lobe epilepsy, or Parkinson’s disease
129
the Wechsler Individual Achievement Test—Third Edition. An achievement test is used, along with a measure of intellectual functioning, in assessments focused on...
diagnosing learning disabilities and making recommendations for educational plans to address any observed learning problem.
130
the WMS-IV (Wechsler Memory Scale) is designed to assess the _________ form of _________ memory
episodic
declarative
131
the WMS-IV is the main measure used by clinical psychologists and neuropsychologists to assess...
memory impairment
132
What kind of information can psychologists obtain by comparing a person’s results on an intelligence test with those on an achievement test?
allowing easy identification of discrepancies between intellectual functioning and academic achievement. As a result, the WIAT-III, when used in conjunction with any of the three Wechsler intelligence scales, can be used in the diagnosis of learning disabilities and can provide invaluable information for use in planning remedial educational efforts
133
personality traits
the tendency to consistently behave in specific ways.
134
objective personality tests
tests that can be scored objectively, always using the same scoring system
135
behaviour checklists
lists of behaviours that are rated for frequency, intensity, or duration
or symptom checklists are designed to provide information about the nature of an individual’s experience (e.g., psychological distress, mood states, and feared situations) and the frequency or severity of the experience
136
projective personality tests
tests requiring drawings or a response to ambiguous stimuli, based on the assumption that responses reveal information about personality structure
137
What led to the development of situation-specific or disorder-specific checklists and rating scales?
the person-situation debate and Mischel's work
138
Having information on both situational characteristics and personality characteristics can enhance...
the prediction of human behaviour
139
validity scales
scales designed to detect whether a person is faking good, faking bad, or responding randomly
140
clinical utility
the extent to which a test and the resulting data improve upon typical clinical decision-making and treatment outcome
In other words, does using the measure eventually make a difference in terms of the services offered to a client and, eventually, the client’s functioning?
141
Lima and colleagues examined the value of clinicians having access to patient MMPI-2 data at the beginning of treatment. They found that...
these data available had no impact on the number of sessions patients attended, whether therapy ended prematurely, or overall patient improvement in functioning assessed at the end of treatment. So, does the test have any clinical effectiveness?
142
empirical criterion-keying approach
a method of test construction that involves the generation and analysis of a pool of items; those items that discriminate between two clearly defined groups are retained in the scale.
143
content approach
a method of test construction that involves developing items specifically designed to tap the construct being assessed
144
How is the MMPI-2 different from the MMPI?
extensive data analysis led to the elimination of some old and some new items, which resulted in the 567-item MMPI-2. The first 370 items on the test contain all of the original validity and clinical scales, with the remaining items providing information for a range of additional scales designed to supplement the information available from the original MMPI scales. Many of these new scales were formed by means of a content approach to test construction
145
What were the problems with test use of the MMPI for adolescents? What did this lead to?
Over the years, problems specific to test use with adolescents became apparent: for example, the MMPI was too long for many youth to complete, the reading level was too high, and the norms were not suitable for use in interpreting the scores obtained by adolescents
This led to the development of the MMPI-Adolescent (MMPI-A) - This test includes a normative sample of adolescents, fewer items (478) than the MMPI-2, as well as reworded and additional items of particular relevance to youth.
146
What is one problem with the MMPI-2's normative sample?
The only limitation is a slight under-representation of adults with lower education and lower income. Consequently, for these individuals, the cut-off scores for determining the presence of clinical problems may be too low. This means that the test is likely to yield a high number of false positives (i.e., inaccurately identifying substantial clinical problems) in the evaluation of patients of lower socioeconomic levels
Clinicians therefore need to be aware of the possible tendency to overpathologize (i.e., exaggerate and overestimate the extent of psychopathology) such patients
147
MMPI-2: Several options are available to clinical psychologists for interpreting the test data, including interpretation by...
a test-scoring service, the use of MMPI interpretation software, and reference to one of several professional books on the topic (e.g., Graham, 2011; Nichols, 2001). In most instances, psychologists use a combination of these sources of interpretive information.
a computer-generated test report should never be used without careful review and analysis by a clinical psychologist who is knowledgeable about the test’s strengths and limitations and about the current status of MMPI research
148
code types
summary codes for the highest two clinical scale elevations on the MMPI scales.
Interpretive guidelines provide details on the possible meaning of code types, other high clinical scale scores, high content scale scores, and high restructured clinical scale scores. Regardless of the source of the interpretative information, it is imperative that factors related to age, ethnicity, and life context be taken into account when drawing conclusions from test data.
149
The MCMI-IV is a 195-item true-false self-report measure designed to assess...
personality styles and disorders (e.g., avoidant personality pattern, passive-aggressive personality pattern, borderline personality pathology) and major clinical syndromes (e.g., mood disorders, anxiety disorders, and substance dependency). It is intended for use with clients seeking mental health services and is not appropriate for use with adults with no psychological problems.
150
Some measures, such as the ________, are intended to provide information to help determine the presence and nature of the distress or disorder, whereas others, such as the ________, are only appropriate for use with individuals who have already been determined to have clinically relevant problems.
MMPI-2 and the MMPI-A
MCMI-IV
151
A host of inventories focused on normal personality assessment are available for use in clinical practice and research. These types of measures may be especially appropriate in assessing clients in what type of context?
in vocational or counselling contexts, in which the goal of the assessment is to obtain data to help improve or optimize the client’s adjustment rather than to treat a mental disorder
For example, in dealing with a common event such as the ending of an intimate relationship, a person may seek psychological services as an aid to understanding what went wrong in the relationship and what could be done to enhance relationship functioning in the future. It may be advantageous in such a case for the psychologist to provide the client with research-based feedback on his or her personality as part of a discussion about personal preferences and styles that the client may wish to consider altering through treatment or through his or her own efforts.
152
What type of measure is the NEO Personality Inventory–3 (NEO PI-3)?
The NEO PI-3 is based on the five-factor model of personality that is generally seen as the most scientifically supported personality theory
It is a 240-item test that measures the personality factors of neuroticism, extraversion, openness, agreeableness, and conscientiousness. The current version eliminated outdated and difficult items found in the previous edition, and completion of this instrument requires Grade 5 reading skills.
153
What does the SCL-90-R measure?
a widely used general measure of distress. It is a 90-item measure with nine subscales that cover a range of symptom dimensions, including interpersonal sensitivity, phobic anxiety, and hostility.
Respondents are asked to indicate the extent to which they have been distressed by various symptoms over the past two weeks
154
What are some problems with the SCL-90-R?
there is considerable evidence that most subscales do not adequately measure the constructs they are designed to assess. Moreover, a commonly voiced concern among clinicians is that the scale tends to overpathologize. Finally, there is substantial intercorrelation among the subscales and little evidence for the divergent validity of the subscales. As a result, the SCL-90-R is probably best conceptualized as a brief measure of general psychological distress.
155
What is the Outcome Questionnaire 45 used for?
The OQ-45 is composed of three subscales: symptom distress, interpersonal relations, and social role functioning. These subscales provide a good overview of a client’s psychosocial functioning that takes only five minutes or so to complete.
it is probably most appropriate that the total score be used as an indicator of client distress
There is also evidence that the OQ-45 is a useful tool for assessing change over the course of psychological services
156
What is the BDI-II used for? Strengths and weaknesses?
a 21-item checklist with a multiple-choice format (i.e., several response options are available to describe each symptom). It is designed to evaluate the severity of depressive symptoms experienced in the past two weeks.
does not provide sufficient detail to determine whether a person meets diagnostic depression for a mood disorder
Although the precise factor structure and validity of the BDI-II vary somewhat across these groups, there is compelling evidence that the measure is a psychometrically strong tool for assessing depressive symptoms in adolescents and adults
It appears, though, that scores can drop appreciably simply due to repeated administration of the test (e.g., Longwell & Truax, 2005). Such findings are concerning, as they indicate that the BDI-II may yield imprecise results when used for treatment-monitoring purposes.
157
What was the original belief behind projective testing? How accurate was it?
The original concept of projection was developed by Freud and was seen as a type of defence mechanism in which people unconsciously attribute to others undesirable or negative parts of themselves. There is little evidence to support the existence of projection and little doubt that the process involved in responding to projective tests doesn’t rely on projection per se—rather, the process involves responses being influenced by a person’s experiences and personality
158
most projective tests used in clinical settings do not have _________________, _________, or _____________________, and only the __________ has normative data
standardized administration
scoring
interpretation guidelines
Rorschach
159
Unlike most projective tests, the Rorschach Inkblot Test has some ___________ that can be used in its administration
scoring systems
The Comprehensive System (CS) devised by John Exner is now considered the principal scoring system for the Rorschach, although a new system, the Rorschach Performance Assessment System (R-PAS), was recently introduced
Unfortunately, research indicates that (a) administration errors are easy to make even if the examiner is careful, has received training in the CS, and is well supervised, and (b) these errors are likely to have a substantial impact on the examinee’s Rorschach responses and test scores
160
What is the main problem with the Rorschach norms?
A major problem for the CS norms is the likelihood that non-patient norms overpathologize normal individuals—a phenomenon found for both child and adult samples
Because of the concerns about the quality of the CS norms, considerable efforts have been devoted to developing norms that meet the standards expected of psychological tests. To that end, a series of norms (called the International Reference Samples) has been published for the CS that draws on data from over 5,800 people from 16 countries. These norms are now recommended for scoring and interpreting adults’ responses to the Rorschach when the CS is used, even though none of the normative samples were representative of the countries in which the data were collected. In trying to develop norms for data from youth, substantial and erratic differences were found in CS scores both within and across samples from the various countries. As a result, the primary researchers behind this international norming effort recommended against using available norms for Rorschach responses from children and adolescents
161
What should Rorschach be used for? What should it not?
Even the harshest critics of the Rorschach agree that the test can provide valid information about cognitive impairment and thought disorder, although evidence of validity does not suggest that the Rorschach is necessarily the best method to assess these constructs
The Rorschach is likely to have value in research examining personality structure and correlates.
There is consensus, however, that the Rorschach should not be used to provide diagnostic information.
162
What are the challenges involved for psychologists in synthesizing all of the information collected as part of a psychological assessment?
Depending on the nature of the assessment, a simple account might involve a consideration of the client’s personality structure, level of emotional distress, coping resources, and/or intellectual capacity. In many instances, this description includes diagnosis using a classification system such as the DSM-5.
As comorbidity is common in clinical diagnoses, with many clients receiving more than one diagnosis, the psychologist must indicate how these diagnoses are related to each other and to the person’s overall psychosocial functioning.
Unlike pieces of a jigsaw puzzle, data obtained in psychological assessments infrequently fit together smoothly and neatly—rarely does one piece of information perfectly conform to a related piece of information.
De Los Reyes et al. (2015) found that situational context (i.e., home vs. school) and symptom type (i.e., internalizing vs. externalizing) affected the degree of agreement across raters. Consistent with the tenets of evidence-based assessment, they suggested that a clinician must be aware of the research on the way that these factors may affect the assessment of a child or adolescent client.
163
What is common practice for combining info from multiple scales within a self-report personality test?
begin by examining the client’s test responses at the most global level. This would mean, for example, that on the MMPI-2 (Minnesota Multiphasic Personality Inventory-2), the psychologist would first consider scores on the various validity scales and then move to examine the MMPI-2 code type (i.e., the highest two scores on the clinical scales). The validity score data allow the psychologist to evaluate the extent to which the other scale scores are likely to accurately reflect the client’s personality and psychosocial functioning. In this way, the code type information serves as the foundation for generating hypotheses about the client, with other MMPI-2 scales and other sources of assessment data added to this foundation
164
Interpersonally oriented psychodynamic case formulations are likely to focus on ______________________ (called __________________) as the premise for the formulations, whereas process-experiential formulations are likely to use information about the client’s ___________________ and insight into ________________ in developing the main premise
dysfunctional relationship styles
cyclical maladaptive patterns
emotional processing
emotional issues
165
Heuristics
mental shortcuts that people often use to ease the burden of decision-making, but which also tend to result in errors in decision-making. Thus, heuristics are at the heart of cognitive biases
