Assessments and Classification Flashcards
1
Q
reliability
A
- test = instrument = tool
- consistency of measurement
- degree to which test/procedure yields the same results repeatedly under the same circumstances
2
Q
types of reliability
A
- test-retest
- interrater
- internal consistency
3
Q
test-retest
A
test produces similar results when given at 2 different points in time
4
Q
inter-rater
A
2+ raters administer a test to an individual and come to similar conclusions
5
Q
internal consistency
A
various parts of measure yield similar/consistent results
6
Q
validity
A
- extent to which a tool measures what it is supposed to measure
- accuracy, match with the “truth”
7
Q
types of validity
A
- predictive
- construct
- content
8
Q
predictive validity
A
how well a test anticipates person’s B/response
9
Q
construct validity
A
how well a test relates to the characteristics or disorder in question
10
Q
content validity
A
- how well a test measures what it is intended to measure
- test assesses all important aspects of phenomenon
11
Q
standardization
A
administering tests/conducting interviews in the same way for everyone
12
Q
ways of standardizing
A
- procedures
- scoring
- interpretation
13
Q
standardization sample
A
- used as reference
- group of people who initially took the measure
- performance used as norm for comparison
- test takers should be similar to the standardization sample for tests to be valid
14
Q
psychological assessment
A
- gathering/integrating info about person in order to form a judgment/impression
- helps predict course of disorder/future functioning
- helps plan for treatment
- helps monitor treatment progress
15
Q
gathering/integrating info about person in order to form a judgment/impression includes ______
A
- abilities
- emotional function
- psychological problems
- traits
- skills
- can result in diagnosis
16
Q
evidence-based assessment
A
- selects assessment measures based on criteria of the measures and reading level required
- use of multiple methods of assessment
- assessment that is developmentally/culturally sensitive
- assess strengths and weakness of individual/context
- monitoring symptom change over time
17
Q
main assessment methods
A
- biological tests
- interviews
- mental status exam
- observations
- psychological tests and inventories
18
Q
main assessments methods: biological tests
A
- brain imaging
- neuropsychological measures
- psychophysiological measures
19
Q
interviews
A
- from trained clinicians
- observe client and collect data about the person’s life history, current situation and personality
20
Q
types of interviews
A
- structured
- semi-structured
- unstructured
clinician autonomy will vary with the style
21
Q
interviews: domains of interest
A
- current and historical symptoms
- developmental and family history
- medical history
- occupational history
- recent events or major life changes
- socio-cultural factors
- strengths
- treatment history
- treatment goals
22
Q
structured approaches
A
- clinicians often resist use of structured approaches
23
Q
causes of avoiding structured approaches
A
- clinical intuition is better (37%)
- take too long (34%)
- disturb relationship with patient (32%)
24
Q
observations
A
- naturalistic or coontrolled
- highly structured/specific or less formal
- functional analysis (ABC)
- self-monitoring
refer to notes on antecedents, behaviours and consequences
25
self-monitoring
individual assesses themselves with possible guide of clinician
26
mental status exam
- objective:
evaluate client's cognitive, psychological, behavioural functioning
- use structured questions, open-ended questions, observations, tasks
- subjective
27
mental status exam: general description
- appearance
- mood and affect
- speech
- thought process, content
- memory
- judgment and insight
28
cultural and mental status exams
- client's eye contact and posture may reflect cultural factors
- cultural background can influence assessment
29
psychological tests/inventories
- standardized tools
- projective tests
- self-reports inventories
- intelligence tests
scores compared with norms
30
psychological tests/inventories measure ___
characteristics
- personality
- social skills
- intellectual abilities
- vocational interests
31
projective tests
- present standard, ambiguous stimuli
- assumes that people faced with stimuli will project their own needs/personality/conflicts
- reliability and validity = mixed
32
types of projective tests
- Rorschach inkblot test
- thematic apperception test (TAT)
- sentence completion test
- draw a person test
33
issues with projective tests
analysis and interpretation are subject to wide variation
34
thematic apperception test
- what is happening now?
- what lead up to the event?
- what will the outcome be?
- what are they thinking and feeling?
35
self-report inventories
- questionnaires meant to assess people's typical ways of thinking, feeling and behaving
- self-report or observe-report
- group norms
36
self-report inventories: tests
- Minnesota Multiphasc Personality Inventory - 3
(MMPI-3)
- Behavioural Assessment System for Children (BASC)
37
self-report limitations
- fixed number of answer choices
- response bias or response style
- interpretations of the responses of people from different cultural groups may be inaccurate
- cultural factors may shape the way a trait is viewed
38
intelligence tests
- used to assess general intellectual functioning
- obtain IQ, or estimate of current level of cognitive functioning
- highly reliable
39
intelligence tests: used in assessments for ___
- learning disorders
- intellectual disability
- intellectual giftedness
- ADHD
40
common intelligence tests
- Wechsler Adult Intelligence Scale (WAIS-IV)
- Wechsler Intelligence Scale for Children (WISC-IV)
- Stanford-Binet Intelligence Test (SB5)
41
intelligence test limitations
- cultural bias
- does not capture all intelligence
- fail to consider effects of:
1. language proficiency
2. culture
3. poverty
4. discrimination
5. oppression
42
neuropsychological assessment
- indirect measures of brain and physical function
- test developed to assess behavioural disturbances caused by brain dysfunction
43
neuropsychological assessment: examples of tests
- Bender-gestalt Visual Motor Test
- Halstead-Reitan Neuropsychological Test Battery
44
Bender-gestalt Visual Motor Test
- copying geometric designs
- certain errors = characteristics of neurological impairment
- refer to slide 5, class 6
45
Halstead-Reitan Neuropsychological Test Battery
- differentiates patients with brain damage
- slide 6, class 6
46
brain imaging and neurological tests
- directly measuring brain structure or physical process in the brain
- includes structural imaging and functional imaging
47
structural imaging
- computerized axial tomography (CT)
- magnetic resonance imaging (MRI)
48
CT function
- cross-sectional images (slices) of the bones, blood vessels, and soft tissues inside body
- provide more detailed information than plain X-rays
- radiation exposure remains
49
MRI function
- clearer image than CT scan
50
functional imaging
- diffusion tensor imaging (DTI)
- electroencephalograph (EEG)
- functional MRI (fMRI)
- magnetoencephalography (MEG)
- positron emission tomography (PET)
- single photon emission computed tomography (SPECT)
51
DTI function
- detects the white matter fibers that connect different parts of the brain
- show microstructural changes in brain by measuring the motility of water molecules in tissue
52
EEG function
- main goal is to detect epilepsy
53
fMRI function
- shows brain activity
- measures the small changes in blood flow that occur with brain activity
- to examine which parts of the brain are handling critical functions
- can guide brain treatment
54
MEG function
- measures the magnetic fields generated by electric currents in the brain
- provides a very accurate resolution of the timing of neuronal activity
55
PET function
56
SPECT function
57
psychophysiological assessment
- measure autonomic nervous system activity
- assessments not sensitive enough for diagnosis
- electrocardiogram
- electrodermal responding
58
electrocardiogram
measures:
- heart rate
- muscle tension
- blood flow
- etc.
59
electrodermal responding
skin conductance
60
purpose of assessment
- diagnose
- recommend placement or treatment
- provide baseline data at the beginning of intervention
61
recall of assessments
- evidence-based assessment incorporate multiple methods of assessment
- hoose tools that are reliable and valid
- likely use a combination of assessment tools, but not all
- use a hypothesis testing approach, you may collect more data to clarify
conflicting information
62
purposes of diagnoses
1. communication – providers understand what the label means
2. prognosis – label communicates information about future progression
3. treatment planning – labels may help guide treatment choices
4. practical reasons
5. relief + help provide recognition and
understanding of symptoms
6. facilitate research – defines participant group
63
harms of diagnoses?
refer to Rosenhan's 1978 study on mental hospitals
64
approaches to classification
- categorical
- dimensional
65
categorical approach to classification
- category based on theory of etiology or identified disease processes
- each disorder fundamentally different, non-overlapping
- have it or don’t have it
66
dimensional approach to classification
- cognitions, moods, behaviours represented by dimensions
- disorders reside on continuum (normal to severe)
67
DSM classification system
Diagnostic and Statistical Manual – 5th edition
- categorical approach
- diagnostic criteria include the physical,
behavioral, and emotional characteristics
associated with each disorder
68
evolution of DSM
- early editions strong psychodynamic orientations
- current edition more behaviorally based
69
additions since the DSM-4
- Added dimensional ratings within some disorders
- Added subtypes, specifiers, cross-cutting measures
- New conceptualization of some disorders
- New disorders (e.g., binge eating disorders)
70
Controversies and limitations of DSM: ASD
eliminates previous Asperger's syndrome
71
Controversies and limitations of DSM: disruptive mood dysregulation disorder
criticized as temper tantrum disorder
72
Controversies and limitations of DSM: additions of gambling disorder
opens possibility of other behaviour additions
73
Controversies and limitations of DSM: bereavement
- can no longer exclude depression
- maybe over-diagnosing normal grieving
74
Controversies and limitations of DSM: premenstrual dysphoric disorder
has been subject of heated discussion
75
Controversies and limitations of DSM: general
1. gives less attention to disorders of infancy and childhood
2. fails to capture interrelationships and overlap known to exist among many disorders
3. high rates of comorbidity
4. culturally sensitive or applicable?
5. disorders have variable reliability and validity
76
comorbidity
PTSD and substance use disorder (SUD)
- is it both PTSD and substance abuse?
- is it a new/different identity, not currently represented in the classification system?
- if our current diagnostic system is valid, then why is comorbidity the norm?
77
DSM vs ICD
- ICD covers all health conditions
- current editions are well aligned
- which classification you use depend on your profession, employment, setting, country of practice, etc.
78
misdiagnoses/missed diagnoses
- vary based on setting, who is completing assessment, diagnosis
- dependent on information you are receiving
- symptoms may change over time
- comorbidities
