PSY240 2. Assessment Flashcards
(222 cards)
1
Q
Purpose of Assessment
A
used to diagnose
establish a baseline
understand nature of problems
2
Q
Purpose of Assessment
A
=identify strengths (things to draw on)
e.g. good verbal communication - psychodynamic therapy
weaknesses
aid in treatment planning - apply treatment effectively with proper diagnoses
3
Q
Gathering Information: Symptoms and History
A
• Current symptoms
how much they interfere with functioning
how do they cope?
how much distress?
4
Q
Gathering Information: Symptoms and History
A
• Recent events negative events recently are these events tied to the symptoms somehow e.g. PTSD Gives insight to level of functioning
5
Q
Gathering Information: Symptoms and History
A
-e.g. adjustment disorder impairment due to recent event avoiding overpathologizing normal events • History of psychological disorders have they experienced similar symptoms in the past? need to see symptoms over course of life
6
Q
Gathering Information: Symptoms and History
A
-e.g. psychotic disorders
schizo gets diagnosed if 6 months or later
bipolar disorders - hypomanic or depressive episodes then they can’t get diagnosed with a unipolar disorder such as depressive disorders
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Q
Gathering Information: Symptoms and History
A
-• Family history of psychological disorders
insight on childhood, genetic vulnerabilities
e.g. perceptual abnormalities with family history of schizo - categorize them as high risk
8
Q
Physiological and Neurophysiological Factors
A
• Physical Condition
do they have medical disorders?
e.g. underactive thyroid - similar symptoms as depressive
if they can be treated with medication, then it’s not MDD
• Drug and Alcohol Use
might cause or exacerbate symptoms
e.g. substance induced depressive disorder
might be on medication that is not to be mixed with what they’re going to be prescribed
are there cognitive deficits that might cause symptoms
e.g. youth - anxiety of school: may be better treated with learning disability
when considering 2/+ disorders
try to tease out potential symptoms and more specific symptom presentation
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Physiological and Neurophysiological Factors
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Q
Physiological and Neurophysiological Factors
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• Intellectual and Cognitive Functioning • Important for differential diagnosis
11
Q
Gathering Information: Sociocultural Factors
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• Social Resources
12
Q
Gathering Information: Sociocultural Factors
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-• Sociocultural Background
• Acculturation
13
Q
Gathering Information: Sociocultural Factors
A
do they have friends and family? how much contact? what’s the relationship like?
social support can be a protective factor and buffer to alleviate stress
practice multicultural competence
don’t diagnose as abnormal if normal in cultural background
to what extent do they identify with heritage or host culture?
e.g. ambivalence over conflict with traditional parent and culture of peers-
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Gathering Information: Sociocultural Factors
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Gathering Information: Sociocultural Factors
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16
Q
Approaches to Classification
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Categorical Approach
– ALL criteria must be met; Assumes unique etiology
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Q
Approaches to Classification
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Prototypical approach
– MOST criteria must be met (DSM) Dimensional approach
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Q
Approaches to Classification
A
-– Characteristics of disorders can vary in severity
– Psychopathology represents extremes on a continuum
19
Q
Approaches to Classification
A
- have to have 5 symptoms present
e. g. downsyndrome: trisomy 21
not assume that all are met
e.g. MDD: 5/9 symptoms
are you depressed?
most natural characteristics distributed among pop as normal curve
categorical understands it at the extremes - statistically unlikely
e.g. how depressed are you?
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Q
Approaches to Classification
A
-
21
Q
What Best Describes Patients?
A
-are they better described on a continuum or as categories?
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Q
What Best Describes Patients?
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23
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What Best Describes Patients?
A
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24
Q
Categories vs. Dimensions
A
Dimensions show superior psychometric properties – 15% increase in reliability
– 37% increase in validity
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Categories vs. Dimensions
based on analytic studies
| why doesn’t DSM use it?-
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Categories vs. Dimensions
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Scale Construction
Articulate construct and content.
| Choose response format. Assemble initial item pool.
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Scale Construction
Collect data
| Examine psychometric properties and quality
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Scale Construction
Final scale
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Scale Construction
-be specific: definitions may be different
is it gonna be yes/no or a rating scale from 1-5
generating potential questions
if it doesn’t work out then go back to step 1
once satisfactory we use final scale in research
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Scale Construction
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Important Assessment Characteristics: Validity and Reliability
-reliable, but not valid - same results, but not measuring the construct
reliable and valid
unreliable and hence not valid
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Important Assessment Characteristics: Validity and Reliability
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Important Assessment Characteristics: Validity
Type l Description
| Face l Test measures what it is supposed to measure
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Important Assessment Characteristics: Validity
Construct l Test measures what it is supposed to measure and not something else
Content l Test assesses all important aspects of phenomenon
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Important Assessment Characteristics: Validity
Concurrent l Test yields the same results as similar measures
Predictive l Test predicts what it is supposed to measure
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Important Assessment Characteristics: Validity
=meaningfulness and usefulness of the scale
construct: e.g. highly correlated with depression, not somatic complaints
GRE: expected to be correlated with IQ, not with gender
e.g. physical symptoms and distress levels
both criterion
external measure we’re comparing it to
take existing valid test and testing correlation
comparing with something that’s in the future
e.g. comparing IQ with GRE in the future
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Important Assessment Characteristics: Validity
=
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Important Assessment Characteristics: Reliability
Type l Description
| Test-Retest l Test produces similar results when given at two points in time
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Important Assessment Characteristics: Reliability
Alternate Form l Two versions of the same test produce similar results
Internal l Different parts of the same test produce similar results
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Important Assessment Characteristics: Reliability
consistency and repeatability
temporal stability
e.g. IQ - beginning and end of class, thought to be stable
diff versions should achieve same results
components of same test: e.g. first half same results as second half
diff interviewers - do they have same diagnostic conclusion?
critical consensus to get most helpful treatment
reliability is necessary, but not sufficient for validity-
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Important Assessment Characteristics: Reliability
Interrater or Interjudge l Two or more raters or judges who administer a test to an individual and score it come to similar conclusions.
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Important Assessment Characteristics: Reliability
=
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Inter-rater Reliability
Subject Rater Outcome
| Client => Dr. X =>
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Inter-rater Reliability
```
-Bipolar
Disorder
Bipolar
Disorder/Schizo
good internal reliability
```
not reliable assuming similar skills and training
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Inter-rater Reliability
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Inter-rater Reliability
Client => Dr. Y
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Inter-rater Reliability
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Assessment Tools: Clinician-Rated Tools
The Clinical Interview
• Intake interview: gather info on person’s life
– Usually focuses on presenting problem
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Assessment Tools: Clinician-Rated Tools
– Structured, semi-structured, or unstructured
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Assessment Tools: Clinician-Rated Tools
• Limitations of Interviews
| – Resistance from the client
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Assessment Tools: Clinician-Rated Tools
– Selective information provided by the client
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Assessment Tools: Clinician-Rated Tools
-what symptoms brought you here?
structured: specific questions - pulled for responses that are more concrete
e.g. have you been feeling down
unstructured: open ended
e.g. how are you feeling
semi-structured: in between
interviews tough especially first time
e.g. looking to obtain services from insurance
embellish symptoms
e.g. present selves in best possible light
parents for custody
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Mental Status Exam
Components
1. Appearance and behavior
2. Thought Processes
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Mental Status Exam
3. Mood and affect
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Mental Status Exam
4. Intellectual functioning
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Mental Status Exam
5. Sensorium
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Mental Status Exam
```
-1. e.g. groomed
overt, observable behaviour
what they’re wearing, posture, behaviour
2. rate, continuity, content of speech
does it make sense? is it cohesive?
3. predominant feeling state
4. extent of vocabulary
metaphor and abstract ability
5. awareness of surroundings
aware of person, place or time
```
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Assessment Tools: Behavioural Observations and Self-Monitoring
• Behavioural Observation
– Problems with inter-rater reliability
e.g. how they behave in class, interact with peers and teacher
operationalize construct - clear definition of what we’re looking for
improve inter-rater reliability
e.g. track how many cigarettes they’re smoking
prone to self-report biases
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Assessment Tools: Behavioural Observations and Self-Monitoring
– Must “operationalize” the behaviour
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Assessment Tools: Behavioural Observations and Self-Monitoring
• Self-Monitoring
| – Open to self-report bias
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Assessment Tools: Behavioural Observations and Self-Monitoring
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Assessment Tools: Behavioural Observations and Self-Monitoring
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Projective Tests
• Rorschach Inkblot Test
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Projective Tests
• Thematic Apperception Test (TAT)
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Projective Tests
• The Sentence Completion Test
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Projective Tests
• Draw-A-Person Test
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Projective Tests
-Rorschach Inkblot: what they see
detailed scoring method based on human movement, use of colour, location
Thematic Apperception Test: what is happening in this picture
tell dramatic stories
Sentence Completion: e.g. my mom is ____
Draw-a-person
ambiguous and open ended
Freudian: tap into unconscious
draw inferences from themes
concerns with reliability and validity - open to human interpretation error
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Assessment Tools: Projective Tests
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Assessment Tools: Projective Tests
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Assessment Tools: Projective Tests
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Assessment Tools: Projective Tests
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Objective Tests
• What makes them objective?
| – Results are independent of evaluator bias
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Objective Tests
– Standardization
• Examples
– Intelligence tests (WAIS-III, WISC-III)
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Objective Tests
– Achievement tests (WIAT-III; WRAT-4)
– Neuropsychological tests (D-KEFS; NEPSY)
– Questionnaires (MMPI-II, PAI; BDI-II; CBCL)
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Objective Tests
-IQ
school
memory, processing skills, inhibition
Personality and symptoms
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Objective Tests
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Objective Tests: Intelligence Tests
* Used to determine strengths and weaknesses
| * Help place and determine resources for children
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Objective Tests: Intelligence Tests
-• Results
| – Test-by-test (e.g., e.g., Vocabulary, Digit Span)
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Objective Tests: Intelligence Tests
-– Composite Scores (e.g., Verbal Comprehension, Working
Memory, Processing Speed, Perceptual Reasoning)
– Full Scale IQ (overall intellectual functioning)
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Objective Tests: Intelligence Tests
-gifted vs. learning disability
placement
8-12 tests - tap into different abilities
e.g. blocks, identify images
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Objective Tests: Intelligence Tests
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Intelligence Tests
| Example Subtest: Matrix Reasoning
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Intelligence Tests
| Example Subtest: Matrix Reasoning
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Intelligence Tests
| Example Subtest: Matrix Reasoning
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Intelligence Tests
| Example Subtest: Matrix Reasoning
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Objective Tests: Intelligence Tests
Criticisms
| • Little agreement on definition of intelligence
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Objective Tests: Intelligence Tests
```
-• Most tests only assess verbal and analytical abilities
• Biased toward middle and upper-class educated
```
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Objective Tests: Intelligence Tests
-don’t test emotional skills
| standardization based on well-to-do pops
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Objective Tests: Intelligence Tests
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Objective Tests: Achievement Tests
• Learned skills and knowledge
• Assesses
– Strengths
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Objective Tests: Achievement Tests
– Weaknesses
| – Progress
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Objective Tests: Achievement Tests
-measure learner progress
guides teachers for what is helpful when showing difficulties
e.g. WIAT or RAT
need to say standardized achievement test necessary to assess strengths, not specifically
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Objective Tests: Achievement Tests
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Objective Tests: Neuropsychological Tests
• Used when neurological dysfunction is suspected
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Objective Tests: Neuropsychological Tests
• Allow inferences about brain-behaviour relationships
• May also be used with normally functioning brains
car crash or alzheimers
not observable damages in head
get at functioning without brain-imaging
full range of neuro-psychological functioning
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Objective Tests: Neuropsychological Tests
-ask them to recreate image
indicate visual-motor maturity
showing 9 figures on 3x5 card
Tower task: how quickly, point out mistakes, do they plan out actions?
make pegs on board look like image with rules
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Objective Tests: Neuropsychological Tests
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Bender-Gestalt Test a sample neuropsychological test
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Bender-Gestalt Test a sample neuropsychological test
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Bender-Gestalt Test a sample neuropsychological test
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Bender-Gestalt Test a sample neuropsychological test
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Objective Tests: Questionnaires
• Symptom Checklists
– May cover a wide variety of symptoms
– e.g., Revised Beck Depression Inventory (BDI-II)
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Objective Tests: Questionnaires
-• Personality Inventories
– Assess people’s typical ways of thinking, feeling, and acting
– e.g., Minnesota Multiphasic Personality Inventory (MMPI-2)
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Objective Tests: Questionnaires
how severe symptom is?
e.g. are you tired sometimes? all the time?
widely used in clinical practice
how they usually think, feel and act
personality style and symptoms
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Objective Tests: Questionnaires
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MMPI-2 Restructured Form
• 338 True/False Statements
can get computer printouts using standardized scores
indicates range warranting clinical attention
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MMPI-2 Restructured Form
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Standardization
Mean = Average
• Standard Deviation (SD) = variability from the mean
– Used to calculate standardized scores
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Standardization
• Types of Standardized Scores:
– Z-score: SD units
– T-score: M = 50, SD = 10
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Standardization
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Standardization
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Standardization
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Standardization
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Standardization
Steps to standardization
1. Collect data from large representative sample
• AKA “standardization sample”
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Standardization
-2. Standardize standardization sample scores
• Raw score mean ÆT-score mean = 50
• Raw score SD ÆT-score SD = 10
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Standardization
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Standardization
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Standardization Sample: U.S. Sample of 21-year olds (N = 6,076)
```
• Standardization mean: μ = 3.25
• Standardization SD: SD = .90
Compute your z-score (e.g., raw score = 2.50)
Z = X – μ / SD
Z = (X – 3.25) / .90
Z = (____ – 3.25) / .90
Z = _____ / .90
Z =
```
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Standardization Sample: U.S. Sample of 21-year olds (N = 6,076)
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Standardization Sample: U.S. Sample of 21-year olds (N = 6,076)
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Standardization Sample: U.S. Sample of 21-year olds (N = 6,076)
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Distribution
0
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Distribution
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Distribution
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Distribution
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Note re: Intelligence Tests
IQ:
Mean = 100
SD = 15
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Note re: Intelligence Tests
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Note re: Intelligence Tests
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Note re: Intelligence Tests
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Assessment Tools: Brain-Imaging Techniques
• Images of brain structure
– CT (or CAT) scan
– MRI
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Assessment Tools: Brain-Imaging Techniques
-• Images of brain functioning
– PET scan
– SPECT
– fMRI
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Assessment Tools: Brain-Imaging Techniques
cite and extent of brain damage
identify specific deficits and abnormalities
X-Ray beams passed through brain - just an image
magnets to generate 3D image
activation patterns
inject radioactive isotope and measure movements of photons in brain
gamma rays to generate 3D image
brain activity by looking at changes in blood flow
regions of brain in ppl with + without depression
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Assessment Tools: Brain-Imaging Techniques
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Assessment Tools: Brain-Imaging Techniques
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Limitations
absent of human interpretation
norms unavailable - can’t standardize
expensive
patients exposed to radioactivity
localizations of brain functions not fully known
```
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Assessment Tools: Brain-Imaging Techniques
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Assessment Tools: Psychophysiological Techniques
• Electroencephalogram (EEG)
| – Event-related potential (ERP)
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Assessment Tools: Psychophysiological Techniques
• Electrodermal response
peripheral measures of electrical activity
sensory or cognitive, motor event - brain activity following provocation
neurons communicating chemically and electrically
galvanic skin response
sweat in response to stimulants
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Assessment Tools: Psychophysiological Techniques
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Problems in Assessment
rely on various assessments because no one test is perfect
• Cultural Bias
– Language barriers
– Different cultures may experience disorders differently
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Problems in Assessment
• Evaluating Children
– Difficulties in communication and reporting
– Parent-child discrepancies are common
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Problems in Assessment
parents don’t have good insight on what adolescents experience on a day to day basis
standardized measures for parents and youth
no perfect overlap in responses
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Problems in Assessment
0
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Parent vs. Youth-Report CBCL & YSR
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Parent vs. Youth-Report CBCL & YSR
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Parent vs. Youth-Report CBCL & YSR
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Research in Abnormal Psychology is HARD!
1. It is difficult to convince people to participate
2. Abnormality is difficult to measure
3. Most forms of abnormality have multiple causes
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Research in Abnormal Psychology is HARD!
-2. we need a good concept to define abnormality
biases - e.g. overendorsing symptoms
3. we have to do a lot of research to find all causes
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Research in Abnormal Psychology is HARD!
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The Scientific Method
1. Defining a problem
| 2. Specifying a testable hypothesis (educated guess)
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The Scientific Method
-3. Choosing and implementing a research method
4. Analyzing data, drawing appropriate conclusions, and
communicating the findings
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The Scientific Method
- 1. justify research
2. needs to be amenable to research
3. insight on research design we want to use
4. basing conclusions on data + communicate it to other researchers
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The Scientific Method
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The Hypothesis
Tested in two ways:
| 1. As predicted (as in, there is a relationship or effect)
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The Hypothesis
-2. As if your prediction is incorrect (no relationship)
• null hypothesis
are there significant correlations?
comparing to null hypothesis - wanna disprove this
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Operationalization
• Dependent Variable (DV):
– variable being predicted/measured (outcome)
• Independent Variable (IV):
– variable being manipulated (predictor)
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Operationalization
-e.g. DV: Depression Scores
| IV: depression status
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Operationalization
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Validity
1. Internal: Is the IV really causing the DV?
| 2. External: Do study results relate to real world?
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Validity
-how confident we are that it is not due to confounds
random assignment
generalizability of results
how can they be generalized for the real world
don’t get randomly assigned in real world
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Sources of Information
• Case studies
• Self-report data
• Observational approaches
study design may depend on who is providing info
having trained judges observe kids
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Sources of Information
-more detail when focusing on 1 person
| helps set stage for more empirically valid research
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Sources of Information
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Case Studies
Advantages
1. Provide rich and unique detail
2. May be only way to study rare problems
3. Good for generating ideas and hypotheses
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Case Studies
-more detail when focusing on 1 person
| helps set stage for more empirically valid research
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Case Studies
Disadvantages
1. Low generalizability
2. Biased / lack objectivity
3. Hard to replicate
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Case Studies
maybe the person is an anomaly, can’t assume they hold for diverse pops
requiring 1 person to interpret results
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Case Studies
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Correlational Research
• Correlation: strength of association between two variables
• Correlation coefficient (r):
– Statistic reflecting strength of association
– Ranges from +1.00 (positive) to -1.00 (negative)
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Correlational Research
-positive - same direction
| negative - opposite/inverted directions
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Correlational Research
-• Statistical significance:
– Conventional threshold
– Results cannot be attributed to chance (p
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Correlational Research
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A Zero Correlation
-no discernable pattern
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A Zero Correlation
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A Moderate Correlation
-positive correlation
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A Moderate Correlation
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Correlational Studies Time Designs
• Cross-sectional: measurement at one time point
| – Cohort effects
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Correlational Studies Time Designs
• Longitudinal: measure same group over time
– Permits conclusions about change/development
– Expensive (time and labour)
– Research standards change over time
– Attrition
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Correlational Studies Time Designs
-prone to cohort effects
e.g. born after 9/11 may be affected
may be different than someone born in 80s
can’t be confident in causation
more confident in longitudinal
because of sequencing you might get causation
are we still measuring same thing if standards change
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Correlational Studies Time Designs
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Correlational Studies
• Advantage: reflect real world problems
– Results can be generalized to real life
– Depends on representativeness of sample
• Disadvantages: cause vs. consequence challenge
– Third variable problem
– Importance of timing and measurement
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Correlational Studies
depends on sample - larger, more generalizable
needs to measure consistently same things
take extra statistical precautions so that IV is causing DV
maybe there’s another variable that’s causing a spurious relationships
relationships dependent on when and how we’re measuring things
e.g. we have to measure stress before depression because depressed ppl create stress
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Correlational Studies
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Correlational Studies
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Epidemiological Studies
• Estimate distribution of diseases in a given population
– Prevalence rates: cases of a disorder at any one time
– Incidence rates: new cases during a specific time period
– Risk factors
• Same limitations as correlational studies
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Epidemiological Studies
-large representative samples
can run tests to check correlation within assessments
e.g. income and depression
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Epidemiological Studies
-treatment studies
| confident in causation
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Experimental Studies
• Involve:
– Control and manipulation of independent variable (IV)
– An experimental group or condition
– A control group or condition
• Allows for making cause and effect statements
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Experimental Studies
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Experimental Studies
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Experimental Studies
Advantages
• More control
• Random assignment
• Control groups
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Experimental Studies
- confident in internal validity
| ethical: offering treatment to some and not others
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Experimental Studies
Disadvantages
• May not generalize
• Ethical limitations
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Experimental Studies
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Therapy Outcome Studies
• Effectiveness Studies: Treatment as usual
| – Maximize external validity
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Therapy Outcome Studies
• Efficacy Studies: Controlled experimental research
– e.g., randomized controlled trial (RCT)
– Maximizes internal validity
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Therapy Outcome Studies
-confident that there is similar effects in real world patients
tradeoff between internal and external validity
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Therapy Outcome Studies
Advantages • Help those in distress
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Therapy Outcome Studies
```
-Disadvantages
• What causes improvement?
• Issues with control groups &
randomization
• Must balance patients’ needs
with standardization
• Generalizability is unclear
```
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Therapy Outcome Studies
maybe can’t afford psychotherapy - not covered by OHIP
| reliant on strict inclusion and exclusion criteria
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Therapy Outcome Studies
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More Experimental Studies
• Animal studies:
– When ethical concerns preclude use of humans subjects
• Single case designs:
– e.g., ABAB or reversal design
– The participant acts as his or her own control
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More Experimental Studies
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More Experimental Studies
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More Experimental Studies
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Single-subject Research (ABAB Experimental Design)
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Single-subject Research (ABAB Experimental Design)
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GENETIC RESEARCH Family Studies
Twin Studies
• Dizygotic twins (DZ): 50%
• Monozygotic twins (MZ): 100% -
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GENETIC RESEARCH Family Studies
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Family Studies
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Family Studies
Adoption Studies:
• Look at rates of disorders in adopted probands
• Sensitive at identifying environmental effects
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Family Studies
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Genetic Research
• Genome Wide Association Studies
– Examine many common genetic variants
– Is any variant is associated with a specific trait?
• Candidate Genes Research Studies
– Is a marker overrepresented among those with a disorder?
– Problems: $$$; multigenic nature of most traits
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Genetic Research
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Genetic Research
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Genetic Research
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Single Nucleotide Polymorphism (SNP)
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Single Nucleotide Polymorphism (SNP)
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Single Nucleotide Polymorphism (SNP)
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Genetic Research
• Epigenetics: Environmental impact on gene function
• Hormones influence gene expression
– Pubertal hormones
• Psychosocial factors influence biology
– Stress and social interactions Æ hormones
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Genetic Research
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Genetic Research
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