Week 6: Projective + Objective Flashcards
1
Q
Identify 5 purposes of Clinical Interview.
A
1• Gather clinical data on problem experienced
2• Process information
3• First clinical exposure
4• Initiate and develop therapeutic alliance
5• Context for understanding difficulties and treatment
2
Q
What is the most used test in internship sites?
A
Clinical interviews
3
Q
What kind of data is gathered in a clinical interview?
A
- Demographic
- Presenting Problem
- History of Problem
- Medical History
- Current and Past Living Situation
- Family History
- Childhood, Adolescence, Early Adult
- Previous Treatment
4
Q
What are the 2 key interview skills?
A
- Developing Rapport
2. Active listening - which consists of primary and secondary listening skills.
5
Q
What do Primary listening skills consist of?
A
Primary Listening Skills: • Open ended questions • Paraphrasing • Reflection of affect • Clarifications • Summarizing • Minimal Encourages
6
Q
What do Secondary listening skills consist of?
A
Secondary Listening Skills
• Normalizing
• Structuring
• Probing
7
Q
Is Carl Rogers’ interview with Gloria an unstructured interview?
A
Yes, because he is not trying to get a diagnosis/formulation - just trying to understand the patient and communicate to the patient that he understands.
8
Q
Some notes on Rogers’ interview:
A
- Relates Gloria’s relationship with her daughter to the shame she feels in herself.
- Repeats her feelings to her, to make her feel understood.
- Childhood is brought up - by the patient herself!
- Perfectionism is brought up; he redirects her thoughts respectfully - she doesn’t want to be perfect, but she wants to seem perfect.
- She wants to approve of herself, but what she does doesn’t let her approve herself. It’s mainly to do with her sex life, and her guilt with casual sex.
9
Q
Pros of Semi-structured interviews?
A
- Rapport/relationship + positive experience with clinical psychology
- Flexibility
- Modifiable - can shift and change/no script
- Not limited to certain tools or norms - not really measuring anything to compare, or using tools (other than during a Mental Status Exam - if it’s very severe (suicidal or homicidal)
- Useful and used commonly in a clinical setting (more than an unstructured interview)
10
Q
Cons of Semi-structured interviews?
A
- Reliability/Validity - statistically, it differs from clinician to clinician so it’s hard to gain inter-rater reliability.
- The unstructured/structured interviews themselves, bc they are not the same questions, lack reliability.
- May be susceptible to clinical biases (pre-judgment, looking for confirming evidence)
- Sucks for research purposes - lack of validity and reliability!
11
Q
Is Wald’s interview a semi-structured interview?
A
Yes, got a good handle on the disorder (symptom based), and then decide treatment based on that.
12
Q
What are the aims of a semi-structured interview?
A
- Trying to get specific content/info to develop diagnosis and formulation info AND trying to make the patient feel understood.
- Wants to keep it open dialogue and keep the patient talking; prioritizes flexibility of the interaction between patient and clinician.
13
Q
Pros of Structured interviews?
A
- Reliability
- Good research tool
- Modules for specific disorders (different set of questions)
14
Q
Cons of structured interviews?
A
- Questions limited by diagnostic criteria
- Time consuming
- No other pertinent information gathered - context!!!
- Not as good at establishing rapport - in fact kinda messes it up
- Process information (do they look anxious? Commenting on it to understand it would be a psychodynamic approach) not focused on, just content
15
Q
Is the SCID (Structured clinical interview for DSM Diagnosis) Interview structured?
A
Yes, not done in the clinical world - done more in research. Really cold.
16
Q
What is Reverse scoring?
A
The numerical scoring scale runs in the opposite direction.
17
Q
What’s the use of The Big 5 Objectives (HILDA)?
A
Would likely use it with lots of other measures to get the big picture, figure out discrepancies/scoring differently in the same aspect (ex extraversion), or acting differently in interviews, etc. to synthesize it to understand the person.
Also empirically used to compare scores to the norm to predict abnormal behavior in research, etc.
18
Q
What are Objective tests?
A
- Self-report tests: describe thoughts, emotions, attitudes, behaviors… (unobservable behaviors usually)
- Items of these unobservable behaviors are usually the following:
1. Multiple choice alternatives
2. True or false alternatives
3. Ratings of agreement
19
Q
Identify 4 qualities such as the items, measures and use of Objective tests.
A
- Items/Questions presented are the same to all test takers
- Options are also the same
- Measures: characteristics that the responder is aware of (surface level)
- Widely used
20
Q
Pros of Objective tests?
A
- Economical
- Easy administration and scoring
- Objective in stimuli
- Can be quite reliable
21
Q
Cons of Objective tests?
A
- Only surface/behavioral characteristics measured (does not measure things person is unaware of)
- Single summary score - does it really capture the whole domain of the person and extraversion? Probably not
- Transparency in meaning - the person can look at the item and determine what it is measuring, can affect answers (“Do you go out a lot?” → oh it measures extraversion.)
22
Q
What are Projective tests?
A
Rather than objective stimuli use ambiguous stimuli that requires subject to impose their interpretation and respond. By doing so, revealing something of themselves.
Includes a Projective Hypothesis with the following measures:
• Psychological states
• Personality styles or traits
• Underlying psychological makeup (defenses, coping, behavioral styles and so forth)
23
Q
Pros of Projective tests?
A
- Assess behavior at deeper level (defenses, conflicts, interpersonal styles, motivation, etc.)
- Widely used
24
Q
Cons of Projective tests?
A
- No real psychometric measuring!
25
What's an example of a Projective test?
Example: Rorschach (ink blot test thing)
| It doesn’t matter WHAT you see but HOW you see it/don’t see it
26
True or False: the well-trained clinical psychologist uses a Multi-method Approach in assessment to balance out the relative strengths and weaknesses of any one single instrument and no one instrument is used solely.
True.
27
What is content information, and why is it used in clinical interviews?
To derives hypotheses and conclusions, content information is what information the patient provides or what they say.
28
What is process information, and why is it used in clinical interviews?
To derives hypotheses and conclusions, with the manner in which the patient behaves and provides information.
29
What is psychic determinism?
The idea that everything (i.e., every overt and covert behavior) has some goal, meaning, purpose, and cause.
30
What are the 14 components of a Mental Status Exam (MSE)?
1. Appearance of patient
2. Behavior of Patient
3. Orientation: Patient’s orientation to time (i.e., knows year, month, date), orientation to place (i.e., knows where he is), and orientation to person (i.e.,knows who he is).
4. Memory of patient
5. Sensorium: Problems with any of the five senses.
6. Psychomotor activity: Patient’s behavior, such as exhibiting slowness of behavior (psychomotor retardation) or agitation/accelerated behavior (psychomotor agitation).
7. States of consciousness: Patient’s level of awareness ranging from confusion and bewilderment to alertness and awareness.
8. Affect: Patient’s emotional expression as well as the level and appropriateness of affect (e.g., laughing while disclosing sad events).
9. Mood: Patient’s general mood in the interview
10. Personality: General terms used to describe the patient (e.g., extroverted, manipulative, stubborn).
11. Thought content: The presence of hallucinations or delusions.
12. Thought processes: Patient’s speech in terms of whether it is logical or rambling or whether the patient has disconnected thoughts, loosening of associations tangential speech, and so forth.
13. Intellect: The judged level of intelligence of the patient, often based on the vocabulary of the patient.
14. Judgment and insight: The quality of the patient’s decision-making and the patient’s own understanding of his problems.
31
What does the MMPI-2 (Minnesota Multiphasic Personality Inventory) measure? (Objective test)
True/false self-report measure of a person's psychological state.
32
Identify and describe the 3 Validity Scales of the MMPI-2.
Validity scales were developed to control response biases.
A high score on the Validity tests can invalidate the entire test results, and if it's a moderate score the response set must be taken into account when interpreting findings.
1. L Scale (Lie Scale): designed to measure defensiveness;
If a person is not prepared to reveal anything negative or unfavorable about himself, then that person will score highly on this measure.
2. K Scale: developed to assess frankness and desire to present self image as overly positive.
The items of the K Scale are more subtle than those of the L Scale (e.g., “People often disappoint me” and “I like to let people know where I stand on things”) and, hence, are less susceptible to overt conscious attempts to overreport or under-report psychopathology.
3. F Scale (Infrequency Scale): a measure of unusual attitudes and behaviors seen in severe psychopathology or in individuals seeking to present themselves in a negative and unfavorable light.
Items that reflect the unusual content of the F Scale such as “When I am with people, I am bothered by hearing strange things” and “No one cares much what happens to you.”
33
What do scores on Validity Scales tell you?
The scores on these scales and particular patterns among the three scales can provide information on test-taking attitudes and the aspects of the person’s personality styles.
34
What are the Clinical Scales of the MMPI for?
Though they mostly bear the names of various disorders, they actually measure behaviors and characteristics that are evident in individuals with those disorders rather than behaviors that are uniquely diagnostic of the disorder.
35
Pros of MMPI-2.
1. It has strong and extensive empirical basis for interpretation.
2. It has a long-standing body of research.
3. It has adequate reliability and validity for clinical and research purposes.
4. The measure is familiar and popular and well-known and respected.
5. Lots of clinical information is available on the MMPI and MMPI-2.
6. It is easy to administer and can be used with a variety of populations.
7. The scoring is objective, if somewhat complicated.
8. Assessment of a broad range of symptoms, syndromes, and personality features is possible.
36
Cons of the MMPI-2.
1. The instrument is excessively long compared to other similar measures.
2. Although the standardization sample is better than the original, it may also be problematic.
3. It is not certain if research on the MMPI can truly be generalized to the MMPI-2.
4. The labels for the subscales use antiquated terms that can produce some confusion.
5. The normative sample has a high level of education and socioeconomic status that may not be representative.
6. The interpretive process can be quite complicated.
37
What does the MCMI-3 (Millon Clinical Multiaxial Inventory) measure? (objective test)
A 175-item measure of personality and psychopathology.
38
How is the MMPI-2 different from the MCMI-3?
the MCMI and MMPI-2 measure different characteristics and the MCMI is shorter to administer to patients. Whereas the MMPI measures a broad range of psychopathology, the MCMI has its premier focus on the assessment of personality disorders.
39
True or false: MCMI-3 has been validated only on clinical samples and is appropriate for use only in clinical populations
True
40
Pros of the MCMI-3?
1. It has been developed from a comprehensive theory.
2. It reflects the current diagnostic system of the DSM and is especially useful with
personality disorders.
3. It provides diagnostic accuracy by taking into account base rates.
4. It uses strong test construction approach.
5. It is easy to administer.
6. It contains 175 items, which is shorter than other omnibus measures.
41
Cons of the MCMI-3?
1. There is imbalance in the number of True and False items. (Items that reflect psychopathology most often have a “true” response; therefore test is susceptible to
acquiescence response set.)
2. The test is weak in assessing subclinical levels of psychopathology.
3. There are validity problems.
4. Subtypes of personality disorders are not measured.
5. The normative sample is relatively small and may not be representative of minority groups.
6. There are few validation studies.
42
Cons of Roschach Inkblot Test (RIT)?
1. It was not developed for purpose it is currently used for.
2. Early research with different systems has created confusion and bias.
3. There is lack of research and normative information for minorities.
4. Additional reliability and validity, especially on specific scores, is necessary.
5. There is complexity in scoring and interpretation.
6. It may be of limited use with children, especially over the long term.
43
Pros of Roschach Inkblot Test (RIT)?
Pros of the RIT
1. It is easy to administer.
2. The utility of Exner’s Comprehensive System.
3. It has standardized administration, scoring, and interpretation.
4. It has a large normative sample and normative data for various scores.
5. There is evidence of acceptable reliability and validity.
6. It taps information that is not tapped by objective tests.
7. It may be resistant to faking.
8. It is the second-most researched personality assessment instrument.
44
What are the Big 5 Adjectives? (HILDA)
```
Emotional Stability
Extraversion
Conscientiousness
Agreeableness
Openness to Experience
```
