Chapter 3 - Assessment & Diagnosis

1. Chapter 3 - Assessment & Diagnosis • Classification = ordering & grouping

2. Advantages of Classification • Means of communication • Labels help to condense & order info • To guide treatment strategies • To facilitate research • Etiology & progression of disorder

3. Disadvantages of Classification • Self-fulfilling prophecies & stigma - Rosenhan (1973) - Pygmalion in the classroom (“bloomers”) • Overlooking other important problems - aspects not typical of a diagnosis e.g., CD & depression

4. Disadvantages, cont. • Automatically label those who seek help • Focus on weaknesses vs. strengths • Categories = less individual information

5. DSM-IV-TR • The most widely used system • Pros - reliable - based on research (validity) - communication - atheoretical - multiaxial

6. DSM axes I. Clinical disorders II Personality/enduring problems • Medical problems • Environment/psychosocial • Global assessment

7. DSM Cons • Disorders created by committee • Labels => stigma • Culture-bound • No treatment suggestions • No causes • Focus on problems • Most axes rarely used -> reduces person to one disorder

8. Reliability & Validity Reliability - consistency • Internal consistency - over all the items • Test-retest reliability - over time • Interrater reliability - over raters

9. Validity - test measures what it purports to 1. Content - covers much of the trait 2. Concurrent - correlates with other measures of the trait • Predictive - predicts other measures of the trait {Concurrent & Predictive are both criterion} • Construct - test supports theory • Face - looks like what it measures

10. Interviews Clinical interview • First step • Talk to client • Not reliable across examiners • Valid • Good for rapport • Nonverbal behavior

11. Structured Interviews - decision trees - for diagnosis • Mental Status Exam - brief measure of cognitive functioning

12. Intelligence Tests Reasons to use • Mental abilities affect other problems? • Strengths & weaknesses • General functioning

13. Problems • Cultural bias • IQ = small part of intelligence

14. Personality Tests Objective & Projective Objective Tests • unambiguous • reliably interpreted • usually self-report

15. Multi-Trait Scales MMPI - 567 items • normed on psychiatric patients • items distinguished patient groups • 10 clinical scales & 3 validity scales • patterns suggest disorders & malingering

16. Other multi-trait scales • MCMI (personality disorders) • Child Behavior Checklist • Strong Vocational Interest Test

17. Single-trait self-report scales • Many scales ex. BDI • Face-valid • Good reliability & validity

18. Projective Tests • Ambiguous stimuli -> responses reflect person • “Project” psyche onto stimuli • Given by trained person • Interpretations differ (? reliability) • ?Validity • Difficult to research • Used for getting ideas

19. Rorschach Inkblot Test • Scoring system (reliability) • More validity research • Good for psychosis

20. Thematic Apperception Test -TAT • Ambiguous scenes • Pattern of responses • Scoring system seldom used • Not reliable (subjective) • Suggests ideas

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22. Neuropsychological Tests • Brain damage & deterioration • Measures cognitive processes perception, memory, attention • Includes IQ testing

23. Behavioral Assessment Focus on problem behavior • Antecedent conditions • Problem description • Person’s response • Result of response

24. Leads to treatment • Self-rating - person monitors own behavior • Analogue Measures - simulate the problem in clinic/laboratory