The document discusses clinical assessment and diagnosis in psychopathology. It describes the goals of assessment as understanding how and why a person is behaving abnormally and how they can be helped. Assessment tools should be standardized, reliable, and valid. Clinical interviews and psychological tests are common forms of assessment. Treatment decisions are based on assessment and diagnosis to determine an appropriate treatment plan. Research shows that therapy is generally effective compared to no treatment, and certain therapies are effective for specific disorders.

1. PSYC 3553 – Psychopathology Week 4: Assessment and Diagnosis • September 29, 2009

2. What is assessment? Goals of clinical assessment: How and why a person is behaving abnormally How that person may be helped Also may be used to evaluate treatment progress Focus is idiographic – on an individual person

3. Characteristics of Assessment Tools Standardization A test is administered to a large group, and their performance serves as a common standard (norm) against which individual scores are judged The “ standardization sample ” must be representative One must standardize administration, scoring, and interpretation

4. Reliability : The consistency of a test Test – retest reliability Interrater reliability Validity : the accuracy of the test results Face validity Predictive validity Concurrent validity Characteristics of Assessment Tools

5. Are Classifications Reliable and Valid? Reliability : different diagnosticians agreeing on diagnosis using same classification system DSM-IV : greater reliability than previous editions Used field trials to increase reliability Validity : accuracy of information diagnostic categories provide DSM-IV has greater validity than any previous edition Conducted extensive lit reviews and field studies

6. I. Clinical Interviews Face-to-face encounters Often the first contact between a client and a therapist/assessor Used to collect detailed information, especially personal history, about a client Allow the interviewer to focus on whatever topics they consider most important

7. II. Psychological Tests Six categories of psychological tests Projective tests Personality Inventories Response Inventories Psychophysiological Tests Neurological/neuropsychological Tests Intelligence Tests

8. Projective tests : Interpret characteristics onto vague & ambiguous stimuli or follow open-ended instruction Strengths and weaknesses : Helpful for providing “supplementary” information Rarely demonstrated much reliability or validity May be biased against minority ethnic groups II. Psychological Tests

9. Example: The Rorschach Inkblot

10. Example: Thematic Apperception Test

11. Example: Sentence-Completion Test “ I wish ___________________________” “ My father ________________________”

12. Example: Draw-a-Person Test “ Draw a person” “ Draw another person of the opposite sex”

14. II. Psychological Tests Personality inventories - self-report questionnaires Focus is on behaviors, beliefs, and feelings Ask how similar/dissimilar a person is to a set of statements Strengths and weaknesses : Objectively scored and standardized Although more valid than projective tests, often we cannot directly examine trait

15. Example – The MMPI

16. II. Psychological Tests Response inventories Usually based on self-reported responses Focus on one specific area of functioning E.G., emotion, social skills, cognition Strengths and weaknesses : Have strong face validity Rarely careless/inaccurate questions Few subjected to careful procedures

17. II. Psychological Tests Psychophysiological tests Measure physiological response as an indication of psychological problems Most popular is the polygraph (lie detector) Strengths and weaknesses : Require expensive equipment that must be tuned and maintained Physical evidence for psychological symptoms

18. II. Psychological Tests Neurological tests: direct assessment brain function Neuropsychological tests: indirect assessment via cognitive, perceptual & motor function

19. Example: Bender Visual-Motor Gestalt

20. II. Psychological Tests Intelligence tests Designed to measure intellectual ability Assess both verbal and non-verbal skills Generate an intelligence quotient (IQ) Strengths and weaknesses : Highly standardized, reliable and valid Influences on performance…cultural factors

21. Clinical Observations Naturalistic observations Occur in everyday environments : homes, schools… Analog observations If impractical, conduct observations in artificial settings Self-monitoring People observe themselves and carefully record the frequency of certain behaviors, feelings...

22. Clinical Observations Strengths and weaknesses : Different observers focus on different aspects? Careful training and use of observer checklists “ Overload,” “observer drift,” and observer bias Client reactivity may also limit validity Observations may lack cross-situational validity

23. Treatment: How Might Clients Be Helped? Treatment decisions : begin with assessment info & diagnosis to determine treatment plan Other factors : therapist’s orientation, current research, empirical support, evidence-based treatment Difficult question to answer: How do you define success ? How do you measure improvement ? How do you compare treatments – differing in range, complexity, skill, knowledge

24. The Effectiveness of Treatment Is therapy generally effective ? … more effective than no treatment or placebo In one study, average person in treatment was better off than 75% of untreated Consumer Reports found that “consumers” of therapy found it to be helpful or at least satisfying Can therapy can be harmful? Has potential… Studies report ~5% get worse with treatment

25. The Effectiveness of Treatment Are particular therapies effective for particular problems ? Studies now conducted to examine efficacy of specific treatments for specific disorders: Recent studies focus on the effectiveness of combined approaches Drug therapy combined with certain forms of psychotherapy – to treat certain disorders