 Assessment & Classification OVERVIEW Clinical Assessment Basics Types of Assessments Clinical interviews Clinical Tests Clinical Observations Diagnosis Treatment I. Clinical Assessment Basics A. Assessment Definition Clinical Assessment: collecting relevant information to determine: How and why a person is behaving abnormally  How that person may be helped Progress that has been made in treatment  Idiographic vs. nomothetic perspective B. CHARACTERISTICS OF ASSESSMENT TOOLS To be useful, assessment tools must: 1) be standardized 2) have established norms 3) have high reliability and validity. 1. STANDARDIZATION Standardization – the same steps followed whenever test is administered One must standardize administration, scoring, and interpretation 2. NORMS Developed with standardization sample Norms – comparison group Needed in order to interpret scores 3. Reliability and validity Reliability -the consistency of a test or diagnosis resulting from a test Two main types: Inter-rater  Test-retest  Validity Validity –the extent to which an assessment tool is accurate Face validity – a test a ppears to measure what it is supposed to measure Concurrent validity – a test’s results agree with other measures of similar things Predictive validity – a test accurately predicts future characteristics or behavior Reliability and Validity TYPES OF ASSESSMENT TOOLS The specific tools used in an assessment depend on the clinician’s theoretical orientation Hundreds of clinical assessment tools have been developed and fall into three categories: Clinical interviews Tests Observations II. Clinical Interviews A. CLINICAL INTERVIEW DEFINITION Often the first contact between a client and a clinician/assessor Used to collect detailed information about: Personal history Problems and feelings Relationships Work/school functioning B. STRUCTURED INTERVIEWS Specific schedule of questions Same info gathered in all interviews Allows for more comparison between people Example: Mental Status Exam  C. UNSTRUCTURED INTERVIEWS Open ended questions More flexibility D. EVALUATING CLINICAL INTERVIEWS Advantages Control over the interaction Observation of nonverbal behavior Lots of information in a short time Disadvantages Client may be unable or unwilling to answer accurately Interviewers may be biased or may make mistakes in judgment  Unstructured interviews can have low reliability III. Clinical Tests A. CLINICAL TESTS OVERVIEW Tests are devices for gathering information about specific aspects of a person’s psychological functioning  More than 500 clinical tests are currently in use They fall into six categories…  B. TYPES OF CLINICAL TESTS1. Projective Tests2. Personality Tests3. Response Inventories4. Psychophysiological Tests5. Neurological and Neuropsychological Tests6. Intelligence Tests 1. PROJECTIVE TESTS  Require that clients interpret vague and ambiguous stimuli or follow open-ended instruction Mainly used by psychodynamic practitioners  Projective Test Examples: EVALUATING PROJECTIVE TESTS  Advantages Helpful for providing “supplementary” information Unconscious attitudes/beliefs Disadvantages Generally low reliability / validity Time consuming to score Few established norms Possible improvement for validity and reliability of the Rorschach: Exner’s system 2. Personality Tests Designed to measure broad personality characteristics Focus on behaviors, beliefs, and feelings Most widely used:  Minnesota Multiphasic Personality Inventory (MMPI-2) Personality Test Example:MMPI-2 Consists of 567 T/F self-statements › Statements describe: Physical concerns; mood; morale; attitudes toward religion, sex, and social activities; and psychological symptoms Three validity scales (L, F, K) assess lying, confusing, or carelessness Developed using criterion keying MMPI-like Items MMPI-2: CLINICAL SCALES  Hypochondriasis (HS) Depression (D) Conversion hysteria (Hy) Psychopathic deviate (PD) Masculinity-femininity (Mf) Paranoia (P) Psychasthenia (Pt) Schizophrenia (Sc) Hypomania (Ma) Social introversion (Si) MMPI: SAMPLE PROFILE Scores range from 0 to 120 Above 70 = abnormal responses Graphed to create a “profile” Evaluating Personality Tests Advantages› Easier, cheaper, and faster to administer than projective tests› Objectively scored› Standardized› Good reliability and validity Disadvantages› Not perfectly valid› Cultural limitations› 3. Response Inventories Self-report questionnaires that focus on one specific area of functioning EXAMPLE: BECK DEPRESSION INVENTORY  Evaluating Response Inventories Advantages› Short administration time› Objectively scored› Standardized and normed  Disadvantages› Variable reliability and validity (depending on inventory)› Few checks for carelessness or inaccuracy Potential downfalls of face validity› 4. Psychophysiological Tests Measure physiological responses as indicators of psychological problems Examples: Measurements of heart rate, respiration rate, blood pressure, temperature Galvanic Skin Response Polygraph  Evaluating Psychophysiological Tests Advantages Less subjective  Disadvantages Rely on expensive equipment Low correlation among measures No norms (individual differences) Reaction to equipment 5. Neurological and Neuropsychological Tests Neurological tests directly assess brain function by assessing brain structure and activity Examples: EEG, CAT scans, PET scans, MRI Neuropsychological tests indirectly assess brain function by assessing cognitive, perceptual, and motor functioning Example: Bender Visual-Motor Gestalt Test Electroencephalogram (EEG) Magnetic Resonance Imaging (MRI) Computerized Axial Tomography (CAT) and Positron Emission Tomography (PET) scans Evaluating Neurological and Neuropsychological Tests Advantages Less subjective  May rule out neurological factors Relationship between brain areas and psychological factors Disadvantages Rely on expensive equipment No norms (individual differences) 6.