Chapter 3

• Assessment

  = Collection of relevant information to reach a conclusion; idiographic information
• Clinical assessment


  = Information used to determine whether, how, and why a person is behaving abnormally and how that person may be helped

  • Idiographic; program-based
• 3 categories of clinical assessment tools:

  • Clinical interviews

  • Tests

  • Observations
• Characteristics of assessment tools

  must be standardized and have clear reliability and validity
• Standardization

  = setting up common steps to be followed whenever it is administered

  • One must standardize administration, scoring, and interpretation
• Reliability


  = The consistency of an assessment measure

  • A good tool will always yield the same results in the same situation
• 2 main types of reliability

  • Test–retest reliability: Yields the same results every time it is given to the same people

  • Interrater reliability: Different judges independently agree on how to score and interpret a particular tool
• Validity


  = The accuracy of a tool's results

  • An assessment tool must accurately measure what it is supposed to measure
• 3 specific types of validity

  • Face validity

  • Predictive validity

  • Concurrent validity
• Clinical interviews

  • Face-to-face encounter

  • Basic background data gathered with specific theoretical focus

  • Unstructured or structured

  • Mental status exam
• Clinical interview- limitations

  • Lack of reliability

  • Interviewer bias or mistakes in judgment

  • Lack of validity or accuracy
• Clinical tests


  = Used to gather information about psychological functioning from which broader information is inferred
• Projective tests


  = clinical test

  -> require client interpretation of vague or ambiguous stimuli

  or open-ended instruction; psychodynamic orientation

  • Rorschach test

  • Thematic Appreciation Test (TAT)

  • Sentence-completion test

  • Drawings
• What are drawing tests commonly used for?

  to assess the psychological functioning of children
• Projective tests- Strengths

  • Until the 1950s, the most commonly used tests for personality assessment

  • Now used to gain supplementary information
• Projective tests- Limitations

  • Reliability and validity not consistently shown

  • May be biased against minority ethnic groups
• Personality inventories


  • Designed to measure broad personality characteristics

  • Focus on behaviors, beliefs, and feelings

  • Usually based on self-reported responses
• Most widely used personality inventory

  = Minnesota Multiphasic Personality Inventory

  • For adults: MMPI (original) or MMPI-2 (1989 revision)

  • For adolescents: MMPI-A
• Personality inventories • Strengths

  • Easier, cheaper, and faster to administer than projective tests

  • Objectively scored and standardized

  • Greater reliability and validity than projective tests
• Personality inventories • Limitations

  • Cannot be considered highly valid

  • Measured traits often cannot be directly examined; only self-report

  • Tests do not allow for cultural differences in responses
• Response inventories

  • Usually based on self-reported responses

  • Focus on one specific area of functioning

  • Affective inventories (i.e., Beck Depression Inventory)

  • Social skills inventories

  • Cognitive inventories
• Response inventories 2.0

  • Have strong face validity

  • Not all have been subjected to careful standardization, reliability, and/or validity procedures

  • Beck Depression Inventory and a few others are exceptions
• Psychophysiological tests

  • Measure physiological response as an indication of psychological problems

  • Includes heart rate, blood pressure, body temperature, galvanic skin response, and muscle contraction

  • Polygraph (lie detector)
• Psychophysiological tests • Strengths and weaknesses

  • Require expensive equipment that must be tuned and maintained

  • Can be inaccurate and unreliable
• Neuroimaging and neurological tests

  • Neurological tests directly assess brain function by directly

  assessing brain structure and activity

  • Examples: EEG, PET scans, CT

  scans, MRI, fMRI
• Neuropsychological tests


  • indirectly assess brain function by assessing cognitive, perceptual, and motor functioning

  • Example: Bender Visual-Motor Gestalt Test

  • Clinicians often use a battery of tests
• Intelligence tests

  • Designed to indirectly measure intellectual ability

  • Typically consist of a series of tests assessing both verbal and nonverbal skills
• General score is an intelligence quotient (IQ)


  = Represents a person's score relative to the average score of people of a similar age
• Intelligence tests - strengths

  Are among the most carefully produced of all clinical tests

  • Highly standardized on large groups of subjects

  • Have very high reliability and validity
• Intelligence tests • Weaknesses

  • Performance can be influenced by nonintelligence

  • Tests may contain cultural biases in language or tasks

  • Members of minority groups may have less experience and be less comfortable with these

  types of tests, influencing their results
• Clinical observations- Naturalistic and analog observations

  • Naturalistic observations occur in everyday environments

  • Observations are generally made by “participant observers” and reported to a clinician

  • Reliability and validity are a concern

  • If naturalistic observation is impractical, analogue observations are used and conducted in artificial settings
• Clinical observations • Self-monitoring

  • People observe themselves and carefully record the frequency of certain behaviors, feelings, or cognitions as they occur over time

  • Useful in assessing infrequent or overly frequent behaviors

  • Provides a means of measuring private thoughts or perceptions

  • Validity and reliability can be a problem
• Classification systems

  = Using all available information, clinicians attempt to paint a “clinical picture”and make a diagnosis

  • A determination that a person's psychological problems constitute a particular disorder

  • Based on an existing classification system
• Diagnostic and Statistical Manual (DSM)

  = most used system for mental disorders, but faces competition from two other diagnostic systems

  • International Classification of Disorders (ICD)

  • Research Domain Criteria (RDoC)
• DSM-5 (2013)

  most often used in the Europe + United States

  • Lists of categories, disorders, and symptom descriptions, with guidelines for assignment

  • Focus on clusters of symptoms (syndromes)
• ICD-10

  used in many other countries

  • Some differences, but some matching with DSM-5
• What info does DSM-5 require for proper diagnosis?

  • Categorical information

  • Dimensional information
• Categorical information

  = The name of the category (disorder) indicated by the client’s symptoms
• Dimensional information

  A rating of how severe a client’s symptoms are + how dysfunctional the client is across various dimensions of personality (negative affectivity, detachment, antagonism, disinhibition, and psychoticism)
• DSM-5 categorical information

  Anxiety disorders

  • Generalized anxiety disorder; social anxiety disorder; panic disorder; separation anxiety disorder

  Depressive disorders

  • Major depressive disorder; persistent depressive disorder; premenstrual dysphoric disorder