ch10

• Clinical Interpretation


  Influence of theoretical framework<|>Samples, Signs, and Correlates
• Clinical Interpretation


  1. Sample of general behavior

  2. Sign of underlying state or condition

  3. Behavioral, attitudinal, or emotional correlate
• Levels of Interpretation


  Level I - involves little inference; data to prediction<|>Level II - involves inference about person in general (descriptive generalization; hypothetical construct)<|>Level III - involves inference about individual in a particular situation
• Types of clinicians


  • Behavioral clinicians
  • Psychometrically-oriented clinicians
  • Psychodynamic clinicians
• Quantitative/Statistical Approach


  Obtain scores for one or more relevant characteristics; use these to predict outcome<|>Mechanical prediction<|>Must keep careful records of test data, observations, etc. so that interpretations/judgments can be quantified
• Subjective/Clinical Approach


  More subjective and intuitive<|>Integrate data from multiple sources<|>Summary of behaviors
• Advantages of Quantitative/Statistical Approach

  • More specificity
  • Predictions are "mechanical"
  • Large group application
  • Avoid Barnum effect
• Reasons clinicians don't use Quantitative/Statistical Approach

  • Predictors seem short-term and not profound
  • Clinicians remember their successful predictions and forget their errors
  • Ethical arguments
• Advantages of Subjective/Clinical Approach

  • Formulas are not available for all prediction situations
  • Judgment can add to prediction in some situations where statistical approach does not allow for flexibility
  • Clinician as data gatherer
• Goldberg (1965) found that statistical predictions were comparable to or outperformed clinicians' predictions
• Grove et al. (2000) found that quantitative approaches were superior in 50% of studies, while clinical approaches were only superior in 6% of studies
• Quantitative approaches are less expensive than clinical approaches
• Limitations of clinical approaches include applications and definitions
• There is little support for the belief that lower socioeconomic-class patients are judged to be more seriously disturbed or that women are judged to be more dysfunctional
• There is strong support for bias that Blacks and Hispanics are misdiagnosed with schizophrenia, even with the same symptoms, and that men are more likely to be diagnosed as antisocial while women are more likely to be diagnosed as histrionic
• There is no strong support for increased clinical experience resulting in increased accuracy in prediction, and one profession is not better than another
• When the clinical approach is valuable

  • No adequate tests available
  • Rare or unusual events are to be predicted
  • No statistical equations have been developed
  • Circumstances may negate accuracy of equation
• When the statistical approach is valuable

  • Outcome to be predicted is objective and specific
  • Interest in individual case is minimal
  • There is reason to be concerned about human judgment error or bias
• Information processing: although there are many bits of information available, we must guard against over-simplifying and "cherry-picking"
• Reading-in syndrome: don't over-pathologize; note strengths too
• Validation and records: record your interpretations and predictions to track later
• Vague reports, concepts, criteria: be specific as possible
• Effects of predictions: knowledge of prediction may influence actions and perceptions of others
• Prediction to unknown situations: risky without knowledge of situational influence on behavior
• Fallacious prediction principles: failure to consider base rates, regression to the mean, etc.
• Influence of stereotyped beliefs: belief despite empirical evidence to the contrary
• Clinical Report


  Referral source: address the referral question!<|>Language<|>Individualize reports<|>Level of detail<|>Cite items and observations