CLIN311 - LECTURE

LESSON 7 - DIAGNOSIS AND CLASSIFICATION ISSUES MENTAL ILLNESS

• According to the definition provided in the DSM-IV-TR, the
ABNORMALITY syndrome (cluster of abnormal behavior) must be associated
a. Personal distress with distress, disability, or increased risk of problems.
b. Deviance • A mental disorder is considered to represent a dysfunction
c. Statistical infrequency within an individual; and
d. Impaired social functioning • Not all deviant behaviors or conflicts with society are signs
PERSONAL DISTRESS/ SUBJECTIVE DISTRESS of mental disorder.
• Personal Distress/ Subjective Distress HARMFUL DYSFUNCTION THEORY (Wakefield, 1992)
- This definition labels as psychologically abnormal those • I argue that a disorder is a harmful dysfunction; wherein
people with a poor sense of well-being and/or a high harmful is a value term based on social norms, and
level of subjective distress. dysfunction is a scientific term referring to the failure of a
Advantages of This Problems with This mental mechanism to perform a natural function for which it
Definition Definition was designed by evolution. Thus, the concept of disorder
It seems reasonable to There is a certain charm to combines value and scientific components. (p. 373)
expect that adults and some the idea that if we want to • iyan ay sinabi ni wakefield
children can assess whether know whether a person is DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL
they are experiencing maladjusted, we should ask DISORDERS (DSM)
emotional or behavioral that person, but there are • “clinically significant disturbance”
problems and can share this obvious pitfalls in doing so. • “cognition, emotion regulation, or behavior”
information when asked to • “dysfunction” in “mental functioning”
do so. • “usually associated with significant distress or disability”
STATISTICAL INFREQUENCY AND VIOLATION OF SOCIAL • A medical model of psychopathology
NORMS (DEVIANCE) THE IMPORTANCE OF DIAGNOSIS
• When a person’s behavior becomes patently deviant, • Diagnosis
outrageous, or otherwise nonconforming, then he or she is - A type of expert-level categorization (enable us to make
more likely to be categorized as “abnormal” distinctions).
Advantages of This Problems with This • Four Advantages of Diagnosis:
Definition Definition 1. Communication – descriptive, “verbal shorthand”
Cutoff Points: Choice of Cutoff Points: 2. Enables and promotes empirical research in
• Frequently used in the • Difficulty in establishing psychopathology – individual criteria of disorders,
interpretation of agreed-upon cutoff points. comorbidity.
psychological test scores. The Number of 3. Research on etiology/causes of abnormal behavior
• The tests authors Deviations: will be impossible without a standard diagnostic
designate a cutoff point, • The number of behaviors system.
often that one must evidence to 4. They may suggest which mode of treatment is more
based on statistical bear label “deviant” likely to be effective.
deviance from the mean Cultural and Professionals
score Developmental Relativity:
- Professional Vocabulary
obtained by a “normal” • Judgments can vary
- Powerful impact on the attention it receives from clinical
sample of test-takers. depending on whether
psychologists
• Scores at or beyond the family, school officials or
Clients
cutoff are considered as peers are making them.
“clinically significant” - Beneficial cons: identify and demystify an otherwise
Intuitive Appeal: nameless experience
• Those behaviors we - To share a recognized problem with others Acknowledge
ourselves consider the significance of experience
abnormal would be - Easier access to treatment
evaluated similarly by - Harmful cons: Stigma that damages self-image
others. Stereotyping by individuals Outcome of legal issues
• We believe we know it DIAGNOSIS AND CLASSIFICATION OF MENTAL DISORDERS: A
when we see it. BRIEF HISTORY

IMPAIRED SOCIAL FUNCTIONING

• For a behavior to be considered abnormal, it must create
some degree of social (interpersonal) or occupational (or
educational) problems for the individual.
Advantages of This Problems with This
Definition Definition
• Little inference is • Judgments regarding both
required social and occupational
• Problems in both the functioning are relative (not
social and occupational absolute) and involve a DSM EARLIER EDITIONS (I AND II)
sphere often prompt value-oriented standard • 3 broad categories of disorders: Psychoses, neuroses, and
individuals to seek out • Achieving a reliable character disorder.
treatment. consensus about the nature • Reflected the psychoanalytic approach
of an individual’s social • Limited generalizability or utility for clinicians
relationships and • Presented 106 and 182 disorders, respectively
contributions as a worker
DSM-RECENT EDITIONS (III, III-R, IV, AND IV-TR)
or student may be difficult.
• Greater extent on empirical data
• Used specific diagnostic criteria (checklists)
• Dropped any allegiance to a particular theory
• Multiaxial assessment
 CLIN311 - LECTURE

• Axis V: Global Assessment of Functioning (GAF) Scale – a had a history of a number of rather severe problems that had been
100 point continuum of the overall level of functioning present since her teenage years. First, she had great difficulty
• Presented 265 disorders controlling her emotions. She was prone to become intensely
dysphoric, irritable, or anxious almost at a moment’s notice. These
• AXIS I
intense negative affect states were often unpredictable and,
- Used to indicate the presence of all psychological
although frequent, rarely lasted more than 4 or 5 hours. Dina also
diagnostic categories except personality disorders and reported a long history of impulsive behaviors, including
mental retardation (which are reported in Axis II). polysubstance abuse, excessive promiscuity (an average of about 30
different sexual partners a year), and binge eating. Her anger was
unpredictable and quite intense. For example, she once used a
hammer to literally smash a wall to pieces following a bad grade on
a test.
• Dina’s relationships with her friends, boyfriends, and parents were
intense and unstable. People who spent time with her frequently
complained that she would often be angry with them and devalue
them for no apparent reason. She also constantly reported an
intense fear that others (including her parents) might abandon her.
For example, she once clutched a friend’s leg and was dragged out
the door to her friend’s car while Michelle tried to convince the
• Axis II friend to stay for dinner. In addition, she had attempted to leave
- For reporting personality disorders and MR. Also for home and attend college in nearby cities on four occasions. Each
noting prominent maladaptive personality features and time, she returned home within a few weeks. Prior to her hospital
defense mechanisms. admission, her words to her ex-boyfriend over the telephone were,
“I want to end it all. No one loves me.”

• Axis III
- For reporting current general medical conditions that are
potentially relevant to the understanding or
management of the individual’s mental disorder.
- Purpose is to encourage thoroughness in evaluation and
to enhance communication among health care providers. DSM-CURRENT EDITIONS (5, 5-TR)
- General medical condition can be related mental • Committee of prominent researchers
disorders in a variety of ways. • Scientific review committee and work groups
• Axis IV • Practicing clinicians participated by utilizing the DSM
- For reporting psychosocial and environmental problems • Dsm.org
that may affect the diagnosis, treatment and prognosis of • Presented around 300 disorders
mental disorders (Axes I and II) • “Emerging Measures and Models”
- They may be a negative life event, an environmental • New features:
difficulty or deficiency, a familial or interpersonal stress, - Organized and presented
an inadequacy of social support or personal resources, or - Not DSM-V, but DSM-5
other problem relating to the context in which a person’s - A “living document” – quick to respond to new research
difficulty have developed. that improves understanding of disorders
- Multiaxial assessment system, including GAF scale was
removed
- Prolonged Grief Disorder
• New disorders:
- Premenstrual dysphoric disorder (PMDD)
- Disruptive mood dysregulation disorder (DMDD)
- Binge eating disorder (BED)
• Axis V - Somatic symptom disorder (SSD)
- For reporting the clinician’s judgment of the individual’s - Hoarding disorder
overall level of functioning. • Revised disorders:
- Done using the GAF (Global Assessment of Functioning) - Dropped the “bereavement exclusion” in major
Scale. depression
- Axis V: GAF = score (current) - Autistic disorder revised to autism spectrum disorder
(highest level in the past year) - In ADHD, the age at which symptoms must first appear
(at discharge) was changed from 7 to 12 years old, and the number
- Mental retardation was renamed intellectual disability
(intellectual development disorder), and learning
disabilities in reading, math, and writing were combined
into a single diagnosis with a new name: specific learning
disorder.
• Possible changes in the future:
- Expanded “biological markers”
- View disorders not in a categorical way, but along a
continuum
THE CASE OF DINA CAYA - Dimensional approach
• Dina is a 23-year-old woman admitted to an inpatient unit at a - Removing 5 of 10 personality disorders: paranoid,
hospital following her sixth suicide attempt in 2 years. She toldher - schizoid, histrionic, dependent, and narcissistic
ex- boyfriend (who had broken up with her a week earlier) that she
had swallowed a bottle of aspirin, and he rushed her to the local
emergency room. Michelle had a 5-year history of multiple
depressive symptoms that never abated; however, these had not
been severe enough to necessitate hospitalization or treatment.
• They included dysphoric mood, poor appetite, low self-esteem,
poor concentration, and feelings of hopelessness. In addition, Dina
 CLIN311 - LECTURE

• Criticisms:  There is no formula for developing positive working

- Diagnostic - Improvements - Gender Bias relationships during
overexpansio over their an interview; however, attentive listening,
n predecessors appropriate empathy, genuine respect, and cultural
- Transparency - Facilitated - Nonempirical
sensitivity play significant roles.
of the communicatio Influences
revision n between
 A function of the interviewer’s attitude as well as
process researchers the interviewer’s actions.
and clinicians
- Membership - Newer - Limitations SPECIFIC BEHAVIORS
of work group disorders are on objectivity  When interviewers succeed in quieting themselves,
not entirely knowing themselves, and developing good working
“mental”
relationships, they have laid the groundwork for
disorders
conducting successful interviews. The next task is to
- Field trial - Controversial
problems cutoffs
master the tools of the trade, the specific behaviors
- Price - Cultural Issues characteristic of effective interviewers.
 Ex. Listening, attending behavior
ALTERNATIVE DIRECTIONS IN DIAGNOSIS AND
CLASSIFICATIONS Eye Contact
• DIMENSIONAL APPROACH  Eye contact not only facilitates listening, but it also
- According to a dimensional approach, the issue isn’t the communicates
presence or absence of a disorder; instead, the issue is Listening.
where on a continuum (or “dimension”) a client’s  A specific behavior that requires cultural knowledge
symptoms fall. and sensitivity on the part of the interviewer, both
• FIVE-FACTOR MODEL OF PERSONALITY (Big Five model) as the sender and receiver of eye contact.
(O.C.E.A.N.) Body Language
- according to the dimensional approach to abnormality,  Few general guidelines for the interviewer include
each of our personalities contains the same five basic
facing the client, appearing attentive, minimizing
factors—neuroticism, extraversion, openness to
experience, agreeableness, and conscientiousness restlessness, and displaying appropriate facial
expressions.
Vocal Qualities
LESSON 8: THE CLINICAL INTERVIEW  Skilled interviewers have mastered the subtleties of
the vocal qualities of language—not just the words
You are your own tool but how those words sound to the client’s ears.
They use pitch, tone, volume, and fluctuation in
CLINICAL INTERVIEW their own voices to.
 To provide feedback Verbal Tracking
 Can be in the form of face-to-face meeting, a  Effective interviewers are able to repeat key words
written report, or other forms. and phrases back to their clients to assure the
 Most psychologists believe that clients find their clients that they have been accurately heard.
feedback to be helpful and positive, even before Referring to the client by the proper name
any type of intervention  It sounds simple enough, but using the client’s
name correctly is essential (Fontes, 2008).
 The misuse of names in this way may be
THE INTERVIEWER
disrespectful and may be received as a
 The most pivotal element of a clinical interview is
microaggression.
the person who conducts it. Observing client behavior
 A master of the technical and practical aspects of  Typically, when psychologists write a report
the interview but also
summarizing the results of an assessment (including
demonstrates broad-based wisdom about the the clinical interview), that report contains at least a
human interaction interviewing entails.
brief section describing the behavior of the client
 General Skills: (1) quieting yourself, (2) being self- during the process.
aware, and (3) developing positive working  The interviewer should carry out all these attending
relationships.
behaviors naturally and authentically.
Quieting yourself
 What should be quieted is the interviewer’s
internal, self-directed thinking pattern.
COMPONENTS OF THE INTERVIEW
 the voice in the interviewer’s own mind should not
Components are universal to interviews: rapport,
interrupt or drown out the voice of the client.
technique, and conclusions.
Being self-aware
Rapport
 Self-awareness should not be confused with the
 Positive, comfortable relationship between
excessive self-
interviewer and client. When clients feel a strong
Consciousness.
sense of rapport with interviewers, they feel that
 The interviewer’s ability to know how he or she
the interviewers have “connected” with them and
tends to affect others interpersonally and how
that the interviewers empathize with their issues.
others tend to relate to him or her.
Technique
Developing positive working relationships with clients.
 If rapport is how an interviewer is with clients,
technique is what an interviewer does with clients.
 CLIN311 - LECTURE

 These are the tools in the interviewer’s toolbox,  may consist of a specific diagnosis and
including questions, responses, and other specific recommendations.
actions.
Directive Versus Nondirective Styles PRAGMATICS OF THE INTERVIEW
 A directive style gets exactly the information they
need by asking clients specifically for it. Note Taking
 Directive questions tend to be targeted toward  Should an interviewer take notes during interview?
specific pieces of information, and client responses  Written notes are certainly more reliable than the
are typically brief, sometimes as short as a single interviewer’s memory.
word (e.g., “yes” or “no”)  Many clients will expect the interviewer to take
 A nondirective style allows the client to determine notes and may feel as though their words will soon
the course of the interview. Without direction from be forgotten if the interviewer is not taking notes
the interviewer, a client may choose to spend a lot Audio and Video Recordings
of time on some topics and none on others.  Recording a client’s interview requires that the
 The best strategy regarding directive and interviewer obtain written permission from the
nondirective interviewing is one that involves client.
balance and versatility (J. Morrison, 2008).  While obviously providing a full record of the entire
Open- and Closed-Ended Questions session, recordings can, with some clients, hinder
 Open-ended questions allow for individualized and openness and willingness to disclose information
spontaneous responses from clients. The Interview Room
 Closed-ended questions allow for far less  What should the interview room look like?
elaboration and self-expression by the client but  The size of the room, its furnishings, and its decor
yield quick and precise answers. are among the features that may differ.
Clarifications  As a general rule, “when choosing a room [for
 To make sure the interviewer has an accurate interviews], it is useful to strike a balance between
understanding of the client’s comments. professional formality and casual comfort”
 Clarification questions not only enhance the Confidentiality
interviewer’s ability to “get it,” they also  To inform their clients about confidentiality, and
communicate to the client that the interviewer is especially to correct any misconceptions such as
actively listening and processing what the client those described earlier, interviewers should
says. routinely explain policies regarding confidentiality
Confrontation as early as possible.
 Interviewers use confrontation when they notice  Has exceptions.
discrepancies or inconsistencies in a client’s
comments. TYPES OF INTERVIEWS
 Confrontations can be similar to clarifications, but
they focus on apparently contradictory information
Intake Interviews
provided by clients.
 intake interview is essentially to determine whether
Paraphrasing
to “intake” the client to the setting where the
 Paraphrasing is used simply to assure clients that
interview is taking place. In other words, the intake
they are being accurately heard.
interview determines whether the client needs
 When interviewers paraphrase, they typically
treatment; if so, what form of treatment is needed
restate the content of clients’ comments, using
(inpatient, outpatient, specialized provider, etc.);
similar language.
and whether the current facility can provide that
Reflection of Feeling
treatment or the client should be referred to a
 Reflection of feeling echoes the client’s emotions. more suitable facility
 Reflections of feeling are intended to make clients Diagnostic Interviews
feel that their emotions are recognized, even if their  To diagnose.
comments did not explicitly include labels of their
 At the end of a well-conducted diagnostic interview,
feelings.
the interviewer is able to confidently and accurately
Summarizing
assign Diagnostic and Statistical Manual of Mental
 At certain points during the interview—most often Disorders (DSM) diagnoses to the client’s problems.
at the end—the interviewer may choose to Structured Interviews Versus Unstructured Interviews
summarize the client’s comments
 A structured interview is a predetermined, planned
 Summarizing usually involves tying together various sequence of questions that an interviewer asks a
topics that may have been discussed, connecting client. Structured interviews are constructed for
statements that may have been made at different particular purposes, usually diagnostic.
points, and identifying themes that have recurred
 An unstructured interview, in contrast, involves no
during the interview
predetermined or planned questions
Conclusions
 Structured Clinical Interview for DSM-5 Disorders
 In some cases, the conclusion can be essentially
(SCID)
similar to a summarization.
 Semi-structured interview.
 the interviewer might be able to go a step further
Mental Status Exam (MSE)
by providing an initial conceptualization of the
 To quickly assess how the client is functioning at the
client’s problem that incorporates a greater degree
time of the evaluation. The mental status exam
of detail than a brief summarization statement.
does not delve into the client’s personal history, nor
 CLIN311 - LECTURE

is it designed to determine a DSM diagnosis o Verbal and numerical symbols

definitively. CHARLES SPEARMAN: INTELLIGENCE IS ONE THING
 Instead, its yield is usually a brief paragraph that • “g”
captures the psychological and cognitive processes - represented a person’s global, overall intellectual
of an individual at the present ability
Crisis Interviews • Intelligence is a singular characteristic.
• Conducted a research that measured academic abilities and
 The crisis interview is a special type of clinical
sensory discrimination tasks.
interview and can be uniquely challenging for the • Acknowledged that more specific abilities (“s”) existed, but
interviewer. Crisis interviews have purposes that he argued that they played a relatively minor role in
extend beyond mere assessment. They are designed intelligence.
not only to assess a problem demanding urgent LOUIS THURSTONE: INTELLIGENCE IS MANY THINGS
attention but also to provide immediate and • Intelligence as numerous distinct abilities that have little
effective intervention for that problem (Sommers- relationship to one another.
Flanagan & Shaw, 2017). • A pioneer of the statistical procedure called multiple factor
 “no-suicide contracts” analysis.
 “commitment to treatment” • Verbal comprehension, numerical ability, spatial reasoning,
 When interviewing an actively suicidal person, five and memory.
• Primary mental abilities: verbal comprehension, numerical
specific issues should be assessed (adapted from
ability, spatial reasoning, perceptual speed, associative
Sommers-Flanagan & Sommers- Flanagan, 2009):
memory, and word fluency and reasoning.
- How depressed is the client?
HIERARCHICAL MODEL OF INTELLIGENCE
- Does the client have suicidal thoughts?
- Does the client have a suicide plan?
- How much self-control does the client currently
- appear to have?
- Does the client have definite suicidal intentions?

CULTURAL COMPONENTS
 Clinical psychologists should make efforts, in
interviews and other interactions with clients, to
appreciate clients from a perspective that takes into • Specific abilities (“s”) existed and were import ant, but they
account the clients’ own cultures. were all at least somewhat related to one another and to a
 Clinical psychologists also make adaptations to global, overall, general intelligence (“g”)Hierarchical model of
cultural expectations or norms when conducting the Intelligence.
interview, such as perhaps including a bit more
small talk with a member of a culture where its
absence is likely to hinder rapport, or consulting
with professionals who know the culture well MORE CONTEMPORARY THEORIES OF INTELLIGENCE
GUILFORD’S CLASSIFICATION
• Operations: (cognition, memory recording, memory
retention, divergent production, convergent production,
LESSON 9 - THE ASSESSMENT OF INTELLIGENCE
evaluation)
• Contents: (visual, auditory, symbolic, semantic, behavioral)
TYPES OF TESTS • Products: (units, classes, relations, systems,
1. Intelligent tests transformations, and implications)
o Measure a client’s intellectual abilities. GARDNER’S MULTIPLE INTELLIGENCES
2. Achievement tests • Problem solving skills – 8 formal groupings:
o Measure what a client has accomplished with those 1. linguistic
intellectual abilities. 2. musical,
3. Neuropsychological tests 3. logical-mathematical
o Focus on issues of cognitive or brain dysfunction, 4. spatial
including the effects of brain injuries and illnesses. 5. bodily-kinesthetic
WHAT IS INTELLIGENCE? 6. naturalistic
• Experts in this area of clinical psychology have emphasized 7. interpersonal
many abilities as central to intelligence: 8. intrapersonal
- speed of mental processing, • Major issue: “Intelligences” vs. “talents”
- sensory capacity, TRIARCHIC THEORY OF INTELLIGENCE
- abstract thinking,
- imagination,
- adaptability, capacity to learn through experience,
- memory,
- reasoning, and
- Inhibition of instinct,
- and to name a few.
• Emphasis on adjustment to environment:
o Adaptability in new situations • A person’s ability to react and adapt to the world around
o Capacity to deal with a range of situations them—as well as creativity are equally important when
• Emphasis on the ability to learn: measuring an individual's.
o Educability • Intelligence isn’t fixed, but rather comprises a set of abilities
• Emphasis on abstract thinking: that can be developed.
o Ability to use symbols and concepts
 CLIN311 - LECTURE

JAMES CATTELL planning, school placement and qualification, and other

• Fluid intelligence—the ability to reason when faced with targeted assessment questions (Zhu & Weiss, 2005).
novel problems
• Crystallized intelligence—the body of knowledge one has
accumulated as a result of life experiences.
• Falls between Spearman’s theory of a singular intelligence
and Thurstone’s theory of many intelligences.
JOHN CAROLL

• Three-stratum theory of intelligence, in which intelligence

operates at three levels: a single “g” at the top, eight broad
factors immediately beneath “g,” and more than 60 highly
specific abilities beneath these broad factors.
RATIO IQ
• Mental Age (MA) STANFORD-BINET INTELLIGENCE SCALES—FIFTH EDITION
o Index of mental performance • Administered face-to-face and one-on-one.
o Determined using a Binet test • Employs a hierarchical model of intelligence.
• Chronological age (CA): • Yields a singular measure of full-scale IQ (or “g”), five factor
o actual age in years scores, and
• IQ = MA/CA * 100 • (ages 2–85+) as a single test.
WECHSLER INTELLIGENCE TESTS • Stanford-Binet Intelligence Scales—Fifth Edition (SB5)
• The three Wechsler intelligence tests cover virtually the Features 5 factors:
entire life span: 1. Fluid Reasoning—the ability to solve novel problems
1. Weschsler Intelligence Scale - Fourth Edition (WAIS- 2. Knowledge—general information accumulated over time
IV) via personal experiences, including education, home, and
2. Wechsler Intelligence Scale for Children—Fifth environment.
Edition (WISC-V) 3. Quantitative Reasoning—the ability to solve numerical
3. Wechsler Preschool and Primary Scale of problems.
Intelligence— Fourth Edition (WPPSI-IV) 4. Visual-Spatial Processing—the ability to analyze visually
presented information, including relationships between
objects, spatial orientation, assembling pieces to make a
• Wechsler intelligence tests whole, and detecting visual patterns.
- Yield a single full-scale intelligence score, four or five 5. Working Memory—the ability to hold and transform
index scores, and about a dozen specific subtest scores. information in short-term memory.
- Employ a hierarchical model of intelligence (“g”) and ADDRESSING CULTURAL FAIRNESS
(“s”) UNIVERSAL NONVERBAL INTELLIGENCE TEST-2 (UNIT-2)
- Administered one-on-one and face-to-face; cannot be • For clients aged 5 to 21 years and was normed on 1,800
administered to a group. people.
- Each subtest is brief (lasting about 2–10 minutes) and • Administered one-on-one and face-to-face.
consists of items that increase in difficulty as the • Consists of 6 subtests organized into a two-tiered model:
subtest progresses. 1. Memory tier:
- Designed with four factors: a. Object Memory, in which the examinee views a visual
o Verbal Comprehension Index—a measure of verbal assortment of common objects for 5 seconds and then
concept formation and verbal reasoning. views a larger array and identifies the objects from the
o Perceptual Reasoning Index—a measure of fluid first array;
reasoning, spatial processing, and visual-motor b. Spatial Memory, in which the examinee recalls the
integration. placement of colored chips on a three-by-three or four-
o Working Memory Index—a measure of the capacity by- four grid; and
to store, transform, and recall incoming information c. Symbolic Memory, in which the examinee recalls and
and data in short-term memory. re- creates sequences of visually presented symbols.
o Processing Speed Index—a measure of the ability to 2. Reasoning tier:
process simple or rote information rapidly and a. Cube Design, in which the examinee arranges colored
accurately. blocks in a specific three dimensional design;
• They feature large, carefully collected sets of normative b. Mazes, in which the examinee completes traditional
data. That is, the manual for each Wechsler test includes maze puzzles; and
norms collected from about 2,000 people. c. Analogic Reasoning, in which the examinee solves
• Generated by the Wechsler tests are “IQ” scores. analogy problems that are presented visually rather
• Share a general approach to interpretation of scores. than verbally.
Assessors are instructed to first consider the full-scale IQ
score.
• Backed by very impressive psychometric data: strong
reliability and validity.
• Focus on issues of intellectual developmental disorder,
developmental delays, giftedness, educational and vocational
 CLIN311 - LECTURE

- MMPI -2, PAI, MCMI -IV,

- NEO -PI -3, BDI -II
 03 Projective Personality Tests Rorschach, TAT, RISB
 04 Behavioral Assessment
- Methods
- Technology

Multimethod Assessment
 the integration of multiple methods that ultimately
proves most informative.
Evidence –based Assessment
 Integrating “what works” empirically with clinical
judgment and clients’ needs as they make decisions
about assessment.
Culturally Competent Assessment
 To appreciate the meaning of a behavior, thought,
or feeling within the context of the client’s culture,
which may differ from the context of the
psychologist’s own culture include unambiguous
test items, offer clients a limited range of
ACHIEVEMENT TESTING
responses, and are objectively scored.
• Achievement is what a person has accomplished, especially
in the kinds of subjects that people learn in school, such as
reading, spelling, writing, or math. OBJECTIVE PERSONALITY TESTS
• Typically produce age- or grade- equivalency scores as well  include unambiguous test items, offer clients a
as standard scores. limited range of responses, and are objectively
WECHSLER INDIVIDUAL ACHIEVEMENT TEST—THIRD scored.
EDITION Minnesota Multiphasic Personality Inventory-2
• WIAT-III (MMPI-2)
- Comprehensive achievement test for clients aged 4 to  Most popular and the most psychometrically sound
50 years
objective personality test
- Measures achievement in four broad areas: reading,
math, written language, and oral language  For 18 years and older, 60 – 90 minutes
- Two subtests: Listening Comprehension and Oral  The client reads 567 self-descriptive sentences and,
Expression using a pencil-and-paper answer sheet, marks each
NEUROPSYCHOLOGICAL TESTS sentence as either true or false as it applies to him
• Measure cognitive functioning or impairment of the brain or her
and its specific components or structures.  The items span a wide range of behavior, feelings,
• Useful for targeted assessment of problems that might and attitudes.
result from a head injury, prolonged alcohol or drug use, or a  Empirical criterion keying – identifying distinct
degenerative brain illness. groups of people, asking the all to respond to the
same test items and comparing responses between
FULL NEUROPSYCHOLOGICAL BATTERIES groups
1. Halstead-Reitan Neuropsychological Battery (HRB)  Validity scales – inform the clinical psychologist
- Age 15+
about the client’s approach to the test and allow
- Assess brain malfunction
the psychologist to determine whether the test is
2. Catgory Test
- Pattern of shapes & design valid 1. L (Lying, faking good) 2. K (Defensiveness,
3. NEPSY-II faking good) 3. F (Infrequency, faking bad) -
- Age 3 – 16 Malingering
- 32 separete subtests’; 6 categories  Criticisms: - Lengthy - Susceptible to “faking” -
Emphasis on psychopathology
 Other versions: - MMPI-2-RF - MMPI-3 - MMPI-A
LESSON 10-11 Personality Assessment and Behavioral
Assessment
Content
 01 Multimethod Assessment, Evident -based
Assessment, and Culturally Competent Assessment.
 02 Objective Personality Tests
 CLIN311 - LECTURE

 Each item is a set of four statements regarding a

particular symptom of depression, listed in order of
increasing severity
 Lacks validity scales, has strong validity and
reliability
 Related instruments: -Beck Hopelessness Scale -
Beck Anxiety Inventory

PROJECTIVE PERSONALITY TESTS

Rorschach Inkblot Method

Personality Assessment Inventory (PAI)  10 inkblots, 5 with only black ink and the other 5
 contains 344 items, each of which offers four with multiple colors.
responses: totally false, slightly true, mainly true,  Two-phased administration: “response” or “free-
and very true. It is appropriate for association phase” and “inquiry” phase
 clients 18 to 89 years old, but an adolescent  not accompanied by a scoring method.
version, the PAI-A, can be used for clients as young  John Exner – created the comprehensive System
as 12
 11 clinical scales, some that match with those of the
MMPI but others that are more uniquely tied to
specific diagnoses or problems, like Borderline
Features, Antisocial Features, Anxiety- Related
Disorders, Alcohol Problems, and Drug Problems
Millon Clinical Multiaxial Inventory-IV (MCMI-IV)
 Comprehensive personality test
 Self-report, pencil-and-paper, 195 true/false
format
 MCMI-IV features separate clinical scales
corresponding to each of the 10 current
personality disorders (e.g., antisocial, borderline,
narcissistic, paranoid).
 For 18 years and older
 Other version: Millon Adolescent Clinical Inventory
(MACI) – 160 items, for 13 to 19 years old
NEO Personality Inventory-3 (NEO-PI-3)
 Assesses “normal” personality characteristics
 Produces 30 “facet” scores (six facets within each of
the five domains) to offer more specific descriptions
of components within each trait
 Criticize for the ack of validity scales.

Beck Depression Inventory-II (BDI-II)

 typically briefer (21 items, 5-10 mins) and focus
exclusively on one characteristic, such as
depression, anxiety, or eating disorders.
Thematic Apperception Test (TAT)
 self-report, pencil-and-paper test that assesses
 the 31 TAT cards feature interpersonal scenes
depressive symptoms in adults and adolescents (13
 client’s task is to create a story to go along with
– 80 years old)
each scene
 CLIN311 - LECTURE

 the client tells stories aloud and the psychologist

writes them down Behavioral Assessment in Therapy
 often analyzed without formal scoring at all: “Most
clinicians today seem to rely on their own
impressionistic inferences,” resulting in
“idiosyncratic and inconsistent” use of the TAT
 Other versions: CAT, SAT, and TEMAS

Technology in Behavioral Assessment

 To utilize devices such as laptop computer or
Rotter Incomplete Sentences Blank (RISB) smartphone to record observations
 The RISB tests include 40 written sentence  Customized apps or software may be provided to
 “stems” referring to various aspects of the client’s clients
life.  Self-monitoring
 has a formal scoring system, but may also be highly  Texts, email, downloading of records.
dependent on the clinical judgment of the
psychologist.
 May be integrated with other personality tests
BEHAVIORAL ASSESSMENT
1. Personality is a stable, internal construct
2. Assessing personality requires a high degree of
inference.
3. Client behaviors are signs of deep-seated,
underlying issues or problems, sometimes taking
the form of DSM diagnoses.
Methods of Behavioral Assessment
 Behavioral Observation
1. Naturalistic Observation
2. Systematic Observation
3. Analogue Observation
4. Traditional Assessment methods (interviews,
questionnaires)