1
Q
What time of data do we use in assessment to help make our decisions?
A
- BASERATES for how they were before.
- self reports
- reaction time based assessment (that are compared with norms on meaningful variables.)
- School records
- how someone presents in the room with you
- observations in natural settings
2
Q
Decisions in assessment are subjective and subject to cognitive bias, what does this mean for analyzing data?
A
it means that we are going to be looking at data in different ways.
have to look at bias to make sure that the assessments we do are valid
examining bias is important so we are making ethical decisons
3
Q
what does it mean that psychological assessment is systematic?
A
- there is a plan for how the assessment will go
- there is an order in which we execute that plan
- all practitioners will execute the assessment in a particular way
4
Q
Goals and measures vary in assessment.. what does that mean?
A
goals help set a road map for what the assessment is going to look like.
going to use different materials and measures depending on the goal of assessment
5
Q
When do we not provide feedback (back to client) on the assessment?
A
- ## court mandated
6
Q
What are some qualities that a psycholigist is supposed to have at the point of licensure?
A
- apply knowledge of individual and cultural characteristics in ax and dx
- effective interviewing
- instruments selected are based on normed data (carrying out the appropriate tests)
- administer and score the instrument following guidelines and psychometric research
- interpret and syntesize information from multiple sources
-formulate diagnosis, recommendations, and professional opinions using relevant criteria
- communicate the results form assessment in an integrative manner
- evaluate the effectiveness of psychological services (e.g., what treatment you would recommend for [i.e, PTSD])
7
Q
What are STAND ALONE assessments?
A
Services conducted primarily to provide information on a persons psychological functioning.
intent: CONCLUSIONS and RECCOMENDATIONS about a persons functioning.
-providing information to the REFERRAL source
- e.g., custody, screening, return to work, forensic, psychodiagnostics
8
Q
what is intervention focused assessment?
A
When assessment is not a stand alone service but is the first step in providing intervention..
intent: to IMPROVE the persons functioning.
- providing information on types of treatment that would benefit the client
- shared with client and clinicians..
- this type of assessment will give us a good baseline for where someone is at before treatment.
9
Q
Breakdown of STAND ALONE assessments… what are all the components that are in it?
A
- screening
(focus on prevention) - diagnosis
- prognosis
- treatment recommendations
10
Q
Evidence based assessment
A
the use of research and theory to guide
a) the variable assessed
b) the methods and measures
c) the manner in which the assessment unfolds
11
Q
define: screening
A
identifying individuals who have / are at risk for developing problems of a clinical magnitude, and who may have not sought out assessment services
goal: identify those who might require services
+ early identification and treatment
12
Q
define: case formulation
A
a description of the patient that provides information on his or her life situation, current problems, and a set of hypothesis linking psychosocial factors with the patients clinical condition
13
Q
define: prognosis
A
predictions made about the future course of a patients psychological functioning based on the use of assessment data in combination with empirical literature.
14
Q
define: base rates
A
the frequency with which a problem or diagnosis occurs in a specific population
15
Q
What is a “true positive”
A
the prediction that an event would occur is true.
(correct prediction)
16
Q
what is a true negative?
A
prediction of a non-event was accurate (no diagnosis was warranted, or the suicide attempt did not occur)
17
Q
what is a false positive?
A
psychologist predicts an event will occur, but the vent does NOT occur..
e.g., ADHD diagnosis, but person does not have ADHD
18
Q
what is a false negative?
A
an event occurs, but it was NOT predicted by the psychologist. (e.g., failure to diagnose someone with a personality disorder)/.
19
Q
Accuracy is the combination of 2 concepts… What are they & what do they mean?
A
1) sensitivity:
the number of times an event is predicted.. (the proportion of true positives identified by assessment)
( true pos (divided by) true pos + false neg) = sensitivity
2) Specificity:
# of times a non-event is predicted..
- the relative proportion of true negatives.
true neg (divided by) true neg + false positive
20
Q
What is the first step in treatment planning?
A
assessing how well the client fits with the population the norms were created from
21
Q
Useful treatment plans MUST cover 3 things, what are they?
A
1) problem identification = a clear statement about the problem to be addressed..
2) Treatment goals = Goals must be specified. Both ultimate and intermediate treatment goals
3) Treatment Strategies & Tactics = general approach to addressing clinical problems & descriptions of tactics to provide details on specific tasks, procedures and techniques..
e.g., strategy = emotionally focused couples therapy
tactic = work on emotionally connecting this week.
22
Q
Define: treatment monitoring
what does it include?
A
Treatment Monitoring: Allows psychologist to change treatment in response to patient. e.g., shorten / alter
- tracking progress thorugh explicit measures like specific questionaires or psychological measures
- data on problems in the process of treatment and obstical patient encounters outside of therapy (not doing self assessments) are an opportunity to readjust treatment
monitoring = positive effects on treatment outcomes
23
Q
Define Treatment Evaluation.. what does it involve?
A
basically tells you if the therapy was effective in a hcieveing the stated goals.. you compare the outcome data with intake data to see how much change happened..
- gives info on the nature & duration of the treatment needed
- typical treatment responses = profiles of symptom reduction and improvements in functioning over the course of the treatment.
24
Q
How do you measure psychological functioning?
A
tests that requires norms, reliability and validity
25
What is the difference between assessment and testing?
testing is when a device is used to gather a sample or behaviour from a client. the scores are then assigned and compared against norms.
- "what is the score that someone has on their cognitive measure"
assessments address a specific question.. They
integrate life history, client observation and results from psychological tests, and people in the clients life...
- multiple sources of data including standardized testing an interviews.
- requires integration and interpretation
e.g., "do they have a learning disability, if so how can we deal with it"
26
How does assessing kids differ from assessing adults?
need a larger number of children and more variety of tests than would typically be used for an adult..
27
what are some psychometric elements that make a test scientifically sound and clinically useful?
- standardization (of stimuli, administration and scoring)
- reliability
- validity
- norms
28
What is standardization?
consistency across clinicians and testing occasions in the procedure used to administer a test..
29
what happens if you dont have standardization?
its impossible to replicate information gathered in assessment / cant generalize data
30
How does a clinical reduce variability in standardized testing?
giving specific instructions about the stimuli, administrative procedures, time limits, and types of verbal probes and responses.
31
What is reliability?
the consistency of the test / if all aspects of the test contribute to meaningful data.
e.g., IQ testing is generally reliable.. (if you test in grade 10 and then again in a few years you would expect a similar range).
- has to give accurate representation of some concept that we think its tapping into.
32
what is test-retest reliability?
the extent to which similar results would be obtained if the person was retested at the same point after the initial test.
33
what is internal consistency?
the extent to which all aspects of a test contribute to the overall score
34
what is inter-rater reliability?
the extent to which similar results would be obtained if by another scorer
35
Some things to know:
just skip to answer
- reliability for one demographic does not mean reliability for a different demographic
(we may have validated / normed a measure for one group, but it doesnt hold up with others)
- some tests dont need internal consistency (death of a loved one / stressful life event / job loss), all of those questions might not be related to eachother..
- same thing with test-retest reliability, you wouldn't expect those items to stay the same.
36
what is the minimum reliability score for clinical tests.....
what is the minimum reliability score for research?
.90 for clinical testing
.70 for research
--> (.90) is important for clinical tests because it impacts error... important when working with cut off scores.. e.g., if a child is disabled or gifted.
37
What is validity?
does the test measure what it says it measures?
38
what is evidence of content validity?
test items are representative of all aspects of the underlying psychological construct that the test is designed to measure...
so... the content of the test is relevant to what the test is trying to measure.
39
what is evidence of concurrent validity?
the extent to which scores on the test are correlated with scores on measures of similar constructs..
like.. do two anxiety tests look the same?
40
what is evidence of predictive validity?
the extent to which the test predicts a relevant outcome
41
what is evidence of discriminant validity?
the extent to which the test provides a pure measure of the construct and is minimally contaminated by other psychological constructs..
if the test measures depression, it should measure depression more than anxiety.
42
what is evidence of incremental validity?
the extent to which a measure adds to the prediction of a criterion above what can be predicted by other sources of data...
does it do a better job at predicting something than other tests?
43
just because a test is valid for some groups does not make it valid for other groups
fun fact
44
why do you need norms?
they are essential for the meaningful interpretation of the results obtained from the client
- without, its impossible to determine any precise meaning of a test result
- have to know the range of scores and how most other people score
- gender norms / non-distressed vs. psychologically distressed norms / norms for Dif age groups
45
what is a convenient sample (for norms)?
undergrad students, hospitalized inpatients.. need to be skeptical because there was likely no effort to make sure they are the same age / race / sex / education level to the group of people receiving assessment
46
true or false: you want research participants to represent the national population from which the test will be used.
true
47
what are test norms?
percentile ranks, standard scores and developmental norms..
the amount of scores under thermal curve allows your to interpret thenormative meaning of a percentile rank and standard score.
48
when is the only time 'informed consent' is violated?
court mandated assessment, or when an individuals capacity to make decisions
e.g., a custody or legal thing that makes the person get a psych evaluation.
but most of the time, its the psychologists ethical responsibility to communicate the results of the assessment to the client and make sure they understand it.
49
When are the only times you break confidentiality?
- suicide // a plan and means to carry out self harm.
- danger to other..
- child protection
- court supina.
- risk to driving (if they are drunk / high / processing speed is super low on a cognitive test you have to report it to ICBC)
(limits of confidentiality must be outlined in informed consent procedures)
50
Define: base rates (might be a double)
the frequency by which a problem occurs in the general population.
for most mental health disorders we see super low base rates...
they are super important to look at when we are making clinical predictions..
- e.g., schizophrenia 1%
- depression 10%
51
What are true events?
True positives..
False Negatives
a disorder is present.. it is true that the disorder is there... whether it is predicted or not.
52
What are True non-events?
True negatives
False positives
a disorder is not present.. it is true that it is not there, whether it is predicted or not.
53
what does informed consent involve?
- what the assessment will involve
- what reccomendations we are able to make
- what we are NOT able to do
- who will get a copy of the report.
- awareness of the limits of confidentiality
- responsible caring - selecting appropriate tools for the referral (idk if this is informed consent tho)
54
what are some examples of radicalized bias in psychological assessment?
- early IQ tests were developed to support the eugenics movement
- standford-binet test was constructed to determine minority groups were inferior.
- IQ and cognitive tests used to support deportations in US WW1
- racial segregation of students in school due to biasing in IQ testing.
55
what are some consequences of bias in psychological assessment for POC people currently
- bias adversely affects POC as norms and standardization are based on the dominant culture..
consequences:
- misdiagnosis,
- improper and determinative treatment
- lack of beneficial treatment, recommendations, referrals and services
56
Things psychologists must consider when assessing culturally diverse individuals:
- acculturation level
- English language proficiency and literacy
- sustainability of test norms for the client
- using best available measures for clients background
- discussing interpretation of finding with other colleagues who might have more expertise in the background your client is from
- aknowledge limitations of testing in the report.
- triangulation of test findings with other sources of information (clinical interview + informant report)
57
psychologists do not have "client privilege" - true or false
true...
not like lawyers where a clients gets to hold the privilege and decide if something is disclosed or not...
psychologists must report if someone is going to kill someone lol
58
what is an unstructured interview?
does not follow any sort of structure, all based on what the psychologist feels is the most important thing to follow in an interview.
we dont use unstructured interviews in assessment settings.
but we DO USE unstructured interviews in therapy settings.
59
what are some benefits of using unstructured interview?
- creates a safe environment for client to feel comfortable.
- positive relationship
- gather pertinent information (as long as the person isn't tangential)
you get a sense of what is important to that person and what they are comfortable talking about.
- can help the client feel comfortable opening up
60
What is the role of the psychologist in facilitating an unstructured conversation
(key skills)
- setting the context of what someone will be speaking to
- asking open and closed ended questions (pursuing a line of questioning)
- clarifying, reflecting, and paraphrasing
- silence (used to elicit more information from the client, or give them space to process).
61
what is an open ended question?
what are the pros and cons?
can be answered with anything...
- you get a ton of information..
- have to shade through what is useful and what is not
- can be hard to bring people back to topic if they are going on a tangent.
62
what is a closed question?
what are the pros and cons?
yes / no answers
pros: gives interviewer the ability to move through alot of relevant topics quickly
cons: surface level.
have to be careful not to ask leading questions
63
what is pursuing a line of questioning?
asking questions that centre around what the assessment is about.
64
what is clarifying in an interview?
attempted restating of a clients message, proceeded with a closed question (e.g., is that right)
it facilitates / inhibits spontaneous client talk
want to know exactly what someone means
- will probably be subject to our biases.
65
what is reflecting in an interview?
reflecting back what someone said.. they will often elaborate
66
what is paraphrasing in an interview?
reflection of rephrasing of what client said.
assures client you hear them accurately and allows them to hear what they said
paraphrasing is a tool to see if that is what the client really means
67
What are some issues with unstructured interviews?
- confirmation bias
- ranting
- low diagnostic reliability
68
Major differences between assessments and chats with friends lol
- painful topics
- innate power imbalances
- Disclosure
- confidentiality
- treatment notes
69
What sort of interview was created to increase diagnostic reliability?
semi-structured interviews
70
What is a semi-structured interview?
interviews with a specific format for asking questions and specific sequence in which questions are asked...
based on initial responses, the interviewer will ask follow up questions that help confirm or rule out possible diagnosis
71
what is the purpose of a semi-structured interview?
addresses almost any clinical issues.
provides diagnostic information
72
What are two examples of semi-structured interviews?
the SCID-5 and the SCIDpd
says things like:
- do you experience flashbacks, nightmares and avoidance
if someone says yes, you can ask them to elaborate.
73
the SCID-5 is the most widely used clinical interview in North America
(Structured clinical interview for DSM)
has different versions... what are they?
Research version - covers most DSM diagnosises
Clinical version - shorter - covers disorders that are common in clinical settings
personality disorder - detailed evaluations of all 10 DSM personality disorders
Clinical trials version - tailored to the needs of treatment trials
74
What is the Clinical Version of the SCID-5 like?
- opens with less structured questions.
- designed to build rapport
- then structured questions geared towards diagnosis
- NOT completely standardized
- time consuming
- about as much validity as the the DSM5
75
ADIS-5 (Anxiety and related disorders interviewing schedule for DSM)
what sort of interview structure?
what does it focus on?
how many versions of it are there?
Semi structured
- Anxiety and anxiety comorbid disorder (depressive, substance related disorders, somatic symptom disorders)
- 2 versions for adults:
1. current diagnosis only.
2. current symptomology and lifetime history.
- 1 version for youth
(includes things like feeling thermometers)
76
How do we adapt tests for kids?
- break it up, do activities
- the language we use
- attention span (length of sessions, capacity)
77
What are some things we can do to make the client feel more comfortable in evaluation?
- relaxing environment
- body language
-- mirroring people
-- modeling calm behaviour
-- nodding to let people know you're listening
- small talk off the bat
78
What are some general issues we might face in an interview with 'skills in questioning'
- dont want to make it seem like an interrogation
- reading the room
- finding discrepancies between a clients body language and behaviour helps find good information..
- you can reflect this too
79
What are some skills in listening that you can demonstrate within an interview?
- mirroring body language - leaves a person with the sense that you are trying to understand them
- want to attend to their emotions (e.g., if the affect is changing through out the interview).
- start with small talk: pronouns, DOB - not just jumping into trauma lol
- demonstrate unconditional positive regard, empathy, and being yourself
- "accurate empathy" = being able to understand someones life experience without diving into sympathy
80
What is attending behaviour?
eye contact, leaning forward, head nods, facial expression....
facilitates / inhibits spontaneous client talk
81
what is summarization?
brief review of several topics covered during the session
purpose: enhances recall of session content and ties together or integrates themes covered in a session
82
What are Cultural Formation Interviews?
focuses on the POV of client and people in clients social network..
explores client's presenting problems, the problems meanings, and avenues for dealing with it..
takes into account ethnic, socioeconomic, regional, and spiritual variables..
(e.g., not interpreting things as lack of social engagement / lack of eye contact as negative if they could be coming from a religious / cultural difference)
goal is to be able to understand the client holistically, so we can make the best recommendations that will land for them
giving the power back to people because they are experts of their own experience
clinical needs to evaluate their cultural blind spots and biases.
83
what are microagressions?
slights, misunderstandings, and unwanted assumptions on part of the psychologist.
84
What are some phrases that would be involved in pursuing a line of questioning?
* Tell me more about…
* Can you explain what you mean by…
* Give me an example…
* What does depressed mean to you?
* I want to be sure I understand…
* Help me understand what you mean by out of control…
* What happens when…
* Describe what it’s like when…
* Tell me about the last time that…
- you are essentially trying to define the problem that you are pursuing
85
problem definition involves 3 main question themes: what are they?
Frequency
Intensity
Duration
86
Why is clinical goal setting SO IMPORTANT?
#1 thing in therapy, it is what we are working towards... its an objective goal to show that therapy is working..
if there are no objective goals/ markers.. then its hard for people to see theres a difference.
AVOID: dead persons goals
measuring progress is imperative - need to OPERATIONALIZE it.
" if you were less anxious, what would that look like"
-- you can MEASURE that.
operationalizing becomes very important
87
what are SMART goals?
- specific
- measurable
- attainable
- relevant
- timely
the goal must be important to the client and expressed in positive terms
88
define: suicide
an intentional, self inflicted act that results in death
89
What does the degree of risk for suicide include?
- history
(like history of abuse or ACEs)
- accute condition
(are they actively manic, in psychosis, in a depressive episode?)
- present. plans,
(do they have the means / tools to carry out suicide)
- current ideation
(the level of intent - coping via self harm or are they going to end their life in an immediate context)
- available support networks...
90
what is a warning sign?
things that can set the action of suicide in motion in the near future
91
what is a risk factor?
things that are associated with an individual potentially contemplating suicide on some point
- dont necessarily predict suicide, but they are red flags
92
what are some risk factors?
- social connections
- recent unemployment or financial difficulty
- being divorced, separated, or widowed
- recent traumatic events or being exposed to recent abuse
- any recents elf harm, suicidal events
(one of the biggest predictions of an attempt is a previous attempt)
- chronic mental illness
(schizophrenia patients have a significantly higher rates of suicide)
93
What are some warning signs?
- threatening to end someones life
- talking about plans they have
- always have to follow up with questions like where are you at in your planning stage"
- hopelessness
(its an independent predictor of suicide, learned helplessness, nothing is going to change)
- significant emotions
( rage, anger, regenve seeking, impulsivity)
- Withdrawn
( from friends, family, society)
- Dramatic changes in mood
(people feel super up beat before their suicide attempt)
- shifts in medication
(can be a risk factor and a warning sign)
- hospitalization - after they get out is the highest risk for a suicide attempt
- being immobile, staying in bed for long periods of time
(they are most likely to attempt suicide when their symptoms alleviate because they have the energy and means)
* when risk factors are paired with warning signs we need to be asking questions and following up *
94
What are some protective factors?
(protective factors might mitigate risk)
BUT should never supersede evidence of warning signs
- strong connection to family / community support
- skills in problem solving, coping and conflict resolution
- sense of belonging, sense of identity and good self esteem
- cultural / spiritual / religious connections
- identification of future goals
- constructive use of leisure time (enjoyable activities)
95
The continuum of risk for suicide:
what does non-existent risk look like?
absence of suicidal ideation
96
The continuum of risk for suicide:
what does mild risk look like?
- suicidal ideation of limited frequency intensity or duration
- no plans, no intent, good self control, few risk factors
97
The continuum of risk for suicide:
what does moderate risk look like?
frequent sucidal ideation with limited intensity and duration.
- some specific plans, no intent, some risk factors, presence of protective factors
98
The continuum of risk for suicide:
what does high risk look like?
- frequent, intense, and enduring suicidal ideations
- specific plans, objective markers of intent
- access to lethal methods
- evidence of impaired self control
- multiple risk factors
- few, if any, protective factors
99
The continuum of risk for suicide:
what does imminent risk look like?
- frequent, intense and enduring sucidal ideation
- specific plans, access to methods, clear subjective self report, and objective judgement
- intent, impaired self control, severe dysphoria
- many risk factors, no protective factors..
- this ALWAYS means the person needs to go to the hospital.
100
How do you interview for suicide risk?
- establish report
- build therapeutic alliance
- want to ask blunt questions (so they know exactly what we are asking)
- ask about frequency, intensity and duration of thoughts and feelings
- asking why they want to live.
101
In interviews with children (observational) what are we looking for?
- what their play looks like
- interaction style
- how do they transition (from one environment to another)
102
What is self monitoring?
strategies to monitor ones own behaviour /thoughts / emotions...
strategies for psychologist to obtain accurate information (e.g., getting client to record # of occurrences)
103
what is the purpose of using self report measures?
helps establish baseline conditions for a behaviour / problem that will be the focus of treatment..
- can also get the client to self report their thought patterns e.g., "being a failure" so you can see the context / what provokes and maintains those thoughts
might be used in the treatment of eating disorders or anxiety disorders
104
what are some advantages of self reports?
- fuller picture of behaviour / emotion / thought in question..
- daily context
- correct retrospective recall problem (its hard to average out how we are doing in a week.. daily questionnaires help curb that)
105
what are some challenges In self-reports
- forgetting
-reluctance
(it makes them more salient... e.g,, if you're tracking compulsions you are going to think about your compulsions more)
(when you are tracking substance use, the rule is multiply it by 3)
- harder with kids
- instructions must be clear
- selective reporting
(we want to get the full picture the good / bad / ugly)
106
what is the issue of reactivity in self monitoring?
a change in the phenomenon being monitored that is due specifically to the process of monitoring the phenomenon..
e.g., hallucinations, substance abuse, worry and insomnia.. usually reduces the behaviour but we cant get accurate data
107
define: intelligence
involves the ability to reason, plan, solve problems, think abstractly comprehend complex ideas, learn quickly, learn from experience.... not just academic skill but thither reflects a broader and deeper capacity for comprehending surroundings... catching on / making sense / figuring out what to do.
108
why should we assess intelligence?
(3 main reasons)
1) to identify impairments, weaknesses / strengths
- giftedness (above 130)
- disability ( bellow 70)
2) to identify appropriate learning environments
(learning supports / menthol health supports)
3) make recommendations for modifying work / home environments
109
what is g
intelligence..
spearman proposed that all intellectual activities share a single common core, known as the general factor or g
110
the more a test is influenced by s (specific factor) the less it represents the influence on g.
his focus on s and g was known as the two factor model.
fun fact
111
define: fluid intelligence
the ability to solve novel problems without drawing on prior experience or formal learning.. it is therefore best understood as initiate intellectual potential
112
what is crystallized intelligence?
what we have learned in life, both from formal education and vernal experiences.
113
what is the triactic theory of intelligence?
1) componential
- mental processes of planning, performance of solving problems, and knowledge aquisition
2) experiential
- task novelty
3) contextual
- different ways of interacting with environment
114
What is gardeners theory of multiple intelligences?
linguistic, musical, logical-mathematics, spatial, bodily kinaesthetic, intrapersonal, interpersonal, naturalist, spiritual, existential, and mortal
= full range of intelligences
115
what is premorbid IQ?
intellectual functioning prior to an accident or the onset of a neurological decline.
116
intelligence tests have limited content validity for the larger construct of intelligence.
yess because they usually only focus on academic performance and not designed to measure social, emotional and other domains.
117
Wechsler Intelligence Scales
3 main ones:
WAIS-IV (wechler adult intelligence scale)
-age 16-90
WISC-V (Wechsler intelligence scale for children)
- 6-16
WPPSI-IV (Wechsler preschool and primary scale of intelligence)
- 2-6/7
others:
WASI
- brief version of the WAIS
- for people 16-90
- instances where people have done a WAIS before and need an alternative
118
what are the 4 scales that make up the FULL IQ SCALE?
/ What are the Wechsler Scales measuring? *
1) verbal comprehension
- vocabulary, syntax, and process verbal material
2) perceptual reasoning
-how people manipulate stimuli in their mind..
-e.g., building a pattern based on what you see with visual stimuli
3) working memory
- short term memory
4) processing speed
- how quickly can you process new information
- e.g,, crossing out pictures if a word pops up
119
Wechler introduced the deviation of scores to measure intelligence
120
the Stanford-binet test measures intelligence by relying on the comparisons between chronological age and the persons mental age.
e.g., if someones CA iss 20 and their MA is also 20, they will have an IQ score of 100
121
What is Full Scale IQ?
the total score for an intelligence scale obtained by summing scores on verbal and non-verbal scales.. usually referred to simply as the IQ
122
what is the main variability across the Wechler scales?
age
123
define: representativeness
the extent to which a sample reflects the characteristics of the population from which its drawn
124
what are some issues in testing outside of the normative sample?
- giftedness or disability might be overemphasized
- the content of the test might not be relevant to other groups
125
define: emotional intelligence
is composed of related abilities that enable the person to perceive, understand and regulate emotions
126
what is a scale measuring emotional intelligence?
the emotional quotient inventory
EQ-I-short
based on a definition of emotional intelligence is made up of cognitive e, personality a and motivational and affective factors.
requires participants to rate themselves pn intrapersonal, interpresoanl, stress management, and adaptability scales.
critique: high scores can easily be faked and thus its not super valid
127
EI is associated with:
- better social relations for children
- better social relations for adults
- better family and intimate relations
- more positive percetptions by others - considered to be morepleasent and more empathetic
- better academic achievement
- better social relations during work performance
- better psychological wellbeing
128
WAIS-IV
go off a little
16-90 years old
- exhausting
- can take multiple hours
- asks general knowledge questions
- based on normative sample: 1000+ representative adults (sex, education level, ethnicity and religion)
- problems basic norms on census data... the WEIRD POPULATION?
- census requires you have a pernament address and documentation
- census does not represent people who are undocumented...
- undocumented people are generally of a certain demographic
- there is a French version
- reliability estimate is .90
129
Why are we going from looking at the scales broadly to looking at them ore specifically?
if they get a lower than average IQ score, then we want to see where specifically their deficit is that is pulling down their overall score.
130
What is the flynn effect?
The observation that IQ has been getting higher (by roughly 3 points) with every generation
whyyy>?
- we are becoming more familiar with standardized testing..
- more diverse populations are completing education
- improved nutrition and physical health
131
what is the reverse flynn effect?
IQ scores peaked in the 90s and have been steadily declining since..
- lowest scores visiospatial and verbal reasoning..
- steepest decline for 18-22 year olds...
132
what is the TEST GAP?
black individuals score lower than European Americans on vocabulary, reading and math, scholastic aptitude and intelligence tests..
- gap has narrowed, but black individuals still score bellow 75% of all white Americans on almost every standardized test...
133
what are some outcomes of closing the test gap?
- promotes racial equality
- reduces racial disparities in mens and women's earning
- increase rates of black individuals being accepted into universities
134
Standford Binet intelligence test
- age 2-85
- good reliability / norms
- limited outside of US
- icky roots in white supremacy
- WE UE IT WHEN: we are concerned someone might have a low IQ,
(the WEIS bottoms out at 50).. the Stanford Binet has a LOWER FLOOR and we can test someone who has an iq range of 30-40*
- not used alot outside of canada/US
- Racism
(developed to support eugenics)
135
Daniel Goldman EI
(4x)
- self-awareness
- self-management
(handling distressing emotions in an effective way)
- empathy
- putting that all together in relationship....
when EI is implemented in schools..
antisocial behaviour goes down 10%
prosocial behaviour goes up 10%
136
What is the Wechler Memory scale?
- specifically for when someone has a concern about their memory
- both episodic and declarative memory
- also long term memory (amnesia)
137
What Is Index Scores?
a cognitive assessment scale that measures
1) auditory memory
- say something / repeat it
2) visual memory
- visual stim, take away, what do they remember, can they redraw it?
3) Visual working memory,
- hold somting in mind, use it in some way
4) immediate memory
- working memory
5) delayed memory
- read a story, 10/20/30 min later recap it
138
What is the Wechsler Individual Achievement Test?
- used to make learning disability diagnosis or help with educational planning..
- evaluates academic and problem solving skills (age 4-51)
- reading score
- math score
- written expression form (e.g., sentences, grammar)
- oral language
139
WAIS-IV..
what are the components of the verbal comprehension scale?
- similarities (between two concepts or objects)
- vocabulary (defining words that are orally or visually presented)
- information (about events, objects, people and places)
- comprehension (about common concepts and problems)
140
WAIS-IV..
what are the components of the perceptual reasoning scale
- block design (coloured blocks to make 3d things out of 2d pictures)
- Matrix reasoning (has to complete patterns based on 5 choices)
- visual puzzles
- picture completion (identifying missing part of object)
- figure weights (guessing how much something weighs)
141
WAIS-IV..
what are the components of the working memory scale?
- digit span (repeating sequences of numbers or reversed)
- arithmetic
- letter-number sequencing (a bunch of letters and numbers are given... person has to order them alphabetically and accending order)
142
WAIS-IV..
what are the components of the processing speed scale
symbol search: whether target symbols appear in a group of symbols
coding : correct symbols to numbers
cancellation - cross out images that have specific shapes and colours..
143
What are the components on the WISC-V
(wechler intelligence scale for children-5)
age 6-16
- Verbal comprehension index
- Visual-Spatial Index
- Fluid reasoning Index
(matrix reasoning - child presented with incomplete patterns - select image that completes pattern)
- Working memory index
(digit span)
- Processing speed index
(coding)
144
How many different subtests are there for the WPPSI?
15!
e.g., from kids 2 years 6month -- 3 years 11 moths...
4 years --- 7 years 7 months
145
what does the intelligence by Kaufman & Kaufman measure?
how children and adults learn, and they assess styles of learning rather than knowledge or skill areas.
sub scales for kids:
- sequential processing
-stimutanious processing
-mental processing
- composite
- achievement
--> comparing a persons score on processing scales with those obtained on achievement scaled identifies a gap between that persons potential to learn and what he or she has actually learned..
146
clinicans usually need to supplement the results from an intelligence test with information obtained on other tests that address cognitive functioning....
2 common tests that measure cognitive functioning are:::
- Wechler memory scale (used for: brain injury/ brain dysfunction due to dementia, epilepsy, or Parkinson's )
- WEchler individual achievement scale
(used for: assessing learning disabilities and making recommendations for educational plans to address any observed learning problem)
147
Wechsler memory scale: (MWS-4)
- procedural memory - involving skills and complex motor actions (like riding a bike)
- and declarative memory
(involving symbolic representations)
declarative memory is further divided into semantic and episodic memory
Semantic = memory of general knowledge of words, concepts and events
episodic = memory of a persons direct experience
subsets: designs, logical memory, spatial attention, symbol span, verbal paired associates, visual reproduction)
index scores:
- auditory memory
-visual memory
visual working memory
- immediate memory
delayed memory
148
What do the WMS and the WIAT have in common?
2 common tests that measure cognitive functioning that are normed with the WAIS and used alongside the intelligence measures.
149
what is the WIAT-3
Wechsler individual achievement test
designed to evaluate a persons academic and problem solving skills
ages 4-51
when used in combo with intelligence scales it can identify learning disabilities...
subtests are organized into:
- reading
(word reading, reading comprehension, pseudo word decoding, oral reading fluency)
- mathematics composite
(numerical operations, math problem solving, math fluency (addition, subtraction, and multiplication))
- written expression
(spelling, sentence composition, essay composition)
- oral language composite
(listening comprehension, oral expression)
150
Define: personality traits
consistencies in behaviour, emotions, and attitudes that are evidence across situations and time
151
define: objective personality tests
personality measures that are baed on self report data.. they are called objective becasue they can be scored objectively... always using the same scoring systems.
152
define: behavioural checklists
derived from descriptive characteristics of an experience or an event rather than from personalitiy theories..
they re lists of behaviours that are rated for frequency, intensity or duration..
give information about the nature of someones experience, e.g., psychological distress, mood states and feared situations.
153
define: projective personality tests..
respond to ambiguous stimuli like a picture or incomplete sentences or generate drawings based on instructions..
the responses reveal information about personality structure.
154
What is the difference between a TRAIT AND A STATE
trait = someone is always a little bit anxious, anxiety sensitivity is a trait (or conscientiousness)
state = someone feels anxiety becasue they have some identifiable situation coming up , and that situation is causing them to feel anxiety
155
do genetics and environmental influences impact personality?
yes
156
personality helps us make predictions over time.
- relatively stable across time and environemtnts
- personality is still developing into adult years...
157
what are some things that might cause a change in personality?
- brain injury
- traumatic event
- medication
158
what are 3 ways you can assess personality?
1) objective personality tests
e.g., (PAI, MMPI, MCMI)
- usually self report
2) Behavioural Checklists
- never/ always ratings
- get a sense of how often someone experiences something..
- if its 'always' its probably a 'trait'
3) projective personality tests
- Rorschach - ink blot
- fill in the blanks
- ambiguous stimuli
159
what is the person-situation debate
(Walter Mischel)
- what if personality couldn't accurately predict individual differences among people or the behaviour of an individual..
what if the the stability of personality is illusory
- Mischel reviewed the relationship between personality and actual behaviour..
- the idea WAS that the more an individual possessed a certain trait, the more likely the person was to behave in a manner sonsitent with the trait in ANY environment or situation ..
it was found that context matters just as much or more..
- correlation between personality and situation was .3 (low)
we have situational variability...
(different contexts can pull out different personality characteristics)
160
variability across situations co-exists with stability across time..
emphasis the power of situation influences and personality.
having information on both situational and personality traits can help predict behaviour.
161
what is self-presentation bias
presenting self in a better or worse light than is realistic..
problems - it impacts the diagnosis we make or dont make.. impacts treatment recommendations
162
define validity scales:
why are they used?
scales that are designed to detect whether a person is faking good, faking bad or responding randomly..
used to combat self presentation bias
163
define: malingering
emphasizing negative characteristics and deliberately presenting a more problematic picture..
usually has secondary gain or reduces some sort of punishment
164
what is a test that captures malingering?
the TOM (test of malingering lol)
- gives us an idea if someone is responding realistically or not..
- should score above 50%, if bellow that its a red flag.
165
what is one way to combat malingering and self presentation bias?
multiple informants.
166
what is faking good?
faking positive things / traits.. saying you're doing better than you are (custody evaluations)
167
what are random responses?
- give us a sense of someones reporting style
- can be because of carelessness or cognitive deficit
- use other sources / tests if concerned.
168
How do we make sure that we are developing culturally useful measures?
1) is the content applicable across different groups?
- the language used to derscribe things lead to the same interpretations?
- simple enough language??
2) are constructs related in similar ways across groups
- e.g., is the construct of anxiety the same in different groups?
3) do the cut off scores developed with one group apply to other groups?
- or do the cut scores differ based on the way that group defines the construct?
4) is the factor structure the same across groups?
factor = all the questions that group together are a factor.
e.g., BECK inventory has 2 factors that get assessed: cognitive and physical..
- but! anxiety might have different factors for different groups.
169
How should psychologists conduct an assessment with a client from an ethnic minority background?
a) use measures that have been shown to be psychometrically sound dfor people who come from the same ethnic group as the client
b) consult published norms relevant to the clients think group in interpreting the test results
c) adopt multiple assessment methods to minimize errors that might be assoicatediwth either method.
- if cant follow the recommendations of a and b, and the measures available dont have strong validation and relevant norms, then caution MUST be exercised in interpreting the results
170
when there are no measures validated for a specific group
- avoid over interpreting the raw data from a measure
- use tests to generate hypothesis only
- explicitly acknowledge questionablee validity of test with this group.
171
* Steps to translate a measure * - will be on test
1. translate from language 1 to language 2... back translate from language 2 to 1, compare both ...
2. pilot test translated version for comprehensibility
- does it still capture what it is meant to capture
- pilot test is small
- find inconsistencies
3. Test reliability of translated version in larger sample..
- give to large group of people twice, see if they score the same thing
4. re-standardize score with norms from 2nd language group
- might have to shift cut off scores
5. study construct validity of translated measure
- is the new translated version accurately assessing anxiety within a cultural group?
172
when assessing cultural and linguistic factors, we must consider:
- immigration history
- contact with other cultural groups
- acculturative status
- acculturative stress
-socioeconomic status
- language
173
What is clinical utility?
how useful are the measures that we have... do they help us come to treatment reccomondations?
is there replicated evidence or reliability and validity?
does it accurately capture someones complaint?
does it make a difference?
174
what are two measures of self reporting that actually do have good clinical utility?
- symptom checklists
- outcome monitoring
175
Do the MMPI and the Rorscharch have high or low clinical utility?
low.
it doesnt make a difference in the diagnosis we come to in the end.
- doesnt make a difference to our clinical services
176
even though personality measures are good at assessment focused evaluations, they are not as useful for intervention focused evaluations...
so even though the instrument has scientific support for evaluating personality characteristics and psychosocial functioning, its not necessarily valid for determining the optimal way to enhance or improve problematic aspects of personality and psychoscocial functioning...
aka low clinical utility
177
What are the 3 big objective personalty tests we use in clinical?
1) MMPI -2 (now 3)
- grade 6-8 reading level, reduced to 4.5
- 60-90 min, reduced to 30-60
- T/F
- was the longest.. now 335 items
2) MCMI-IV
- grade 5 reading level
- 25-30 min
- shortest 195 items
- T/F
3) PAI
- grade 4 reading level
- 40-50 min
- 4 point scale
- 344 items
178
our self report measures are based on the assumptions that we are good at reporting things on ourselves *
gives us indication of some kind of diagnosis of peronsality traits that might be impacting someone OR personality traits that might be absent
179
what is the empirical criterion - key9ing approach?
a method of test construction that involves the generation and analysis of a pool of items, those items that discriminate between two clearly defined groups are retained in the sacal.e..
e.g., patients with mental disorders vs a control group of patients family members and recent high school graduates
180
what is the content approach?
a method of test construction that involves developing items specifically designed to tap the construct of being assessed this approach is more consistent with Current views of optimal test development strategies..
181
MMPI-3
goal: information on symptom severity and possible diagnosis for those suspected of having mental disorders
- has validity scales to assess responding inaccurately
- has 24 languages and an adolescent version
- this version took out gender norms because they dont accurately reflect all people
182
What are the validity scales in the MMPI-3?
- Cannot say
- Lie
- Infrequently
- Defensivness
- Back F
- Variable response inconsistency scale
- True response inconsistency sccale
183
what is the "cannot say" validity scale?
how many unanswered questions there are..
if someone missed 50 questions, the test would be rendered invalid
184
what is the LIE (F) validity scale?
a measure of unrealistically positive reporting (faking good)
185
What is the INFREQUENCY validity scale?
measures faking bad... / malingering..
186
What is the DEFENSIVENESS validity scale?
someones unwillingness to disclose personal information
187
what is the BACK F validity scale...
- similar to F scale..
- but only for the last 3rd of the MMPI
why?
- people sometimes switch how they are responding on the last third of the test...
- usually if someone is faking schizophrenia or psychosis..
188
What is Variable response inconsistence scale?
- there are lots of questions in the MMPI-3 that go together...
- if someone responds to those sets with different answers it tells us different things.
189
True response inconsistency scale.
- questions that have pairs, but the pairs are opposites
- "I like dogs" / "I dislike dogs"
- if you say true to both you might have a yay-saying bias
- no to both, then a nay-saying bias
190
define: overpathologize
the tendency to exaggerate and overestimate the extent of pathology
191
define: code types
summary codes for the highest two clinical scale elections on the MMPI scales.
192
What is the MCMI-IV..
what does it do?
- personality measure
- someones level of depression / anxiety / trauma..
- this is the scale we use when we want to assess for personality disorders.
- we use this for people who are in SIGNIFICANT DISTRESS
-e.g., psych units
- we DO NOT have norms for the general healthy population with this test
193
go off about PAI
- doesnt give great information about personality...
- broad strokes regarding clinical stress about psychopathology
- covers substance use, depression, anxiety and eating related pathology
- vast majority of time not assessing people with personality disorders
- has 4 validity scales for
- faking good
- faking bad
has 11 clinical scales that assesses (somatic complaints, antisocial, borderline)
2 intrapersonal scales
- dominance and warm
has 5 treatment oriented scales (for stress, non support, and aggression)
- gives information on what might affect engagement in therapy or disrupt..
194
What personality measure has the BEST RELIABILITY of all the scales?
the PAI..
you can take it today, and in 5 years and it will have consistent results across time
195
what are some examples of self-report checklists of behaviour and symptoms?
- OCEAN / NEO
- big 5
- outcome questionaire - 90
(composed of 3 sub scales: symptom distress, interpersonal relations, and social role funtioning)
- psychometrically strong
- assesses change over the course of psychological services
-the use of the OQ in monitoring treatment process can dramatically improve success rates and reduce rates of deterioration associated with treatment
- SCL-90-R
(the symptom checklist revised0
(the extent to which they were distressed by various symptoms over the past 2 weeks)
- beck depression inventory
-evaluates the severity of depressive symptoms experienced in the past 2 weeks
- one of the most frequently used symptom checklists.
- beck anxiety inventory
- children's depression inventory 2
- self report designed to evaluate symptoms of depression In the past 2 weeks..
196
projective measures of personality:
why do we use ambiguous stimuli to elicit personality related answers?
comes from an idea that the subconscious holds important ideas of personalities.
comes from Freuds idea of projection.
197
projective measures of personality have 5 categories. what are they?
1. association techniques
2. construction techniques
- produce a story / type of drawing
3. completion techniques
- finish a sentence / story
4. arrangement / selection techniques
- arrange based on ranked orders (preference)
5. expression techniques
- handwriting / what colours
198
Rorscharch
- 10 cards with inkblots
- report what you see
- scored personally or with the comprehensive system that use age related norms (kinda valid...)
- quite subjective / errors are common with administration.
- leads to invalid score / idea of what someone pathology is
- concern about over patholgoizing --- this is the major critique..
we dont use it to make diagnosis / prognosis / not clinically useful. dont know when we would use
199
What is the biggest concern regarding projective measures of personality testing?
- Lack of standardization
- Not appropriate for youth or children
- Reliability and validity are variable based on the test / technique
- Not to be used for diagnosis
200
on an intelligence measure, you go from broad to specific...
within the 4 scales of the WEIS we want to look at which specific scale is dragging down the score.. e.g., if the client is 2 SD bellow the mean we want to know why.
this is will be on the test
201
What does case formulation do?
- integrates material
- addresses diagnostic issue
- hypothesis about development / maintenance of the problem
- credits the trajectory with and without treatment
- informs treatment plan
- discusses obsticals to implementing treatment plan
202
How would the MMPI give us an understanding of how to help someone in treatment?
the MMPI will give us a sense if someone is treatment resistance, and what barriers for treatment they might have..
--> we are looking at all of these individual pieces together to form a fuller picture of the diagnosis
203
How to draw up a case formulation..
1) look at how we define the symptoms / problem the client is having..
2) underlying vulnerabilities
- stress / diathesis model..
- if someone has a history of psychosis in their family, if they are smoking weed and funky things start happening..
- looking at stress / protective factors.
3) stressors
- are they housed?
- do they have access to food?
4) is there an underlying mechanism which is linking 1,2 and 3, and maintaining the problem.
- we use our understanding of the person...
204
what are some threats to the validity of assessment and case formulations?
client factors:
1) self presentation bias
- faking good, faking bad, random responding
2) retrospective recall
- the assumption that we are good at remember what happened to us in the past..
- not super accurate.
- combat with multi informants
205
what are some threats to validity of assessment and case formulations:
clinician factors:
BIASES AND HEURISTICS.
bias = something that you conclude that is different than logic or reason..
heuristic = a mental shortcut that we have developed to make faster decisions.
- can lead to less accurate decision making
206
What are some common biases and heuristics than clinicians make?
- fundamental attribution error
- inattention to base rates
- belief in the law of small numbers
- regression to the mean
- inferring causation from correlation
- hindsight bias
- confirmatory bias
- bias blind spot
- representativeness heuristics
- availability heuristic
- affect heuristic
- anchoring and adjustment heuristic
207
define: case formulation
a description of th patient that provides information on his or her life, situation, current problems, and a set of hyptheses linking psychosocial factors with he patients clinical condition
208
what is self-serving attributional bias?
a tendency to take more personal credit for success than for failure, by attributing success but not failure to internal, stable, and global cauises
209
What the fundamental attribution error?
in attempting to understand why a person acted in such a manner, there is a tendency to overestimate the influence of personality traits and to underestimate the influence of situation effects on the persons behaviour
210
what is inattention to base rates?
a psychologist may believe that certain patterns of response on a test is indicitve of a specific diagnosis, and support this belief twith the information on some relevant cases.. however, without full knowledge of the base rate of a) the patter of test responses and b) the diagnosis, its not possible to detemine the extent to which the test responses accurately predict the diagnosis.
211
What is the belief in the law of small numbers?
results drawn from small samples are likely to be more extreme and less consistent than those obtained from large samples. Nevertheless, the clinical psychologist may be tempted to attend more to information gained from two or three patients with a specific disorder than to the results of research on the disorder. direct experience with a small number of patients may feel more relevant and compelling, even though it is less likely to yield accurate information compared with data drawn from research samples
212
What is regression to the mean?
because of the nature of measurement error, a person who obtains an extreme score on a test at one point in time is likely to obtain a less extreme score when next taking the test. this apparent change in test scores has nothing to do with real alterations in the persons life.
(the standard error of measure meant is available for many psychological tests so that psychologists can take this into account when comparing test scores from two points in time)
213
What is inferring causation from correlation?
a psycholoigist may note that there appears to be a substantial co-occurance of certain patient characteristics (like history of sexual abuse and the presence of borderline personality disorder) and infer that the earlier of the two characteristics causes the later characteristic (e.g., the abuse lead to the development of BDP). Before drawing causal inferences, though, other factors must be considered, including whether the later characteristic may influence the information provided about the earlier characteristic, and the possibility that both characteristics stemmed from a third variable (e.g., a dysfunctional family environment)
214
What is hindsight bias
hindsight 20/20
most decisions (including clinical decisions) must be made without the benefit of all the pertinent information. after a decision has been made and, as a consequence, a certain course of action has been taken, new information may become available. it is tempting to validate or question the initial decision based on data gathered after the fact even though it was not possible to have these data inform the original decision.
215
what is confirmation bias?
once a clinical hunch has been formed, it is tempting to gather information to support tit. however, in testing a hypothesis, it is important to evaluate evidence both for and against the hypothesis. the clinical psychologist must avoid simply looking for evidence to support tthe hypothesis and also actively look for evidence that would refute or temper the strength of the hypothesis
216
what is bias blind spot
researchers have found that almost everyone recognizes that people who often make erroneous deciosns and are negatively influenced by personal biases. however, researches have found that almost everyone believe that they are less likely than others to have their decisions affected by errors and biases.
217
what is representative heuristics
relying on biases such as the belief in the law of small numbers to draw conclusions about the degree to which a symptom or behaviour is representative of an underlying disorder or condition
218
what are availability heurstics?
making a decision based on easily recalled information, such as recent, extreme, or unusual examples that are relevant to that decision. using only easily recalled examples will lead to an incomplete evaluation of the elements that must be considered in the deciosn. by definition, extreme examples are atypical and likely to bias a decision.
219
Affect heuristic
when researching a decision, the affective qualities (such as likability, negativity, disgust, or pleasure) of cognitive representation of people or objects are rapidly considered. this usually occurs at an unconscious level and can lead to a judgement based solely on emotional considerations (such as the attractiveness of an individual), with only minimal attention paid to the full range of factors relevant to that decision.
220
anchoring and adjustment heuristic
initial conditions or characteristics determine a starting point for considering then nature of an individual or task (such as using the dealers price when negotiating to buy a car).. in a clinical context, this means that for example the first impressions may serve as the (possibly inaccurate) basis for considering and integrating all subsequent information gathered about a person.
221
How do We improve the accuracy of clinical judgements?
use tests that are relevant and have strong psychometrics
- check for scoring errors
- use computerized measures / scoring whenever possible
- use normative data and base rate
- use established diagnostic criteria
- use evidence based decisions aids
- strive to be as systematic, structured and quatifyabile as possible
- know relevant research
- be aware of personal biases
- be self critical
- seek consultation from other professionals
- dont rely on memory or rush conclusions
222
Final steps of assessment reports and treatment plans:
- writing the report and providing feedback are the important final steps..
- knowing the audiences for the report
- where is the report going
- confidentiality and privacy considerations
- separating (and identifying) facts, client opinion and psycholigist opinion
223
What is in an assessment report??
- identifying patient / client information
- reason for referral
- background information (history of development, education, employment, family, relationship, medical, symptoms and disorders)
- assessment methods (including tests administered)
- interview data and behavioural observations
- test results (including interpretaiton of test scores)
- diagnostic impressions and case formulation
- summary
- recommendations
224
What is in a treatment plan report?
- identifying patient / client information
- reason for referal
- evaluation of primary symptoms and problem
- diagnosis
- patient strengths
- treatment-related goals and objectives
-proposed treatments
- potential barriers to treatment
- criteria for treatment and termination or transfer to other service providers
225
How do we provide assessment feedback?
- verify accuracy of results
- correct any errors or misunderstandings
- contextualize individual's symptoms, problems and experiences within life history
- help make sense of the individuals difficulties
- provide steps to take to address personal difficutlies
- identify stressful situations that can exacerbate difficulties
-collaborate in creating therapeutic goals.
226
what is the therapeutic model of assessment?
an approach to psychological assessment in which clients are actively encouraged to participate in discussions about the reasons for the assessment, the results of the testing and how the assessment data should be integrated and interpreted
227
Clinical Psych
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