Download Psy631 Psychological Assessment

Psy631
Psychological Assessment
William P. Wattles, Ph.D.
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• Without _____, most psychological tests are
meaningless. (p. 69)
a. the MMPI-2
b. interview datac.
structure
d. DSM-IV e. construct validity
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Psychological assessment
• Psychological assessment is a process that
involves the integration of information from
multiple sources, such as psychological
tests, personal history, description of current
symptoms and problems by either self or
others, and collateral information.
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Psychological testing
• the use of samples of
behavior in order to
infer generalizations
about a given
individual.
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Issues in assessment
•
•
•
•
•
•
Referral Question
Who will read report
Ethical guidelines
Test bias
Test selection
Computer-assisted
tests
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Context of assessment
• Referral Setting plays
key role type of
assessment
• Many different
settings
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The Psychiatric Setting
• Psychiatrist as administrator (beyond
diagnosis and treatment)
– Custody
– freedom of the patient
– safety of society
• Psychiatrist as therapist
– ward
– type of treatment
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General Medical Setting
• As many as 2/3 of
patients seen by
physicians have
primarily psychosocial
difficulties
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Somatization
• Somatization is one of
the oldest of all known
psychological
diagnoses. The first
reference to this kind
of phenomena appears
about 1900 B.C. in
Egyptian documents,
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Why somaticize?
• in our society,
psychological
diagnoses become
curse words
• Pathological
• Neurotic
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Somatization
• As we understand it
today, somatization is
a phenomena where a
person becomes
somatically
preoccupied.
• Typically, there are
underlying feelings of
depression, anxiety or
other feelings, which
are not recognized or
acknowledged by the
person.
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Somatization
• Instead, what the
person may be aware
of is all the physical
correlates of these
underlying difficulties.
• The very fact that
psychological
difficulties are seen as
weaknesses, makes it
shameful for a person
to admit that he or she
has such a problem
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Somatization
• This lucidly written
guide presents an
innovative approach
for treating
somatization disorder
and related problems,
such as fibromyalgia,
irritable bowel
syndrome, and chronic
fatigue syndrome.
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Somatization
• The causes of
somatization that we
are able to implicate
are neither proximate
nor somatic, seeming
instead to be indirect
and to reside in the
patient’s mind or
culture.
• Somatization appears
to be universal.
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DSM-IV
• Somatoform Disorders
– Physical symptoms
that suggest a general
medical condition and
are not fully explained
by a general medical
condition.
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Somatization Disorder
• A pattern of recurring,
multiple, clinically
significant somatic
complaints, not fully
explained by any
known general
medical condition.
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Hypochondriasis
• Preoccupation with
fears of having a
serious disease based
on a misinterpretation
of one or more
symptoms.
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General Medical Setting
• Mental disorders in
addition to physical
• Behavioral aspects of
physical illness
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General Medical Setting
• Most common psychological referrals
– emotional factors
– neuropsychological assessment
• How the person is functioning
– chronic pain
– chemical dependency
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The Legal Context
•
•
•
•
•
Variety of uses
child custody
competency
juvenile commitment
personal injury
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The Legal Context
• We equivocate; they decide
• Legal terms =/= everyday or psychological
meanings
• May not understand the scientific method
– Competency
– Insanity
– Dangerousness
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Dangerousness
• Problem area
• Low base rate
– High false positives
• Text: err on the side of
caution
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Truth
Dangerous
Not
Dangerous
False Positive
Dangerous
Hit
Type II error
Test
Miss
Not
Dangerous
Type I error
Correct
Rejection
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The Scientific Method
• Fixation of Belief –Peirce
– “Doubt is an uneasy and dissatisfied state from
which we struggle to free ourselves and pass
into the state of belief…”
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Fixation of Belief
•
•
•
•
•
Charles Saunders Peirce
Method of Tenacity
Method of Authority
A priori
Method of science
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The Scientific Method
• empirical:
• a. Relying on or derived from observation
or experiment: empirical results that
supported the hypothesis.
• b. Verifiable or provable by means of
observation or experiment: empirical laws
• others can arrive at the same results.
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Empirical Example
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Child Custody
• Mental health of the
parent
• quality of love
between parent and
child
• nature of parent-child
relationship
• long-term effect of
different decisions
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Education Context
•
•
•
•
•
Learning difficulties
Measuring intellectual strengths
Identifying intellectual problems
Assessing behavioral difficulties
estimating responsiveness to intervention
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Psychological Clinic
• The decision maker
– appropriate for the
setting?
– Which therapist or
group?
– Best treatment
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Ethics of Assessment
• http://www.apa.org/ethics/code2002.html#9
• Developing a professional relationship
– signed consent
– discussion of procedures
– discussion of results
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Competence and Appropriate Use
of Assessments and Interventions
• Psychologists refrain from misuse of
assessment techniques, interventions,
results, and interpretations and take
reasonable steps to prevent others from
misusing the information these
techniques provide.
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Test Construction.
• Psychologists who develop and conduct
research with tests and other assessment
techniques use scientific procedures and
current professional knowledge for test
design, standardization, validation,
reduction or elimination of bias, and
recommendations for use.
34
Use of assessment
• familiar with the reliability, validation, and
related standardization or outcome studies
of, and proper applications
• recognize limits to the certainty with which
diagnoses, judgments, or predictions can be
made about individuals.
35
Interpreting Assessment Results
• They indicate any significant reservations
they have about the accuracy or limitations
of their interpretations.
36
Unqualified Persons.
• Psychologists do not promote the use of
psychological assessment techniques by
unqualified persons.
37
Obsolete Tests and Outdated Test
Results
• Do not use old tests or old results
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Test Scoring and Interpretation
Services.
• Retain responsibility for reliability and
validity as well as appropriate use of tests.
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Explaining Assessment Results
• Psychologists ensure that an explanation of
the results is provided using language that is
reasonably understandable to the person
assessed or to another legally authorized
person on behalf of the client.
40
Maintaining Test Security.
• Psychologists make reasonable efforts to
maintain the integrity and security of tests
and other assessment techniques
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Privacy
• Psychologists accord
appropriate respect to
the fundamental
rights, dignity, and
worth of all people.
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Personnel Selection
• Lovell:
– tests for hiring lack
adequate validity.
– Do not serve the
public’s interest
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Personnel Selection
• Text:
– “If a position requires
careful screening …
may warrant careful
testing.”
44
Truth
Honest
Honest
Hit
Dishonest
Miss
Type II
error
Test
Dishonest
False
Alarm
Correct
Rejection
type I error
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Bias in testing minority groups
• Does validity extend to minority groups?
– Adverse impact
– Must demonstrate utility of assessment
• Sensitivity to attitudes towards testing
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Selecting psychological tests
• Referral question
• Practical considerations of time, cost and
availability
• Practitioner training
• Short forms
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