Psy631 Psychological Assessment

1. Psy631Psychological Assessment The Assessment Interview DSM-IV William P. Wattles, Ph.D.

2. Core Concepts • Diagnosis/Labeling • In Context • Abnormal per culture • Multiple Causality • On a Continuum • Neurons (Mind/Body Connection) • Data (Empiricism)

3. Diagnosis/Labeling • Diagnosis. The method or process by which the nature or category of an individual's disorder is determined

4. Advantages: Facilitate Treatment Enhance Research Improve Teaching Disadvantages: Oversimplifies complex problems Diagnosis can stigmatize Diagnosis can be demoralizing. Advantages and Disadvantages of Diagnosis

5. In Context • Behavior is only abnormal in a situational context.

7. Demographic contextual variables influence diagnosis, and treatment of abnormal behaviors. Age Race Gender Class Culture In Context

8. Abnormal per culture • Definitions of abnormal behavior vary across cultures and historical periods. • Cultural and historical relativism.

10. Cultural Relativity Theory • A theory stating that human behavior lies on a continuum and that it is the role of culture to limit the spectrum by defining acceptable forms of behavior.

11. Mental disorders can result from a variety of causes. Different theoretical perspectives can contribute to the field. Psychological Biological Internal External Multiple Causality

12. Emotional and behavioral symptoms occur along a continuum that ranges from mild to severe. Also, many forms of abnormality are exaggerated versions of normal feelings and behaviors. Paranoia- Extreme, irrational distrust of others. On a Continuum

14. Brain abnormalities can cause emotional symptoms and emotional stress can cause physical symptoms. Neurons (Mind/Body)

15. Psychology is a science Empirical data Data (Empiricism)

17. Science Methodology • Control and manipulation • Connectivity to current knowledge • Building upon existing base • Convergence of multiple sources • Different methods and progress • Probabilistic reasoning • Correlation and prediction • Multiple Causation and Interaction • The role of chance From Stanovich, K. How to think straight about psychology

18. Science Methodology • Systematic Empiricism • Public Knowledge • Operationalism • The role of Theory • Falsifiability • Testimonials and case study evidence • Placebo • Correlation and Causality From Stanovich, K. How to think straight about psychology

19. What Is Psychological Abnormality? • Many definitions have been proposed, yet none are universally accepted • Most definitions, however, share some common features… • “The Four Ds” • Deviance – Different, extreme, unusual • Distress – Unpleasant & upsetting • Dysfunction – Causes interference with life • Danger – Poses risk of harm

20. Deviance • No one had ever won the Tour de France six times.

21. Deviance • From what? • From behaviors, thoughts, and emotions considered normal in a specific place and time and by specific people • From social norms • Stated and unstated rules for proper conduct in a given society or culture • Examples? • Judgments of deviance also depend on specific circumstances (i.e., social context)

22. Eccentricity • Eccentric: Departing from a recognized, conventional, or established norm or pattern. See Synonyms at strange.

23. Distress • According to many clinical guidelines, behavior must be personally distressing before it can be labeled abnormal • Not always the case • Examples?

24. Dysfunction • Abnormal behavior tends to be dysfunctional – it interferes with daily functioning • Dysfunction alone does not mean abnormality.

25. Danger • Abnormal behavior may become dangerous to oneself or others • Behavior may be careless, hostile, or confused

26. Danger • Although cited as a feature of psychological abnormality, dangerousness is an exception rather than a rule

27. The Assessment Interview • Without Interview data, most psychological tests are meaningless.

28. The Assessment Interview • Behavioral Observations • Unique characteristics • Patient’s reaction to events • Rapport builder • Check against test validity

29. Interview Sequence Organized Discuss unpleasant subjects One-sided Conversational elements Build rapport Help Client relax Observe social skills Interview vs. Conversation

30. Interview Goals • Assess: • strengths • Level of adjustment • Nature and history of problem • Diagnosis • Relevant personal and family history.

31. Content Versus Process • Information explicitly given by client. • Information gleaned from observation. • i.e., dreams

32. Psychometric considerations • Interrater Reliability • Varies from .23 to .97 • Dilemma of differing results • Interviews: structure versus flexibility

33. Halo Effects • Tendency of interviews to develop a general impression of a person and then infer other seemingly related characteristics. • NYT clipping • jurors

34. Halo Effect • May cause interview to exaggerate or minimize pathology.

35. Confirmatory Bias • Occurs when interviewer makes an inference and that directs the interview to confirm the inference.

36. Unstructured Interview • Data should be treated cautiously and hypotheses considered tentative needing further support. • Adding structure increases reliability.

37. Unstructured Interviews • Interviews allow clinicians to place test results in context. • Build rapport • Encourage client self-exploration

38. Minimum requirements • Interviewer must show: • Sincerity • Acceptance • Understanding • Genuine interest • Warmth • Positive regard

39. Interview Prep • Setting: lighting, comfortable seating, proper space, comfortable but tidy. • Introduce self and preferred manner of address • Explain purpose of interview, check client’s expectation. • Explain how interview and test data will be used.

40. Interview Prep • Explain confidentiality • Limits • Danger to self or other • Child abuse • Get a release if relevant • Explain assessment procedure • Clarify fee arrangements.

41. Directive versus Nondirective • You only learn if the client is talking • Client’s agenda or yours? • Author suggests not competing styles.

42. Sequence of interview tactics • Many begin with open-ended questions. • Lack of structure contrasts to most other assessment processes. • Can Observe • Verbal fluency • Level of assertiveness • Tone of voice • Anxiety • Energy level

43. Avoidance of why questions. • Increases defensiveness • Sounds critical and accusatory • Can lead to justification or excuse-making. WHY?

44. Structured Interviews • Criterion Variance-vague guidelines for categories of information to be included. • Information variance-variability in the amount and type of information.

45. The End