Chapter 3 - Assessment & Diagnosis Classification = ordering & grouping

Advantages of Classification Means of communication Labels help to condense & order info To guide treatment strategies To facilitate research Etiology & progression of disorder

Disadvantages of Classification Self-fulfilling prophecies & stigma - Rosenhan (1973) - Pygmalion in the classroom (“bloomers”) Overlooking other important problems - aspects not typical of a diagnosis e.g., CD & depression

Disadvantages, cont. Automatically label those who seek help Focus on weaknesses vs. strengths Categories = less individual information

DSM-IV-TR The most widely used system Pros - reliable - based on research (validity) - communication - atheoretical - multiaxial

DSM axes I.Clinical disorders IIPersonality/enduring problems III.Medical problems IV.Environment/psychosocial V.Global assessment

DSM Cons Disorders created by committee Labels => stigma Culture-bound No treatment suggestions No causes Focus on problems Most axes rarely used -> reduces person to one disorder

Reliability & Validity Reliability - consistency 1.Internal consistency - over all the items 2.Test-retest reliability - over time 3.Interrater reliability - over raters

Validity - test measures what it purports to 1.Content - covers much of the trait 2.Concurrent - correlates with other measures of the trait 3.Predictive - predicts other measures of the trait {Concurrent & Predictive are both criterion} 4.Construct - test supports theory 5.Face - looks like what it measures

Interviews Clinical interview First step Talk to client Not reliable across examiners Valid Good for rapport Nonverbal behavior

Structured Interviews - decision trees - for diagnosis Mental Status Exam - brief measure of cognitive functioning

Intelligence Tests Reasons to use Mental abilities affect other problems? Strengths & weaknesses General functioning

Problems Cultural bias IQ = small part of intelligence

Personality Tests Objective & Projective Objective Tests unambiguous reliably interpreted usually self-report

Multi-Trait Scales MMPI items normed on psychiatric patients items distinguished patient groups 10 clinical scales & 3 validity scales patterns suggest disorders & malingering

Other multi-trait scales MCMI (personality disorders) Child Behavior Checklist Strong Vocational Interest Test

Single-trait self-report scales Many scales ex. BDI Face-valid Good reliability & validity

Projective Tests Ambiguous stimuli -> responses reflect person “Project” psyche onto stimuli Given by trained person Interpretations differ (? reliability) ?Validity Difficult to research Used for getting ideas

Rorschach Inkblot Test Scoring system (reliability) More validity research Good for psychosis

Thematic Apperception Test -TAT Ambiguous scenes Pattern of responses Scoring system seldom used Not reliable (subjective) Suggests ideas

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Neuropsychological Tests Brain damage & deterioration Measures cognitive processes perception, memory, attention Includes IQ testing

Behavioral Assessment Focus on problem behavior Antecedent conditions Problem description Person’s response Result of response

Leads to treatment Self-rating - person monitors own behavior Analogue Measures - simulate the problem in clinic/laboratory