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Psy631 Psychological Assessment

Psy631 Psychological Assessment. The Assessment Interview DSM-IV William P. Wattles, Ph.D. Core Concepts. D iagnosis/Labeling I n Context A bnormal per culture M ultiple Causality O n a Continuum N eurons (Mind/Body Connection) D ata (Empiricism). D iagnosis/Labeling.

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Psy631 Psychological Assessment

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  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.

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

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

  8. 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.

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

  10. 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

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

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

  13. 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

  14. 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

  15. 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

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

  17. 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)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

  35. 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.

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

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

  38. 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

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

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

  41. The End

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