Psychological Assessment - Final Exam

Flashcards by jmrpeach, updated more than 1 year ago
Created by jmrpeach almost 5 years ago


Psychological Assessment: PAI, MCMI, Rorschach, TAT Assessment with Children, Elderly, and Multicultural Populations

Resource summary

Question Answer
What are recommendations for using computer based test interpretations? 1. always adapt interpretations for inaccuracies and for fit within case info 2. note why if you remove any info 3. don't just use for complex cases 4. only a hypothesis - need additional info
What is meant by the term “people first language”? Putting the individual before their disorder when describing them reflects value of the individual above/beyond their disorder
Define the Goldberg Rule. Why is it important? What does it show? How does the Goldberg Rule contend criticisms of using actuarial judgement? Goldberg Rule = decision rule for MMPI that used algorithms for diagnosis, 70% correct rate was better than clinical judgment every time *case promoting actuarial judment
What is the “broken leg” problem? Tendency of clinicians to judge that they can outperform an actuarial procedure in diagnosis by considering rare events that the computer cannot account for *problematic because we are not good at determining which extraneous variables are significant enough to warrant overriding actuarial judgment
What is a self-fulfilling prophecy? Prediction of a certain outcome often leads to decisions that influence or bias that outcome.
What are clients entitled to? WHEN CLIENT Entitled to know what the test is, what it’s for, who will receive the results Entitled to verbal feedback, scale scores, and physical report
What are clients entitled to? WHEN THIRD PARTY Does not have access to results 1. clarify with outside client what the person can and cannot access 2. inform the person upfront about what the test is, what it's for, and who will receive the results (and that they cannot see the results)
What are clients NOT entitled to? Copyrighted materials (MMPI, WAIS)
Exceptions to client entitlement? Clinician may refrain from releasing test data if it may cause substantial harm to person or others, be misused, misrepresented
Why do clinicians continue to use clinical judgment over actuarial despite evidence against it? Confirmation Bias (remember correct outcomes only) can lead clinicians to believe that they are accurate in clinical judgment without statistical rules
Clinician arguments against Actuarial Judgment 1. No clear guidelines 2. Too specific to population and measure of interest 3. Group stats don't apply to individuals 4. Incongruence between theoretical orientation of clinician and actuarial
Professional Ageism Clinician prejudicial perception that elders can't or won't change in treatment, resulting in a judgment of poor prognosis *sometimes clinicians use baby-talk, or demean elderly clients
Sonny Boy Phenomenon Elderly clients may believe that younger clinicians are not adequately trained or cannot help them due to lack of life experience
MCMI: Validity scales 1. Omissions 2. Validity (V) 3. Disclosure (X) 4. Desirability (Y) 5. Debasement (Z)
MCMI: Omissions 12+ = invalid
MCMI: Validity V 3 items 2+ = invalid; 1 = questionable
MCMI: Inconsistency W detects random responding/44 item pairs crosscheck with V to determine validity
MCMI: Disclosure X Frank/Self-revealing -34 or 178+ = invalid
MCMI: Desirability Y Defensive Responding/Faking Good *low motivation to change
MCMI: Debasement Z Self-Deprecating/Faking Bad *Cry for help *severe pathology
MCMI: V Validity 3 items 2+ = invalid; 1 = questionable
MCMI: W Inconsistency Detects random responding/44 item pairs cross check with V to determine validity
MCMI: X Disclosure Frank/Self-revealing -34 or 178+ = invalid
MCMI: Y Desirability Defensive responding/Faking Good *low motivation to change
MCMI: Z Debasement Self-deprecating/De-valuing/Faking Bad *cry for help *severe pathology
What are the primary reasons for providing clients with feedback? GIVE ASS Goals, Individualize, Validate, Explain, Accuracy, Symptom relief, Suggestions, Stressful Situations
Why might minorities be resistant to mental health treatment? 1. institutional racism 2. knowledge of discriminatory research practices such as Tuskegee 3. mental health is an extension of the “system” 4. cultural differences in definitions and approaches to mental health
What are the four dimensions of Berry’s model? Integration Assimilation Rejection Marginalization
How does Berry's model relate to mental health treatment among minorities? Treatment more difficult with clients whose perception of host (majority) culture is negative (ie. rejection and marginalization)
Bias in Clinical Work (Garb article main points) 1. women more likely diagnosed histrionic, men antisocial; men diagnosed with substance abuse and violent 2. eliminate bias by using several tests, sources of info, and statistical rules 3. clinicians should be aware of biases and strive to eliminate them
Garb Study Limitations 1. samples possibly not representative of all clinicians 2. some of the raters knew the purpose of the study - interjects bias
Garb Study Control for pathology Control for pathology so results reveal differences beyong those attributed to pathology: bias
What are the criticisms of the Rorschach identified by Lillenfeld? 1. Poor validity; poor interrater and test/retest reliability 2. poor methodology in research on it 3. people with more responses (R) more likely to be pathologized 4. low intercorrelation of variables
What are the limits of projective testing identified by Lillenfeld? 1. non-standardized administration 2. non-standardized scoring 3. poor norming 4. no treatment utility 5. susceptible to faking
What are techniques to establish rapport with child clients? 1. use appropriate opening statements, letting the child know the reason for the interview 2. incorporate games, drawing, etc. 3. know what’s COOL 4. use positive speech
Name some specific techniques for interviewing children. 1. affect-label technique 2. picture-question technique 3. thought-bubble technique
Affect-Label Technique Show pictures of faces; ask questions: "How do you look when you go to school?" "How does your mom look when..."
Picture-Question Technique Show child a picture and ask for a story about that picture *similar to thematic projective techniques *less intrusive way to get a child talking about feeligns
Thought-Bubble Technique ask child to fill in thought bubbles in a cartoon of interacting people *not appropriate for children too young
What theory is the MCMI founded in? Evolutionary Theory = imbalance or deficiency in one of the following: 1. Survival 2. ecological adaptation 3. Reproductive strategy
What are the benefits of using the MCMI over the MMPI? 1. Not atheoretical 2. relatively short 3. maps onto DSM personality disorders 4. normed to psychiatric samples 5. base rate vs. t scores
Base Rate vs T-scores 1. t-score arbitrarily set to forced normaly dist. (does not match PR) *may not be ecologically valid *% cut-off doesn't coincide with PR 2. base rate scores normed for PRs on psychiatric population: if your client doesn't match = problematic
MCMI Construction 1. determined constructs with face validity 2. checked internal consistency 3. empirical validation (clinician-test agreement)
Differences PAI / MCMI / MMPI 1. PAI no repeated items on mult. scales 2. PAI/MCMI face valid, MMPI not 3. PAI likert scale, MCMI/MMPI not 4. MCMI weighted scores 5. MCMI clinical norm; PAI mult. norms 6.MMPI (criterion-keying), PAI (rational), and MCMI (evolutionary theory)
Compare the Rorschach and TAT. 1. performance-based/indirect measure of personality characteristics 2. generate structural, thematic, and behavioral data
Contrast the Rorschach and TAT. TAT: *real pics, less ambiguity *expand on stories, not locate where/why *use of imagination *clinician chooses cards by apparent relevance to client, not given all cards
TAT Criticisms 1. Walter Mitty problem = people could describe desired traits *lead to clinician misinterpretation #2. Inhibition problem = client may not say everything on his/her mind *lead to underpathologizing
TAT Content Scales SCORS: Social Cognition and Object Relations Scale DMM: Defense Mechanism Manual n-Ach: Need for Achievment
Halo Effect Demographic characteristics of client could influence perceptions/actions of the providing clinician HOUND: homely old unattractive nonverbal dumb = overpathologized, medicated more frequently
PAI Somatic Complaints Scale T-59 = few bodily complaints T60-69 = concern about health functioning T70+ = sig. concern about somatic functioning; likely impairment
PAI Content Subscales Conversion = functional impairment Somatization = physical symptoms Health concerns = perceived health problems or belief in handicap
Two Phases of Rorschach Response Inquiry
Rorschach: Response Phase R-BUM Behavioral Data - unstructured *length of time to first response, total time with each card, direction picked up card
Rorschach: Inquiry Phase I-CLD Read Back Client answers verbatim *ask for LOCATION, DETERMINANTS, CONTENT
Privileged Communication info transmitted from client to psychologist is protected by state gov. psychologist does not have to disclose in most judicial settings
Confidentiality information from client that cannot be revealed without client consent, client legal representation, or legal court order/subpoena
ABC Model Antecedents Behavior Consequences
Strategies for children *use direct answer format *caution to not pollute memories
MCMI "Cry for Help" Profile High X and Z accompanied by High Clinical Scales
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