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Psy Psychological Assessment

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Psychological Assessment

   William P. Wattles, Ph.D.




                               1
     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.


                                                2
         Psychological testing
• the use of samples of
  behavior in order to
  infer generalizations
  about a given
  individual.




                                 3
           Issues in assessment
•   Referral Question
•   Who will read report
•   Ethical guidelines
•   Test bias
•   Test selection
•   Computer-assisted
    tests


                                  4
         Context of assessment
• Referral Setting plays
  key role type of
  assessment
• Many different
  settings




                                 5
       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
                                          6
       General Medical Setting
• As many as 2/3 of
  patients seen by
  physicians have
  primarily psychosocial
  difficulties




                                 7
                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,


                               8
           Why somaticize?
• in our society,
  psychological
  diagnoses become
  curse words
• Pathological
• Neurotic




                             9
                Somatization
• As we understand it      • Typically, there are
  today, somatization is     underlying feelings of
  a phenomena where a        depression, anxiety or
  person becomes             other feelings, which
  somatically                are not recognized or
  preoccupied.               acknowledged by the
                             person.



                                                  10
                Somatization
• Instead, what the          • The very fact that
  person may be aware          psychological
  of is all the physical       difficulties are seen as
  correlates of these          weaknesses, makes it
  underlying difficulties.     shameful for a person
                               to admit that he or she
                               has such a problem



                                                      11
              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.
                             12
                Somatization
• The causes of            • Somatization appears
  somatization that we       to be universal.
  are able to implicate
  are neither proximate
  nor somatic, seeming
  instead to be indirect
  and to reside in the
  patient’s mind or
  culture.
                                                    13
                     DSM-IV
• Somatoform Disorders
  – Physical symptoms
    that suggest a general
    medical condition and
    are not fully explained
    by a general medical
    condition.




                              14
        Somatization Disorder
• A pattern of recurring,
  multiple, clinically
  significant somatic
  complaints, not fully
  explained by any
  known general
  medical condition.



                                15
             Hypochondriasis
• Preoccupation with
  fears of having a
  serious disease based
  on a misinterpretation
  of one or more
  symptoms.




                               16
       General Medical Setting
• Mental disorders in
  addition to physical
• Behavioral aspects of
  physical illness




                                 17
      General Medical Setting
• Most common psychological referrals
  – emotional factors
  – neuropsychological assessment
     • How the person is functioning
  – chronic pain
  – chemical dependency



                                        18
            The Legal Context
•   Variety of uses
•   child custody
•   competency
•   juvenile commitment
•   personal injury




                                19
         The Legal Context
• We equivocate; they decide
• Legal terms =/= everyday or psychological
  meanings
• May not understand the scientific method
  – Competency
  – Insanity
  – Dangerousness

                                              20
                Dangerousness
• Problem area
• Low base rate
   – High false positives
• Text: err on the side of
  caution




                                21
                           Truth
            Dangerous                 Not
                                   Dangerous

                                   False Positive
Dangerous    Hit                     Type II error



 Test
              Miss                  Correct
   Not      Type I error
                                   Rejection
Dangerous



                                                     22
        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…”




                                                  23
24
            Fixation of Belief
•   Charles Saunders Peirce
•   Method of Tenacity
•   Method of Authority
•   A priori
•   Method of science



                                 25
       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.

                                              26
Empirical Example




                    27
               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

                               28
            Education Context
•   Learning difficulties
•   Measuring intellectual strengths
•   Identifying intellectual problems
•   Assessing behavioral difficulties
•   estimating responsiveness to intervention



                                                29
          Psychological Clinic
• The decision maker
  – appropriate for the
    setting?
  – Which therapist or
    group?
  – Best treatment




                                 30
        Ethics of Assessment
• http://www.apa.org/ethics/code2002.html#9
• Developing a professional relationship
  – signed consent
  – discussion of procedures
  – discussion of results




                                          31
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.


                                            32
          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.

                                             33
           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.


                                               34
 Interpreting Assessment Results
• They indicate any significant reservations
  they have about the accuracy or limitations
  of their interpretations.




                                                35
        Unqualified Persons.
• Psychologists do not promote the use of
  psychological assessment techniques by
  unqualified persons.




                                            36
Obsolete Tests and Outdated Test
            Results
• Do not use old tests or old results




                                        37
  Test Scoring and Interpretation
             Services.
• Retain responsibility for reliability and
  validity as well as appropriate use of tests.




                                                  38
 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.




                                               39
     Maintaining Test Security.
• Psychologists make reasonable efforts to
  maintain the integrity and security of tests
  and other assessment techniques




                                                 40
                    Privacy
• Psychologists accord
  appropriate respect to
  the fundamental
  rights, dignity, and
  worth of all people.




                              41
            Personnel Selection
• Lovell:
   – tests for hiring lack
     adequate validity.
   – Do not serve the
     public’s interest




                                  42
           Personnel Selection
• Text:
  – “If a position requires
    careful screening …
    may warrant careful
    testing.”




                                 43
                           Truth
                  Honest           Dishonest



  Honest       Hit                  Miss
                                    Type II
                                     error
Test
             False                  Correct
Dishonest    Alarm                 Rejection
            type I error



                                               44
  Bias in testing minority groups
• Does validity extend to minority groups?
  – Adverse impact
  – Must demonstrate utility of assessment
• Sensitivity to attitudes towards testing




                                             45
   Selecting psychological tests
• Referral question
• Practical considerations of time, cost and
  availability
• Practitioner training
• Short forms



                                               46
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posted:10/19/2011
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