Psychology Chapter 5: Assessment

Psychological Assessment

• Definition: An iterative decision-making process involving the collection of data on a person, their history, and their physical, social, and cultural environments.
• Involves gathering and integrating multiple types of data from multiple sources and perspectives.
• Undertaken to address specific goals, with the psychologist formulating questions to be addressed and selecting appropriate assessment methods and instruments.

Evidence-Based Assessment (EBA)

• Use of research and theory to guide the assessment process.
• Involves recognition of the assessment process as a decision-making task, with the clinician formulating and testing hypotheses by integrating data.
• Identification of psychological instruments with solid psychometric properties.
• Development of rating systems for instruments used for specific assessment purposes.

Assessment-Focused Services

• Conducted primarily to provide information to address a person's current or anticipated psychosocial deficits.
• Psychologist must use EBA tools and follow ethical standards in providing these services.
• Influence of referral factors on the assessment process.

Intervention-Focused Assessment Services

• Psychological assessment is not a stand-alone service but is conducted as a first step in providing an effective intervention.
• Assessment data is used to support the intervention.

Screening

• Procedure to identify individuals who may have problems of a clinical magnitude or who may be at risk for developing such problems.
• Goal: to identify those who may require services, with the expectation that steps will be taken to facilitate the provision of services.

Diagnosis and Case Formulation

• Assessment data used to formulate a clinical diagnosis.
• Information on symptoms is compared with diagnostic criteria to determine whether the symptom profile matches criteria for DSM diagnoses.
• Case formulation: a description of the patient that provides information on their life situation, current problems, and hypotheses linking psychosocial factors with the patient's clinical condition.

Prognosis and Prediction

• Prognosis: predictions made about the future course of a patient's psychological functioning.
• Prediction errors can occur, including false positives and false negatives.
• Importance of considering sensitivity, specificity, and base rate in prediction.

Treatment Planning

• Process of developing a proposed course of action that addresses the client's needs and circumstances.
• Involves considering the client's context, diagnoses, and life circumstances, as well as the scientific literature on psychotherapy.

Treatment Monitoring and Evaluation

• Treatment monitoring: closely tracking the impact of treatment to alter the treatment plan based on the patient's response.
• Treatment evaluation: collecting data to determine the extent to which psychological services are effective in achieving stated goals.
• Importance of routine treatment monitoring in enhancing treatment outcome.

Psychological Testing

• Definition: an evaluative device or procedure in which a sample of an examinee's behavior in a specified domain is obtained and subsequently evaluated and scored using a standardized process.
• Importance of meeting scientific standards, including reliability, validity, and norms.

Assessment vs. Testing

• Assessment: a complex and multifaceted process involving the integration of life history information, clinical observation, and test results.
• Testing: a specific device used to gather a sample of behavior, with a score assigned to the resulting sample and comparisons made with the scores of other people.

Psychometric Considerations

• Standardization: consistency across clinicians and testing occasions in the procedure used to administer and score a test.### Reliability
• Refers to the consistency of a test, including internal consistency, test-retest reliability, and inter-rater reliability
• Internal consistency: whether all aspects of the test contribute in a meaningful way to the data obtained
• Test-retest reliability: whether similar results would be obtained if the person was retested at some point after the initial test
• Inter-rater reliability: whether similar results would be obtained if the test was conducted and/or scored by another evaluator
• Reliable results are necessary to generalize test results and their psychological implications beyond the immediate assessment situation

Validity

• Refers to whether a test truly measures what it purports to measure and how the test results are interpreted
• Different types of validity evidence:
  • Content validity: the extent to which the test samples the type of behavior that is relevant to the underlying psychological construct
  • Concurrent validity: the extent to which scores on the test are correlated with scores on measures of similar constructs
  • Predictive validity: the extent to which the test predicts a relevant outcome
  • Discriminant validity: the extent to which the test provides a pure measure of the construct that is minimally contaminated by other psychological constructs
  • Incremental validity: the extent to which a measure adds to the prediction of a criterion above what can be predicted by other sources of data

Norms

• Refers to the standards or criteria against which individual test scores are compared
• Types of norms:
  • Percentile ranks: indicate the percentage of those in the normative group whose scores fell below a given test score
  • Standard scores: calculated using a z-score formula
  • Developmental norms: used when the psychological construct being assessed develops systematically over time
• Importance of norms: necessary to meaningfully interpret test results and determine the precise meaning of any test score

Clinical Assessment Interviews

• Structured, semi-structured, and unstructured interviews
• Clinical utility: the extent to which assessment measures are useful in clinical practice
• Self-presentation biases: the tendency for individuals to present themselves in a more favorable light

Intellectual and Cognitive Measures

• Defining intelligence: various theories and definitions
• Theories of intelligence: factor models, hierarchical models, and information processing theories
• Assessing intelligence: the clinical context, Wechsler Intelligence Scales, and other intelligence scales

Self-Report and Projective Measures

• Self-report personality measures: MMPI-2, Millon Clinical Multiaxial Inventory-IV, and Personality Assessment Inventory
• Projective measures of personality: Rorschach Inkblot Test, Thematic Apperception Test, and projective drawings
• Limitations of projective measures: lacking standardization, administration errors, and overpathologizing normal individuals

Integration and Clinical Decision-Making

• Integrating assessment data: combining information from multiple sources to form a comprehensive picture
• Case formulation: a hypothesis about the underlying causes and mechanisms of an individual's presenting problems
• Threats to validity: various sources of error and bias in assessment and case formulation
• Psychological assessment reports and treatment plans: written documents that summarize assessment findings and outline treatment goals and strategies