Assessment

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Assessment

• To collect and INTERPRET information about a
  client or subject
• Remember, the data do not speak for themselves
• The purpose of assessment biopsychosocial
  formulation
• Dynamic formulation
• The results of an assessment process will be used
  idiographically
• Although most assessment tools are nomothetic
• i.e., standardized procedure and established norms

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Physical Assessment Tools

• Medical examination referral to rule out medical
  disorders with psychological or behavioral
  concomitants or sequelae
• Neuropsychological examination
• EEG electrical activity
• CAT scan locate abnormalities in the brain
• MRI view anatomical features of the CNS,
  especially the brain
• fMRI anatomy and function
• PET monitors metabolic processes

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fMRI
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Standardization

• Two types
• Administration and scoring
• Sampling
• Reliability
• Is a test consistent?
• Test-retest
• Inter-rater
• Validity
• Is the test measuring what it purports to
  measure?

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Important note

• We can have reliability without validity
• But
• We cannot have validity without reliability.

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The clinical interview

• A GOOD interview is a clinicians best assessment
  tool (according to Dr. S).
• Structured intake interview
• Unstructured suitability for therapy
• Semi-structured diagnostic
• Clinical interview criticized observer bias

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Mental Status Exam

• A structured interview, sometimes embedded within
  a semi-structured interview.
• Tests cognitive functioning
• Eg. Clarity of thought, orientation, ability to
  follow instructions

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Projective Tests

• Presentation of ambiguous stimuli
• The purpose is to tap unconscious mental
  processes

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Some of the most common Projective Tests

• Rorschach Inkblot Test
• Thematic Apperception Test
• Drawing Tests
• Draw A family
• House-Tree-Person
• Kinetic Family Drawing

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A Rorschach-type Stimulus

• What might this be
• Similar to seeing objects in clouds
• Useful for assessing how the client views his/her
  world

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A TAT-card Stimulus

• Tell me a story a complete story with a
  beginning, a middle and an end. What is happening
  in the picture. What happened before, and how
  will it end.
• Useful for learning about clients relationships

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Drawing Tests

• Useful with children
• Develops rapport
• Aids in diagnosis
• Also useful with non-verbal adults

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Personality Inventories

• Usually personality inventories consist of a
  series of questions to which the respondents
  answer true or false (yes/no)
• The scoring is objective
• Most popular is MMPI2 designed to identify
  psychopathology
• CPI also frequently used but is designed to
  identify positive psychological characteristics

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MMPI-Profile

• Left side validity scales ?, L, F, K.
• An advantage of the MMPI
• Right side 10 clinical scales
• Designed to identify pathology.

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Misuses of the MMPI

• Hiring and promotion decisions in business the
  test is designed to detect pathology, and normed
  on a psychiatric sample
• Elevated scores in a non-psychiatric sample may
  not have the same meaning as in a psychiatric
  sample

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Response Inventories

• Tests which are focused on a specific area of
  functioning
• Example Beck Depression Inventory (text p. 94)

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Other psychological assessment tools

• Psychophysiological tests measure autonomic
  nervous system functioning
• Example Polygraph (lie detector)
• Neuropsychological tests
• Example Bender - Gestalt