Chapter 4
Clinical Assessment Procedures
Ch 4
Reliability
• Reliability refers to consistency of
measurement
• Types of reliability:
– Interrater reliability refers to the degree of
agreement between 2 observers
– Test-retest reliability refers to the extent to
which scores are similar for a person being
observed twice or taking the same test twice
– Internal consistency reliability examines
whether the items on a test are related
Ch 4.1
Validity
• Validity assesses the extent to which a
test or instrument fulfills its intended
purpose
– Some tests are designed to assess an
inferred dimension referred to as a
construct
• “Anxiety” is an inferred construct
– The validity of an instrument is constrained
by the reliability of the instrument
• Unreliable measures will not have good validity
Ch 4.2
Forms of Validity
• Content validity refers to whether a
measure adequately samples the
domain of interest
• Criterion validity refers to whether a
measure is associated in an expected
way with another measure (the criterion)
• Construct validity refers to whether a
measure of a construct is supported by
other measures of that construct
Ch 4.3
Psychological Assessment
• The goal of psychological assessment is to
determine cognitive, emotional, personality
and behavioral factors in psychopathology
• The importance of standardization of
assessment
• Techniques of assessment include
–
–
–
–
Clinical interviews
Psychological tests
Behavioral assessment procedures
Cognitive assessment procedures
Ch 4.4
Clinical Interviews
• An interview is any interpersonal
encounter in which language is used to
gather information about a client
– A clinical interviewer pays attention to how
the client answers questions posed by the
interviewer
– Clinical interviews involve a degree of
empathy for the problems of the client
– Clinical interviews can be highly structured
or very informal
Ch 4.5
Psychological Tests
• Psychological tests are standardized
procedures designed to measure a
person’s performance on a task or to
assess his or her personality
• Psychological tests include:
– Personality inventories
• Minnesota Multiphasic Personality Inventory
– Projective personality tests
• Rorschach Inkblot test
– Intelligence tests
Ch 4.6
Projective Tests
• Projective tests provide ambiguous
stimuli that are interpreted by the test
subject according to unconscious
needs/impulses
– Rorschach Inkblot Test: person is asked to
explain each of 10 ink blots (half of the blots
are in color while half are black and white)
– Thematic Apperception Test: person is
shown a series of pictures and asked to
explain the story behind each
Ch 4.7
Intelligence Tests
• Intelligence (IQ) tests can be used to
– provide a standardized assessment of a
person’s current mental abilities
– diagnose learning disabilities
– determine whether a person is mentally
retarded
– identify intellectually gifted children
• IQ tests typically have good reliability
and criterion validity
Ch 4.8
Behavioral Assessment
• Behavioral and cognitive assessments are
made using the SORC system:
– S (Stimuli): refers to the environmental
situations that precede the problem
– O (Organismic): refers to physiological and
psychological factors operating “under the skin”
– R (Overt Responses): what are the responses
and are these a problem?
– C (Consequent Variables): are there events that
are punishing or reinforcing for the client?
Ch 4.9
Behavioral Methods
• Direct observation of behavior
• Self-monitoring
– Reactivity: behavior changes during
monitoring
• Interviews
• Self-report inventories
• Other procedures
– Thought listing
Ch 4.10
Neurochemical Assessment
• The biological view is that
neurotransmitters and receptors are key to
understanding normal/abnormal behavior
• Postmortem studies: brain is removed and
chemical analyses are performed to
– Determine specific amounts of transmitter in
specific brain regions
– Determine amount of transmitter metabolites
• More metabolite suggests the presence of more
transmitter in brain
Ch 4.11
Human Brain Structure
Figure 4.a
Figure 4.b
Ch 4.12
Neuropsychological
Assessment
• A Neuropsychologist is a psychologist who
studies how brain damage alters the way we
think, behave and feel
• A neurologist studies brain diseases
• Neuropsychological tests assess behavioral
disturbances caused by brain dysfunction
– Halstead-Reitan battery
– Luria-Nebraska battery
Ch 4.13
Psychophysiological
Measurement
• Psychophysiology is concerned with the bodily
changes that accompany psychological events
or a person’s psychological characteristics
• Measures includes:
– Heart rate (EKG)
– Skin conductance (GSR)
– Brain electrical activity (EEG)
Ch 4.14
The Autonomic Nervous System
Figure 4.c
Ch 4.15
Cultural Bias in Assessment
• Cultural bias can occur because of
– language differences, differing views of
competition, differing religious/spiritual views
• Clinicians can avoid cultural bias by
– making efforts to learn about the culture of the
client
– determining the client’s preferred language
– ensuring that the client understands the
assessment task
– establishing a rapport with the client
Ch 4.16
Is Human Behavior
Consistent?
• A key issue in clinical assessment is the
extent to which human behavior is
consistent/variable over time
– Trait theory: people possess certain levels of characteristics
that remain constant over time
– Mischel: argued that traits are not important determinants of a
person’s behavior
• People are inconsistent across situations
– “Big Five” (NEO-PI): Broad factors, consistent across
situations, time, and most cultures
Ch 4.17