Dr. Kineta Morgan-Paisley, Ph.D.
PSY 3633: Abnormal Psychology
Introduction
Assessment: process of gathering information about
people’s symptoms & the possible causes of SXs
Assessment is the Basis for
Determining or Making a Diagnosis
Intervention/Treatment Planning
Accuracy of Assessment Impacts
The effectiveness of the selected intervention
Ultimately, the case outcome
Diagnosis: a label for a set of SXs that occur together
Introduction
Validity: means that the test measures what it’s
supposed to measure
Supposed to predict academic performance
Then why do so many people with high IQs do so
poorly in college?
Types of Validity
Face Validity
Content Validity
Concurrent Validity
Predictive Validity
Construct Validity
Introduction
Reliability: refers to consistency
Score on a test at one point in time should be
similar to the score obtained by the same person
on a similar test at a later point in time
Score on a test at one point in time should be
similar to the score obtained by the same person
on a similar test at a later point in time
Types of Reliability
Test-Retest Reliability
Alternate Form Reliability
Internal Reliability
Interrater Reliability
Clinical Interview
Personality Inventories
Intelligence Tests
Projective Tests
Symptom Questionnaires
Clinical & Psychoanalytic
Assessment Tools
Clinical Interview
Initial interview
• Mental status exam
• Appearance and behavior
• Thought processes
• Mood and affect
• Intellectual functioning
• Orientation
Structured interview
• Constitute a series of questions about symptoms
experienced currently or in the past
• Has a standardized format
• Concrete criteria is used to score a person’s answers
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Clinical Interview
 May Include a Mental Status Exam
Assesses the person’s general functioning
Clinician Probes for 5 Types of Information
Appearance & Behavior
Thought Processes
Mood & Affect
Intellectual Functioning
Appropriate Orientation to Place, Time & Person
 Structured Interview: the clinician asks questions that are
standardized & are usually designed to determine whether
a diagnosis is warranted
Format of questions & entire interview are standardized
Concrete criteria to score answers
Clinician should be able to diagnose based on the results
Personality Inventories
Personality Inventories: questionnaires that assess
people’s typical ways of thinking, feeling & behaving
Used as a assessment measure to obtain info about
people’s:
Well-being
Self-concept
Attitudes & beliefs
Ways of coping
Perceptions of their environments
Social resources
Vulnerabilities
Personality Inventories
Examples of Personality Inventories
NEO-PI-R: an objective personality test designed to
assess the Big Five personality traits
Minnesota Multiphasic Personality Inventory (MMPI2): most widely used objective clinical assessment
inventory; originally intended for psychiatric diagnosis
E.g., Paranoia, Anxiety, Social Introversion
10 scales that measure these problems
Sixteen Personality Factor Questionnaire: objective
personality test created by Cattall, that provides scores
on the 16 traits he identified
Get a cool printout analysis
Intelligence Tests
Intelligence Tests: tests that assess a person’s
intellectual strengths & weaknesses
Used to get a sense of an individuals strengths &
weaknesses
Especially when MR or brain damage is suspected
Deigned to measure basic intellectual abilities
Abstract reasoning
Verbal fluency
Spatial memory
Intelligence Tests
Wechsler Intelligence Scale
 Most widely used IQ tests
Wechsler Adult Intelligence Scale (WAIS-III), ages
16 & older
 Wechsler Intelligence Scale for Children (WISC-III)
for children ages 3 to 16


Items are organized into various subtests
Verbal section
 Performance section


Verbal & Performance combined give a single IQ
WAIS Verbal Scale: Subtests
Information
Subtests for the
Verbal Scale
include:
On what continent is France?
-Information
Arithmetic
-Comprehension
How many hours to drive 150 miles at 50 mph?
-Arithmetic
-Similarities
-Digit span
-Vocabulary
Comprehension
Why are children required to go to school?
Similarities
How are a calculator and a typewriter alike?
Digit Span
Repeat the following #s backwards: 2,4,3,5,8,9
Vocabulary
What does audacity mean?
WAIS Performance Scale: Subtests
Digit-Symbol Coding
Subtests for the
Performance
Scale include:
Shown:
1 2 3 4
Fill In:
1 4 3 2
__ __ __ __
Block Design
-Digit-Symbol
Coding
Assemble the blocks to
match this design
-Block Design
Picture Completion
-Picture
Completion
Tell me what
is missing?
-Cancellation Test
Cancellation Test
Draw a line b/w each red
square & yellow triangle

Normal Distribution: a statistical arrangement of
scores so they resemble the shape of a bell

i.e., “bell-shaped curve”
Projective Tests
 Projective Tests: presentation of an ambiguous stimulus to
a client who then projects unconscious motives & issues
onto the stimulus in his or her interpretation of its content
Supposed to uncover unconscious issues or motives
Used by psychoanalysts
No evidence to support usefulness/accuracy
 Examples of Projective Tests
Rorschach Tests: a projective test composed of ambiguous
inkblots; the way people interpret the blots is thought to
reveal aspects of their personality
Thematic Apperception Test (TAT): a projective test composed
of ambiguous pictures, about which a person is asked to write
a complete story
Behavioral Observation
Self-Monitoring
Neuropsychological Tests
Brain-Imaging Techniques
Psychophysiological Tests
Behavioral & Biological
Assessment Tools
Behavioral Observation
Behavioral Observation: method for assessing
the frequency of a clients behaviors & the specific
situations in which they occur
Clinicians will observe individuals & assess deficits
in their skills or ways of handling situations
ID the ABS of Behavior
Naturalistic vs. Contrived
Lab or real-world setting
Covert or Overt
Behavioral Observation
Behavioral Observation: Ethical Considerations
Some things cannot be directly observed
Impossible, impractical or even immoral
Overt-Subject Reactivity
Covert-Ethical Considerations
 Observer Bias: Expectations or biases of the
observer that might distort or influence his or her
interpretation of what was actually observed
Self-Monitoring
Self-Monitoring: method of assessment in which
a client records the number of times per day that
she or he engages in a specific behavior & the
conditions around that behavior
Open to multiple biases
What individuals notice about their behavior
Obviously have a problem identifying their own issues
What individuals are willing to report
They can discover triggers to their behavior
Which may lead to behavior change
Neuropsychological Tests
 Neuropsychological Tests: tests of cognitive, sensory
and/or motor skills that attempt to differentiate people
with deficits in these areas from normal subjects
Useful in detecting specific cognitive deficits (e.g., memory
problem)
AKA Paper-and-Pencil Tests
 Examples of Neuropsychological Tests
Bender-Gestalt Test: assesses sensory motor abilities by
having subjects reproduce a set of 9 drawings
Halstead-Reitan & Luria-Nebraska Tests
Both measure individuals functioning in several skill areas
e.g., concentration, dexterity, & speed of comprehension
Brain Imaging Techniques
Microelectrode To study function of individual neurons
Structural
Imaging
CAT or CT
Family of techniques used to map structures in living
brain
MRI
Produces pictures of inner brain structures
Functional
Imaging
PET, SPECT
Family of techniques that can image activity in the
brain as it responds to various stimuli
fMRI
Measures movement of blood molecules in brain;
pinpoints specific sites & details of neuronal activity
Permits three dimensional imaging of a living human
brain
Techniques that use radioactive energy to map exact
regions of brain activity
Psychophysiological Tests
Psychophysiological Tests: tests in which instruments
are attached to the periphery of the body to record
changes due to activity in the nervous system
Used to assess peoples emotional responses to certain
stimuli
Common Psychophysiological Measures:
Heart Rate
Respiration
Electrodermal Response: sweat gland activity
All can measure emotional arousal
Psychophysiological Tests
Another Psychophysiological Test
Electroencephalogram (EEG): measures electrical
activity along the scalp produced by specific
neurons in the brain
Clinicians can present stimuli & compare clients
response to that of healthy respondents
Can assess people’s emotional responses to certain
stimuli
EEGs provide an index of the strength & rhythm of
neural activity
Tools for Studying the Brain
Macroelectrode
Functional
Imaging
*EEG Imaging
MEG or MSI
To obtain a picture of the activity in a
particular region of brain. EEG
Family of techniques that can image
activity in the brain as it responds to
various stimuli
Measures brain activity on a
millisecond-by-millisecond basis
2 procedures similar to EEG but with
greater accuracy
Symptom Questionnaires
 Cover a wide variety of symptoms,
representing several different disorders
 Beck Depression Inventory (BDI)
 Has 21 items, each of which describes four
levels of a given symptom of depression
 Criticized for not clearly differentiating
between the clinical syndrome of
depression and the general distress
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Evaluating Children
Cross-Cultural Differences
Understanding Diagnosis
Use of the DSM
The Dangers of Diagnosis
Issues in Psychological
Assessment & Diagnosis
Evaluating Children
 Problems with children’s self-reporting
Cannot describe their feelings or associated events as easily
as adults can
May nor be able to differentiate b/w different types of
emotions
Often say they feel “bad”
May describe physical SXs when it is really psychological
 Problem with parents
May take child for assessment as a way of seeking attention
for themselves
May themselves be the source of the problem(s)
Unwilling to acknowledge or seek help for them
 Teachers are often the first to recognize a child has a
problem & seek help for them
Cross-Cultural Differences
Cultural norms for behavior differ
Jamaican parents tend to be more tolerant than
American parents of unusual behaviors in children
Including aggression, shyness & inhibition
Different threshold for seeking treatment
African Americans in the US are overdiagnosed as
having symptoms of schizophrenia
Difference in SX presentation
Euro Americans view the body & mind separately
Other cultures do not make such sharp distinctions
SX reporting: anxious & sad vs. physical maladies
Understanding Diagnosis
Diagnosis: a label we attach to a set of SXs that tend
to occur together
Syndrome: a set of symptoms that tend to occur
together
Biological Model contends a syndrome is an observable
manifestation of an underlying biological disorder
Yet there are NO definitive biological tests for PSY disorders
Syndromes are lists of SXs that tend to occur together
But usually the person will only display some of the
possible SXs
so they set a criteria for diagnosis (e.g., must have 6 of
the 12 of these SXs, all of these SXs, etc.)
Understanding Diagnosis
Overlapping SXs b/w multiple disorders occurs often
E.g., Major Depressive Disorder & GAD
Fatigue, sleep disturbances, concentration problems
But each disorder has SXs that are specific to it
How do we organize this confusing array of SXs?
Classification System: a set of syndromes & the rules
for determining whether the individuals SXs are part of
one of these syndrome
International Classification of Disease (ICD-10):
classification system issued by the WHO
Used in Europe & much of the rest of the world
DSM = most widely used system in US
Use of the DSM
Diagnostic & Statistical Manual of Mental Disorders
(DSM): official manual for diagnosing mental
disorders in the US, contains the following:
Lists of specific criteria for each disorder
How long SXs must be present to qualify for DX
Requirements that SXs interfere with daily functioning
Unlike the ICD, the DSM focuses only on PSY disorders
DSM-V = the 5th & most recent version of the DSM
Released in May 2013
Published by the APA (American Psychiatric Association); not
to be confused with the American Psychological Association
Reliability of the DSM
 Low reliability of diagnoses is due to many
factors
 Criteria were still vague requiring the clinician to:
• Make inferences about the individual’s symptoms
• Rely on the individual’s willingness to report symptoms
 Reliability of the DSM-5 diagnoses remains to
be determined
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Use of the DSM
Reliability of the DSM
Experienced clinicians using the DSM to diagnose
an individual agree 70% of the time on average
This was for the DSM-II & DSM III
Newer versions have “better” reliability
Considering the continuum
DSM-5 will reflect a continuum model of
abnormality for at least some disorders
PDs & ASDs
Dangers of Diagnosis
Person labeled as abnormal is treated differently
Differential TX occurs long a/f they stop exhibiting
SXs
Study about pseudopatients who were admitted to
mental hospitals for “schizophrenia”
Not one was detected
The label “Abnormal” may be especially
dangerous when applied to children
Strongly affects the behavior of other children
towards the child
Study about pairs of boys with “behavior problems”
Dangers of Diagnosis
Should we abandon psychiatric diagnosis?
Probably not
Despite disadvantages, diagnostic systems serve several
vital functions
Functions of Diagnostic Systems
Primary Role = organize a confusing array of
psychological SXs in an agreed upon manner
Facilitates communication b/w clinicians & across time
E.g., had this issue years ago & responded well to drug X
Facilitates research on psychological disorders
Which may lead to effective TXs
Integration of Biological, Psychological, &
Social Factors in Assessment & Diagnosis
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