Behavioral & Personality
Assessment
PSY 4930
Melissa Stern
October 10, 2006
Outline for Today

Go over Exam
 Lecture
 Fact Finding Mission
Exam

Exam Questions we “threw out”
– 26
– 40
– 43
This means we added 6 points to EVERYONE’S
total score
Exams

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Before we gave you 6
pts
22 exams > 90
13 exams 80 - 89
11 exams 70 – 79
5 exams 50 - 69
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After we gave you 6
pts
30 exams > 90
15 exams 80-89
3 exams 70-79
3 exams 60-69
Exam

Review of the questions and answers
Behavior Assessment
•
Observational assessment
• Narrative recording
• Interval recording—observations are divided
into time segments, target behaviors are
recorded
•
Observational coding systems (DPICS)
• Event recording
• Ratings recording
• Self-Monitoring record
Self-Monitoring Record
Situation
What
happened
before?
Kids were The bell
laughing rang
when I
gave my
presentation
What
happened
after?
Thoughts
Feelings
My face
turned red,
I messed
up my
presentation
They’re
Sad
making
Embarasfun of me, sed
Nobody
likes me,
I’m stupid
Subjective
Unit of
Distress
(1-10)
8
Observational Assessment

Advantages

Disadvantages
– Can quantify target
– Time intensive
behaviors
– Can clarify parent- and
teacher-report data
– May provide
qualitative data as well
– Trained observers with
reliability checks
– May require intensive
training
– Reactivity effects
– May not generalize/be
representative
– May miss other
behaviors of interest
Behavior Assessment:
Rating Scales

Epidemiology and classification
 Screening
 Assessment
 Intervention planning
 Outcome- treatment effectiveness
**Warning- use with extreme caution with
making diagnoses
How accurate are rating
scales?
 1) Rating scales with more global items are more
susceptible to biased information.
 2) Generally, the more response choices, the
better (although there's a limit)
 3) Specificity of anchors/answer choices
provides more precision of response
 4) Time period affects responding (i.e. how long
ago that behavior occurred, or how long a period
of time they are supposed to recall to assess
behaviors)
Why do we use parents
and teachers?
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1) They often make the referral
2) They provide information about the child in
variety of situations and for a variety of
behaviors
3) They often have a longitudinal familiarity
with the child
4) Parents- compare to other siblings knowing
how household functions
5) Teachers- can compare child to other
students (more aware of developmental norms)
How convergent are parents
and teachers (and children)?

1) Between parent agreement generally modest
– Lower between parents for personality assessment
(internalizing issues) rather than behavioral problems

2) Agreement much lower for individual items
than overall scores
 3) Generally, parent scores tend to be higher than
teacher scores, with modest agreement overall
 4) Generally, parent scores of externalizing
problems tend to be higher than child report
 5) Generally, parent scores of internalizing
problems tend to be lower than child report
Personality Inventory for
Children (PIC)

Measures a wide range of child functioning:
behavior, affect, cognitive status
 Two versions: Long (420 questions) and
Short (280 questions). Short is most
frequently used.
 True False Format
 Takes approx 30 minutes
 Ages 3-16
Personality Inventory for
Children (PIC)



Developed from theoretical constructs, then validated
using populations with specific maladaptive
functioning.
Also based on empirical research, primary factors of
personality based on behavioral observations, and
areas of interest believe to be useful for practicing
clinicians.
Subscales and Profile Types
– Combinations of scale elevations to produce 12 profile
types
PIC Factors

Based on scores from the subscales
 Factor I: Externalizing and acting out
 Factor II: Intellectual functioning
 Factor III: Internalization and
psychological discomfort
 Factor IV: Activity Level
 Factor V: Somatic Concerns
PIC Scales
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Lie- defensive response set
Frequency- deliberate or unintentional
exaggeration of symptoms or random responding
Defensiveness
Adjustment- poor psychological adjustment
Achievement- academic achievement
Intellectual Screening- impaired intellectual
functioning or cognitive deficits
Development- poor intellectual and physical
development, developmentally delayed
Somatic Concerns- health-related variables,
PIC Scales

Depression
 Family Relations- family effectiveness and cohesiveness
 Delinquency- behaviors matching those of juvenile
delinquents
 Withdrawal- isolation from social contact, distrust of
others, avoidance of people
 Anxiety- exaggerated concerns and worries, irrational fears
 Psychosis- thought disturbance
 Hyperactivity
 Social Skills- social relationships
PIC: Strengths

1)
 2)
 3)
 4)
Large normative sample
Sound psychometrics
Very comprehensive
Questions based on clinical profiles
PIC: Weaknesses
1) Most norms collected in 1960’s and
from Minneapolis Public School System
 2) Norms primarily based on maternal
report. Some criticize PIC saying its
targeted too much toward mothers.
 3) Questions based on clinical profiles

Child Behavior Checklist
(CBCL)

Developed by Achenbach
 Two forms (ages 2-3 & ages 4-18)
 Approximately 20 min to complete

2-3 year old form:
 Subscales = Aggressive, Depressed,
Destructive, Sleep Problems, Social
Withdrawn, Somatic Problems
Child Behavior Checklist

4-18 year old version:
 Total score, Externalizing (Aggressive,
Delinquent), Internalizing (Anxious/Depressed,
Somatic Complaints, Withdrawn), Social
Competence (Activities, Social, School).
 Competence scores (low T is considered clinical)
– Activity: number of activities child is involved in, the
frequency of participation, and skill level in these
– Social: depth and types of social interactions
– School: grades, repetition of grade levels, special
classes, and other school problems
Teacher Report Form (TRF)

Some items adapted to make them more
appropriate for teachers.
– Social competency items replaced with academic
performance and adaptive functioning questions.

Total, Externalizing (Aggressive, Delinquent),
Internalizing (Anxious/Depressed, Somatic
Complaints, Withdrawn), Adaptive Functioning
(Behaving Appropriately, Happy, Learning,
School Performance, Working Hard)
Achenbach Measures:
Strengths

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1) Provides a more extensive assessment of social
competency than many other rating scales
2) Supported by extensive empirical analyses as
accurate measure of problematic child functioning
3) Accurately discriminates clinic referred vs.
non-referred children
4) Good norms: normative samples were large
and diverse. Scoring norms separate for ages (2-3,
4-5, 6-11, 12-18) and sex
5) Strong psychometric properties
Achenbach Measures:
Strengths

6) Having equivalent forms allows for
information from multiple informants on similar
questions and constructs, and allows for a detailed
comaprison across informants and situations.
 7) Can be used for a variety of purposesscreening, classification, treatment evaluation.
 8) Provides competencies (strengths) not just
weaknesses and problems
 9) Empirically derived scales
Achenbach Measures:
Weaknesses

1) Limited range of response choices.
 2) Questions are global; lack specificity
 3) Measure as a whole is too broad
Conners Rating Scales

Focuses on ADHD symptoms, with
additional measures of externalizing and
internalizing problems
 Ages 3-17
 Parent & Teachers version
 Long and Short version of each
 Responses on a 4 point scale (not at all, just
a little, pretty much, very much)
Conners Parent Rating Scale
Long version (CPRS-R:L)

Long version– 80 items (30 minutes to complete)
– 14 factors: oppositional, cognitive problems,
hyperactivity, anxious-shy, perfectionism, social
problems, psychosomatic, Global Index (RestlessImpulsive, Emotional Lability), ADHD Index, DSMIV Symptoms subscale (DSM-IV Inattentive, DSM-IV
Hyperactive-Impulsive)

There is also a short version . . .
Conners Teacher Rating Scale
Long version (CTRS-R:L)

Long version– 59 items (15 minutes)
– 13 factors- oppositional, cognitive problems,
hyperactivity, anxious-shy, perfectionism, social
problems, Global Index (Restless-Impulsive, Emotional
Lability), ADHD Index, DSM-IV Symptoms subscale
(DSM-IV Inattentive, DSM-IV Hyperactive-Impulsive)

There is also a short version . . .
Conners Scale Descriptions
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Oppositional: break rules, problems with authority figures, easily
angered
Cognitive Problems: learn more slowly, organizational problems,
completing tasks
Hyperactivity: difficulty sitting still, restless
Anxious-shy: excessive worries and fears, emotional, sensitive to
criticism
Perfectionism: set high goals, fastidious, obsessive about work
Social Problems: have few friends, low self-esteem, distant from
peers
Psychosomatic: excessive physical symptoms
ADHD Index: identifies children “at risk: for ADHD diagnosis.
Global Index: items most sensitive to treatment effects, i.e. key
ADHD symptoms
DSM-IV Symptoms subscale: based on DSM-IV diagnostic criteria
Conners Rating Scales:
Strengths



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Huge normative sample
Reliability between parents: moderate to high
Reliability between teachers: moderate to high
Reliability between parent and teacher: low
adequate, w/ parents indicating more deviancy
Validity: Discriminates between
hyperactive/nonhyperactive,
depressed/nondepressed, distinguishes between
diagnostic groups.
Conners Rating Scales:
Weaknesses

1) All questions are worded negatively
 2) Psychometric properties good, not great
 3) Some factors have few questions
 4) Test-retest reliability for younger
children is unstable (developmental issue?)
 5) Heavy loading of items on one factor
(hyperactivity), while some have few items
Eyberg Child Behavior Inventory (ECBI)
Sutter-Eyberg Student Behavior
Inventory-Revised (SESBI-R)
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Specifically assesses conduct problem behavior
Ages 2-16
36/38 items: Questions selected from psychology clinic
case records- thought to be most typical disruptive
behaviors of children, and also very specific in nature
Two scales– Intensity- frequency of occurrence (7 point Likert
scale)
– Problem- informant tolerance(yes/no)
Takes only 5 to 10 minutes to complete
ECBI & SESBI-R

SESBI- 11 items identical to ECBI, 12 items
slightly reworded, 13 new items
– Reworded: “Teases or provokes other
children/students”
– Different items: Parent- “Dawdles in getting dressed”
Teacher- “Has difficulty entering groups”

Good screener
 Discriminates conduct problem children from
those without problematic behavior. Accuracy of
classification: 91%.
 Sensitive to treatment
ECBI & SESBI-R: Strengths

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1) Good normative sample
2) Strong psychometrics
3) Strong classification rates for conduct
problems and normal behavior
4) Suitable across a wide range of populations
5) Strong correlations from parent to parent,
teacher to teacher, and both are stable over time
ECBI & SESBI-R: Weaknesses

1) Mother scores tend to be higher than
father scores (true for most rating scales) on
ECBI
 2) SESBI scores for high SES preschoolers
likely to be lower
 3) Correlations between ECBI and SESBI
scores not significant (should they be?)
 4) Factor Structure Inconsistent
A note about measures . . .

Objective: contain clear and structured items,
limited response sets, scoring is precise and
straightforward
– CBCL
– ECBI/SESBI
– CPRS/CTRS
•
Projective: contain ambiguous stimuli, covert
personality traits are “projected” onto the stimuli,
responses are interpreted based on criteria
Personality Assessment

Minnesota Multiphasic Personality
Inventory – Adolescent (MMPI-A)
MMPI-A

The MMPI-A is often referred to as an objective
personality test; however, it was actually designed
to assess psychopathology rather than personality
– Scale development based on differential responses to
items by the specific criterion groups and normal
groups
– e.g., If most depressed teenagers in the normative
sample answered a question a particular way, when a
patient taking the test answers that way for a question,
it contributes to a score on a scale of depression
MMPI-A

It was published in 1992
 It is comprised of 478 true/false items
 Age range = 14-18 years
 Standardization sample was 1,610
adolescents who lived in eight different
states

California, Minnesota, New York, North Carolina,
Ohio, Pennsylvania, Virginia, and Washington
Updating the MMPI

The original MMPI had over 10,000 publications,
so although the inventory was updated, there were
also efforts to not change too much of it so that the
literature would not be lost
 The language and norms were updated in the
MMPI-2 and MMPI-A (e.g., a question about
playing drop the handkerchief was deleted)
Updating the MMPI

The MMPI-A uses uniform T scores
– This ensures that the same T score elevation has
similar meaning or equal probability of
occurring across the scales (similar to deviation
IQs)
– T 60-65 indicates a range approaching clinical
attention
MMPI-A vs. MMPI

The MMPI-A is scored differently than the
MMPI-2
– F: I have fits of laughing or crying that I can’t control
– F: At times, I have the urge to do something shocking
– The 2 items above are much more commonly true for
adolescent females than adult females
– M & F: I like to go to parties where there is loud fun
– M & F: I dream frequently about things best kept to
myself
– The 2 items above are much more commonly true for
adolescent than adults
Interpretation of the MMPI-A

Basic methods of interpretation of the
MMPI-A compare a person’s true/false
response pattern to criterion reference
groups (e.g., depressed, paranoid,
psychopathic, etc.)
Clinical Scales of the MMPI-A

1 (Hs) Hypochondriasis
 2 (D) Depression
 3 (Hy) Hysteria
 4 (Pd) Psychopathic Deviate
 5 (Mf) Masculinity-Femininity
Clinical Scales of the MMPI-A

6 (Pa) Paranoia
 7 (Pt) Psychasthenia
 8 (Sc) Schizophrenia
 9 (Ma) Hypomania
 0 (Si) Social Introversion
Common Codes of the MMPIA

The most common 1-point codes
– 4 and Within-Normal-Limit (WNL) profiles
– 40% of the clinical sample have WNL profiles

The most common 2-point codes
–
–
–
–
2-4 – 8.6%
3-4 – 6.6%
6-4 – 5.9%
4-9 – 12.7%
Frequency of Use

In a survey of 30 tests used with adolescents
the MMPI-A is the 5th or 6th most popularly
used test with teens
 Reference Guides:
– MMPI-A: Assessing Adolescent
Psychopathology (2nd Ed.) by Bob Archer
– MMPI-A: A Casebook by Bob Archer
Reference Guides

MMPI-A: Assessing Adolescent
Psychopathology (2nd Ed.) by Bob Archer
 MMPI-A: A Casebook by Bob Archer
– He is a psychologist/researcher at Eastern
Virginia Medical School in Norfolk
Final notes on Assessment

There are a variety of additional assessment
measures not covered in class:
– CDIs
– BRIEF
– Additional personality/behavior measures
– Projectives
– Structured Diagnostic interviews

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(K-SADS, DISC)
Family assessment is also common
General Goals of Assessment

Diagnosis—this is controversial
– Some insurance will not reimburse w/o a
diagnosis . . .

Differential diagnosis—deciding which
disorder best captures the child’s
symptoms/behaviors and ruling out the
other diagnoses
– Comorbidities—child may have more than one
disorder
General Goals of Assessment

Recommendations or Treatment Planning
 Case conceptualization/formulation—
“integration of all information about a case
into a comprehensive picture that provides a
basis for decisions” (Achenbach, 1998, p. 78)
– Clinical judgment and decision making are
crucial
– Diagnosis is like research, develop a hypothesis
and then test it
FACT FINDING MISSION

How it works:
– I gave you basic info on a case
– You generate differential diagnoses
– You ask me questions about the
case/assessment, and try to figure out what the
diagnosis is
Case #1

7 Year old Caucasian female referred to the
ADHD clinic.
 About to enter the 2nd grade, presenting
with attention and concentration problems
Differential Diagnoses

So, what are the possible diagnoses?
FACT FINDING

Hints:
– What do you need to know? What are the
various aspects of child assessment in general,
educational & IQ assessment, behavioral and
personality testing do you want to know about?
In particular, what do you need to assess for to
rule out some of your differential diagnoses
Case #2

5year old African American male referred to
the psychology clinic
 In Kindergarten, refusing to sleep in own
bed