This document discusses clinical assessment and diagnosis in psychopathology. It covers the goals of assessment to understand abnormal behavior and help individuals. Assessment tools discussed include standardized clinical interviews and psychological tests that measure traits, responses, physiology, neurology, and intelligence. The document also addresses the reliability and validity of diagnostic classifications and treatments. Effectiveness of treatment is examined, finding that therapy is generally more helpful than no treatment and certain combined approaches show promise.

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PSYC 3553 – Psychopathology
Week 4: Assessment and Diagnosis • September 29, 2009
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What is assessment?
• Goals of clinical assessment:
• How and why a person is behaving abnormally
• How that person may be helped
• Also may be used to evaluate treatment
progress
• Focus is idiographic – on an individual person
Characteristics of Assessment Tools
• Standardization
• A test is administered to a large group, and their
performance serves as a common standard (norm)
against which individual scores are judged
• The “standardization sample” must be
representative
• One must standardize administration, scoring, and
interpretation
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Characteristics of Assessment Tools
• Reliability: The consistency of a test
• Test–retest reliability
• Interrater reliability
• Validity: the accuracy of the test results
• Face validity
• Predictive validity
• Concurrent validity
Are Classifications Reliable and Valid?
• Reliability: different diagnosticians agreeing
on diagnosis using same classification system
• DSM-IV: greater reliability than previous editions
• Used field trials to increase reliability
• Validity: accuracy of information diagnostic
categories provide
• DSM-IV has greater validity than any previous
edition
• Conducted extensive lit reviews and field studies
I. Clinical Interviews
• Face-to-face encounters
• Often the first contact between a client and a
therapist/assessor
• Used to collect detailed information,
especially personal history, about a client
• Allow the interviewer to focus on whatever
topics they consider most important
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II. Psychological Tests
• Six categories of psychological tests
1. Projective tests
2. Personality Inventories
3. Response Inventories
4. Psychophysiological Tests
5. Neurological/neuropsychological Tests
6. Intelligence Tests
II. Psychological Tests
 Projective tests: Interpret characteristics onto
vague & ambiguous stimuli or follow open-ended
instruction
• Strengths and weaknesses:
• Helpful for providing “supplementary” information
• Rarely demonstrated much reliability or validity
• May be biased against minority ethnic groups
Example: The Rorschach Inkblot
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Example: Thematic Apperception Test
Example: Sentence-Completion Test
• “I wish ___________________________”
• “My father ________________________”
Example: Draw-a-Person Test
• “Draw a person”
• “Draw another person
of the opposite sex”
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II. Psychological Tests
 Personality inventories - self-report
questionnaires
 Focus is on behaviors, beliefs, and feelings
 Ask how similar/dissimilar a person is to a set
of statements
• Strengths and weaknesses:
• Objectively scored and standardized
• Although more valid than projective tests,
often we cannot directly examine trait
Example – The MMPI
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II. Psychological Tests
 Response inventories
• Usually based on self-reported responses
• Focus on one specific area of functioning
• E.G., emotion, social skills, cognition
• Strengths and weaknesses:
• Have strong face validity
• Rarely careless/inaccurate questions
• Few subjected to careful procedures
II. Psychological Tests
 Psychophysiological tests
• Measure physiological response as an
indication of psychological problems
• Most popular is the polygraph (lie detector)
• Strengths and weaknesses:
• Require expensive equipment that must be
tuned and maintained
• Physical evidence for psychological
symptoms
II. Psychological Tests
 Neurological tests: direct
assessment brain
function
 Neuropsychological
tests: indirect assessment
via cognitive, perceptual
& motor function
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Example: Bender Visual-Motor Gestalt
II. Psychological Tests
 Intelligence tests
• Designed to measure intellectual ability
• Assess both verbal and non-verbal skills
• Generate an intelligence quotient (IQ)
• Strengths and weaknesses:
• Highly standardized, reliable and valid
• Influences on performance…cultural factors
Clinical Observations
• Naturalistic observations
• Occur in everyday environments: homes, schools…
• Analog observations
• If impractical, conduct observations in artificial
settings
• Self-monitoring
• People observe themselves and carefully record the
frequency of certain behaviors, feelings...
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Clinical Observations
• Strengths and weaknesses:
• Different observers focus on different aspects?
• Careful training and use of observer checklists
• “Overload,” “observer drift,” and observer bias
• Client reactivity may also limit validity
• Observations may lack cross-situational validity
Treatment: How Might Clients Be Helped?
• Treatment decisions: begin with assessment info &
diagnosis to determine treatment plan
• Other factors: therapist’s orientation, current research,
empirical support, evidence-based treatment
• Difficult question to answer:
• How do you define success?
• How do you measure improvement?
• How do you compare treatments – differing in
range, complexity, skill, knowledge
The Effectiveness of Treatment
• Is therapy generally effective?
• … more effective than no treatment or placebo
• In one study, average person in treatment was better
off than 75% of untreated
• Consumer Reports found that “consumers” of therapy
found it to be helpful or at least satisfying
• Can therapy can be harmful? Has potential…
• Studies report ~5% get worse with treatment
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The Effectiveness of Treatment
• Are particular therapies effective for particular
problems?
• Studies now conducted to examine efficacy of
specific treatments for specific disorders:
• Recent studies focus on the effectiveness of
combined approaches
• Drug therapy combined with certain forms of
psychotherapy – to treat certain disorders
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