psy472 exam 1, PSY472 exam 2, psy472 unit 3

administration

Committee work and management positions in businesses and corporations

tertiary prevention (rehabilitation)

Compliance with long-term treatment (goal: reducation in relapse and recurrence) Prevention of another episode of that disorder Relapse prevention After-care (including rehabilition)-reduction of disability Can we maximize functioning and minimize effects of disorder? focuses on rehabilitation and long-term adaptation

Respect for people's rights and dignity

Ex: a wife is in a domestic violence situation and does not want to leave the husband, what do you do? Respect her rights and what she wants to do even if it is a dumb decision We must respect people's decisions even if they are stupid Notes say what the therapist would want to have shown in court Must treat people with what they came to therapy for In Arizona if someone is threatening the client, therapist doesn't have duty to warrant NO DUTY TO WARN THE VICTIMS if they are clients of domestic violence unless they are a child or elder We are poor predictors of violence behavior

theory

Extremely useful Influence the way the researcher interprets the data he or she obtains from the completed research study (researchers not immune to potential biasing effects of their own beliefs and values)

Sigmund Freud

First elaborated treatment of mental health issues Focuses on role of unconscious Many subsequent followers elaborating related psychodynamic theories-was the foundation of this theory

Lightner Witmer

First person to open a clinic (1904) His clinic helped children by assessing and remediating learning difficulties Coined term clinical psychology

Beneficence and nonmaleficence

Have to help people and have to avoid harm

empirical criterion keying

-items were chosen that discriminated groups -Create questions related to Items you want to assess and items you don't want to assess -So you have people you want to eliminate

treatment plan report

-report involves problem identification, specification of the aims and goals of treatment, and a description of the strategies and tactics involved in the planning of treatment Attention is also paid to the need for ongoing evaluation of the patient's functioning, because monitoring of treatment is important in determining whether treatment should be discontinued or alternative treatment options should be considered

musterbation

-someone saying a sentence with a MUST or a SHOULD dichotomous thinking and mind reading

high vs low face validity

-you know vs you don't know what test is measuring -depends on what the clinician or researcher is trying to measure Ex: with a paranoid person they overthink everything so it needs to be high

translation and adaptation of a test

1) Back translation 2) Pilot testing should be conducted with the translated measure to ensure there are no problems with comprehension of items 3) Evidence of good reliability should be obtained on the translated measure 4) Scores on the measure should be restandardized using norms specific to the translated measure 5) Construct validation efforts should be undertaken to determine whether the instrument measures the same psychological qualities in both languages

fake-bad profile

Low L, high F, low K

psychotherapy (talk therapy)

Majority of sessions are 16-20 weeks for short term but most clients only show up to 10 regardless of the problem Insurance companies will only cover 8 sessions of mental health treatment (ON AVERAGE) Insurance company managed healthcare has made the clinical scene a bit more difficult for therapists

marital problems in men v women

Marital problems in men: Target work stress and see what is left Marital problems in women: unhappy with environment in general

forensic psychology clients

Never fully trust clients!-pretend to trust them but don't actually Population is starving for anything Clients leave more victimized more tough than when they arrive, best clients in terms of homework compliance, because they are never not observed A few psychopaths, you know them when you see them

culturally appropriate measures

Personality measures must be relevant and unbiased across cultural and ethnic groups Malgady (1968)-both practitioners and researchers should assume that measures are culturally biased unless there are data to suggest the opposite

(parts of) structural equation modeling

Researcher lays out structural model Researcher considers how best to measure each variable in the model

resilience issue(DSM)

Resilience and strength factors are crucial to determine how long treatment is (look at this in the book too) You might be so depressed but so resilient, so many strengths that they will be able to flourish once they get the resources Might have someone with poor coping abilities, low self-efficacy=longer treatment than someone with higher resilience

Correlational designs

association of variables (most common) ex: Tracking different people one with disorder and one not without manipulating anything that is a correlational design DSM group vs control is this type of design factor analysis

primary health problems (that clinical health psychologists work with)

asthma, chronic pain, cancer, diabetes, heart disease

Publication credit

authorship must accurately reflect contribution of authors

Different types of clinical trials

Type 1: high quality Randomized Controlled Trials (RCTs) Type 2: Imperfect RCTs Type 3: Open trials without a control condition Ex: HIV

Arbitrary inference

jumping to conclusions, drawing a conclusion that isn't supported by evidence

Self-efficacy (behavior therapy)

person's sense of competence to learn and perform new tasks (best predictor of tx (treatment) success) (improving this sense of competence) Behavior therapy focuses on this

Client/patient, student, and subordinate research participants

steps must be taken to protect potential participants from adverse consequences of declining or withdrawing participation

self-report measures

used all the time; report themselves, their thoughts and behaviors; a participant report

VRIN

variable response inconsistency Measures tendency to respond inconsistently High VRIN and F=invalid profile Normal VRIN, high F=serious issues or faking bad

neuropsychological assessment

vast array of test and assessments for brain function

VCI

vocabulary, similarities, information comprehension

classification

way for scientists and clinicians to organize, describe, and relate subject matter For us, this is mental illness

Selective abstraction

when you blow things out of proportion, focus on one detail and ignore all other evidence; very common Just taking one aspect-one thing you focus on that develops a cognitive schema

Overgeneralization

when you draw a general conclusion based on a single incident First impressions, having an opinion on best friends' significant other that you haven't met yet

hierarchical models

when you have different levels of factors with some factors being sub-domains

factor models

when you have two or more factors that are thought to be of the same level

Variable Response Inconsistency (VRIN)

measure the tendency to answer these item pairs inconsistently and may reflect random or confused responding to the test; a number of these items have either similar or opposite content

visual puzzles (perceptual reasoning)

pieces of a puzzle where images are chosen that go together to match the example Given a puzzle with one missing piece and you have to select which piece fits in the puzzle

Labeling

place a fixed and global label on either oneself or someone else Can be positive or negative Ex: I'm a procrastinator, you're a drama queen,

informant-report measures

reports by someone who knows the participant Ex: sending evaluation to teacher to hear about observations; perception of each other and of themselves in marriage counseling

Francis Galton

studied individual differences among people, especially differences in motor skills and reaction times which he believed were related to differences in intelligence

wilhelm wundt

studied sensation and perception and established the first psychology laboratory and was a central figure in advocating for psychology as the study of human experience

dimensional approach

symptoms can be on a continuum; people differ in degrees from each other Dimensions must reflect significant higher-order constructs rather than simple descriptive features Example: You can be moderately or severely depressed (within diagnosis there is a spectrum of severity)

syndrome (kraepelin)

symptoms that frequently co- occurred by considering the entire range of symptoms it would be possible to identify the precise disorder

biopsychosocial model

takes into account biological, individual, and social factors associated with the individual's participation in varous activities

clinical health psychologists

talk about co-influence of health and mental health Ex: dialysis and depressive symptoms, treatment compliance, better mental health functioning, more likely to comply to treatment, lessened symptoms, how stress can lead to worse episodes of renal functioning In the US most health psychologists train in general clinical psychology programs AND THEN they receive specialized health psychology training

Symbol search (processing speed)

the person must indicate, by checking in a box, whether target symbols occur in the group of symbols presented How quickly can you visually scan, select the correct answer, and respond back Looking at speed

arithmetic (working memory)

the person solves arithmetic problems and provides the answer orally Have to solve the problem in their head and they are given the problem orally as well

pharmacology

ways that environmental toxins, chemotherapy, and recreational drugs affect brain functioning

neuropathology

ways that injuries and diseases affect the brain

detecting failure

we are poor at detecting failure when clients don't get better we blame the client-this is clinician bias

deception in research

we can deceive participants but it goes under really careful consideration and in the end we have to show the deception overcompensates for the risk; nobody likes to be deceived so we have to show the deception in research compensates

intervention

Psychotherapy: talk therapy

MMPI-2

has 567 and adolescent version 478 items; used content approach to test construction

mcfall's manifesto (3)

the benefits MUST be SCIENTIFICALLY VALIDATED

factor analysis

the underlying structure of a variable

prevalence

overall rate of cases of a disorder in a specific time period

definition of iq

"Intelligence is the aggregate or global capacity of the individual to act purposefully, to think rationally and to deal effectively with his environment."-David Wechsler (1939)

working memory

-Ability to encode information into STM, store it there, and retrieve it there when needed -Assesses ability to Manipulate information in your head (e.g., addition)

inferring causation from correlation

-A psychologist may see two things co-occur and believe the first caused the second -Ex: childhood sexual abuse and borderline or EDs

Verbal comprehension

-Assesses general verbal skills, such as verbal fluency-ability to understand verbal directions, ability to understand and use verbal reasoning, and verbal knowledge -Based on both formal and informal education -Influenced by culture

perceptual reasoning

-Assesses visual, spatial, and visually-guided motor skills -Assesses Ability to organize thoughts -Assesses comfort with new, unfamiliar situations

projective measures

-Based on psychoanalytic idea that people project their negative attributes about themselves onto ambiguous external stimuli -However, recent evidence indicates the responses people give are based on their experience right before their testing and not personality -Lack the rigor of testing guidelines Because of this, responses can be influenced by clinician or administrator

process-experiential therapy

-Based on the assumption that human nature is fundamentally growth-oriented, trustworthy, and guided by choice -Client-centered therapy (Rogers), Gestalt Therapy, and existential therapy -Emphasizes using therapeutic relationship to help clients process their emotions and, subsequently, to create new meaning for their emotional experiences

meta-analysis (example)

-Can take all treatment trials on CBT and some manuals vary -What is optimal number of sessions for CBT with depression? When is it too little? When does it stop adding value?

?

-Cannot Say -How many questions unanswered -10 or more unanswered questions makes test invalid

how confirmatory bias relates to psychotherapy

-Client comes in seeming depressed, therapist will only ask questions about depression and even if clients bring up something not related to depression, the therapist will disregard the info -if you think you're doing a good job, you will only focus on things that will help your hypothesis and disregard everything else -If client doesn't do well, you're going to blame the client -Leading questions can help detect malingering in forensic therapy -Leading questions can create false memories

how self-serving attributional bias relates to psychotherapy

-Clinicians are more likely to attribute successes in client's life to therapy and intervention and being a good clinician -Clinicians cannot identify psychotherapy failure in the moment- -Clinicians consistently think they are better than they actually are -No clinician center will report clients that get worse or don't respond to treatment -More years of experience-worst outcome (less time-less tools-less innovation)

CBT (scientific investigation)

-Collect data which are thoughts, feelings, and events -Create hypotheses based on data -Test and revise hypothesis based on new info (thinking patterns) Hypotheses are client's thinking patterns The idea behind CBT is that when people are presenting for psychological services, something is awry and it is often what they think or perceive of the world -Most change takes place in-between sessions

short-term psychodynamic therapy

-Current evidence-based treatment for a number of disorders and symptoms -Based on psychoanalytic theories of Freud and recent theorists

therapeutic tasks (STPP)

-Developing a positive transference relationship, identifying themes that are important for the patient -Analyzing the transference relationship; exploring themes through clarification and confrontation -Terminating therapy, dealing with loss, dealing with expectable challenges in life

recent major developments with MMPI

-Development of restructured clinical scales -Inclusion of the Symptom Validity scale -Scales that don't overlap- and items that were specific to the construct being assessed by the scale

normal reactions to life stressors (DSM)

-Diagnoses don't account for normal reaction to life stressors and there is a comorbidity issue-once you have diagnosis/meet criteria for one disorder, you have a higher likelihood of getting a diagnosis/meeting the criteria for another disorder and this is problematic because our goal is to deal with abnormal functioning -It is problematic because the discreet categories get blurred, ability to make inferences about that category get diminished

ways of generating a research hypothesis

-Everyday experience and observation -Professional experience and observation -Addressing applied problems and needs of a group, of a society, of an organization -Previous research -Theory

Nine steps to EFT

-First four steps involve assessment and de-escalation Get couple to talk without arguing with each other -Remaining steps are about changing relational pattern and developing new connections New way of communicating

principles (PE)

-Fostering a therapeutic relationship -Facilitating work on therapeutic tasks -Experiential response modes -Therapeutic tasks

background issues of intelligence scales

-Full scale IQ -Research evidence does not support the use of VIQ and PIQ scores of their own -Wechsler-Bellevue test greatly criticized for limited set of norms -Test may not be fair -Wechsler tests do not measure examinee's current ability or some of the products of intelligence, particularly processes that underlie intelligence -Wechsler tests do not measure abilities in the artistic, social, or emotional domains, among others -Performance on the wechsler scales indicates a great deal about how well he or she can solve problems in a few important areas, but very little about exactly how he or she solves diverse problems

Emotionally focused therapy for couple distress

-Goals: modify emotional responses to be adaptive, enhance a secure emotional bond for the couple -Focuses on understanding and listening -Help couples present their attachment needs in an adaptive, understanding (and validating) manner

fake-good profile

-High L, low F, high K -If you score 15 points or higher on K than F: Compared to other adults in the US, you tend to view yourself in a better light Narcissists, sociopath

underlying assumptions of CBT

-How an individual interprets life events plays a role in determining how he or she responds to those events -Patients are seen as being excessively negative in their beliefs and suffering from the use of maladaptive information processing strategies -More you know someone, the less likely you are to be able to predict their behavior Because of schemas-everything is filtered through schemas -Seeks to teach patients to identify their maladaptive beliefs & processing tendencies & to systematically test the accuracy of those beliefs & tendencies -Encourages examining the accuracy of their beliefs, and engaging in a series of "experiments" in which behaviors are systematically varied in order to test the accuracy of those beliefs-to test hypotheses -Just telling people about schema is not enough to change their behavior -Relational distress-partner is often discrediting experience of patient

processing speed (assesses)

-How fast can you focus, your scanning speed, sequentially ordering visual information -Assesses how difficult it is for individuals to work under pressure and assesses senstivitiy to motivation -BIOLOGICAL-parents and offspring tend to have similar processing speeds -Cultural factors have little impact

additional foci (STPP)

-Identification of themes and central conflicts that keep occurring -Defensive patterns in the person's life -Evoking emotions-still interact while evoking emotions -Goal-setting-still using homework -Termination of therapy-you end treatment

inclusion in treatment (of) (PE)

-Increasing client's awareness of emotion -Encouraging client to express emotion -Enhancing the client's emotion regulation abilities -Aiding the client to reflect on emotions -Helping client to transform maladaptive emotions into adaptive emotions

how tests can be biased

-May not be relevant to all cultural groups -How tests are related may not be equal across groups -Cut-off scores may be different for different groups Can actually be fixed by using cut-off scores to show elevation that shows true problematic items or traits that lead to poor mental health -Different factors may exist for different groups (different structure's for different groups)

componential (deals with)

-Mental processes of planning, monitoring, and evaluating -Performance, or solving of a problem -Knowledge acquisition-including encoding, combining, and comparing information

evidence of treatment efficacy

-Must be a minimum of a single, high-quality RCT showing treatment efficacy -Must be a clear description of this treatment -Must be a clear description of the recipients of this therapy

interpreting the WAIS

-Neurological impairment -Emotional trauma -Language-related learning difficulty -50-60% of IQ is related to genetics and rest is related to environment

why rorschach has been thrown out in court

-No rater reliability-accuracy in scoring a Rorschach doesn't change between somebody with no experience and somebody with all the experience; not being able to detect also is the sae -No difference between what indicates schizophrenia and what doesn't -No interrater reliability-people cannot come up with same diagnoses for the person

goals of case formulation

-Obtain a detailed understanding of the patient's presenting problems -Identify those variables that are functionally related to such difficulties -Delineate treatment targets, goals, and objectives -The problems influence each other in varying degrees

Similarities (verbal)

pairs of words (describing concepts or objects) presented and the subject must explain how the objects are similar

benefits of case formulation

-Provides guidance for a treatment -Provides ways of understanding connections between various problems (these are hypotheses) -Can help predict patient's functioning with or without treatment -Provides options to consider if difficulties are encountered in implementing and following through on treatment -Indicates options, outside of psychological services, for the patient to consider -Provides alternative treatments options to consider if the initial treatment is unsuccessful

developmental psychology (3 facets)

-Recognizes biological and psychological systems as constantly changing -Emphasizes the importance of major developmental transitions as well as disruptions to normal patterns of development -Essential to be informed by research on a wide range of issues

belief in the law of small numbers

-Results drawn from small samples are likely to be more extreme and less consistent Results drawn from small samples rather than all the data -Personal experience is given more weight

people with comorbidity (are more)

-Severely impaired in daily life functioning, -Are more likely to have a chronic history of mental health problems, -Have more physical health problems, -Use more health care services

how intelligence tests become invalid

-Stress, can't administer the test after a negative life event unless you are trying to assess something like emotional trauma but if you're just trying to get IQ, you have to reschedule -Dyslexia -People give up -Colorblindness -Extraneous variables Kids are encouraged to sleep for 9 hours the night before and are given a snack before the test Teenager girls are not scheduled while they are PMS'ing -Kids who cannot stand still -Clinician bias can invalidate the test

two key factors of case formulation

-Succinct analysis of the client's core strengths and weakness -Supporting material-in-depth analysis of these strengths and weakness

Wechsler intelligence scales

-Test norms may not be appropriate I must ensure that Test norms must be appropriate for client -Test biases may be a part of the test In particular, there are test questions that rely on knowledge of living in the US Either not administer questions related to this or not count them toward full IQ -Test only focuses on academically related intelligences -This test has best and highest reliability and validity data out there

ways to improve accuracy of clinical judgment

-Use psychological tests that are directly relevant to the assessment task and that have strong psychometric qualities -Check for scoring errors when using test data -Use computers as aids in the collection, scoring, and interpretation of clinical data whenever possible -Use normative data and base rate information whenever available -Use evidence-based decision aids, such as decision trees or clinical guidelines -Be as systematic and structured as possible in obtaining, considering, and using all relevant information -Be aware of relevant research in psychological assessment, psychopathology, and prevention/intervention -Be aware of personal biases and preconceptions -Be self-critical: search for alternative explanations for hypotheses and challenge evolving case formulations -Seek consultation from other professionals when unsure of the accuracy of conclusions -Don't rely on memory, and don't rush any conclusion or decision

WAIS

-VCI-similarities, vocabulary information -Perceptual reasoning: block design, matrix reasoning, visual puzzles, picture completion, figure weights -WMI: digit span, arithmetic, letter-number sequencing -PSI: symbol search, cancellation

culture and DSM

-When scientific evidence exists for cultural/ethnic variations in the clinical presentations of a mental disorder, this information is provided in the text accompanying the diagnostic criteria -A limited number of cultural syndromes are described in an index -A section on cultural formation provides information to assist the clinician in making a culturally sensitive and appropriate diagnosis and overall clinical formulation

importance of case formulation

-Writing down hypotheses holds you accountable, gives clinician something so they can check back their hypothesis (otherwise how do you know you're making progress etc?) -Also important because I'm wrong most of the time -Increases efficiency, and also ensures I am targeting all the right things to prevent having the disorder again -Hurts patient if therapist doesn't go back and check on hypothesis -Holds the therapist accountable -Case formulation will guide the psychologist in determining what issues should be emphasized in treatment and how the steps in a treatment manual can be individualized to match client needs

Wechsler IQ test

-a hierarchical model with two equal factors of verbal IQ and performance IQ that make up total IQ; each have two subdomains with tests that make up each subdomain -verbal (VCI and WMI) and performance (PQI and PSI)

(Charles) Spearman model of intelligence (factor model)

-all intellectual activities share a single common core known as general factor-g; measures of intellectual abilities are not perfectly correlated so there a number of specific factors-s -There was a general factors g with specific factors s-this focus was called the two-factor model -More a test is influenced by s, the less it represents the influence of g -based on sensory abilities

what influences research hypothesis

-choices about ethical conduct, -type of research design, -sample of participants, -measures used

internal validity

-controlling for biases -extent to which interpretations drawn from results of study can be justified and alternative interpretations can be reasonably ruled out But we have to assess internal validity in each therapy case, in our assessments, and even in clinical trials

process group vs structured group approaches

-designed to capitalize on the dynamics of the group -extensions of treatments also offered in an individual format

Behavior checklists (symptom checklists)

-designed to provide information about the nature of an individual's experience Less complex personality tests that are derived from descriptive characteristics of an event rather than from personality theories

content approach

-developing items that designed to tap a construct -Assesses one thing in categorical and dimensional ways You're either depressed or not but also degree to how depressed you are Took a while to come up with all the items because it is so comprehensive

testing

repeated this may influence results of a study due to familiarity with a test and memory of response previously on a test or measure

Components of a case formulation

1)Description of problem and symptoms 2)Events and stressors that led to problems or symptoms 3)Any predisposing life events or vulnerabilities 4)Hypotheses

steps of a case formulation

1)Develop a problem list 2)Describe triggers or precipitants of the problem 3)Identify patterns among the problems 4)Writing hypotheses for each problem 5)As treatment occurs, you refine and evaluate the hypothesis 6)Give final results in the end a.Necessary to prevent client from needing my services again

Focus (STPP)

1. Brining things from unconscious to conscious a. Bringing to awareness unconscious 2. Re-enacting problematic relationship with the therapist 3. Working through this pattern and development of new interpersonal patterns

goals of IPT

1. Grief 2. Role Disputes 3. Role transitions 4. Interpersonal deficits

Stepped care model for management of depression

1. Identification and recognition 2. Treatment of persistent subtreshold depressive symptoms or mild to moderate depression 3. Treatment of persistent subtreshold depressive symptoms or mild to moderate depression with inadequate response to initial interventions and moderate to severe depression 4. Sequencing of treatments after initial inadequate response 5. Treatment of complex and severe depression

how to address clinical utility

1. Is the test considered useful by clinical practitioners? 2. Is there replicated evidence that the measurement data provide reliable and valid information about clients' psychological functioning? 3. Does using the measure eventually make a difference in terms of the client's functioning?

steps to generating a research hypothesis

1. Researcher conducts a systematic search of the published research on the phenomenon of interest 2. Researcher begins to formalize ideas so they can be tested in a scientific manner 3. The researcher must carefully consider the extent to which the research idea may be based on cultural assumptions that may limit the applicability or relevance of the planned research 4. Researcher must consider ethical issues in testing idea 5. Researcher must draw together all the results of the previous steps to sketch out the study procedures

treatment (PE)

12-20 sessions-places emphasis on client's self-exploration and understanding rather than on relationships with others Takes a task-focused approach, largely emphasizing emotional content

digit span (working memory)

:the person is presented with a series of numbers and must repeat them in the same sequence first and then the second half is when the participant is given a series of numbers and must recite them back to the person but recite them backwards

case formulation

A set of hypotheses, generally framed by a particular theory or orientation, regarding what variables serve as causes, triggers, or maintaining factors of an individual's emotional, psychological, interpersonal, and behavior problems. Also describes patient in his or her life context

MMPI t-scores

A t-score of 50 is average for all clinical tests, including the MMPI With a standard deviation of 10 A t-score of 65 or higher is of clinical concern but a t-score of 70 or higher is clinically significant

Thurstone (similar to Spearman)

Primary mental abilities-spatial, perceptual, numerical, memory, verbal, word, reasoning, deduction, and induction abilities the small overlap between these abilities that was Spearman's g

teaching

University courses (graduate or Also can teach in several other settings (e.g., community colleges, in clinics training professionals, to medical students, in workshops/seminars, etc.) In practice with multiple people, one PhD or PsyD student looks over master's levels

assessing intelligence

Commonly used intelligence tests do not tap the full range f abilities that are included in modern theories of intelligence-they focus on those abilities that are related to academic performance and are not designed to measure social, emotional, and other domains Any result on an intelligence test does not fully represent a person's total intelligence

pain (clinical health psychology setting)

Psychological factors short-term and long-term influence how you respond to pain, how you report pain All human beings adapt to pain over time but there are certain conditions where we stop adapting to pain Look at it in a clinical health setting to see how individuals respond to pain

what do we use now

An IQ score with a mean and standard deviation -Mean is 100; standard deviation is standard -If you have an average IQ, you have a score between 85 and 115, 68% of the population falls in this range -16.1% fall higher than 115

Outcome Questionnaire 45 (OQ-45)

Composed of three subscales: symptom distress, interpersonal relations, and social role functioning Subscales provide good overview of client's psychosocial functioning Takes 5 or so minutes to complete Can assess client progress accurately Can dramatically improve treatment success rates and reduce the rates of deterioration associated with treatment

DSM IV (1994)

Focus on reliability (first time focus on reliability) 'Work groups' worked on clusters of disorders Tons of work groups created the classification system of each disorder based on the literature important thing to know is that one symptom CANNOT get you a diagnosis

behavior therapy (focus)

Focuses on skill-building-teaching people skill's they might need work on and also promoting adaptive coping skills Focuses on how learning skills can take place by observation and imitation Ex: show people how to cope instead of procrastinating

International Statistical Classification of Diseases and Related Health Problems (ICD (developed by World Health Organization))

International classification of functioning, disability, and health-provides a system for describing health and health related conditions Used for information on person's body, societal involvement, and environmental factors used by all professionals

developmental psychology (range of issues)

Interpersonal attachment, cognitive development, and sleep patterns

recidivism

Intervention usually is focused on this which means committing crimes after release from incarceration

World War I

APA asked to develop a scale to measure mental functioning of recruits Army Alpha Test (assessed verbal abilities) Army Beta Test (non-verbal abilities-for those who could not read or spoke limited English) These tests tested nothing other than psychotic individuals or people who couldn't sit through the test These tests and the value they gave recognized clinical psychology as a discipline The tests saved a lot of money and increased efficiency by weeding these people out

Anger (ANG)

a measure of anger, aggression, and lack of control

support for evidence-based practice

All criticism can be tested through science and have been More respect from other fields Similar to the medical field, clinical psychology should have standards to protect patients

research

All psychologists are trained to conduct and evaluate research APA's ethics code requires a commitment to increasing scientific knowledge APA mandates that all psychology students must be trained in research Must be able to critically evaluate literature and have to show 15 hours of continuing education each year, you pay for that out of pocket, no training is free

Antisocial Practices (ASP)

a measure of antisocial attitudes and a history of engaging in antisocial acts such as stealing

Cynicism (CYN)

a measure of beliefs related to a general lack of trust in people and little faith in their intentions

Depression (DEP)

a measure of depressive symptoms

Anxiety (ANX)

a measure of general anxiety and worry

(MMPI) content scales

Anxiety (ANX) Fears (FRS) Obsessiveness (OBS) Depression (DEP) Health Concerns (HEA) Bizarre Mentation (BIZ) Anger (ANG) Cynicism (CYN) Antisocial Practices (ASP) Type A Behavior (TPA) Low Self-Esteem (LSE) Social Discomfort (SOD) Family Problems (FAM) Work Interference (WRK) Negative Treatment Indicators (TRT)

seeking psychological services

Anyone can refer to themselves as a psychotherapist A licensed and credentialed person avoids using the term psychotherapist A license ensures that all individuals meet the basic educational and experience requirements Life coach-requires no credentials-anyone can call themselves a life coach There is a median number of visits and hours that you need to become licensed and graduate with a PhD-an average of 2 years of post-PhD experience to be license eligible

Howard Garb

Appropriate training is generally more important than clinical experience in ensuring accurate and valid judgments; Psychologists typically do a good job of describing clients' psychological characteristics but less well with case formulation

common cognitive errors

Arbitrary inference Overgeneralization Dichotomous thinking Catastrophizing Mind reading Labeling

Health Concerns (HEA)

a measure of general health concerns

Low Self-Esteem (LSE)

a measure of general self-esteem

Obsessiveness (OBS)

a measure of indecisiveness and obsessiveness

activities of clinical psychologists

Assessment and diagnosis, psychotherapy, consultation, research, teaching, supervision-supervision of clinical psychology student therapy sessions, and administration-firing people in a nice way

assessments

Assessment is normally thought about as diagnosis and "what's going on?" The typical form of assessments: cognitive tests, IQ tests etc... But also career assessments can fall into this The state of Arizona can ask clinical psychologists the amount of evidence-based treatments for children in the entire state

administration, scoring, and interpretation issues

Assessor encourages test-taker to answer all the questions Important to ensure no visual impairment that interferes with test-taking Several standardized and objective scoring options are available Direct entry Scoring system Computerized administration and scoring Interpretation Examination of validity scales Categorizing the test profile into code types-summary codes for highest two clinical scale elevations

criticism for evidence-based practice

Group-based data not relevant to individual clients We can't afford to wait for research Each individual has a unique life experience so general psychology principles don't apply Some clients won't respond to a lot of treatment

Negative Treatment Indicators (TRT)

a measure of negative attitudes toward health care professionals and mental health treatments

Family Problems (FAM)

a measure of reported family conflict and the tendency to have characteristics that increase the likelihood of current interpersonal conflict

does psychotherapy work?

Hans Eysenck (1952)-published a paper showing that clients in therapy were worse off than untreated individuals It was the 1960s, psychoanalysis, depression goes away by itself after 9 months, no evidence-based treatments Several problems with the study invalidated results-but led to push for additional research on effectiveness this study launched the field of efficacy

lie scale (L)

a measure of self-presentation that is unrealistically positive

prevention

Most prevention programs are in community settings Jobs are to develop, implement, and evaluate the program Treating disorder before it occurs is easier to treat and saves society and the individual a lot of money! Prevention usually based in community settings Psychologist usually has several roles in prevention Developing programs Implementing programs Evaluating outcomes of programs

Stenberg's triarchic theory

Based on how humans process information componential, experiential, and contextual

second principle of clinical psychology: ethics

Beneficence and nonmaleficence Fidelity and responsibility Integrity Justice Respect for people's rights and dignity

brain regeneration

Brain Can regenerate itself but capability depends on age Even when there is complete death in one area, we can retrain the brain to recircuit itself so whatever the brain did in that area, to another area and also the injured area

validity scales

Cannot say (?) Lie scale (L) Infrequency Scale (F) Defensiveness scale (K) Back F Scale (FB) Variable Response Inconsistency (VRIN) True Response Inconsistency Scale (TRIN)

secondary prevention (treatment)

Case identification (diagnosis)-do you have mental disorder we think you have? After identification-STANDARD treatment for known disorders case identification and standard treatment occurs when disorder is evident

behavior therapy

Oldest form of CBT-with a focus on operant and classical conditioning as etiology of symptoms problems Symptom and present focused Focused on reducing symptoms and the here and now

carl rogers (client-centered approach)

Client-centered approach still used today

consultation

Clinical consultation: offering advice and information for other treatment professionals An entity to an employer

purposes of a diagnostic system

Concise description Reflects best current scientific knowledge of psychopathology, Provide a common language for clinicians, researchers, and patients, Indicates possible causes of condition, Indicates possible future developments in the condition, Provides guidance on possible co-existing problems or conditions that should be evaluated, Provide guidance on treatment options to be considered, Provide a key term that can be used by clinicians to search scientific literature, Provide a framework for determining reimbursement of health services and eligibility for special programs and services

Infrequency Scale (F)

a measure of self-presentation that is very unfavorable-malingering or severe psychopathology Is someone trying to present themselves with more psychopathology than they really have

Translating efficacy to effectiveness

Current research indicates that efficacy trials can be translated into real-world settings Effectiveness studies show similar results e.g. CBT for depression meta-analysis (2013) effect sizes of 1.0

prescription privileges debate

Currently on a select few psychologists can prescribe (IL, NM, and LA) Why should they get prescription privileges? Psychologists spend more time with clients Psychologists can track and detect things earlier than the psychiatrists who only see you monthly Cheaper for the states than psychiatrists and cheaper for patients These states have a lot of places where there are no psychiatrists but clinical psychologists do exist If there is a black market for drug, psychologists can't prescribe it; very limited area of prescribing Ex: XANAX

Social Discomfort (SOD)

a measure of social introversion

Type A Behavior (TPA)

a measure of the Type A personality (i.e., characteristics of impatience, irritability, and being easily annoyed)

Fears (FRS)

a measure of the fear of specific objects, events, and situations

Bizarre Mentation (BIZ)

a measure of very peculiar or psychotic thought processes

Work Interference (WRK)

a measure of work-related impairments

context of abnormal behavior

Determination of whether a behavior is abnormal requires knowledge of the context in which the behavior occurs Diagnostic criteria for many childhood disorders specify that the symptom must be developmentally inappropriate Psychologist must have a good sense of the range of normal behavior in a particular developmental period in order to be able to judge what is abnormal

harmful dysfunction

Diagnosis of a disorder requires that there is something wrong or dysfunctional and that this dysfunction causes harm to the individual or those around him or her Some form of pathology is evident and this pathology causes impairment Must have both dysfunction and harm because some people have pathology without it resulting in impairment

1980s DSM

Diagnostic and Statistical Manual for Mental Disorders (DSM-III) published DSM-III more focused on observable symptoms Before DSM-III, there was a lot of variability and allowed for inconsistencies in diagnoses

diagnosis (criteria)

Diagnostic criteria always includes a cluster of symptoms that co-occur Classification systems for mental disorders rely almost entirely on the observation of symptoms Most diagnostic decisions are derived largely from client self-report data Diagnosis must rely on scientific evidence not just value judgements

adaptations to freud's model

Fritz Perls-Gestalt therapy Joseph Wolpe-systematic desensitization Victor Frankl logotherapy

behavior therapy (goal)

Goal is focused on increasing the person's engagement in positive or socially reinforcing activities

other research activities of forensic psychologists

Helps the field decide what is admissible in court-keep track of literature, what is legit what is not? Rorsharch, polygraphs not admissible

guidelines from apa

I. Well-Established Treatments II. Probably efficacious treatments III. Experimental treatments a. American Psychology Association, division 12 task force (1995)

regression to the mean

If a person reports extreme mood, or receives an extreme score, they will naturally regress to their own average without intervention Clients will report to therapy at their worst so necessary to keep regression to the mean in mind

disability

Impairment, activity limitation, and participation restrictions

DSM 5 (changes)

In DSM-4 had all different kinds of disorders that in DSM-5 are now Autism Spectrum Disorder or Schizophrenia or Addiction disorder We want our classification system to make sure that the diagnosis sticks and doesn't change Validity has increased with these changes but clinical utility has decreased

F

Infrequency Important!-measures how much responses deviate from the general population Taking the test at home, a T-score above 80 is (clear) evidence of psychopathology Clinically settings it's a score of 65 Make sure profile is valid

Stanford-Binet Intelligence Test

Lewis Terman's modified scale of the Binet-Simon Scale of intelligence for the United States

Gardner's theory of multiple intelligences

Linguistic, musical, logical-mathematical, spatial, bodily-kinesthetic, intrapersonal, interpersonal, naturalist, spiritual, existential, and moral

Scale 5 (Mf: Masculinity-Femininity)

Measures gender-stereotyped interests and activities Assesses gender stereotyped roles Especially in leadership training-leaders can switch on and off gender and know when androgyny is best Used more in occupational settings

Interpersonal therapy

Much more emphasis on problems with communication and on dysfunctional relationships than dynamic therapy (although some overlap) Some overlap between interpersonal and short-term dynamic Clear understanding of current and past relationships is central to this approach Although mainly present-focused Brief-usually 3-4 months Efficacious for depression, eating disorders, substance use disorders, some personality disorders and some anxiety disorders You don't focus on the symptoms, focus on relationships

Confirmatory bias

Once a hypothesis is formed, you look for data to support your blief and discredit data that disproves your belief.

norms, reliability, and validity

Only limitation in representativeness is slight underrepresentation of adults with lower education and lower income For these individuals, the cutoff scores may be too low-test is likely to yield large number of false positives in the evaluation of these individuals Clinicians need to be aware of tendency to overpathologize-exaggerate and overestimate the extent of psychopathology Surprisingly little research on degree to which MMPI-2 and MMPI-A are appropriate for English-speaking populations outside the United States A number of MMPI scales are likely to have relatively weak internal consistency

US definition of race/ethnicity (problematic)

Our definition of black is very US-based (it can apply to West Indians and Latinx) May cause problems especially if person gets asked about what it is like to be black

utility of developmental psychopathology

Particularly useful in understanding problems of infancy and childhood but it can also be applied to help us understand the challenges of later phases in development such as retirement

Self-serving attributional bias

People make more internal, stable, and global attributions for positive events in their life than negative events

techniques (STPP)

Reflection-paraphrasing clients' statements or commenting on emotional states in order to enhance their awareness of current experiences Clarification-asking clients to attend more closely to some aspects of their experience in order to see connections or patterns Interpretation-commenting o a problem or experience and relating it to the use of defense mechanisms or underlying core conflictual themes Confrontation-challenging clients to recognize that defense mechanisms are interfering with their optimal functioning or that core conflictual themes are responsible for aspects of their experience

First Pillar of Clinical Psychology: Science

Science of Clinical psychology Clinical psychologists must maintain their knowledge of research relevant to their activities (only to what is relevant to what you do) No one is forcing you to implement that knowledge

McFall's manifesto

Scientific clinical psychology is the only legitimate and acceptable form of clinical psychology only scientifically supported treatments should be offered to the public (although this was met with strong opposition)

(MMPI) clinical scales

Scale 1 (Hs: hypochondriasis): Scale 2 (D: depression) Scale 3 (Hy: Hysteria) Scale 4 (Pd: Psychopathic Deviate): Scale 5 (Mf: Masculinity-Femininity) Scale 6 (Pa: Paranoia) Scale 7 (Pt: Psychasthenia): Scale 8 (Sc: schizophrenia) Scale 9 (Ma: Hypomania): Scale 0 (Si: Social introversion):

SMART

Specific, Measurable, Achievable, Realistic, Timely used to underline the importance of establishing goals

Exner's Comprehensive scoring system

Scoring system is highly problematic because it is not reliable No evidence to back up why you scored Might be thrown out-under investigation for falsification of data

activities of clinical health psychologists

Settings include-community clinics, hospitals, and can work in private practice (not full-time, get referrals from hospital also get diagnosed at hospital then go to psychologist at private practice) Most work/are affiliated with-a medical setting of some sort Most work with a variety of health problems Many focus on BOTH assessment and treatment intervention Ask for reports from doctors and add mental health component to it, can be looking at a number of medical reports and case notes

fidelity and responsibility

Should develop a trusting relationship with patients and conduct ourselves in a professional manner Would you want your ex to be dating your therapist? Except when they have made a threat to us, themselves, or to somebody else Ex: violating a client's confidentiality to refer him elsewhere due to a history of domestic violence (counselor office not equipped to deal with specific case) Threat trumps fidelity and responsibility

WWII (need for intervention)

Soldiers needing therapy when returning from war All of a sudden there were massive and massive amounts of soldiers coming back with PTSD, TBIs, and other mental health issues Members of public affected by loss VA hired many clinical psychologists-first time clinical psychologists were really being told "treat these individuals" The need, demand, and pressure lead to many therapy approaches developed

evidence based treatments (issues)

Some (most people) not receiving full dose of treatment This is for episodic disorders but for bipolar, schizophrenia and personality disorders they have longer treatments that are at least one year-sets up a disparity The individuals that need psychotherapy the most are the least likely to get what they need Important bc it shows how selective you need to be with therapist Have to be a really well-informed consumer and go to someone who is up to date and uses evidence-based practice

drawbacks of diagnosis

Stigmatization, Potential for an inaccurate diagnosis to result in harmful or inappropriate treatment Without diagnosis, insurance companies might not disperse reimbursement

DSM problems/limitations

Still uses/is based on the US definition of race and ethnicity doesn't include normal reactions to life stressors Diagnostic criteria Although better than the earlier versions of the DSM Goal of DSM is to find those having trouble, those struggling in the society Heterogeneity of symptom profiles is problematic Validity is questionable Current research indicates that some disorders may be both a category and a continuum (e.g., depression) What about resilience? Defining abnormality Diagnostic reliability Diagnostic validity

Scale 9 (Ma: Hypomania)

Tendency toward hyperarousal, excessive energy, agitation People who go go go

projective personality test

Test taker is responding to ambiguous stimuli and assessor determines interpretation of data No standardization of ambiguous stimuli Not allowed in courts or assessments because they are so influenced by bias In practice, use stimuli to engage in conversation but not using it for testing Also require test-taker to generate drawings according to assessor's instructions Based on the assumption that valuable information on aspects of the test-taker's personality structure can be gleaned from responses to these ambiguous stimuli

DSM 5 (culture)

The DSM-5 does a really good job of discussing culture (better than previous versions) Places the responsibility on the clinician to find out what is culturally typical If someone is really religious but from another country where that is normal, it won't contribute to a psychosis diagnosis Expanded cultural bound symptoms We don't recognize symptoms in the us but is diagnosed in another country, clinician can diagnose you with that disorder if you are from that country even though you are in the US If it is culturally typical cannot be part of symptoms for diagnosing Recognize disorders from other countries

DSM III (published under task force chair Robert Spitzer)

The manual was explicitly atheoretical allowing for the possibility of greater acceptance within the mental health field and for the introduction of concrete behavioral descriptions of most disorders The diagnostic criteria were must more explicit because of the lists of symptoms provided for each diagnosis Thousands of patients and hundreds of clinicians were involved in field trials to improve the reliability of the diagnostic systems Multiaxial diagnostic system was introduced to encourage cliniians to consider more than just symptoms when diagnosing a person

behavior therapy (theory)

Theory is that you are in an environment that is reinforcing depressive symptoms so it is necessary to change the reinforcers in your environment

back translation

The practice where a translated word or phrase is retranslated into the original language by a different interpreter to catch errors.

WPPSI (preschool and primary school)

There are 15 subtests 5 core subtests: receptive vocabulary, information, block design, object assembly, and picture memory For children aged 4 years to 7 years, 7 months, psychologist administers 6 subtests: information, similarities, block design, matrix reasoning, picture memory, and bug search

scoring the MMPI

These are the clinical scales above 65 Name of scales are horrible Scales 5 (masculinity & feminity) and 0 (social introversion) are not included Only clinically meaningful parts of concern None of the scores of 65 or higher we care about Co-types only matter if we have a valid test

Back F Scale (FB)

This scale measures a possible change in self-presentation, which may be due to a change in test-taking strategy. Similar to the F scale, the items for this scale all occur in the final third of the inventory

why don't people want guidelines from apa?

Treatments that don't have any evidence based will be removed and insurance won't cover these treatments that work best for you that don't fall on the list If you did a therapy that worked best for the client but the client could sue you if you didn't do a therapy that fell on the list, now clinicians have to get insurance to operate to protect themselves

central concepts (STPP)

Unconscious Transference Counter-transference

heterogeneity of symptom profiles

Variability in response to treatment So many symptoms of depression and you don't need all of them; how different people can present for depression, makes it harder for people to diagnose it accurately same symptoms can overlap

beck depression inventory (clinical utility)

Was high in clinical utility because it gives clinician brief background, reduces clinician bias, really efficient (can do it in waiting room), it is meant to be efficient for the clinician and can help the clinician cover all other bases, high clinical utility and good validity-good measure for its intended purpose

researchers and clinicians

We influence our work but our work influences us so much and our pathology We don't just treat our clients, they impact us; so in most trauma-related centers the therapists have their own process groups to reduce their traumatic symptoms Researchers and clinicians are influenced by the process of their work The ability to stay optimistic and to be able to live a normal life is very important

prototype model (and dsm)

When people present for depression the most common symptoms presented are... COMMON SYMPTOMS but also SEVERE SYMPTOMS Adds a lot of lines of text to DSM

mediator vs moderator design

When you present with a problem, I create a hypothesis of what is driving that problem-hypothesis is based on literature and science and based on unique situation based to you; it could be a mediator or a moderator Work stress of women may have a huge effect on relationship satisfaction but also might not Hypothesis is that if you target work stress without targeting relationship, the change will occur

Psychological assessment reports and treatment plans

Write a report that serves as a record of assessment, can be referred to subsequently, and can be used as a document for legal purposes. Psychologist must be cognizant of audience of report Crucial that psychologist clearly attribute who said what Ambiguous terms should be avoided Computers should be used to improve accuracy of some aspects of clinical decision making No standards dictating necessary components of a report, content and structure depend on reasons for the assessment

mcfall's manifesto (4)

You must tell people the NEGATIVE SIDE EFFECTS to the service or treatment you are providing

McFall's Manifesto (1)

You need to tell people THE EXACT NATURE of the service or treatment you are providing

mcfall's manifesto (2)

You need to tell them the BENEFITS of the services or treatments you are providing

clinical neuropsychologists work with

a large variety of patients including alzheimer's, traumatic brain injury, multiple sclerosis, brain tumors, Parkinson's disease and many others

DSM definition of mental disorder

a mental disorder is a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities

Inattention to base rates

a psychologist's belief that a certain pattern of responses on a test is indicative of a specific diagnosis and they support this belief with information on relevant cases Without full knowledge of pattern of test responses and diagnosis, it is not possible to determine extent to which test responses accurately predict the diagnosis

paul meehl

a purely clinical approach to assessmet was typically inferior to a more statistically oriented approach to accurately describing or diagnosing adults scientific methodsmust be used to test the validity of the hypothesis

psychophysiological measures

a range of measures reflecting biological markers (e.g., heart rate, blood pressure, neural activity) Improving physiology improves mental health

effect size

a statistical measure of how strong the experimental effect is (i.e., statistical significance does not say how strong the effect is, only that it is unlikely to have a strong effect)

one-third conundrum

a third of the patients need more care than whatever the clinical facilities can provide, a third are at the level of the care, and a third doesn't need that much care.

True Response Inconsistency Scale (TRIN)

a very high score indicates a tendency to give "true" answers indiscriminately; a very low score indicates a tendency to give "false" answers indiscriminately; based on answers to item pairs that are opposite in content

Diagnosis

concisely describes the symptoms that comprise the person's condition-decision-making rules applied to the symptoms of a specific individual

role disputes (IPT)

a. Identify dispute i. Ex: miserable as a college student, negative relationships b. Formulate plan for dispute resolution c. Modify communication and/or change expectations to resolve dispute

grief (IPT)

a. Help deal with loss; promote healthy mourning i. Transitional periods bring loss b. Facilitate development of new relationships c. Help individuals cope and deal with loss to facilitate and develop a new relationship

role transitions (IPT)

a. Leave old role and mourn its loss b. Develop skills, coping strategies, and support when starting a new role c. Apply for job above skill set

Scale 6 (Pa: Paranoia)

feelings of being mistreated, and delusions of persecution Also elevated by people being discriminated against

crystallized intelligence

ability to use skills, knowledge, and experience; what we have learned in life, both from formal education and general life experiences One subdomain is-the knowledge you have acquired over your lifetime We don't want performance affects

contextual

adaptation, ability to adapt Ways of interacting with the environment-adaptation, alteration of the environment, and selection of a different environment Ex: if lecturer talks faster, would you adapt your typing speed?

Affect heuristic

affective qualities of cognitive representations of people or objects are rapidly considered, usually occurring at an unconscious level and can lead to judgment based solely on emotional considerations with only minimal attention paid to the full range of factors relevant to the decision

Justice

all people have the right to benefit from psychology Pro bono cases, sliding scale clinics, if a student is in training, that is a sliding scale fee

couples therapy (now)

an approach that includes tasks designed to facilitate acceptance of an imperfect but adequate relationship, also used to address psychological disorders such as depression that are associated with relationship dysfunction, may include individual sessions

intervention

an attempt to decrease or eliminate an undesirable outcome that has already occurred

Prevention

an attempt to decrease the likelihood that an undesirable outcome occurs

diagnostic validity

an indication that a disorder is a discrete entity that has clear boundaries with other disorders

rehabilitation

an interactive process between the patient and service providers designed to enable the person to function as adequately as possible

Humane care for animals

animals must be acquired, cared for, used, and disposed of in compliance with laws, government regulations, and professional standards-those involved in research must be instructed in care, maintenance, and handling of animals

universal preventive interventions

applied to everyone Doesn't mean everyone in population has to have it Ex: vaccination, not all individuals are parents but everyone is getting that information that children need to be vaccinated

statistical vs clinical significance

are results due to chance? vs are results clinically meaningful? something can be statistically significant but clinically meaningless

stimulus characteristics and settings

aside form participants, features of study such as the institutional setting and characteristics of those involved in conduct of study may constrain generalizability of study results

army alpha test vs army beta test

assessed verbal abilities vs non-verbal abilities-for those who could not read or spoke limited English

supervision

assisting graduate students in understanding the research literature in a chosen area and then conceptualizing the research that the student will conduct as part of his or her degree

convergent validity

association between a measure and either other measures of the same construct or conceptually related constructs

discriminant validity

association between measures that, conceptually, should not be related

language-related learning difficulty

may be indicated by a low verbal IQ and average or high-performance IQ May be given different non-language based IQ tests

Raymond Cattell (hierarchical model)

believed current tests were too focused on verbal and school-based abilities; two factors each factor (fluid and crystallized) had subdomains

striking change in psychological assessments (2)

best practices in assessment should be based on assessment methods and measures that have solid scientific support

POI

block design, matrix reasoning, picture completion, picture arrangement

clinical vs counseling psychology (today)

both clinical and counseling psychologists are employed in a wide range of work settings clinical psychologists have expanded their practice to address human problems occuring outside realm of mental health services, clinical psychologists also develop programs that are designed to prevent the development of problems counseling psychology also promotes the use of scientifically based interventions clinical and counseling psychologists are usually trained in different academic settings (counseling-faculties of education at doctoral level (phd or edd); clinical-psychology departments in phd or psyd)

emotional trauma (wais)

may be indicated if the client has a low verbal or performance IQ that does seem to match their past level of functioning Seen in PTSD-one of the factor scores shoots up after treatment

Treatment services for offenders

can be at all levels, for high risk individuals

Court-related assessments (forensic psychology)

can be of a victim, accussed, disputing parties A good portion of malingering (are they lying?, can be trying to look more pathological than they actually are) assessments to detect if someone is lying

integrity in professional relationships

can't sleep with clients or other colleagues, two colleagues that are married cannot supervise the same person at the same time, must disclose conflicts of interest Can't allow people to use you for specific purposes, can't cherry pick an assessment to show something No bias

fluid intelligence

capacity to think logically and solve problems in novel situations, independent of acquired knowledge; i.e. ability to solve problems without any prior knowledge or experience Ex: The Amazing Race

maturation

changes in participants due to their psychological or physical development that cannot be disentangled from the experimental manipulation

instrumentation

changes in the definition of constructs and in measurement

Risk factors

characteristic of person or environment that increases the risk of developing a disorder or problem

picture concepts

child chooses pictures from rows of pictures to form a group that has a characteristic in common, matrix reasoning, picture completion

word reasoning

child is asked to describe underlying common concept after being presented a series of clues

diagnosis system

classification scheme that is based on rules that is used to organize and understand diseases and disorders

DSM 5

clear and succinct definition of mental disorder Mental disorders were classified on the basis of specific defining criteria, however classes of disorders were clustered with similar disorders For each mental disorder, there is a wealth of information on diagnostic features that facilitate a fuller appreciation of what is known about the mental disorder and alert the clinician to important aspects that should be considered during the evaluation of the person

Social desirability

clients will say something they think the therapist wants to hear If they think they already have a certain disorder, they will try to display only the symptoms consistent with the disorder People come in with their own expectations of therapy

neuroanatomy, neuropathology, pharmacology

clinical neuropsychologists receive training in

Why is clinical psychology important?

clinical psychologists have developed assessments that are helpful in understanding problems and interventions that are effective in preventing, treating, and even eliminating a broad range of health problems and disorders

observation of behavior

coding systems used to summarize complicated behavior Think Bridges

rational emotive therapy (Ellis)

cognitive behavior therapy with emotions added to it COGNITION, EMOTION, AND BEHAVIOR ALL INFLUENCE EACH OTHER similar to beck's cognitive therapy

books leading to cbt

cognitive-behavior modification: an integrated approach by don meichenbaum cognitive therapy of depression: a treatment manual by aaron beck and colleagues john rush, brian shaw, and gary emery

Block design (perceptual reasoning)

colored blocks to create three-dimensional representations of two-dimensional geometric patterns; Timed-how quick and easy is it for you to do?

structural equation modeling

combines elements of confirmatory factor analysis and mediator analysis

Scale 2 (D: depression)

common symptoms of depression Assesses symptoms of depression consistent with the DSM

Quasi-experimental designs

comparing groups when random assignment is not available or ethical Can't randomize people or can't have control group HIV studies cannot have a control group (randomly give people sample month 1, give another random group of people sample in month 2 but month 1 is control)

Weshcler-bellevue intelligence test 1939

considered the gold standard in IQ tests along with the Wechsler Memory Scale

personality traits

consistent behaviors, attitudes, and emotions over time; attitudes that are evident across situations and across time Your view on events, society, the world Personality traits are changeable Introverts can change and with work become extroverts More stable in adulthood than in childhood and adolescence

(OG) MMPI (1943)

constructed as a self-report test that could provide accurate information on symptom severity and possible diagnoses for adult patients suspected of having mental diosrders 550 items Relied on empirical criterion-keying approach Developed several scales to assess threats to the avalidity of responses to the MMPI

Randomized controlled trials (RCT)

controlled group that is randomized and there is an intervention, something was done

K

correlation Measures defensiveness College students typical to see T scores between 55 and 70 Signifies competency in managing life Score of 45 or lower psychopathology may be present

Neurological impairment (WAIS)

may be indicated when one of the scales falls in the low average or lower ranger, and the other in the average or higher range

archival data

data stored for some other purpose used for research (e.g., police records, health care utilization records, and academic records) Can request permission for medical records without identifying information to look at data Can occur in a number of different settings

duplicate publication of data

data that have been previously published must not be published subsequently as original data

timing of measurement

decision about when to measure variables may result in conclusions that are not true for time points

emil kraepelin

dedicated his career to the study and classification of mental disorders was convinced that all mental disorders were due to biological factors and these biological causes of the disorders could not be effectively treated by the primitive methods of the time so he devoted his career to the study and classification of mental disorders classified schizophrenia

Vocabulary (verbal)

defining a series of orally and visually presented words

Sample characteristics

degree to which characteristics of the research participants map on to other samples and populations of interest

institutional approval

department and university need to know and approve of experiment/study; there are now mechanisms where the department and university needs to use to know and approve of study

Test of Memory Malingering

designed to assess whether an individual with established or suspected neurological impairments is exaggerating his or her memory deficits

capacity assessment

designed to balance the need for autonomy with the need for protection requires an understanding of the ways in which functioinng can be impaired by injury and degenerative processes

WISC

designed to provide age-appropriate assessment of children/adolescents between the age of 6 and 17 -VCI-similarities, vocabulary, comprehension, information, word reasoning -Perceptual reasoning: block design, picture concepts, matrix reasoning, picture completion -WMI: digit span, letter-number sequencing, arithmetic -PSI: coding, symbol search, cancellation

A-B (single-case designs)

designs with a number of clients Implement treatment, behavior went away, if you don't believe it works, remove treatment so you can see if behavior comes back

A-B-A (single-case design)

designs with one person at different time points

Case study

detailed description of a case, which can allow for a great deal of hypothesis generating allow clinicians to tell researchers what is going on and what they are seeing; they also help researchers create some sort of guideline to guide their research; case studies tell us a lot of information of what might get missed in trials heuristic value

Alfred Binet (and colleague Theodore Simon)

developed a strategy to measure mental skills that could yield nformation relevant to the identification of children with limited intelligence Binet-Simon scale of intelligence

DSM IV

developed in a far more collaborative and scientifically informed manner than were preceding editions of the DSM

MMPI-A

developed to include fewer items, reworded, and additional items were added for relevance to younger people

john watson vs mary cover jones

development of phobias vs extinguishing phobic reactions in a child

malingering

exaggerating or faking an illness

examples of neuropsych assessments

diagnosis prognosis treatment planning legal proceedings

Statistically significant differences

differences not due to chance

WMI

digit span, arithmetic, letter-number sequencing

PSI

digit-symbol, coding, symbol search

service evaluation

do treatments work current assessment practices require that measures focus on specific problems or strengths, be brief, and be amenable to repeated use

research of forensic psychology

does a lot of research to improve legal system and research lawyers can use Ex: what are bad personality traits for a juror?, how can we improve jurors? Relates to our legal system, improve the reliability of witnesses and jury decisions Through research we learned that memory is impacted, ex: parent can say something and have that implanted into child's memories Helps prevent and reduce aggression

Clinical utility

does the assessment help with treatment As a clinician, seeing clients-the MMPI is not really helpful

1980s and 1990s

dramatic increase in amount of research on psychotherapy improvement in the methodological sophistication of those studies psychodynamic and humanistic approaches were adapted to provide services over a shorter period of time

heuristic value

draws attention of other professionals to a phenomenon

evidence (PE)

efficacy on treating depression and couple distress

health promotion

efforts to introduce a healthy lifestyle

DSM I

emphasized psychodynamic etiological factors for the majority of the disorders and provided only vague diagnostic descriptions Only psychoanalysis was available at the time of the book

Cognitive-behavioral case formulation approach

emphasizes the importance of identifying the patient's overt problems and longstanding beliefs that are believed to cause the overt problems

evidence-based practice model (b)

emphasizes the importance of informing patients, based on the best available research evidence about viable options for assessment, prevention, or intervention services

Binet's work

established the importance of stanardization in the development of psychological tests and the iportance of references to normative data in interpreting test results

Drew westen

examined how a number of methodological issues affected results of treatment research for depression, bulimia, GAD, panic disorder, PTSD, and OCD On average ore than 80% of patients who began the RCT completed treatment, 40% of patients were excluded from the RCTs they examined Those not in a research trial are more likely to not have as severe symptoms

developmental psychopathology

examines behavior in relation to the milestones that are specific to each stage of development

componential

examines executive functioning and performance speed Ex: timing someone who types notes during a lecture

mediator variable

explains mechanism by which a predictor variable influences a criterion variable

incremental validity

extent to which a measure adds to the prediction of a criterion beyond what can be predicted with other measurement data

Validity

extent to which principles used in classifying an entity are effective in capturing the nature of that entity; does classification scheme accurately capture reality?

statistical regression

extreme scores tend to be less extreme upon retesting

stanford prison experiment

famous for it being unethical even though what they did at the time was perfectly fine, guidelines were created after the fact; he didn't get in too much trouble because he didn't violate any guidelines at the time the study was created; one of the key reasons we have informed consent, must let participants know afterwards whether they were deceived, and IRB has to approve study (no unethical deception, no harm), guided and informed clinical practice, watching experiment changed and influenced Zimbardo as it occurred. Led to the question of how clinicians are changed and influenced by their clinical work

DSM IV-TR (text revision)

fixed typos, corrected errors, updated scientific information and enhanced its educational value

efficacy studies

focus on studies that emphasize internal validity of the study For clinical psychology, use clinic, you want everything to be as pure as possible, no comorbidity, highly trained therapists, ideal circumstances

efficacious studies

focus on studies that look at real world conditions Now we are going to test and bring everybody to receive treatment

International Classification of Functioning Disability and Health (ICF)

focused on overall functioning and health

james mckeen cattell

focused scientific attention on the connection between reaction time and intelligence, credited with coining the term mental tests to describe the battery of test and tasks he developed to evaluate people's cognitive functioning

community psychology

focuses on the reciprocal relations between individuals and the community in which they live

IPT-A

for adolescents; includes attention to developmental issues such as peer pressure, exploration of parental authority, development of dyadic relationships, and separation from parents

details provided in institutional approval

general information about nature of study and procedures, information specific to ethical considerations in recruitment and research involvement of participants

beck depression inventory (gold standard)

gold standard because of utility despite validity

Achenbach System of Empirically Based Assessment

internalizing/externalizing problems When you have a problem do you internalize/withdraw or do you lash out?

debriefing

have to tell people what is going on in study, why they are doing the vignettes, have to tell people what actually occurred and what you were looking for in the study

informed consent

have to tell people what they will be doing

James Butcher

headed project to revise MMPI Attempted to: Improve upon the original test by using better test construction strategies and obtaining representative normative data Ensure continuity with the original test by retaining the MMPI's main scales

promotion

health promotion or mental health promotion-promotion programs can be developed to make people more resilient If we can increase your self-efficacy to increase resiliency, that will decrease risk for mental health disorders

1995

release of the report of the APA division of clinical psychology's task force on promotion and dissemination of psychological procedures, produced a list of efficacious treatments

threats to internal validity

history, maturation, testing, instrumentation, statistical regression, selection bias, attrition

performance measures

how a participant does on a task (e.g., reaction time or behavioral measure) Ex: coding anxiety of tasks done for someone trying to get over a fear of elevators Use performance measures all the time

prototype model

how do people commonly present?; tells us cultural variations and sociocultural variations of the disorder; members of a diagnostic category may differ in the degree to which they represent the concepts underlying the category ex: The prototype describes these kinds of trends, providers will already be trained to help treat when this trend cycled through again

content validity

how fully and accurately the measure represents the construct being assessed Ex: BDI not covering all symptoms of depression-how does BDI cover symptoms of depression?

external validity

how generalizable is the study or the findings to the real world See what treatments work for which client Can tell you what things are universal

internal consistency (reliability)

how homogeneous the test items are

reliability

how internally consistent are the measures?; how well do the test items measure what they are supposed to measures?

face validity

how much the measure overtly appears to be measuring the construct of interest Ex: BDI you know what the test is measuring but with the MMPI you might not know what the test is measuring (high vs low face validity)

test-retest reliability

how stable over time scores on a measure are Without intervention how reliable are items? Items should still work together consistently if they are tested months apart if you never got and intervention

Treatment planning

how to help someone with a serious head injury Will concussion affect long term memory

Inducements for participation

how to pay people without compromising moral values/ethics; biases who participates in the study

Prognosis

how will a head injury affect long term memory

Garbage in, garbage out

if poor-quality studies were included in a meta-analysis, they could negatively influence the results

dyscontrol

impairment must be involuntary or at least not readily controlled

Clinically significant differences

improved quality of life, cure, recovery

family therapy (now)

may be sought to address difficulties associated with transitions, address mental disorders in one or more family members Many current family approaches consider family an important part of the solution to problems

where forensic psychologists work

in a variety of settings including hospitals, private practice, court clinics, penitentiaries, specialized facilities Expert testimony in court cases, can work with all people in criminal justice system, involved in all aspects of criminal justice system

diagnostic criteria

include too much of population; too much of population can meet criteria If so many people meet problems within diagnostic criteria is it really a problem? Can only have a disorder if it causes a severe impairment in functioning (meets two criteria of dysfunction, deviance, distress)

matrix reasoning (perceptual reasoning)

incomplete patterns and, from five choices, must select one that completes the pattern Incomplete pattern and you have to figure out which one completes the pattern

1960s and 70s

increase in numbers of psychotherapies available to public and amount of research devoted to understanding whether psychotherapy was effective rational emotive therapy transactional analysis

striking change in psychological assessments (3)

increased attention to the relevance ofa ssessment data for treatment planning and treatment evaluation

diagnostic reliability (DSM Problematic)

interrater reliability on assigning of diagnoses falls below acceptable levels Reliability doesn't always attain a good level There is often extreme variability in reliability values noted from different sites in DSM field trials

eysenck's effects on the field

it crystallized dissatisfaction among many psychologists who did not agree with a psychodynamic approach it resulted in a flurry of research activity in the following decasdes focused on evaluating both new and traditional forms of psychotherapy

History

influence of events that occur outside context of the study that influence or account for results of the study

Enlightment

influence of this was evident in burgeoning application of scientific principles to understanding both normal and abnormal human behavior in the latter part of the 1800s (history of assessment)

Anchoring and adjustment heuristic

initial conditions or characteristics determine a starting point for considering the nature of an individual or task

premorbid IQ

intellectual functioning prior to an accident or neurological decline Ex: medical prescriber assesses functioning in people admitted to nursing home showing signs of dementia

Scale 0 (Si: Social introversion)

introversion, not enjoying social contexts

forensic assessment

involves most all of the assessments/tests that we have discussed in this class plus those targeted to forensic populations, for ex: Psychopathy checklist-revised Violence risk appraisal guide

selection bias

involves the effect that systematic differences in recruiting participants or assigning participants to experimental conditions may have on the outcome of the study

forensic psychology training

is different Because of high rate of incarceration in the US, any work in correctional facilities providing services Train you to physiologically always be ready for a threat Ex: sit in a seat where you are always posed to protect yourself from a threat, metal in your shoe so it is a weapon, don't act feminine

yes

is dsm only used in america?

biggest trap (CSQ)

is that our desired outcome is either unattainable or unrealistic The moment people create desires for other people's behaviors, they will get disappointed The interaction must be examined in a behavioral context-interpretations have nothing to do with actual action

information processing models

less focused on organization more focused on how brain processes information; used a lot in neuropsychology

L

lie scale -T score above 60 is rare -Measures whether an individual is trying to look good; socially correct behavior -Could be someone who has a naïve nature -If it is higher than 50 they are probably behaving in socially desirable ways, they will try to say things therapist wants to hear, and therapist must shape questions in ways that the client doesn't know -Also might show much client values socially desirable behavior

attrition

loss of participants in a study over time

stepped care

lower-cost interventions are offered first with more intensive and more costly interventions provided only to those for whom the first-line intervention was insufficient

availability heuristic

making a decision based on easily recalled information

setting the sample size

making sure there are enough participants to detect differences in groups Majority of fMRI studies are low powered but still make a lot of deal; have a chance to be spurious findings that don't replicate, don't generalize Low power-not a lot of people, ex: 5 to 10 people in the study

Dichotomous thinking (Albert Ellis)

manipulative interpersonal style; things are either black or white People with this get into a lot of negative interpersonal interactions with others

downside to case studies

many threats to internal validity making it difficult to generalize

early iq tests

measured 'mental age (MA)'-the child's test score relative to their chronological age (CA); (most students at a particular age got a certain number of items on a test correct) We no longer use mental age This assumes a linear development of learning-which isn't correct

therapy sessions

median number-between 5 and 13 therapy sessions insurance will cover around 8 Evidence based treatments are between 10 and 16 sessions

Heuristics

mental shortcuts that people often use to ease the burden of decision making, but also tend to result in errors in decision making

Legal proceedings

might this person continue to be violent in the future CPS might be called to house to see if grandparents can remain in the house Should person lose legal rights to decision making?

Unconscious

most of what motivates an individual is outside of conscious awareness Conflicts between id (impulsiveness) and ego (planning, higher cognitive functioning)

informed consent (for recording)

must be obtained prior to the recording unless the research consists solely of observations in public places or research design involves some form of deception that requires informed consent after recording has been completed

Services provided

neuropsychological assessment, psychological assessment, psychological treatment, rehabilitation following brain injury

coping styles questionnaire

never a 100% guarantee that you will get your desired outcome It takes 5 sessions to get through CSQ

neuroanatomy

normal brain structure and functioning

Incidence rates

number of new cases in a given year (requires a very large sample)

34.4 million

number of people who reported activities limited by a health condition to the CDC in 2006

Specifity

number of times a non-event is predicted, compared to the actual/total number of non-events

sensitivity of a measure

number of times an event is predicted compared to the total number of actual events

Effect size

numeric value that indicates size between group differences (d=.5 means ½ SD between group difference) No group difference-d=0

primary intervention

occurs before the onset of the disease and is designed to prevent development of disorder

secondary intervention

occurs when a disorder is evident

64%

of clients in eclectic treatment improved No idea then or now what eclectic means

44%

of clients in psychoanalytic treatment improved

72%

of clients not in therapy improved

strong evidence (STPP)

of effectiveness in depression, panic disorder, substance abuse, borderline PD, etc.

moderator variable

one that influences the strength of the relation between a predictor variable and a criterion variable

Causation

one variable directly or indirectly influences the level of the second variable

mediation

one variable explains the relationship between two others Negative event triggers an angry/stressed reaction, the mediator is the thoughts *Degree of negative emotion is entirely dependent on thoughts*

moderation

one variable influences the direction or size of another Very important in clinical work These are key because it shows what to target to get best bang for buck

dispensing with informed consent

only where research would not be expected to cause harm or distress or where permitted by law or government regulation

projective measures

participant responses to ambiguous stimuli, which may reflect the internal state of the participant These are going away and they are not allowed in court These are neither reliable nor valid Based on old school idea that we had to deceive people to get the truth; also used for kids but kids oftentimes tell you too much truth People love using them until they take them and are being recorded and they get a diagnosis from this

reactivity of assessment

participants awareness that they are being monitored may influence how they respond in a study, and alterations may not be consistent with their responses once the study is completed

reactivity of research arrangements

participants may respond differently than they would in other contexts

informed consent (for research)

participants must be informed of purpose of research, rights to decline or withdraw, possible consequences of declining or withdrawing, possible consequences of being involved, benefits, limits of confidentiality, incentives for research participation, and whom to contact

exploratory factor analysis

pattern of correlations among variables or test items provides the evidence for the underlying factor structure in the data Used when researcher has no prior hypotheses about the structure of the data

random responding

people are just giving responses that don't reflect the truth People getting tired halfway through a survey Invalidates any test Christmas tree

Emphasizing the positive (faking good)

people are often motivated to present themselves in a favorable light (e.g., custody cases, job applications) Exaggerating positive aspects about themselves Usually intentional

Retrospective recall

people are telling us what occurred but it all relies on their own perception of reality and how well they remember those events Malingering Sometimes clients are resistant to recalling events and their avoidance of events will actually cause more flashbacks of events

Walter mischel

personality traits had more to do with how a person was viewed by others than with what a person actually did, knowing someone's personality traits provided very little useful information if you wished to know what someone would actually feel, think, or do in a particular situation bolstered the rising influence of behavioral assessment approaches on clinical assessment

Scale 3 (Hy: Hysteria)

physical symptoms when stressed and minimization of interpersonal problems Sensation seekers have elevation

Picture completion (perceptual reasoning)

pictures of common objects and settings with a missing part have to choose which option is missing

projective test

predicated on the notion that an individual's interpretation of a situation is determined by his or her personality characteristics, thus a person's response to an ambiguous stimulus is presumed to tell us somethig about the person's mental functioning

True positive

predict an event that occurs ex: Measure predicts suicide risk and person attempts suicide

Scale 1 (Hs: hypochondriasis)

preoccupation with health issues Chronic health conditions, having trouble regulating chronic health conditions People with cold also deviate this scale

Protective factors

presence of characteristic of the person or environment that decreases risk of developing a disorder or problem ex: survivor mindset

primary prevention

preventing a disease or mental disorder before it occurs

experiential

problem-solving with task novelty Influence of task novelty or unfamiliarity on the process of problem solving Ex: Ellen DeGeneres games on her show with people who have never played the game before

Transference

problematic interpersonal relationship re-enacted with therapist Your client will enact problematic interpersonal style, relationships, behaviors with therapist

Representativeness heuristic

relying on biases to draw conclusions about the degree to which a symptom or behavior is representative of an underlying disorder or condition

world war ii and mmpi

psychologists again active in tests for armed forces-needed easily administered test that could effectively screen for psychological disturbances among adults MMPI-personality test 1943 Heavy use of statistics and test development You don't want anxious people in the army, especially anxious in high-stress

first and subsequent meta-analysis

psychotherapy has an effect of d=.68 Moderate to large effect size Done on/for behavior therapy Subsequent research indicates d=.85 (smith, glass, and miller) Large effect size That is, the average person in therapy is better off than 80% of people without Subsequent research validated these findings

mary smith and gene glass

published the first meta-analysis

Meta-analysis

quantitatively combining several studies to measure the effect of a variable

Comprehension (verbal)

questions about common concepts and problems and the person must provide the answer or solution

information (verbal)

questions that address knowledge of events, people, and places Very US based

Experimental designs (the 'gold standard' in clinical research)

random assignment and experimental manipulation RCT

distribution

rates of disorders across geographic areas and/or sociodemographic characteristics

hans eysenck (also levitt)

rates of improvement among clients receiving either psychodynamic or eclectic therapy were comparable to rates of remission of smptoms among clients receiving no therapy at all, no evidence that psychotherapy had any demonstrable effect

Scale 4 (Pd: Psychopathic Deviate)

rebellious attitudes, conflict with authorities and family, and antisocial activities

tertiary prevention

reducing the disability from a mental disorder or disease Bipolar is an example of a chronic disorder and give them a treatment to prevent another episode due to their chronic condition

Secondary prevention

reducing the recurrence of a disease or mental disorder One depressive episode, may not have depression right now but give a depression program to prevent another episode A person who has one depression is very likely to have another episode within the next 5 years

effectiveness

refers to treatment effects in real-world treatment settings and context with typical patients and typical therapists

evidence-based practice model (a)

requires clinician to synthesize information drawn from research and systematically collected data on the patient in question, the clinician's professional experience, and the patient's preferences when considering health care options

operationalization

requires that the researcher consider the precise nature of the relations among the concepts that form the research idea

rater evaluations

research assistant rates the participant Use undergrad RAs to code sessions, clinical sessions, to rate participants in clinics that deal with certain disorders to prevent bias Someone other than clinician rates client

inductive process

researcher derives idea from repeated observations of everyday events Influenced by researcher's informal theories including theoretical orientation and general worldview

confirmatory factor analysis

researcher specifies a priori-what the factor structure should be and how each variable or test item contributes to this structure Used to test a specific hypothesis regarding the nature of the factor structure

Deductive process

researcher uses a formal theory to generate a research idea

sharing research data for verification

researchers must ensure their data are available for verification or re-analysis

Clinical practice guidelines

rules and guides for particular problems. Clinical psychology has not been quick to adopt these structures The majority of our history we have not had these What treatments work for this disorder

polythetic nature of disorders

same diagnosis can be applied to individuals with a range of identical and different symptoms

threats to external validity

sample characteristics, stimulus characteristics and settings, reactivity of research arrangements, reactivity of assessment, timing of measurement

computer-based treatment

self-help treatment that is kind of like an online class where it is guided by modules and assessments, kind of like an online course, they could be videos, and they use technology Use of VR to treat phobias

Letter-number sequencing (working memory)

sequences of letters and numbers are presented orally and the person repeats them with the letters in alphabetical order and numbers in ascending order

interpersonal deficits (IPT)

social, communication, relationship-based skills a. Build social skills b. Increase social involvement

Empirically supported treatments (ESTs):

specific criteria must be met for a treatment to be an EST and this treatment would be recommended Controversy over EST The reason we developed EST to begin with is to protect the people/the consumer So people know they are being treated ethically and properly

Cognitive triad

stable internalizing global cognitive errors; outside observation and experience ex: As severity of depression increases, hygiene decreases Part of depression is not engaging in activities and this contributes to depression

Child Behavioral Checklist (CBCL)

standardized questionnaire completed by a child's parents that includes competence items as well as diverse problems Thomas Achenbach Respondent is required to note whether item does not apply, applies occasionally, or applies frequently Has been demonstrated to be reliable and valid Youth Self-Report (YSR)-for young people age 11-18 years

Selective preventive interventions/programs

targeted to high-risk individuals High-risk for developing disorder or problem Ex: Algorithms to identify students at risk of dropping out first or second year of college, resources available to them might differ to prevent dropping out Ex: all adolescents going through puberty whose parents are at risk for divorce

Indicative preventive interventions

targeted to high-risk individuals who are also showing subclinical signs to elevate their risk; really high risk Indicative (identified as high-risk and they barely passed their first semester) Ex: all adolescents going through puberty whose parents are divorcing who have already reported depressive symptoms

Scale 8 (Sc: schizophrenia)

tendency to experience social alienation, experience delusions, hallucinations People who elevate this scale feel socially alienated This combined with scale 2 may show people who are at a suicidal risk

Fundamental attribution error

tendency to overestimate the influence of personality traits and to underestimate the influence of situational effects on th eperson's behavior

Scale 7 (Pt: Psychasthenia)

tendency to worry, rumination, fearing loss of control If you have anxious predisposition, elevate this scale Individuals who meet criteria for anxiety disorders elevate this scale People who are perfectionists tend to elevate this scale as well

objective personality traits

tests that are scored the same way each time and not as open to interpretation Tests used to assess personality traits Scored and tested the same way for everyone as it's standardized Not open to interpretation EXCEPT if person misunderstood the question Based on self-report data

defining abnormality (problematic)

the diagnostic system may overdiagnose mental disorders The medicalization of ordinary life Kessler and colleagues found a liner relationship between disorder severity and subsequent problems in psychosocial functioning Even mild mental disorders are associated with a substantial subsequent risk for impaired functioning and should be represented within a diagnostic system

forensic psychology

the application of psychology to the legal and criminal justice system Like many other clinical psychologists, they engage in the prevention, assessment, treatment, and research

criterion validity

the association of a measure with a related criterion Not only asks if symptom is present but maps on to the criteria in the DSM Might ask-have you experienced symptoms of sadness if yes then asks how often symptoms occur in the last seven days, last six months, etc. (consistent with measures in the DSM)

predictive validity

the association of a measure with other relevant data measured at some FUTURE point in time. How well can measure predict MOOD, BEHAVIOR, OR THOUGHTS in the future?

Concurrent validity

the association of a measure with other relevant data measured at the same point in time How well does this construct relate to all these other constructs/things that it should be related to? You need one or the other of two major symptoms of depression than there is low concurrent validity Must test hypothesis, must assess it and if they don't have it then that suggests the researcher is wrong

What does clinical psychology refer to?

the branch of psychology that focuses on developing numerous assessment strategies and interventions to deal with these painful experiences that touch everyone's life science-based profession also covers indirect services that do not involve contact with those who have a mental disorder ever-evolving field

inter-rater reliability

the consistency of scores on a measure across different raters or observers. Essential when you have multiple people rating observed behavior Have different people coding behavior Must know that coding system yields consistent agreement You want different people rating to come up with the same conclusion

validity

the extent to which a test measures or predicts what it is supposed to

bias

the human tendency to make systematic errors in judgment, or making bad decisions based upon certain thinking, thoughts, or preconceived notions Need awareness to reduce bias but not sufficient on its own

striking change in psychological assessments (1)

the kind of rapprochement among different perspectives on how best to conduct psychological assessments assessment data should be obtained from multiple methods, multiple informants

Rorschach inkblot test

the most widely used projective test, a set of 10 inkblots, designed by Hermann Rorschach; seeks to identify people's inner feelings by analyzing their interpretations of the blots

Number needed to treat

the number of people needed to treat to save one person from getting the disorder (e.g., aspirin=130) If one of your roommates has a decrease in body satisfaction, everyone in room will have decrease, in 12 months all friends will have a decrease, and all friend's friends, but if body satisfaction is increased, impacts all, social network

cancellation (processing speed)

the person is presented with a series of shapes of different colors and is asked to cross out images that have a specific shape (e.g. circles) and a specific color

figure weights (perceptual reasoning)

the person must choose the "weight" depicted in a series of images that would be equivalent to the "weight" depicted in the example

DSM II

the psychodynamic orientation was less prominent and there was greater precision in terminology More treatment options became available around the time of publishing

Processing speed

the speed at which cognitive processes can be carried out

neuropsychology

the study of brain-behavior relationships. Clinical neuropsychology is the assessment and remediation of problems with the central nervous system

Correlation

the variables are associated in some way

Counter-transference

therapist's problematic interpersonal relations OR how the client makes the therapist feel Therapists enact problematic interpersonal relations Client is cute or reminds you of a family member

before 40s and 50s (before WWII)

therapy was only for the rich Demand for therapy increased after these decades

Self-administered

these are like self-help books and they are thought to be for people with low-moderate levels of depression Use a self-help book to track your symptoms but if they're not getting better, you might have one session with person that is a reduced price If clients get access to evidence-based self-help books, the cost of treatment is reduced There is evidence that this is efficacious, BUT the individual has to be self-motivated, have to adhere to the treatment, and to all aspects of the treatment

Biases and heuristics (decision making)

these are likely to lead to errors in decision making-pertinent when thinking about diagnoses as inaccurate or unwarranted diagnoses can lead to unnecessary and costly treatment, considerable stigma and a host of other negative side-effects Ethnic bias in treatment People tend to be overconfident in the accuracy or correctness of their decisions

obligations on reviewers

those who review material submitted for publication or for grant support must respect the confidentiality of the material

CBT

thoughts are central-thoughts of environment lead to psychiatric disorder Thoughts influence behavior but also behavior influences thoughts CBT is a mixture of cognitive and behavioral approaches CBT validated in numerous DSM disorders 16-20 sessions, once a week

Real-time data/measures

through an app or text message can perform interventions or collect data from participant; in the moment information a clinican can use to provide treatment or acquire data Ex: Binge eating disorder-see what triggers event; could use real time data to show that you have learned skill Client has to sign on for this (written permission)-must know that there is no certainty of 100% protection

APA task force (chaired by Diane Chambless)

to develop initial guidelines and maintain and expand them and keeps the information up to date The problem with the current criteria-it's not ideal Diane created critieria for empirically supported treatments

National Institute for Health and Care Excellence (NICE)

to guide health care professionals and patients in making decisions about health care treatment options

ITP-LL

to meet needs of adults in later life; help with practical matters and focused on ways to tolerate negative effect in relationships rather than withdraw from them

Cannot say (?)

total number of unanswered items

counseling vs clinical psychology (traditionally)

traditionally clinical psychology was focused on the assessment and treatment of psychopathology while counseling psychologists provided services to individuals who were dealing with normal challenges in life counseling psychologissts were most commonly employed in educational settings or general clinics in which various social and psychological serivces are available while clinical psychologists were most likely to be employed in hospital settings

APA task force (on EST)

treatment should be informed by research evidence but determined on the basis of other clinical information, patient choice, and the likely costs and benefits of available treatment options

open trials

trials without a control condition

TRIN

true response inconsistency Measures whether answered all true or all false at random Randomly answering or answering everything as true Above 65 is suspicious Above 80=invalid profile

malingering (faking bad/emphasizing the negative)

trying to look worse than one is (e.g., insanity defense) In forensics, fake being schizophrenic to get out of having to stand trial Individuals may try to present themselves as worse than they are to get services

Single-case designs

two measures of symptoms pre and post treatment People attribute change to other things and not the treatment so remove it to track behavior and tell whether or not the treatment actually changed the behavior

Defensiveness scale (K)

unwillingness to disclose personal information and problems. High K scale scores increase some other scores Individuals that are unwilling to admit problems in their life

Efficacy

used to describe treatment effects in tightly controlled experimental designs

Utility

usefulness of the resulting classification scheme: how useful is the classification scheme?

Coding (processing speed)

using a key that matches numbers to symbols, the person must rapidly provide the correct symbols to a list of numbers

Benchmarking strategies

using efficacy trials as a mark for whether the translation of a treatment is working in the real world

Hindsight bias

validation or question of of initial decision based on data gathered after the fact even though it was not possible to have these data to inform the original decision

Reporting results

we can report on cases but all cases told about, all clients create a form to identify resources; here's the vignette on your case, change it so nobody would know it is about you; ethics in reporting results; still cannot disclose information unless they are in a professional or educational setting Data must not be fabricated

Risk reduction model

we want to reduce individual's risk to a disorder

testing began to flourish

wechsler-bellevue test rorschach inkblot test thematic apperception test

biopsychosocial, diathesis-stress model

what would you inquire about patient in terms of depression?-find out if increased stress is maintained in this person

comorbidity

when a person meets criteria for two or more disorders at a specific point in time Services for these people may be suboptimal and underestimate the duration and scope of treatment necessary for satisfactory outcomes

clinician bias

when client's don't get better we blame the client Presence of a clinician in a family doesn't affect Clinicians are not protected from human dysfunction

Mind reading

when people believe they know what the other person was thinking without considering other outcomes

Catastrophizing

when someone predicts future negatively without considering other potential outcomes

Telehealth

when treatment is provided not in person Can be provided via skype, phone, text messaging etc Issues with confidentiality bc things could get hacked and there are no guidelines yet on how to deal with confidentiality issues and no guidelines on ethical practices in implementing it Issues with confidentiality must be exposed

Meta-analysis

when you summarize several similar studies through a statistical analysis Combines the results of prior research using effect size

diagnosis (neuropsychology)

whether cognitive impairment is related to depression or injury

Statistical conclusion validity (in research)

whether the study was designed in a way to adequately test hypotheses through statistical methods

Statistical conclusion validity (in clinical work)

whether the treatment was designed in a way that you can adequately test hypotheses through the assessments you use

categorical approach

you either have diagnosis or you don't; deem individuals to be part of a category or not System categories may or may not be overlapping but those assigned to a category should be very similar to one another