PSYC 242 Readings: Test 1
Cross-sectional designs
assess or compare a participant or group of participants at one particular point in time.
William Tuke (1732-1822)
Created a residential mental hospital in England after seeing the horrific conditions in asylums. It was called the York Retreat that became a model of humane and improved treatment.
Clinical psychologists conduct research to evaluate and improve the assessment methods they use with clients
Example- When psychologists assess depressive symptoms, does the mode of assessment—a self-report questionnaire versus an in-person interview—make a difference?
NEPSY-II
Created specifically for children (between 3-16 years old). 32 separate subtests across 6 different categories: attention and executive functioning, language, memory and learning, sensorimotor, social perception, and visuospatial processing. Similar to the LNNB in application
Professional Issues- Clinical psychologists also examine elements of their own profession through empirical research
Examples-What attitudes do contemporary psychologists hold toward gay, lesbian, and bisexual clients?
Predoctoral internship
1 year internship of a supervised clinical experience (1 year prior to PhD being awarded). Some issues with difficulty finding a spot
Between-groups
2 separate groups that receive either the control or the treatment (control could be nothing, placebo, treatment as usual, waitlist)
Meta-Analysis
A meta-analysis is a statistical method of combining results of separate studies (translated into effect sizes) to create a summation (or, statistically, an overall effect size) of the findings
Eli Todd (1769-1833)
A physician who wanted to broaden access to mental healthcare in the United States. Created The Retreat in 1924.
Statistical significance is different from clinical significance
A result may technically be statistically significant, however, does not represent clinical change (such as a depression score decreasing by 5 points, doesn't show significant change in the patient's condition)
Stanford-Binet Intelligence Scales—Fifth Edition
Administered face to face. Has a hierarchical scale with an overall g factor. The SB5 covers the entire life span (ages 2-85+) as a single test
The Experimental Method
Use experimental studies. Often take the form of randomized control trials. Participants are assigned to either therapy or control and then assessed at baseline and after treatment. Increased internal validity
How are clinical psychologists different from counseling psychologists?
Used to be very distinct, now less so. However, clinical psychologists tend to work with patients with more severe disturbances and have internships in hospital settings
David Wechsler
Wechsler-Bellevue test, 1939, a test specifically for adults, has been revised several times since its creation
Achievement test
Achievement is what a person has accomplished, especially in the kinds of subjects that people learn in school, such as reading, spelling, writing, or math. Achievement tests typically produce age- or grade-equivalency scores as well as standard scores
Wechsler Memory Scale—Fourth Edition (WMS-IV; Wechsler, 2009a, 2009b)
Age: 16 to 90 Length: complex assessment, takes 130 to 190 minutes Test: One of the WMS-IV subtests, Logical Memory, involves the client hearing a story read aloud and then trying to recall the story both immediately and after a 20- to 30-minute delay. Another subtest, Visual Reproduction, involves presenting abstract visual figures to the client and asking him or her to reproduce them after they have been removed. Measures: commonly used, a memory test often used to assess individuals who are suspected of having memory problems due to brain injury, dementia, substance abuse, or other factors. It assesses both visual and auditory memory across its seven subtests. It also assesses both immediate and delayed recall.
Bender Visual-Motor Gestalt Test—Second Edition (Bender-Gestalt-II)
Age: For any age above 3 Length: Only takes 6 minutes Test: Consists of drawing different shapes Measures: Visuoconstructive abilities (perceptual-motor or visual-spatial), also offers memory tasks and additional stimuli Use: Most common screen among psychologists. If the client is strongly suspected, the psychologist will perform a full battery. However, when the evaluation is for another purpose and the clinical psychologist simply wants a rapid appraisal of overall neuropsychological functioning, the Bender-Gestalt can be a good choice. It won't tell specific areas of brain damage but it will give a good idea if one may have brain damage.
Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)
Age: Usually adults but a new version allows 12 years old and up Length: 20-30 minutes Test: 12 subtests in 5 categories- immediate and delayed memory, visuospatial/constructional, language, attention, and delayed memory. Copying visual figures, naming pictures, learning a list of 10 words presented orally, recalling an orally presented list of numbers, recalling a story told 20 minutes earlier. Measures: broader range of abilities than does either the Bender-Gestalt or the Rey-Osterrieth. Visuomotor abilities but also verbal skills, attention, and visual memory. The RBANS yields a total score as well as scores for each of the 12 subtests and 5 indices into which they are organized.
Charles Spearman
Argued for the existence of "g," a general intelligence thought to overlap with many particular abilities.
A final note about neuropsychological testing
As with any other kind of assessment, it is essential for clinical psychologists to develop and use cultural competence when selecting, administering, scoring, and interpreting neuropsychological tests. Many neuropsychological instruments were standardized (either originally or currently) on European Americans, and their form or structure can emphasize European American values. When working with diverse clients, it is important to caution against overpathologizing and to consider (or consider developing) culture-specific norms whenever possible (Horton, 2008).
Professional Counselors
Master's degree (2 years). Work with clients with less severe psychopathology. May counsel for careers as well
Alfred Binet
Binet test, an overall test of intelligence (child-focused) 1905
Intelligence Testing
Measure a client's intellectual abilities.
Emil Kraepelin (1855-1926)
Considered the "father of descriptive psychiatry" (Reisman, 1991, p. 30), offered a different two-category system of mental illness. Kraepelin differentiated exogenous disorders (caused by external factors) from endogenous disorders (caused by internal factors) and suggested that exogenous disorders were the far more treatable type.
Snake oil treatment example
Conversion therapy
Psychiatrists
Can prescribe medicine (MD). First line of defense is medication and biological epidemiology
Teaching and Training Issues research
Clinical psychologists also pursue research questions related to how to educate those entering the profession. Areas of study include training philosophies, specific coursework, opportunities for specialized training, and the outcome of particular training efforts. Ex-To what extent do graduate programs in clinical psychology train students to manage potentially violent clients?
Personality - Evidence-Based Assessment
Clinical psychologists who practice evidence-based assessment select only those methods that have strong psychometrics, including reliability, validity, and clinical utility Moreover, they select tests that have sufficient normative data and are sensitive to issues of diversity such as age, gender, race, and ethnicity. They typically target their assessment strategies toward a particular diagnosis or problem, such that "what works" for assessing attention-deficit/hyperactivity disorder (ADHD) might be a different set of assessment tools than "what works" for assessing panic disorder, schizophrenia, bulimia, PTSD, or any other clinical issue Test-retest ability Moreover, they select tests that have sufficient normative data and are sensitive to issues of diversity such as age, gender, race, and ethnicity. They typically target their assessment strategies toward a particular diagnosis or problem, such that "what works" for assessing attention-deficit/hyperactivity disorder (ADHD) might be a different set of assessment tools than "what works" for assessing panic disorder, schizophrenia, bulimia, PTSD, or any other clinical issue
McFall (1991) "Manifesto" call to action
Clinical psychology must be based in scientifically validated techniques
What therapy perspective has recently gained attention?
Cognitive
Scientist-Practitioner (Boulder) Model
Emphasizes both practice and research
Emil Kraepelin's names for specific disorders also set a precedent for the creation of the
DSM
What are the main aspects of professional development in clinical psychology?
Education and training in clinical psychology became more widespread and more standardized
Social workers
Emphasizes environmental factors (social). Helps connect clients to resources
Lilenfeld 2011 (1-12) Public Skepticism of Psychology- Why Many People Perceive the Study of Human Behavior as Unscientific
Evidence suggests that serious doubts regarding psychology's scientific status are relatively widespread among the general public. Seen as less of a science and not contributing to society. Members of the public appear unaware of the breadth of psychology's current and potential contributions to society
What therapy perspective was popular in the 1960s?
Humanism
When/why did psychotherapy become a core facet of clinical psychology?
Increased in the 1950s, the influx of soldiers with psychopathology returning from WW2 influenced this development
Charles Spearman
Intelligence is a singular characteristic. Spearman labeled this characteristic "g" for general intelligence and argued that it represented a person's global, overall intellectual ability.
Case Studies
Involve a thorough and detailed examination of one person or situation. Idiographic approach—emphasizing or revealing the unique qualities of each person—to the nomothetic approach—determining similarities or common qualities among people. Relatively inexpensive and convenient
Rey-Osterrieth Complex Figure Test
Involves copying shapes, a complex, shape, as well as the use of different colors and a memory component
Examples of objective personality tests
MMPI and J. C. McKinley, NEO
MMPI-2-RF/MMPI-A
MMPI-2 Restructured Form (MMPI-2-RF) - Shorter version of the MMPI-2 Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A) - Designed for clients aged 14 to 18 years - Similar to the MMPI-2
Weschler tests
Many tests for many age groups. They yield a single full-scale intelligence score, four or five index scores, and about a dozen (give or take a few, depending on optional subtests chosen) specific subtest scores. Together, this collection of scores indicates that the Wechsler tests employ a hierarchical model of intelligence (as discussed earlier), in which the full-scale intelligence score reflects a general, global level of intelligence ("g") and the index/factor scores and subtest scores represent increasingly specific areas of ability ("s"). Have strong reliability and validity. Some subtests may be culturally loaded or biased, the connection between the tests and day-to-day life (ecological validity) may be limited, and scoring can be complex or subjective on some subtests
Objective personality - Minnesota Multiphasic Personality Inventory-2
Most popular and psychometrically sound Test: The client reads 567 self-descriptive sentences and, using a pencil-and-paper answer sheet, marks each sentence as either true or false as it applies to him or her. The items span a wide range of behavior, feelings, and attitudes How were the questions created for the MMPI-2: empirical criterion keying, which involves identifying distinct groups of people, asking them all to respond to the same test items, and comparing responses between groups. If the item elicits different responses from one group than from another, it's a worthy item and should be included on the final version of the test. If the groups answer an item similarly, the item is discarded because it does not help categorize a client in one group or the other. Has measures to assess faking good or bad
Getting licensed as a clinical psychologist
Must pass EPPP exam, state specific exam. Have to take accumulated confiniting education units as you practice (ACEU)
Development of the Profession, 1950s
New therapies and research
Universal Nonverbal Intelligence Test-2
Originally published in 1996 and revised in 2015, the UNIT-2 is a completely language-free test of intelligence. Administered one-on-one but no verbal communication is required between the psychologist and the client. Asses memory and reasoning. The UNIT-2 is not without its shortcomings. It assesses a more limited range of abilities than more traditional IQ tests; it is appropriate only for young clients (no version for preschool children or adults older than 21 has yet been developed); and its psychometric data, although encouraging, is limited in quantity.
Personality - Multimethod Assessment
Personality is measured with many tests (including tests of different types, interview data, observations, or other sources), since they all have their own benefits and downfalls Ex: With dating, each different date/situation will reveal a different aspect of personality. With personality tests, each method offers a unique perspective, and although some may be more enlightening than others, it is the integration of multiple methods that ultimately proves most informative.
McFall (1991) "Manifesto" Corollary 2
Primary objective of doctoral training programs in clinical psychology must be to produce the most competent clinical scientists
Edward D. Thorndike
Promoted the idea that each person possesses separate, independent intelligences.
Practitioner-Scholar (Vail) Model
PsyD degree (higher acceptances and less efficacy), More emphasis on coursework related to practice rather than research and statistics
McFall (1991) "Manifesto" Corollary 1
Psych services should not be administered to the public unless we know the disorder it's useful for, how effective it is and what its risks are
What therapy perspective dominated the 1950s?
Psychodynamic and behavioral
Lightner Witmer and the Creation of Clinical Psychology
Received a business degree and a PhD in psychology. However, psychology at the time was only researched and academic, it was not yet practiced. In 1896 Witmer founded the first psychological clinic at the University of Pennsylvania, where he had returned as a professor. Witmer also founded the first scholarly journal in the field (called The Psychological Clinic) in 1907. Created the term clinical psychology.
Clinical psych training
Requires a PhD in Clinical Psychology, 4 years of coursework, internship, thesis, and dissertation
Lewis Terman
Revised the Binet test to the Stanford-Binet Intelligence Scales (child-focused) 1937
McFall (1991) "Manifesto" Cardinal principle
Scientific clinical psychology is the only legitimate and acceptable form of clinical psychology. Anything less is 'pseudoscience'. Boulder Model "Scientist-practitioner" language implies that these have to be separate ("split personality")... and they should be one and the same. Should not be training for a particular trade, but training to function a certain way within a position (whether it's academia, admin, teaching, clinic)
Culturally Competent Assessment
Simply put, every culture has its own perception of "normal" and its own variations of "abnormal" as well. A personality assessment conducted without knowledge or sensitivity to these cultural specifics can be a dangerous thing; in fact, it has been labeled "cultural malpractice" by some A primary danger lies in the possibility of overpathologizing—that is, viewing as abnormal that which is culturally normal. In other words, the clinical psychologist must appreciate the meaning of a behavior, thought, or feeling within the context of the client's culture, which may differ from the context of the psychologist's own culture. Ex: Black client with white therapist, therapist viewed him as paranoid when Duron's behavior was reasonable based on his cultural background, as this guardedness was due to informal racial prejudice, oppression, and betrayal.
Development of the Profession, today
Size, scope, and programs continue to diversify and grow
Luria-Nebraska Neuropsychological Battery (LNNB)
Slightly shorter. Wide-ranging test of neuropsychological functioning. It consists of 12 scales, with a similar range to that of the HRB. A primary difference is the LNNB's emphasis on qualitative data in addition to quantitative data. In other words, to a greater extent than the HRB, the LNNB relies on qualitative written comments from the examiner about the testing process.
Beck Depression Inventory-II
Sometimes psychologists want brief tests that focus on only one characteristic The BDI-II is a self-report, pencil-and-paper test that assesses depressive symptoms in adults and adolescents Length: only 21 items, usually requiring a total of 5 to 10 minutes to complete. Test: Each item is a set of four statements regarding a particular symptom of depression, listed in order of increasing severity. The clients choose the one sentence in each set that best describes their personal experience during the previous 2 weeks (a time period chosen to match DSM criteria). The 21 item scores are summed to produce a total score, which reflects the client's overall level of depression The BDI-II lacks validity scales, limited scope, its reliability and validity are strongly established (Brantley et al., 2004), and it is a frequent choice of psychologists seeking a quick, empirically sound answer to a specific assessment question regarding depression.
Clinical Scientist Model
Stresses scientific side of clinical psychology
Clinical psychologists conduct research to explore issues of diagnosis and categorization regarding psychological problems
Such studies may examine the validity or reliability of existing or proposed diagnostic constructs. Example- When clinical psychologists assess children for ADHD or oppositional defiant disorder (ODD), should they use gender-specific norms?
Quasi-Experiments
Test conditions where it is impossible/unethical to assign the independent variable. A quasi-experiment is an empirical interventional study used to estimate the causal impact of an intervention on the target population without random assignment. (studying age, gender, race, or as an example, consider a group of clinical psychology researchers who are interested in examining the outcome of a particular therapy for specific phobias. If the researchers were designing a true experiment, they would need to take identical individuals, induce in them identical fears, and then assign them to different conditions (perhaps treatment vs. no treatment, or treatment vs. alternate treatment) to measure the influence of the treatment)
Millon Clinical Multiaxial Inventory-IV
Test: comprehensive personality test in a self-report, pencil-and-paper, true/false format. The MCMI-IV consists of 195 true/false items. In addition to its clinical scales, it includes "modifier indices," which function similarly to the validity scales of the MMPI tests by assessing the test-taking attitude of the client. Age: adults, but there are other versions for adolescents and children Emphasizes on personality disorders. Although it does feature scales for many clinical syndromes related to other disorders such as depression, anxiety, and posttraumatic stress, the MCMI-IV is notable for its many scales related to the personality disorders in DSM. In fact, the MCMI-IV features separate clinical scales corresponding to each of the 10 current personality disorders, and clinical scales for other forms of personality pathology, many of which have been considered for inclusion as disorders in DSM but are currently omitted (e.g., self-defeating personality, negativistic/passive-aggressive personality, depressive personality, turbulent personality) Created by Theodore Millon
What idea is the inkblot test, TAT, and Draw a person test based on?
That people will project their personality onto ambiguous stimuli.
Wechsler Individual Achievement Test—Third Edition
The Wechsler Individual Achievement Test—Third Edition (WIAT-III) is a comprehensive achievement test for clients aged 4 to 50 years. Like the Wechsler intelligence tests, the WIAT-III is administered face-to-face and one-on-one. The WIAT-III measures achievement in four broad areas: reading, math, written language, and oral language.The WIAT-III yields standard scores on the same scale as most intelligence tests: a mean of 100 and a standard deviation of 15. Overall, the reliability and validity data supporting the WIAT-III are quite strong
Philippe Pinel (1745-1826)
The William Tuke of France. Helped to advocate for better treatment for the mentally ill in France and move them out of the dungeons and created new institutions in which they were treated as patients. Helped to create a societal shift to be more accepting and compassionate of the mentally ill.
School psychologists
Their primary function is to enhance the intellectual, emotional, social, and developmental lives of students. Intelligence and disability testing
Correlational Methods
Unlike experiments and quasi-experiments, correlational studies do not identify variables as either independent or dependent. Similarly, causality is not implied by the results of correlational studies. In other words, although a correlational study can conclude that one variable predicts or associates with another, it cannot conclude that one variable causes changes in another. May be a third variable at play, may be bi-directional, etc.
Talk Deeply, Be Happy? article
Those who engaged in more substantive conversation tended to be happier. The happiest people engaged in much less small talk than the unhappiest people. This was tested through self-reports as well as reports from others
Why Do Clinical Psychologists Do Research?
The foundation is to gain knowledge about psychological disorders, and to determine how well their treatments work, use questionnaires and measure what we are seeking to change
Neuropsychological Testing
The intent of neuropsychological tests is to measure cognitive functioning or impairment of the brain and its specific components or structures. Medical procedures such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) scans can show that parts of the brain look abnormal, but neuropsychological tests can indicate how the brain is actually functioning. Some neuropsychological testing procedures are lengthy, comprehensive batteries that include a broad array of subtests. The patterns of scores on these subtests can go a long way toward pinpointing specific cognitive weaknesses.
Analogue Designs
When clinical psychologists seek to study clinical populations or situations but are unable to access them adequately, they may conduct a study with an analogue design. A study of this type involves an approximation of the target client or situation as a substitute for the "real thing." At times, it can involve using participants whose characteristics resemble (but don't exactly match) those of the target population, or asking participants to remember or imagine themselves in a certain situation (such as using college students for a study on depression since they are more accessible)
Marriage and Family Therapists
Work with couples families, and people with issues related to partners or families
Dorothea Dix (1802-1887)
Worked as a church leader in jail, observed the high levels of mentally ill / retarded inmates that were housed in prison because there was no other institution to take them. As a result, she made it her mission to increase care for the mentally ill and collected data across the country to present to leaders. In turn, she established over 30 institutions in the U.S.
Halstead-Reitan Neuropsychological Battery (HRB)
a battery of eight standardized neuropsychological tests. It is suitable for clients of age 15 years and older, but alternate versions are available for younger clients. Purpose is to identify people with brain damage and provide detailed information or hypotheses about any brain damage identified, including specific cognitive impairments or physiological regions of the brain that may be deficient. Evaluated more than any other test.
Cargo cult science
a form of pseudoscience in which an imagined hypothesis is offered after the fact for some observed phenomenon, and further occurrences of the phenomenon are deemed to be proof of the hypothesis
Objective personality tests
a test using surveys on different aspects of personality, scoring and interpretation more straightforward than the previous subjective tests
Tuke, Pinel, Todd, and Dix all laid the groundwork for ___ ___ to develop by furthering a culture of compassion rather than fear and punishment towards those with mental illness
clinical psychology
Mixed-group design
combine aspects of between-group and within-group designs.
The Personality Assessment Inventory (PAI)
contains 344 items, each of which offers four responses: totally false, slightly true, mainly true, and very true. It is appropriate for clients 18 to 89 years old, but an adolescent version, the PAI-A, can be used for clients as young as 12.
Hermann Rorschach
created the inkblot test, the first prominent personality test, compatible with the psychodynamic approach. TAT and Draw a person followed
Dissemination strategies
efforts to promote therapies that have demonstrated effectiveness in treatment studies to large numbers of therapists. Shifting towards emphasis during doctoral training and advertising to potential clients certain effective therapies.
Longitudinal designs
emphasize changes across time, often making within-group comparisons from one point in time to another.
Development of the Profession, 1960s, and 70s
field diversified as well as clinical approaches
James McKeen Cattell
first used the term "mental test"
Development of the Profession, 1980s
increased respect from the medical establishment, increased clinicians, psychotherapy use increased
John Carroll's (2005) three-stratum theory of intelligence
intelligence operates at three levels: a single "g" at the top, eight broad factors immediately beneath "g," and more than 60 highly specific abilities beneath these broad factors. This model, like most contemporary models of intelligence, not only acknowledges "g" but also recognizes that more specific abilities exist as well
What kind of testing dominated the early years of clinical psychology?
intelligence testing
Within-groups
involves comparisons of participants in a single condition to themselves at various points in time.
RCTs (randomized control trials) have been criticized for
oversimplifying clinical problems by reducing them to objective and easily measured symptoms, and for producing results that may not translate to "real-world" settings
James Cattell
proposed two separate intelligences- fluid intelligence—the ability to reason when faced with novel problems—and crystallized intelligence—the body of knowledge one has accumulated as a result of life experiences.
External validity
refers to the generalizability of the result—to what extent is the same finding valid for different settings and populations? Efficacy studies are often respected for their internal validity but discounted for their external validity, whereas the opposite is often true for effectiveness studies
Most states require a post-doc internship
still under supervision, but more specialized and more independent
Internal validity
the extent to which the change in the dependent variable is due solely to the change in the independent variable. Based on the experimental design.
Efficacy
the success of a particular therapy in a controlled study conducted with clients who were chosen according to particular study criteria. Have more internal validity.
Effectiveness
the success of a therapy in actual clinical settings in which client problems span a wider range, and clients are not chosen as a result of meeting certain diagnostic criteria. Has more external validity.
Study design with case study
usually some variation of an ABAB design (also known as a reversal design), in which a treatment is alternately applied and removed (with A and B each representing the presence or absence of the treatment). A variation of this design, called the alternating treatments design, involves two treatments alternating rather than a single treatment alternating with no treatment
Clinical psychology
very comprehensive field with many roles. The branch of psychology that studies, assesses, and treats people with psychological problems or disorders. Clinical psychology involves rigorous study and applied practice directed toward understanding and improving the psychological facets of the human experience, including but not limited to issues or problems of behavior, emotions, or intellect.
