EXAM 1 WINTER 2012 LECTURE NOTES STUDY GUIDE

CLASS 1 LECTURE NOTES: FOUNDATIONS OF CLINICAL PSYCH 1. What is clinical psychology? a. Overlaps with other psychology disciplines in content, theory, and research. b. Differs from experimental psychology in that it is both a science and a practice. Its the application of the science of psychology to healthy and problematic behavior. 2. Other careers in mental health a. School psychology: Applies principles of clinical psychology and educational psychology to the diagnosis and treatment of children's and adolescents' behavioral and learning problems. Education Specialist: above master's degree level, but below doctoral level. b. Social Work: Master of Social Work (MSW) programs allow students to choose a clinical track, which focuses on direct practice with clients, or a macro practice track, with a focus on political advocacy, community organizing, policy analysis and/or human services management. c. Psychiatry: Medical specialty devoted to the study and treatment of mental disorders. Psychiatric treatment applies a variety of modalities, including psychoactive medication, psychotherapy, transcranial magnetic stimulation, and electro-shock therapy. d. Expressive Therapy: Use of the creative arts as a form of therapy. Process of creation is emphasized rather than the final product. Expressive therapy is predicated on the assumption that people can heal through use of imagination and various forms of creative expression. e. Counseling psychology: Of all related disciplines, counseling psychology is most similar to clinical psychology. Historically, main difference between counseling and clinical is that counseling psychologists tended to focus on less severe forms of emotional distress, like career issues while clinical psychologists treated people with severe mental illness. 3. Training models a. Scientist-practitioner (Boulder Model): Equal focus on scientific research and clinical training. PhD is the required degree. Trained within a university setting. b. Practitioner-scholar (Vail Model): More focus on clinical training and being a consumer of research, less focus on producing original research. PsyD is typical degree. Trained at either traditional college campuses or freestanding professional schools. c. Clinical-scientist: More focus on original research, less on clinical training. PhD is the required degree. Trained within a university setting. Only scientifically

CLASS 2 LECTURE NOTES: HISTORY OF CLINICAL PSYCH 1. Hippocrates (ancient Greece) a. Believed that diseases were caused naturally and not as a result of superstition or gods. Argued that disease was the product of environmental factors, diet, and living habits. b. Humors: bodily fluids that he believed were influenced by the environment, producing various imbalances in a person's state of health. c. Early version of theory that physiological disturbances or body chemistry might play a role in the development of mental illness. 2. Middle Ages: mentally ill thought to be possessed by the devil or demons 3. Asylums used from 1700s to 1800s: institutions that housed mentally ill- similar conditions to prisons, patients often tortured 4. Philippe Pinel (late 1700s): a. French physician who developed more humane psychological approach to care of psychiatric patients, referred to today as moral therapy. b. Pinels philosophy: 1. Do no harm; 2. Use minimal restraint necessary; 3. Provide humane conditions; 4. Eliminate physical abuse; 5. Patients are sick not criminals; 6. Not all illnesses had biological causes 5. Benjamin Rush (late 1700s): One of the earliest supporters of humane treatment of the mentally ill in United States. 6. Dorothea Dix (mid to late 1800s): American activist on behalf of the indigent (homeless) insane. Helped create the first generation of American mental asylums. 7. Emil Kraeplin (late 1800s to early 1900s): German psychiatrist credited with the classification of mental disorders. His theories on the etiology and diagnosis of psychiatric disorders form the basis of the American Psychiatric Association's DSM-IV classification system. 8. Lightner Witmer: American psychologist a. Founded the world's first "Psychological Clinic" in the United States at the University of Pennsylvania in 1896. b. Clinics purpose: study and treat children who had either learning or behavior problems. 9. James Braid (mid 1800s): Scottish physician considered the "Father of Modern Hypnotism 10. Jean Charcot (1800s): French neurologist known for his work on hypnosis and hysteria. Freud studied under Charcot. 11. Joseph Breur (1800s): Collaborated with Sigmund Freud. Best known for his work with Anna O., a woman suffering from hysteria. Treated her with talking cure, which is widely regarded as the basis of Freudian psychoanalysis.

12. Sigmund Freud (late 1800s to mid 1900s) a. Free association: During psychoanalysis patients are invited to relate whatever comes into their minds during the analytic session, and not to censor their thoughts. b. Dream analysis: meaning of dreams must be uncovered during psychoanalysis c. Oedipus Complex: boys have a desire to sexually possess their mothers, and kill their fathers. 13. Neo-Freudians a. Alfred Adler: Student of Freud, most famous concept is the inferiority complex b. Carl Jung: Founder of analytical psychology: concepts proposed by Jung include the archetype and the collective unconscious. c. Anna Freud: Sigmund Freuds daughter; founder of psychoanalytic child psychology. d. Karen Horney: believed Sigmund Freuds theories to be sexist; pioneer in the discipline of feminine psychology. 14. Cognitive Assessment a. Simon and Binet (1905): inventors of the first usable intelligence test. b. Lewis Terman (1916): brought Simon and Binets IQ test to United States, renamed it StanfordBinet Intelligence Scale. c. David Wechsler: developed Wechsler Adult Intelligence Scale (WAIS) in 1939 because he found the Stanford- Binet IQ test unsatisfactory. 15. Personality Assessment a. Hermann Rorschach (1921): Swiss Freudian psychiatrist and psychoanalyst, best known for developing a projective test known as the Rorschach inkblot test. b. Robert Woodworth (1920): Created Woodworth Personal Data Sheet (WPDS) to assess soldiers during World War I, which was first objective personality test. 16. Neuropsychological Assessment a. Franz Gall and Joseph Spurzheim(1800): developed Phrenology, early attempt to measure brainbehavior relationship. b. Ward Halstead (1947): The Halstead-Reitan Neuropsychological Battery is combination of neuropsychological tests used to assess localization of neurological damage. c. Luria: During World War II his research on patients with brain lesions resulted in creation of the field of Neuropsychology. 17. Behavioral Contributions a. Watson and Rayner (1920): The Little Albert experiment was a case study showing empirical evidence of classical conditioning in humans. Experiment considered unethical by current standards.

b. Joseph Wolpe (1961): Developed systematic desensitization, a type of behavioral therapy used to help effectively overcome phobias and other anxiety disorders. Also called graduated exposure therapy. 18. Implications of World War II on Clinical Psychology a. Group therapy became a popular alternative to individual therapy. b. Doctoral programs in clinical psychology created in response to increased need of clinicians to treat soldiers returning from the war. 19. Humanistic Psychology a. Martin Heidegger: Father of existential psychology, a precursor to humanistic psychology. He believed that it was important to live an authentic life. b. Abraham Maslow: Believed that every person has a strong desire to realize his or her full potential, to reach a level of "self-actualization". Proposed hierarchy of needs theory. c. Carl Rogers: Developed person-centered approach to therapy, in which the therapist must feel empathy and unconditional positive regard for the patient. 20. Deinstitutionalization: Transfer of care from long-term psychiatric facilities to community based alternatives in 1950s-1960s. a. Occurred due to development of psychotropic medication b. Caused many psychiatric patients to become homeless 21. Prescriptive Authority: Controversy over whether clinical psychologists should be allowed to prescribe psychotropic medications if they have the proper training. 22. FILM: Let There Be Light: 1946 American documentary film. a. Patients treated with group therapy, hypnosis, sodium amytal. b. Therapists employed psychoanalytic model in individual and group therapy.

CLASS 3 LECTURE NOTES: PERSONALITY THEORIES 1. Treatment models based on psychological theories: a. Content or focus of the treatment model is unique to the personality theory from which the psychopathology model is derived. b. Then, assessment tools will be chosen that will measure the problem or symptoms that the patient is experiencing. c. Finally, an appropriate intervention strategy is chosen by the psychotherapist. 2. Psychoanalysis: Freud a. The personality consists of three major systems: id, ego, superego.

i. Id: resides in unconscious, acts according to the "pleasure principle", does not know right from wrong ii. Ego: Conscious awareness, acts according to the reality principle; i.e. it seeks to please the ids drive in realistic ways that will benefit in the long term rather than bringing grief to the individual. iii. Superego: resides mainly in unconscious, societal and parental standards of right and wrong, also called ones conscience iv. Neurosis (psychopathology) occurs when the drives of the three aspects of the personality come into conflict. b. Developmental Stages: i. Oral, Anal, Phallic, Latent, Genital ii. Neurosis occurs if individual gets stuck (fixated) at an early developmental stage c. Defense Mechanisms: i. Unconscious psychological strategies used by the ego to cope with reality and to maintain self-image. Defense mechanism becomes pathological only when its persistent use leads to maladaptive behavior such that the physical and/or mental health of the individual is adversely affected ii. Repression: Process of moving uncomfortable thought or desire to the unconscious in the attempt to prevent it from entering consciousness. iii. Denial: Refusal to accept external reality because it is too threatening. iv. Projection: Shifting one's unacceptable thoughts, feelings and impulses within oneself onto someone else, such that those same thoughts, feelings, beliefs and motivations are perceived as being possessed by the other. v. Displacement: Shifts emotion from its real object and redirection of the intense emotion toward someone or something that is less offensive or threatening in order to avoid dealing directly with what is frightening or threatening. vi. Reaction formation: Converting unconscious wishes or impulses that are perceived to be dangerous into their opposites. vii. Sublimation: Transformation of negative emotions or instincts into positive actions, behavior, or emotion. viii. Rationalization: A person convinces him or herself that no wrong was done and that all is or was all right through faulty and false reasoning (making excuses). ix. Intellectualization: Concentrating on the intellectual components of a situation so as to distance oneself from the associated anxiety-provoking emotions.

x. Conversion, also called Somatization: The transformation of negative feelings towards others into negative feelings toward self, pain, illness, and anxiety. xi. Undoing: Performing an act to 'undo' a previous unacceptable act or thought. Often a form of apology. 3. Neo-Freudians a. Alfred Adler: Inferiority complex b. Carl Jung: Distinguished the collective unconscious from the personal unconscious, discussed archetypes, Jung was first to describe introversion and extroversion. c. Karen Horney: Basic anxiety is deep insecurity and fear that have developed in the child because of the way they were treated by their parents. Basic hostility is described as a bad attitude which develops in the child as a result of basic evil, such as parental abuse. 4. Psychoanalysis- implications a. Assessment i. Early childhood experiences ii. Relationship with parents iii. Defense mechanisms used b. Treatment i. Goal: Insight ii. Free Association iii. Dream Analysis iv. Interpret Client-Therapist Relationship c. Difficult to Test These Theories i. Cant directly examine unconscious forces 5. Behaviorism a. Explain personality in terms of the effects external stimuli have on behavior. b. All behaviors are result of conditioning c. Radical shift away from Freudian philosophy. d. Developed by B. F. Skinner i. Stimulus - Response - Consequence Model: Under which circumstances or antecedent 'stimuli' does the organism engage in a particular behavior or 'response', which in turn produces a particular 'consequence'? e. Ivan Pavlov: classical conditioning f. Operant conditioning: Form of learning during which an individual modifies its own behavior due to the association of the behavior with a stimulus.

i. Positive reinforcement: A behavior (response) is followed by a stimulus that is rewarding, increasing the frequency of that behavior. ii. Negative reinforcement: Behavior (response) is followed by the removal of an aversive stimulus, thereby increasing that behavior's frequency. iii. Positive punishment: Behavior (response) is followed by a stimulus, such as introducing a shock or loud noise, resulting in a decrease in that behavior. iv. Negative punishment: occurs when a behavior (response) is followed by the removal of a stimulus, such as taking away a child's toy following an undesired behavior, resulting in a decrease in that behavior. g. Social learning: Learn through models in the environment: i. Conditions for Modeling: Attention, Retention, Reproduction, Motivation, Reinforcement. 6. Behaviorism: implications a. Assessment: functional analysis i. Antecedents ii. Behavior iii. Consequences b. Treatment i. Remove maladaptive behavior 1. Un-pair 2. Punish 3. Remove harmful models ii. Replace with desirable behavior 1. Pair 2. Reward 3. Model 7. Humanism: a. Reaction to behaviorism b. Humanism philosophy: i. Focus on the here and now ii. Psychologically healthy people must take responsibility for their actions iii. All humans possess inherent worth iv. Goal of life should be to achieve personal growth and understanding c. Abraham Maslow: Hierarchy of needs. Basic needs must be met before higher ones can be satisfied. Needs arranged in order from lowest to highest:

i. physiological (satisfaction of hunger and thirst) ii. safety (security) iii. belongingness and love (being loved, avoiding loneliness) iv. esteem (achievement, recognition, self-esteem) v. self-actualization (realization of one's full potential). d. Carl Rogers: i. Theory of self-concept: an organized pattern of perceived characteristics along with the values attached to those attributes. ii. Developed client-centered therapy, in which the therapist offers the client unconditional positive regard by supporting the client regardless of what is said. 8. Humanism: implications a. Assessment i. How client feels they are regarded by others ii. View of self as is iii. Ideal self b. Treatment: Client-Centered i. Unconditional positive regard ii. Reflective listening iii. Warmth, empathy iv. Non-directive 9. Cognitive theories: a. Behavior is guided by cognitions (e.g. expectations) about the world. Cognitive theories emphasize cognitive processes such as thinking and judging. b. Psychopathology is due to distortions in the patient's perspectives, such as all-or-none thinking, over-generalization, and selective perception. c. The therapist initially tries to highlight these distortions, then encourages the patient to change his or her attitudes. d. Empirically based treatment e. Albert Ellis: considered founder of CBT i. developed Rational Emotive Therapy ii. A-B-C model: A= activating event, B= beliefs, C= emotional and behavioral consequences. Change Beliefs through rational analysis and cognitive reconstruction f. Aaron Beck i. His cognitive therapy is based on the belief that depressed people acquire a negative schema of the world in childhood and adolescence

ii. Schema: A structured cluster of pre-conceived ideas. iii. Need to get patients to alter their schema g. Arnold Lazarus: developed multimodal therapy: 10. Cognitive theories: implications a. Psychopathology i. Inaccurate or ineffective cognitions ii. Maladaptive schemas b. Assessment i. Self-monitoring & self-report methods ii. Cognitions, motivations, and expectancies c. Treatment i. Reframe faulty cognitions ii. Improve self-efficacy iii. Cognitive Re-Conditioning 11. Biological theories a. Correlate different areas of the brain with different personality traits. b. Pathology will result from brain lesions and imbalances of neurotransmitters and hormones. c. Temperament: biologically based foundation of ones personality. 12. Biological theories: implications a. Assessment i. Symptoms ii. Biological techniques: for example, measure startle eye blink response to assess for an anxiety disorder b. Treatment i. Medication ii. Psychophysiological techniques: biofeedback: iii. Combined with psychotherapy

CLASS 4 LECTURE NOTES: CLINICAL ASSESSMENT 1. Benefits of diagnosing: a. Assist treatment selection b. Only possible to compare treatment outcomes across studies if the problem being treated has been identified with common language. 2. Drawbacks of diagnosing: a. Societal stigma to being labeled mentally ill

b. Label will stay in medical chart even when the person no longer displays symptoms c. Cultural biases d. Sometimes symptoms do not neatly fit into a single diagnostic category e. Self-fulfilling prophesy 3. Diagnostic and Statistical Manual of Mental Disorders- fourth edition (DSM-IV) a. Multi-axial system: consider patient along 5 different dimensions b. Axis I: Clinical Disorders (schizophrenia, major depressive disorder) c. Axis II: Personality Disorders and Mental Retardation: first appear in childhood or adolescence and persist throughout a person's lifetime. d. Axis III: Medical Conditions: example, HIV/AIDS can cause symptoms of dementia e. Axis IV: Environmental Factors: problems with primary support group, social environment, educational problems, occupational problems, etc f. Axis V: Global Assessment of Functioning (0-100): overall level at which an individual is functioning across all areas of life. 4. Initial clinical interview a. General identifying information b. Behavioral observations c. Presenting problem d. History e. Tentative diagnosis f. Proposed treatment plan 5. Mental status exam a. Most often part of initial screening process b. Areas assessed i. Orientation: person, place, date, time ii. Attention: distractibility iii. Language: receptive: are they able to understand what you are saying to them? Are they confused? iv. Expressive: are they making sense? Are they speaking coherently? v. Memory: do they display memory problems, for example, ask them what they had for breakfast? vi. Executive functioning: are they able to interpret events accurately? vii. Somatic concerns: do they have any obvious health or medical conditions that are affecting them? viii. Perception: are they having any hallucinations or delusions?

ix. Insight and judgment: do they know why they are here? 6. Interviewer skills a. Establishing rapport: building a relationship of trust with the patient, getting the patient comfortable with you and vice versa b. Active Listening: Listening and responding to another person in a way that improves mutual understanding. Focuses attention on the speaker. c. Primary listening skills i. Facilitate psychologist to learn more about the patient ii. open ended questions: Tell me about you family iii. paraphrasing: repeat what the patient said using different words iv. reflection of feeling: taking what the patient said and hypothesized the emotion that the patient feels: It sounds like that makes you feel anxious v. minimal encouragers: keep the patient talking without interrupting. Uh-Huh vi. clarifying remark: asking the patient to repeat something you didnt hear or didnt understand. vii. summarizing: the process of reviewing the major points brought up in the session viii. perception check: make sure you are on the same page with the patient about what the goals of the treatment are. d. Secondary listening skills: not used to get to know the patient, but are helpful to the therapy session as well i. normalizing: letting the patient know that their symptoms and problems are not that abnormal or bad ii. structuring: explain the process of therapy iii. probing: if a particular issue needs to be discussed further (e.g., you think there is any suicidal ideation) 7. Structured interviews a. Standardized Set of Questions i. Based on specific criteria b. Structured Scoring Procedures i. Participant Responses ii. Interviewer Scored c. Examples: i. DISC, SCID: Diagnostic Interview Schedule for Children (DISC) and Structured Clinical Interview for DSM Disorders (SCID). Interviewer administered and scored.

ii. HDRS: Hamilton depression rating scale: also therapist administered, used to measure extent of depression. Continuous scale as opposed to categorical. 8. Behavioral observations a. Appearance i. Age-size related to actual age ii. Facial features iii. Physical Presentation-dress, grooming and hygiene b. Affect i. Prevalent-typical affect of the patient and significant others ii. Range-range of emotional expression c. Emotional State i. Consistent-with displayed affect ii. Type-apparent mood iii. Level-intensity of apparent mood d. Motivation i. Effort-put forth during administration of test material ii. Interest-in test materials and/or results of process iii. Cooperation-degree and consistency in cooperation w/demands e. Motor i. Activity-level during testing ii. Range-variability of activity or stamina iii. Gross-gait, weakness, and balance iv. Fine-dexterity, laterality, and speed f. Cognitive i. General-cognitive control or impulsiveness ii. Attention-sustained, selective and divided iii. Language- communication skills iv. Memory-immediate and delayed, verbal and visual g. Bizarre or Unusual Behaviors 9. Self monitoring a. Patients keep log of: i. Infrequent behaviors ii. Internal behaviors- e.g., negative self thoughts b. Factors that impact accuracy of self-monitoring: patients may be embarrassed to tell therapist the truth, might not remember to do it, might not feel like doing it.

10. Self-report measures a. Depression: Beck depression inventory. Similar to Hamilton, except that the patient can fill it out themselves b. Child behavior measures: Achenbach: CBCL (6-18, parent fills out), teacher report form (6-18, teacher fills out), youth self report (11-18).

CLASS 5 LECTURE NOTES: INTELLIGENCE & NEUROPSYCH ASSESSMENT 1. Reliability: The consistency of the test scores. Types of reliability: a. Test-retest: correlate pairs of scores obtained by the same person on two different administrations of the test, should be highly correlated b. Alternate form: this helps to overcome practice effect that can occur with retesting on the same exact instrument. Alternate form is when two tests have very similar content and level of difficulty. The way to measure this type of reliability is to calculate the correlation between the two scores. c. Split-half reliability: compare persons score on equivalent halves of the test. d. Internal consistency: similar to split half, in order to determine the internal consistency you correlate each item to all other items on the test. 2. Validity: measurement of how well a test measures what it says it measures. Types of validity: a. Content validity: measurement of the extent to which a measure represents all facets of a given concept. For example, a depression scale may lack content validity if it only assesses the affective dimension of depression but fails to take into account the behavioral dimension. b. Predictive validity: how well the test will predict behavior. Example: SAT test is supposed to predict college grades. c. Concurrent validity: how well a new measure correlates with a previously validated measure, sometimes called a gold standard. d. Construct validity: Construct validity is the degree to which a test actually reflects the hypothetical construct being measured, for example, does an intelligence test measures intelligence as opposed to musical ability or memory. i. Convergent validity: the degree to which two or more measures that theoretically should be related to each other are, in fact, observed to be related to one other. ii. Discriminant validity: the test has a low correlation with a test that measures a different construct (i.e. a measure does not measure what it is not meant to measure). For example, scores on a test of basic math skills should have a low

correlation with a test of basic reading skills. If there is high correlation, reading skills may be required in addition to mathematics skills in order to complete the math test. In this case, the math test results would be confounded by students' reading ability. 3. Hitting a psychometric homerun: a. 1st base: reliability b. 2nd base: concurrent validity c. 3rd base: construct validity d. Homerun: predictive validity 4. Classical test theory a. Observed Score = True score + Error: even the most well-validated tests will not provide the psychologist with the true, exact measure of intelligence, because there is always error that must be factored in. b. IQ scores = intellective (actual ability) and non-intellective (experience, attitude, and emotion). 5. IQ tests measure: a. Aptitude: innate potential for acquiring a particular skill. b. Achievement: measure what has been learned. c. Intelligence testing aptitude testing (but some tests have aspects of achievement). 6. Intelligence defined a. Combination of abilities required for survival and advancement within a particular culture b. Capacity to find and maintain purpose, adapt or use self-criticism to adjust strategies. c. Potential to solve problems. 7. Intelligence Tests a. Wechsler Series (WISC & WAIS) i. Purpose: Individually administered assessment of cognitive abilities. Most commonly used test on adults ii. In each subtest, the items get increasingly more difficult until the patient can no longer answer any of the items. iii. Measures: Two scales, verbal and performance, that measure verbal comprehension, perceptual organization, working memory, processing speed 1. Verbal scales: information, comprehension, arithmetic, similarities, digit span, vocabulary, letter-number sequencing 2. Performance scales: digit symbol, picture completion, block design, matrix reasoning, symbol search iv. Raw Scores (# correct) converted to scaled scores

1. Scaled Scores have mean of 10 and SD of 3 2. Allows comparisons between subtests 3. Scaled Scores added together and compared to standardization v. Standardization Sample: 1. Census Data Based 2. All age groups represented b. Stanford-Binet Intelligence Scales (SB5) i. Purpose: Individually administered assessment of intelligence and cognitive abilities ii. Measures: fluid reasoning, knowledge, quantitative reasoning, visual-spatial processing, working memory iii. Ages: 2 to 85+ years iv. Standardization: N = 4,800 matching 2000 Census data. 1. Evaluated test items on whether they were fair relative to religious considerations using an expert panel. 8. Test application issues: a. Sensitivity: the proportion of actual positives which are correctly identified as such (e.g. the percentage of sick people who are correctly identified as having the condition). b. Specificity: the proportion of negatives which are correctly identified (e.g. the percentage of healthy people who are correctly identified as not having the condition). c. Incremental Validity: describe the gain in validity resulting from adding the new test to an existing selection of tests. Incremental validity shows that a new measure improves upon existing measures. d. Examiner Effects i. Rapport: or lack of with the person taking the test. ii. Rosenthal Effect/Expectancy: refers to the phenomenon in which the greater the expectation placed upon people, better they perform. iii. Reactivity: person administering the test may give non-verbal cues to the person taking the test that they are doing well or not. iv. Drift: over time, examiner may change the way they score the tests v. Rating Accuracy: maybe the examiner was never trained properly 9. Test bias a. Biased test is one in which people from two groups who have the same observed score do not have the same standing on the trait of interest. b. People with the same test scores should do equally well on some external criterion.

10. Neuropsychology: Branch of psychology that aims to understand how the structure & function of the brain relate to specific psychological processes. 11. Clinical Neuropsychology a. Correlation: brain damage & loss of function b. Neuropsychological test are used c. Scores are compared to Norms d. Strengths and weaknesses are determined e. Patient receives recommendations based on his clinical profile 12. Common populations: anyone who has suffered a brain injury or has a lesion in the brain 13. Neuopsychological Assessment a. Review medical records: learn patients background b. Laboratory and neuroimaging findings c. Medications: some meds can alter cognitive functioning d. Clinical interview e. Corroborative interview (e.g., spouse): sometimes the patient may not notice or be aware of the change in behavior f. Behavioral observations g. Neuropsychological Battery: many different skills are tested in an attempt to determine what cognitive functions are impaired and which are intact. i. Effort, Attention, IQ, Language, Academic achievement, Memory, Executive functions, Mood, Personality may all be measured during administration of a neuropsychological exam

CLASS 6 LECTURE NOTES: PERSONALITY ASSESSMENT 1. Personality Assessment definitions a. Instruments for the measurement of emotional, motivational, interpersonal, and attitudinal characteristics as distinguished from abilities b. Tests that measure the traits, qualities, or behaviors that determine an individuals individuality c. Assumes that personality is a relatively stable characteristic over time and across situations 2. Types of personality tests a. Objective- self-report responses to discrete items, e.g., multiple choice or true/false. Little, if any interpretation by psychologist. Standardized scoring. b. Projective- ambiguous stimuli and open responses 3. Objective Test Development Strategies a. Deductive

i. Logical Content: In the construction of a personality test, the test items are derived on the basis of reason and deductive logic which may or may not be guided by systematic theory of personality. 1. Relies on face validity- how the surface content matches with the intended characteristic of interest 2. Beck Depression and Anxiety Inventories 3. Tend to measure states (transient symptoms), not traits ii. Theoretical: In the construction of a personality test, items are chosen to measure the construct(s) identified by a specific personality theory and construct validation procedures are used to make sure the test is consistent with the theory. 1. Ex. Myers Briggs which is derived from Jung's personality theory. b. Empirical i. Criterion Group: In the construction of a personality test, the proposed test items are administered to the appropriate criterion groups and items that distinguish between groups are included in the test. ii. Factor Analytic: In the construction of a personality test, the researcher administers a larger pool of items to a group of examinees, factor analyzing the intercorrelations of items to identify underlying factors (traits), assigning labels to identified factors and including items in the test so that each factor is adequately assessed. 4. Logical Content Approach to Test Development a. Advantages i. Fit model: tests are designed to include questions that will assess all aspects of a disorder, so the test maps on very well to the clinical profile of a psychological disorder ii. Face validity: the items measure what they are supposed to be measuring, and they are fairly unambiguous to interpret b. Disadvantages i. Easy to bias: patients can easily fake or lie, to malinger or fake good ii. Time frame varies: depending on what the time frame is, you may not capture the symptoms. 5. Criterion Group Approach: MMPI a. Select known groups (clinical & comparison) b. Generate the item pool c. Administer items d. Develop scales based on items that best differentiate groups e. Test the scale on new groups (cross-validation)

f. Research the meaning of scales or the tests 6. MMPI-2 Criterion Groups (Minnesota Multiphasic Personality Inventory) a. Hypochondriasis: Concern with bodily symptoms b. Depression: Depressive Symptoms c. Hysteria: Lacks insight re: problems and vulnerabilities d. Psychopathic deviate: Conflict, struggle, anger, respect for society's rules e. Masculinity/Feminity: Stereotypical masculine or feminine interests/behaviors f. Paranoia: Level of trust, suspiciousness, sensitivity g. Psychasthenia: Worry, anxiety, tension, doubts, obsessiveness h. Schizophrenia: Odd thinking and social alienation i. Hypomania: Level of excitability j. Social Introversion: People orientation 7. MMPI-2 Validity Scales: Test Taking Style a. Lie Scale: Nave attempt to fake good- someone who wants to collect disability or avoid a jail sentence. Someone who is very self-controlled may score high on this scale. b. K Scale: Defensiveness: high scores on this scale usually indicate severe psychopathology or poor treatment prognosis c. F Scale: Attempt to fake bad- someone who would prefer to be in the hospital than in an unhappy home d. ? Cannot say: Unanswered e. Fb: Faking at end of instrument f. VRIN: Random Responding g. TRIN: True or false response style 8. Criterion Group Approach a. Pros i. Empirically based: developed through research ii. Known groups: used people already diagnosed with psychological disorders iii. Profiles consistent with others with disorder b. Cons i. Not face valid: some questions seem very random. ii. Often hard to interpret/multiple interpretations 9. Factor Analytic Approach a. Decide on content area, ask a large number of questions b. Select heterogeneous/representative sample c. Construct correlation matrix- looks for correlations among questions

d. Factor analyze: if groups of questions correlate with each other, this is evidence of a factor analytic scale e. Define scoring system: name the factors f. Replicate (cross validation) 10. NEO-PI-R: Five Factor Model of Personality (Goldberg, 1993): dimensional model of personality a. Neuroticism: people high on this are prone to psychological distress High in Anxiety, Hostility, Depression, Self-consciousness, Impulsiveness, Vulnerability b. Extraversion: people oriented, optimistic, affectionate. High in Warmth, Gregariousness, Assertiveness, Activity, Excitement seeking, Positive emotions c. Openness to experience: people are imaginative and curious, unconventional values. High in Fantasy, Aesthetics, Feelings, Actions, Ideas, Values d. Agreeableness: trusting and helpful people. High in Trust, Straightforwardness, Altruism, Compliance, Modesty, Tender-mindedness e. Conscientiousness: reliable and hard working. High in Competence, Order, Dutifulness, Achievement striving, Self-discipline, Deliberation 11. Factor Analytic Approach a. Pros i. Purely statistical, no opportunity for bias in how factors are formed b. Cons i. Factor naming: Interpreting factor analysis is based on using a "heuristic", which is a solution that is "convenient even if not absolutely true". More than one interpretation can be made of the same data factored the same way, and factor analysis cannot identify causality. ii. No inherent meaning: there is no a priori logic that goes into what variables end up being factored together, and so can be hard to interpret 12. Projective Hypothesis a. When attempting to understand ambiguous stimuli, people will project onto stimuli their personal needs, feelings and experiences b. Underlying assumption of all projective tests (and psychodynamic therapies) 13. Thematic Apperception Test a. Murrays Theory of Needs: Need refers to internal factors that motivate a person; Press refers to relevant environmental influences on behavior; Thema refers to the interaction between these 2 factors. b. Personality not diagnosis c. Ten examiner selected pictures

d. Used with clinical and normal samples e. Instructions: i. What has led up to the event shown\ ii. What is happening at the moment iii. What the characters are feeling and thinking iv. What the outcome of the story was f. TAT Scoring Dimensions i. Content of Stories ii. Themes of Stories iii. Character Identification iv. Conflict and Resolution v. Stimulus/Story Fit 14. Rorschach a. 10 abstract images (base cards) b. Formed by folding paper with drops of ink c. What might this be? What could this be? d. Rorschach Scoring i. Location: Positive or negative space, whole or detail ii. Determinants: form, color, movement, shading: only shape, or also used color or movement? iii. Content: human", "nature", "animal", "abstract" iv. Popularity: Frequency of interpretation v. Also looked at how many responses were made, how long the patient looked at the inkblot before answering, did patient refuse to answer some 15. Evaluation of Projective Tests