Transcript Intro to Clinical Psychology - Hunsley Lee

Chapter 8
Assessment: Self-Report
and Projective Measures
I N T R O D U C T I O N TO C L I N I C A L P S Y C H O L O G Y 2 E
HUNSLEY & LEE
P R E P A R E D B Y D R . C AT H Y C H O V A Z , K I N G ’ S C O L L E G E , U W O
Topics:
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Central Concepts in Self-Report and Projectives
The Person-Situation Debate
Self-presentation Biases
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Culturally Appropriate Measures
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Clinical Utility
Minnesota Multiphasic Personality Inventory
Millon Measures
Measures of Normal Personality Functioning
Self-report Checklists of Behaviours and Symptoms
Projective Measures
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Central Concepts in
Self-Report and Projectives
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Personality traits: Consistent behaviors, attitudes and
emotions across time
Objective personality tests: Tests that are scored the
same way each time and not as open to interpretation
Projective personality test: Test taker responds to
ambiguous stimuli and assessor determines some
interpretation of the data
Clinical utility: Do the tests add important and useful
information?
The Person-Situation Debate
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Walter Mischel: 1968 book Personality and Assessment
launched debate
Limits to self-knowledge
Situational influences
Are behaviours consistent over time?
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Research evidence points to influence of both person and
situation
Self-Presentation Biases
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Emphasizing the positive: People are often motivated
to present themselves in a favourable light (e.g., custody
cases, job applications) – “faking good”
Malingering: Trying to look worse than one is (e.g.,
insanity defence) – “faking bad”
Random responding: Not taking test seriously or
cognitively impaired?
Validity scales: Portions of personality tests that are
designed to catch these biases
Self-Presentation Biases
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Projective tests may get around the self-presentation bias
issue because the stimuli are ambiguous
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Research evidence is mixed on whether this is the case
Culturally Appropriate Measures
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Tests can be biased in several ways
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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
Different factors may exist for different groups
Culturally Appropriate Measures
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Clinicians should only use measures that are validated
with the ethnic group it is being used with (or results
interpreted with caution)
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Cross-cultural adaptations of tests are often needed
Culturally Appropriate Measures
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Assessing cultural and linguistic factors:
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Immigration history
Contact with other cultural groups
Acculturative status
Acculturative stress
Socioeconomic status
Language
(see Exhibit 8.1 p. 290)
Clinical Utility
Must consider:
1. Basic perspective – extent of knowledge
Applied perspective – clinical utility?
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Do clinicians find the tool useful?
Reliable and valid information?
Does the tool improve upon clinical decision-making and
treatment outcome?
Minnesota Multiphasic
Personality Inventory
MMPI-2 (for adults) and MMPI-A for adolescents:
Most commonly taught and used personality inventory in
clinical psychology
 First version published in 1943, had 550 items
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Used empirical criterion keying: items were chosen that
discriminated groups
Second version has 567 and adolescent version 478 items;
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Used content approach to test construction: developing
items that designed to tap a construct (not by how groups
responded)
Some MMPI-2 Validity Scales
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Cannot Say (?): Total number of unanswered items
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Lie Scale (L): A measure of self-presentation that is
unrealistically positive
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Infrequency Scale (F): A measure of self-presentation
that is very unfavourable–malingering or severe
psychopathology
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Defensiveness Scale (K): Unwillingness to disclose
personal information and problems. High K scale scores
increase some other scores
MMPI-2 Clinical Scales
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Scale 1 (Hs: Hypochondriasis): Preoccupation with health
issues
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Scale 2 (D: Depression): Common symptoms of
depression
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Scale 3 (Hy: Hysteria): Physical symptoms when stressed
and minimization of interpersonal problems
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Scale 4 (Pd: Psychopathic Deviate): Rebellious attitudes,
conflict with authorities and family, and antisocial activities
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Scale 5 (Mf: Masculinity-Femininity): Measures genderstereotyped interests and activities
MMPI-2 Clinical Scales
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Scale 6 (Pa: Paranoia): Feelings of being mistreated, and
delusions of persecution
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Scale 7 (Pt: Psychasthenia): Tendency to worry,
rumination, fearing loss of control
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Scale 8 (Sc: Schizophrenia): Tendency to experience
social alienation, delusions, hallucinations
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Scale 9 (Ma: Hypomania): Tendency toward hyperarousal,
excessive energy, agitation
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Scale 0 (Si: Social Introversion): Introversion, not
enjoying social contexts
MMPI-2 Norms,
Reliability and Validity
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Norms: Developed with a large random sample selected
from a diverse group in terms of ethnicity, SES, geography
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Not a large sample of low educated or low-income individuals
in norm group
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Reliability: Good to mediocre depending on the scale;
test-retest validity is very good (>.8)
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Validity: Enormous amount of data – interpretation is
complicated with many clinical and content scales
Millon Measures:
MCMI-III and the MACI
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Focused on DSM diagnostic categories, but otherwise
similar in design to the MMPI
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MCMI-III 175 item (true false)
MACI (for adolescents) also 175 T/F items
Norms may underrepresent the American and Canadian
population
Good reliability including test-retest reliability and
internal consistency
Some possible over-pathologizing may exist
Measures of Normal
Personality Functioning
Note: used with the general population, so no validity scales
California Psychological Inventory (CPI):
 434 items similar in structure to the MMPI (shares many
similar items); good normative, reliability and validity data
NEO-PI-Revised:
 Factor analytically derived inventory defines five factors:
openness, conscientiousness, extraversion, agreeableness,
neuroticism (acronym: ocean).Very good normative,
reliability and validity data
Self-report Checklists of
Behaviours and Symptoms
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Achenbach (Child Behavior Checklist CBCL):
Parents report a series of problems in their children
(versions for teachers, caregivers)
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Symptom Checklist 90-revised (SCL-90-R): Most
widely used symptom measure in clinical settings. 90
items – 9 subscales; good reliability, but norms are not
adequate and high intercorrelation among items
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Beck Depression Inventory (BDI-II): 21-item multiple
choice on severity of depressive symptoms; scores may
decrease with repeated administration
Projective Measures
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Stimuli are ambiguous with respect to content and
meaning
Based on psychoanalytic idea that people project their
negative attributes about themselves onto ambiguous
external stimuli
However, recent evidence indicates that the responses
are about the person’s experiences and personality, not
projection per se
Many of these tests lack rigor of testing guidelines
Rorschach Inkblot Test
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Developed by Hermann Rorschach – 10 cards;
symmetrical inkblots; people report on what they see in
the inkblots
John Exner’s Comprehensive Scoring System
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Main way to score the inkblots based on a very large
normative sample of responses; although people of colour not
adequately sampled
Recent norms have better representation – although test
is not recommended currently for youth (because of
over-pathologizing)
Good reliability; mixed data on validity
Thematic Apperception Test (TAT)
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Developed by Murray, 1943
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31 cards with pictures on them
Participant tells a story about what they see in the picture
No consistently-used scoring mechanism, although the
stories are supposed to yield data on needs, emotions,
interpersonal relations, and conflicts within the individual
No clear norms or reliability data, making the TAT a test
that is not recommended since its validity cannot be
determined
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