PSYC4121 Quiz 2 - nuance questions

Why do we use self report measures:

-The person knows themselves best, and helps us understand things by their standard (example of high achiever now at average level).

-Relatively non-confrontational

-Fast, cheap, possibly online

-Faster than semi-structured interview which could take 30 mins

-The test-retest is important in a therapy context to be able to check in how therapy is working

-((Measures can get them to reflect and build insight))

-Can use other measures to see overlap, establish validity of self-report responses if needed

-((Can give a collateral measure to parent etc. to look for consistency across contexts))

How to minimize limitations in self-report

-Rapport. Help the person understand you are on their side. You are here to help but can only help if they are honest with their responses.
- Want to interpret self-report scores in the context of other information we have. So if you know about a serious medical diagnosis they have, factor that in to interpreting the scoring.

Considerations working with children (CBCL)

• When working with children. Looks at behaviours of child (outward expression e.g. are they staying in their room, are they fidgety)

• Many child self-report scales start at 7 or 8 as reading is generally considered to become more independent at this stage, but in this case it starts at 11 because the concepts it asks about are considered more mature, so thought more appropriate that 11 and up would be more appropriate

• Measuring behaviour because it could reflect mental states

• Measuring across contexts could detect masking. Maybe they mask at school.

• Consider lens of person filling it out. Teacher could be overly worked, stressed, seeing child as more problematic than they may be at home. Parents might similarly be really seeking funding and so rate child higher than they may otherwise be.

• Ensure we understand the child’s emotional behavioural profile so that we can understand is what Mum and Dad think is ADHD actually some form of anxiety, or some form of trauma

• We will use more than one data point as much as possible to give context to and understand a score on any single test

Importance of reliability and validity in test choice

-We need our test to be as reliable and valid as possible because we have so many contextual factors at play that if also using a poor test, we can’t rely on it

-If you ever are called to court for why you used a certain test, being able to explain because it is reliable and valid will help

Why test personality?

• Establishing stable personality traits could help us understand what is stable and maybe what is part of diagnosis

  • Could also help identify people for organisational positions

Stable, if linked to diagnosis: neurological complaints, PSY-5 (Psychopathology) scales

If we’re exploring ASD diagnosis, we might see social avoidance and shyness. Could help indicate ASD, or could be indicative of something else.

Leander more likely to do this if she is working with a more complex client. Might think “there’s so much going on here. I want to understand more at that state/trait kind of level.”

Reasons to pick one test over a similar one?

-Population it was normed on

-Duration

-Price

When not to test

-Based on how they are presenting

-Try and establish “is this the right thing for this person at this time”

-If they appear to be under the influence of a substance, you would almost never test. Consider though you wouldn’t want them in withdrawal if they have an addiction.

-If they are on their meds or on their meds? For anti-depressant you would assess on medication. ADHD you might assess off the medication. That would be a clinical decision based on the person.

-Someone over-identifying with their diagnosis can be problematic. Some people fixate, seek diagnoses. Still check if they meet diagnosis, but be very considerate with how you write the report.

-Who you are as a clinician

-If you don’t have rapport.

-Environmental factors

-If environment itself is triggering and might introduce factors that will influence their performance

Reporting considerations

-If child is a 15 – 17 year old it can be a tricky scenario. Parents might have funded test, but child might not want parents to know. Help person understand where their results will go. Make sure everyone is clear from the start.

-Diagnosis can be scary (e.g. dementia): you have to tell them. Informed consent, respecting patient. Give them diagnosis and the right scaffolding around it for support.

-When they don’t meet diagnosis: make very clear especially when they don’t meet criteria, particularly if they are seeking it. Be very clear why they don’t. Focus on a strengths-based approach and look at what they can do / keep doing.

What is the point of assessment in older adult and indigenous populations? (4 reasons)

•A diagnosis (maybe)

•Estimation of functional status and competence (with care!)

•Intervention planning / tracking

•Appropriate and timely referrals

What affects test performance? (5 things)

•age and education level

•culture and language

•test conditions

•prior testing (don’t resubmit test too soon. Contaminates results due to memory of the test items).

•health or emotional issues (someone very upset during test).

Types of tests (covered here)

•Cognitive tests for Indigenous and older adults

•affective (self-report)

•personality

•informant

•culturally safe tools for Indigenous groups here in Australia

•population-focused tools

How might you need to adapt testing if language, culture, or sensory deficits are a factor

You might try and find a translation for language, a variation that maybe uses an oral presentation for someone with vision impairment, or a culturally-appropriate variation of an intelligence test so it’s not testing them on knowledge that isn’t appropriate to their culture (not general knowledge for them)

Why we give standardised tests (4 reasons)

1.        Standardisation helps us with scoring. We know where someone sits.

2.        Can help with pre-post intervention to see if there has been change

3.        Can help us compare people within a population and people between populations

4.        Value to having structure so you capture everything you want to capture, and so you’re consistent

How accurate is a given test outcome?

These tests are an estimate. There is standard errors in them, e.g. tiredness, caffeination, hunger can all influence. These things are fluid. There isn’t just one exact true score

-              So exercise care in how we provide these scores.

 

-              Retesting can be crucial, for example, if someone is going through rehabilitation.

Issues with standardised testing in schooling?

It can be a very deficit-based approach.

Why might standardised testing be helpful?

Access funding and further support

When do standardised testing results need to be cautiously interpreted

1. When person is from a different population or cultural background to the population the test was developed on

2. When other potential factors / diagnoses may be at play