Week 5

self-report, interviewing, integration

personality traits

tendency to behave consistently in specific ways

consistency of personality

seen across time

variability of personality

seen across situations

enhances prediction

knowledge of both situational and personality factors

sub-categories of personality traits

behaviours, emotional reactions, ways of thinking, interpersonal style

self report measures are all

based on a subjective view of the self

objective personality tests

scoring standardization based on norms

clinical personality tests

designed for people experiencing high levels of distress or pathology

non-clinical personality tests

designed to assess personality in “normal” population

projective measures

tests based on responses to ambiguous stimuli

low validity and rarely practiced

projective measures

self-report checklists

provide information about an individual’s experience in a specific domain

most often used in treatment monitoring/evaluation

self-report checklists

what type of personality test that a clinician uses depends on

goal of assessment, characteristics of client, characteristics of the test

limitations of personality measures

limits to self knowledge, self-presentation bias, individual test strengths and weaknesses

limits to self knowledge

we are all subjective and biased so there is a limit to how well we know ourselves

self presentation bias

people often try to portray themselves in a particular way

* can be conscious or unconscious

bias

unfairness or inconsistency in test results for different populations

bias in test content

test may capture a construct for one population but not another

differences in predictive

test may predict outcomes for one group but not another

difference in cut-off scores

threshold for significant results can differ between groups resulting in an increase in false positives or negatives

differences in test structure

different factor structure for different groups

culturally sensitive/appropriate testing

* only use measures that have been validated for pop of interest
* consult the published norms for group of interest
* use caution in interpreting results
* use multiple assessment measures
* if not confident in test results, do not use them

clinical utility

extent to which a test and its results improve clinical decision-making

cyclical/reciprocal relationship

personality changes how the person interacts with the world which changes how the world interacts with them

utility of psychological tests on impacting outcome of psychological services

mixed research, may still help with diagnosis

computer-developed interpretative reports

must be used with caution and never used alone

personality inventories

objective personality tests that cover a broad range of clinical syndromes and characteristics

personality inventories used on clinical populations

MMPI, PAI, MCMI

personality inventory used on non-clincal populations

NEO

NEO personality inventory

measures the big 5 personality traits, scoring high or low does not indicate clinical problem

MMPI-2 and MMPI-IV response format

true/false

PAI response format

4 point scale

MMPI-2 reading level

grade 6-8

MMPI-IV reading level

grade 5

PAI reading level

grade 4

MMPI-2 administration time

60-90min

MMPI-IV administration time

25-30min

PAI administration time

40-50min

MMPI-2 validity scales

* cannot say (CNS)
* variable inconsistency (VRIN)
* true-response inconsistency (TRIN)
* infrequent (F)
* fake bad scale (FBS)
* lie scale (L)
* defensiveness (k)

CNS validity scale (MMPI-2)

measures the number of unanswered items

VRIN validity scale (MMPI-2)

measures random/confused responding

* test contains of pairs of questions that are expected to be answered consistently so if they are not then profile may be invalid

TRIN validity scale (MMPI-2)

tendency to respond all true vs. all false

* test contains pairs of questions that should have opposite questions that mean the same thing

F validity scale (MMPI-2)

high levels of unfavourable self-presenting

* above average responding to extreme symptoms that exist in

FBS validity scale (MMPI-2)

faking bad or malingering

* people respond true to symptoms that are not real and therefore cannot be true

L validity scale (MMPI-2)

unrealistic positive self presentation

* questions that ask about really normal flaws so if someone responds “false” to these then they likely have an inflated sense of self

K validity scale (MMPI-2)

unwillingness to disclose information

* tend to describe themselves in a positive way but more subtly than the L scale
* if high score on K scale all the other scores are likely lower

first step in interpreting MMPI-2

look at validity scores

MMPI clinical scales

* hypochondriasis (Hs)
* depression (D)
* hysteria (H)
* psychopathic deviate (Pd)
* masculinity-femininity (Mf)
* paranoia (Pa)
* psych-asthenia (Pt)
* schizophrenia (Sc)
* hypomania (Ma)
* social introversion (Si)

Hs clinical scale (MMPI-2)

measures the tendency to by preoccupied with one’s health and to be unlikely to connect psychological problems to the experience of some physical symptoms

D clinical scale (MMPI-2)

measures common cognitive, physical, and interpersonal symptoms of depression

Hy clinical scale (MMPI-2)

measures the tendency to develop physical symptoms when stressed and to minimize the extent of interpersonal problems

Pd clinical scale (MMPI-2)

measures the tendency toward rebellious attitudes, conflict with authorities and family, and engagement in antisocial activities

Mf clinical scale (MMPI-2)

measures gender-stereotypes interests, beliefs, and activities

Pa clinical scale (MMPI-2)

measures interpersonal sensitivity, feelings of being mistreated, and at the extreme, delusions of persecution

Pt clinical scale (MMPI-2)

measures the tendency toward worry, apprehension, rumination, and fears of loss of control

Sc clinical scale (MMPI-2)

measures the tendency to withdraw and experience social alienation, feel inferior, and at the extreme, experience delusions, hallucinations and extreme disorganization

Ma clinical scale (MMPI-2)

measures the tendency toward hyperarousal, excessive energy, low frustration tolerance, and agitation

Si clinical scale (MMPI-2)

measures introversion, lack of comfort in social contexts, and over-controlled style of coping

critique of MMPI-2 clinical scales

names are very old school and not person focused

MMPI-2 content scales

* anxiety (ANX)


* fears (FRA
* obsessiveness (OBS)
* depression (DEP)
* health concerns (HEA)
* bizzarre mentation (BIZ)
* anger (ANG)
* cynicism (CYN)
* antisocial practices (ASP)
* type A behaviour (TPA)
* low self-esteem (LSE)
* social discomfort (SOD)
* family problems (FAM)
* work interference (WRK)
* negative treatment indicators (TRT)

strengths of MMPI-2

considerable research base, variety of scales, contains validity scales, K-correction

limitations of MMPI-2

length, reading level, under-representation of lower education and SES in standardization, some scales of low internal consistency, older versions have high intercorrelations among scales

code type

refers to the two highest scales on a person’s code type and the typical profile of someone with the same code-type

what to tell people before they take assessment

“there is no right or wrong answers, go with your gut “

PAI validity scales

* inconsistency
* infrequency
* negative impression management
* positive impression management

inconsistency validity scale (PAI)

looks for random responding

infrequency validity scale (PAI)

looks for response of highly unlikely symptoms

negative impression management validity scale (PAI)

trying to make oneself look worse by over reporting symptoms

positive impression management validity scale (PAI)

trying to make oneself look better by under reporting symptoms

key aspect of PAI clinical scales

DSM criteria focused

interpersonal scales (PAI)

how does the person interact/feel in interpersonal relationships

* dominance/warmth

treatment-oriented scales (PAI)

characteristics that may impact treatment engagement

* aggression, stress, treatment, rejection, suicidality, non-support

PAI strengths

reading level, duration, high levels of content and discrimination validity, high reliability, different types of scales

limitations of PAI

lack of personality factors that may be clinical interest, includes many diagnostic categories, but not all, duration

problems with projective measures

can pathologies, not accepted/practiced by many psychologists, open to considerable bias

types of self report checklists

SCL-90-R, Q45.2

goal of psychological interview

both gather contextual information (a lot) and build/maintain rapport

differences between psychological interview and a typical conversation

* not about a back and forth/mutually sharing
* not about letting the client go wherever they want with the conversation
* includes covering tough, personal topics

information collected during an interview

everything!

* can be more or less relevant
* what we emphasize may differ depending on what we are looking for

unstructured interview

questions are not systematically asked in a specific order or way

strengths of unstructured interview

greater flexibility in question type and order and opportunity for discussion and reflection

weaknesses of unstructured interview

reduces validity and reliability of diagnosis

(semi-)structured interviews

specific format and sequence for asking questions

strengths of structured interviews

thorough, diagnostic

weaknesses of structured interviews

time consuming

semi-structured vs. structured interviews

differ in opportunity for exploration/elaboration

open questions

questions that allow client to elaborate; cannot be answered with a simple yes or no

closed questions

questions that can be answered with a single word

problem definition question

questions that clarify a client statement

* “what do u mean by that”

goal definition question

help define where the client wants to “end up”

* must ask specific and detailed questions

closed vs. open questions

dependent on the information needed, and client’s interpersonal style

skills in interviewing

attending, paraphrasing, summarizing, reflection, silence

attending (skills in interviewing)

paying attention to verbal and non-verbal information from client

* clinician should be nodding + making eye contact

paraphrasing (skills in interviewing)

rephrasing what the client says

* this is a tool to make sure that the client knows that the clinician is hearing them accurately

summarizing (skill in interviewing)

tying together main ideas or themes to reinforce key points

* clients may ramble for a while and list so many points so it is helpful to summarize these points and emotions back to them

reflection (skill in interviewing)

identifying underlying emotion and stating it back to the client

* lets client know that you are listening
* helps the client label their complex internal world

silence (skills in interviewing)

allows time for reflection/processing of difficult and important information

* can be difficult or uncomfortable

what clinician is looking for during observation

* appearance/grooming
* activity level
* attention span
* impulsivity
* affect
* emotional expression

internal skills in interviewing (clinician skills)

* ability to broach difficult topics
* maintaining a balance between collecting information and maintaining rapport
* knowing what information to collect vs. not
* remaining non-judgemental