Psychological Assessment – Article summary [UNIVERSITY OF AMSTERDAM]
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Spearman coined general intelligence and stated that this explained a person’s performance on intellectual tests. However, it was contested that there is one factor explaining performance on intellectual tests and multiple factors were formulated.
There are scholastic skills and skills to be able to solve new problems. Crystallized intelligence refers to the knowledge of facts and fluid intelligence refers to the ability to solve new problems and reason. Crystallized intelligence is relatively stable whilst fluid intelligence is not and is disrupted by several factors (e.g. brain damage, age).
The general intelligence test is a method of assessing someone’s intelligence and consists of several sub-tests which assess specific intellectual skills. IQ reflects a person’s overall performance on all subtests in comparison with a group of peers.
The Wechsler Adult Intelligence Scale-IV (WAIS-IV-NL) is an intelligence test that consists of 15 subtests that cover working memory (1), arithmetic (2), vocabulary (3), information processing speed (4), power of abstraction (5) and visual spatial problem solving (6). It is possible to do a shorter version of this, although this is less generalizable than the original, 70-minute version.
The Groninger Intelligence Test-2 (GIT-2) is an individual intelligence test which is applicable to a wide age range whilst representing as many intelligence factors as possible.
The Kaufman Adolescent and Adult Intelligence Test (KAIT) is an individual intelligence test for determining intelligence for people between the age of 14 and 85. It can be administered in two ways. The core battery (i.e. 3 subtests for crystallized intelligence and 3 subtests for fluid intelligence) can be administered. A longer version can also be administered. The total IQ should not be interpreted when the IQ for the crystallized intelligence and the fluid intelligence differ a lot.
Raven’s progressive matrices is a non-verbal test that measures visual problem-solving and can be used as a measure of fluid intelligence. It is an analogue reasoning task. The forms of this test are the Standard Progressive Matrices (1), the Coloured Progressive Matrices (2) and the Advanced Standard Progressive Matrices (3). The advantages of using these tests are that it does not require a verbal response (1) and that it is mostly culture-free (2).
The Nederlandse Leestest voor Volwassenen (NLV) was developed for obtaining a reliable estimate of the level of premorbid intellectual functioning in patients with cerebral dysfunctions within a short time frame. There is a high correlation between the results on this test and verbal IQ.
A lot of consequences (e.g. special education or not) depend on the results on IQ scores and these consequences treat IQ scores as absolute numbers.
IQ value | Verbal description |
>130 | Highly gifted |
121-130 | Gifted |
111-120 | Above average |
90-110 | Average |
80-89 | Below average |
70-79 | Lowly gifted |
50-69 | Mild intellectual disability |
35-49 | Moderate intellectual disability |
20-34 | Severe intellectual disability |
<20 | Profound intellectual disability |
One problem with such classification system is that intelligence tests often do not differentiate properly between participants on the extreme scale of the measure. Another issue is the Flynn effect. It is unclear whether intelligence declines with old age or whether information processing speed declines.
An intelligence test can provide powerful diagnostic information. However, it might not be useful for a localized disorder or for localized damage. There are three levels in intelligence tests in neuropsychological questions:
Clinical psychodiagnostics is based on theory development of the complaints and problem behaviour (1), operationalization and measurement (2) and the application of relevant diagnostic methods (3).
There are five steps in the diagnostic process:
There are five basic questions that form the basis of most questions that are posed in diagnostic process:
Classification refers to assigning the clinical picture to a class of problems. Diagnostic formulation focuses on the individual and one’s unique individual clinical picture. Explanations can be classified according to different things:
There are three elements of indication:
The earliest forms of testing emerged in China (2200 B.C). There were no tests for validity and reliability, although the tests did incorporate relevant selection criteria.
Physiognomy states that it is possible to judge the inner character of people from their appearance, specifically, the face. This is an early form of psychological testing and gave rise to phrenology, using the bumps on the skull as an indicator of personality.
In the early days of experimental psychology, brass instruments were used to measure sensory thresholds and reaction times while linking this to intelligence. During this time, Wundt measured the speed of thought of individuals.
Galton demonstrated that individual differences exist and are objectively measurable. He also demonstrated that objective tests could be devised and that meaningful scores could be obtained through standardized procedures. Wissler was the first to attempt to validate measurements and demonstrated that the use of reaction time and sensory discrimination for intelligence were severely flawed.
Thomasius was the first to use rating scales and was the first to systematically collect and analyse quantitative data. After his use of rating scales, it was used more often in psychology.
Esquirol was the first to formalize the difference between mental retardation and mental illness in writing. He stated that mental retardation was a lifelong phenomenon, whereas mental illness had a more abrupt onset in adulthood. He also proposed the first classification system in mental retardation mainly focused on language skills. Seguin developed educational programmes for people with mental retardation.
Binet proposed the first intelligence test in 1905 and before that suggested the influence of not using a strict methodology. Binet’s tests were heavily focused on verbal skills. Binet standardized the test and introduced the concept of mental level. This led to the comparison of mental age with chronological age in order to determine intelligence.
TESTING FROM 1900 TO PRESENT
Goddard was an early, influential American psychologist who misused intelligence tests. He applied intelligence tests to immigrants without checking the cultural differences and the differences in translation and did not take the context into account. His intelligence testing was strongly influenced by the social ideologies of his time.
Hollingsworth demonstrated the difference between gifted and highly gifted people and stated that gender differences in eminence and achievement were due to social and cultural impacts.
There was progress in the first world war on group intelligence testing. However, the testing on recruits was not very successful due to the large amount of recruits (1), the difficulty comparing verbal and non-verbal tests (2) and the lack of validation of the test (3). However, it did provide psychologists with a lot of experience in the psychometrics of test construction (1) and practice with statistical techniques (2).
A single aptitude test measures one ability domain and a multiple aptitude test measures several distinct ability areas. The development of aptitude tests lagged behind intelligence tests because
.....read morePsychological assessment can provide a catalog of an individual’s cognitive, emotional and psychological strengths, weaknesses, deficits and resources. It can also provide dynamic insights into the inner workings of an individual with invaluable information for diagnosis, potential intervention and prognosis. The goal of psychological assessment is determining what will be most valuable to the individual being assessed.
Psychological assessment consists of six steps:
Psychological assessment only provides a picture of how a person is currently functioning and this cannot be projected on the future with 100% accuracy. The hypothesis testing model contains several steps:
Clinical assessment refers to the combination of the information gathered from the clinical interview and other sources of report.
The presenting problem (i.e. referral question) refers to determining in what way an individual’s functioning is impaired. The nature of this problem often becomes apparent through the process of the clinical interview (1), the collection of background information (2) and clinical observations (3).
The clinical interview consists of the presenting problem (1), a symptomatic evaluation (2) and a psychosocial evaluation (3).
The presenting problem includes whatever complaint the individual identifies as the reason for the assessment. The presenting problem can be straight-forward but can also be unclear because of numerous factors. A detailed history of the presenting problem (e.g. when it began, precipitating events, etc) needs to be developed. This can include using previous assessments.
Symptomatic evaluation refers to the symptomatic and medical features of what may be impairing the client’s functioning (i.e. the specific symptoms). To obtain a full symptomatic evaluation, the developmental history (1), medical history (2) and substance use history (3) needs to be obtained.
The developmental history includes information about the early developmental environment (1), significant events during childhood (2) and childhood behavioural problems (3). The psychiatric history, the history of psychiatric symptoms and treatments, is extremely important for understanding the course of the individual’s problems. Alcohol/substance use history refers to the history of any potential substance use and this should be discussed, even if the use was not with regards to an addiction. The attitudes about using or quitting any substances need to be obtained. Medical history includes information about serious medical illnesses, hospitalizations and medication use. Temporal changes in medical history and in the present problem and symptomology are important.
It is also relevant to ask about the family medical and psychiatric history because of a potential heritable illness/disorder.
The psychosocial evaluation helps to examine the context of the individual’s world. In this part, it is essential to consider that symptoms are manifested within a larger context of relating to others and that they will likely be affecting personal functioning, educational and work functioning and other areas of life.
The family structure and the relationships with family members needs to be assessed. The educational and vocational history should also be assessed, including the functioning within school and educational aspirations. The criminal and legal history should also be assessed. This includes legal involvement and a history of criminal behaviour. The social history, the history of socialization, should also be discussed. This includes the number of friends and the quality of these friendships. The social networks and social activities during development are also of interest.
The psychosexual history refers to all psychosocial issues related to sexuality, including history of romantic and sexual behaviour and exploration, sexual adjustment and attitudes, gender identification and sexual orientation. The multicultural evaluation refers to understanding the cultural environment in which a person is functioning.
MENTAL STATUS EVALUATION
Clinical observation is one of the most important tools for evaluating a person’s
Mapping out personalities is useful for choosing a career (1), personnel selection (2) and clinical diagnostics (3). There are three psychometric issues with personality tests:
Cronbach’s alpha is the lower-limit for reliability.
Type of decision | Reliability level |
Important decisions at individual level | >.90 (good) |
Less important decisions at individual level | >.80 (good) |
Research at group level | >.70 (good) |
Personality traits are relatively stable. The criterion refers to what one wants to predict. Postdictive validity refers to criterion validity with a criterion that lies in the past. Concurrent validity refers to criterion validity with a criterion that is measured at the same time as the predictor. Predictive validity refers to criterion validity with a criterion that lies in the future.
A good reliability is needed for good validity although good validity is not needed for good reliability. Tests are often assessed based on principles of test construction (1), quality of the test material (2), quality of the manual (3), norms (4), reliability (5), construct validity (6), criterion validity (7).
In projective tasks, the subject is presented with a fairly unstructured task and the idea is that everyone will tackle these tasks in their own way, revealing something about their personality traits and preferences. There are several projective techniques:
For laypeople, personality refers to components of an individual’s makeup that can elicit positive or negative reactions from others.
Personality refers to an individual’s unique constellation of psychological traits that is relatively stable over time. Personality assessment refers to the measurement and evaluation of psychological traits, values, interests, attitudes, worldviews, acculturation, sense of humour, cognitive and behavioural styles and related individual characteristics.
A personality trait refers to any distinguishable relatively enduring way in which one individual varies from another. The context in which behaviour is displayed is important in applying trait terms to behaviour. The trait is dependent on both the behaviour and the context in which the behaviour appears. Some behaviour might be governed more by societal expectations and cultural role restrictions than personality traits.
A personality type refers to a constellation of traits that is similar in pattern to one identified category of personality within a taxonomy of personalities (i.e. descriptions of people). A profile refers to a narrative description, graph, table or other representation of the extent to which a person as demonstrated certain targeted characteristics (i.e. personality traits) as a result of the administration or application of tools of assessment.
Type A personality refers to a personality characterized by competitiveness, haste, restlessness, impatience, feelings of being time-pressured and strong needs for achievement and dominance. Type B personality refers to a personality characterized by the opposite of type A personality.
Personality state refers to the transitory exhibition of some personality trait. A state is temporary.
There are several questions that need to be addressed in any overview of personality assessment and the approach differs per question:
A self-concept measure refers to an instrument designed to yield information relevant to how an individual sees oneself with regard to the selected psychological variables. Self-concept differentiation refers to the degree to which a person has different self-concepts in different roles. A disadvantage of using raters (i.e. informant) is that it is unclear how neutral they are as they show the leniency error (1), generosity error (2), severity error (3), halo effect (4) and error of central tendency (5). The context of evaluation needs to be taken into account when using a rater. The cultural background of the person that is being assessed needs to be taken into account by the rater.
The response style refers
.....read moreObjective methods of personality assessment typically contain short-answer items for which the person being assessed needs to select a response. The answers of questions is indicative for the presence or absence of a personality trait. However, these methods are prone to response biases and the content of the items can be guided by theory.
The sign approach states that test responses are deemed to be signs or clues to underlying personality or ability. The sample approach states that behaviour is to be interpreted in light of a trait of interest. An advantage of the sign approach is that the client might become aware of feelings that one was not previously aware of.
Behavioural assessment refers to what a person does in situations rather than on inferences about what attributes this person has. In traditional approaches to assessment, data is used to diagnose and classify, whereas in behavioural approaches to assessment, data is used to describe targeted behaviours and maintaining conditions usually for the purpose of selecting specific therapeutic conditions.
In traditional assessment, an individual’s behavioural history is afforded great weight (i.e. it is seen as predictive of future behaviour). In behavioural approaches, behavioural history provides a baseline information relevant to an individual’s learning history.
There are several questions that can be asked in behavioural assessment:
Timeline
.....read moreSpearman coined general intelligence and stated that this explained a person’s performance on intellectual tests. However, it was contested that there is one factor explaining performance on intellectual tests and multiple factors were formulated.
There are scholastic skills and skills to be able to solve new problems. Crystallized intelligence refers to the knowledge of facts and fluid intelligence refers to the ability to solve new problems and reason. Crystallized intelligence is relatively stable whilst fluid intelligence is not and is disrupted by several factors (e.g. brain damage, age).
The general intelligence test is a method of assessing someone’s intelligence and consists of several sub-tests which assess specific intellectual skills. IQ reflects a person’s overall performance on all subtests in comparison with a group of peers.
The Wechsler Adult Intelligence Scale-IV (WAIS-IV-NL) is an intelligence test that consists of 15 subtests that cover working memory (1), arithmetic (2), vocabulary (3), information processing speed (4), power of abstraction (5) and visual spatial problem solving (6). It is possible to do a shorter version of this, although this is less generalizable than the original, 70-minute version.
The Groninger Intelligence Test-2 (GIT-2) is an individual intelligence test which is applicable to a wide age range whilst representing as many intelligence factors as possible.
The Kaufman Adolescent and Adult Intelligence Test (KAIT) is an individual intelligence test for determining intelligence for people between the age of 14 and 85. It can be administered in two ways. The core battery (i.e. 3 subtests for crystallized intelligence and 3 subtests for fluid intelligence) can be administered. A longer version can also be administered. The total IQ should not be interpreted when the IQ for the crystallized intelligence and the fluid intelligence differ a lot.
Raven’s progressive matrices is a non-verbal test that measures visual problem-solving and can be used as a measure of fluid intelligence. It is an analogue reasoning task. The forms of this test are the Standard Progressive Matrices (1), the Coloured Progressive Matrices (2) and the Advanced Standard Progressive Matrices (3). The advantages of using these tests are that it does not require a verbal response (1) and that it is mostly culture-free (2).
The Nederlandse Leestest voor Volwassenen (NLV) was developed for obtaining a reliable estimate of the level of premorbid intellectual functioning in patients with cerebral dysfunctions within a short time frame. There is a high correlation between the results on this test and verbal IQ.
A lot of consequences (e.g. special education or not) depend on the results on IQ scores and these consequences treat IQ scores as absolute numbers.
IQ value | Verbal description |
On the test day, the test administrator needs to make sure the logistics are in order (1), needs to be sensitive to the client’s feelings and perceptions (2), needs to communicate clearly (3).
After scheduling the test, it is imperative to select the norm-groups with which to compare the client’s raw scores. Norm data provides important support for making good-quality decisions (e.g. generating the cut-off scores for personnel selection). It is impossible to have one individual do a test several times so the individual one-off scores is collected from the population in order to make comparisons.
The accuracy of conclusions drawn depends on the reliability of the test. In order to compare scores of two different constructs, it is necessary to standardize them.
Personal interest is closely related to occupational fulfilment and success. These interests are solidified by the age of 15 and will remain relatively stable throughout life. It promotes better performance (1), greater productivity (2) and greater job satisfaction (3).
An interest measure refers to an instrument designed to evaluate testtakers’ likes, dislikes, leisure activities, curiosities and involvements in various pursuits for the purpose of comparison with groups of members of various occupations and professions.
The Strong Interest Inventory was created by selecting hundreds of items that could distinguish interests of a person by that person’s occupation (1), administering this to people representative of occupations (2), keep the items with discriminative ability (3) and construct a final version where one’s interests are mapped out against different occupations (4).
Holland’s theory of vocational personality types states that there are six personality types (i.e. realistic, investigative, artistic, social, enterprising and conventional) and vocational choice reflects one of the personality types. Race norming refers to the process of adjusting scores to show an individual testtaker’s standing within one’s racial group.
Aptitude in high school predicts job performance. However, job satisfaction was not predicted by aptitude in high school and job satisfaction and job performance are not predicted by interest tests. There are several tests measuring specific aptitude which can be useful in predicting job performance in a specific occupation.
According to Hunter, there are five families of jobs; setting up (1), feeding and off-bearing (2), synthesising and coordinating (3), analysing, compiling and computing (4) and copying and comparing (5). Recommendations for individual test takers (e.g. general aptitude test battery) could be generalized to various jobs.
Personality has been measured as a predictor for occupation and to determine which occupation would fit a person. An integrity test refers to a narrowly designed personality test specifically designed to predict an employee’s integrity (e.g. theft). These tests are characterized as criterion-focused occupational personality scales. Overt integrity tests ask straight-forward questions regarding integrity and personality-based measures which employs personality-based items to predict integrity.
No relationship between personality and work performance has been found, partially because there is no consensus on the definition of work performance. In addition to that, it is unclear which aspect of personality should be measured. There are personality traits that appear to be helpful for some types of jobs (e.g. high conscientiousness, high extraversion, low neuroticism).
The emotional disposition of children is related to job satisfaction. There are also other measures that have been used to predict job satisfaction and work performance (e.g. cultural adaptation).
Task change refers to a shift in tasks but the job remains the same. Position change refers to a change in job with the same employer. Occupation change refers to a shift in duties and work settings. Career transition is an exit strategy, such as retirement.
Screening refers to a relatively superficial process of evaluation based on certain
.....read moreCoping refers to the thoughts and behaviours used to manage internal and external demands of situations that are appraised as stressful.
Coping is a process that unfolds in the context of a situation or condition that is appraised as personally significant and as taxing or exceeding the individual’s resources for coping. The coping process is initiated in response to the individual’s appraisal that important goals have been harmed, lost or threatened and these appraisals are often characterized by intense negative emotions. Emotions are essential in the coping process.
Coping is sensitive to the environment (1), its demands (2), resources (3) and personality dispositions that influence the appraisal of stress (4). Coping is strongly associated with the regulation of emotion and escapist coping techniques are associated with poor mental health outcomes.
Measurement (1), nomenclature (2) and determination of effectiveness (3) are criticized in the research on coping.
The first measurements of coping included retrospective reports. This allowed for multi-dimensional descriptions of situation-specific coping thoughts and behaviours. However, there are several limitations to the use of these inventories:
These problems were overcome using momentary assessment. However, this might lead to people focussing on concrete events and not mentioning more complex, abstract events (1), people not mentioning all the coping efforts (2) and people focusing on specific thoughts and actions rather than a broader conceptualization of coping (3).
Narrative approaches ask a person to recall a stressful event, what happened and the emotions associated with it. This could provide information in understanding what a person is coping with (1) and provide information on ways of coping not included in checklists (2).
One challenge to coping research is finding common terminology which allows for the diverse coping strategies to be compared and discussed in a meaningful manner across studies. The coping responses have been clustered according to a theory (1), according to factor analysis (2) or through a mixture of both (3).
Problem-focused coping refers to addressing the problem causing distress. Emotion-focused coping refers to ameliorating the negative emotions associated with the problem. This is one terminology that has been used. Meaning-focused coping refers to the use of cognitive strategies to manage the meaning of the situation. Social coping also exists. Problems of these categories are that it might mask differences within categories (1), the internal consistency might not be good (2) and the factors within the multifactorial scale are not independent of each other (3).
It is
.....read moreValues refers to a broad tendency to prefer certain state of affairs over others. Values reflect an employee’s needs and personality. Values are enduring and general in nature, rather than specific. Traits are core qualities or basic tendencies of an individual that are largely inherited. Values are an individual difference variable and can be seen as trans-situational goals. Goals are similar in meaning to values except that they are more specific. Goals are the mechanism by which values lead to action.
Outcomes with the potential to activate a person’s central values instigate the acquisition of information and motivate choice decisions in accordance with pursuing the values in question. Activation and information collection mediate the relationship between values and the choices one makes.
Context affects the extent to which an employee’s needs are met and values are fulfilled. It can have a direct effect or interact with personality variables to affect a person’s behaviour in the workplace.
The attributes of values for individualism versus collectivism are fourfold:
People from collectivistic cultures tend to be prevention-oriented and people from individualistic cultures tend to be promotion-oriented. The norms for appropriate behaviour are more cooperative for collectivists and more competitive for individualists.
Societal culture affects job satisfaction and can moderate perceptions of organizational justice. The model of cultural self-representation states that people strive to fulfil values for self-enhancement, efficacy and self-consistency. In order to design and implement motivation and reward systems the cultural characteristics of a country (i.e. individualism vs. collectivism and high vs. low power distance) need to be identified (1), the values oneself has need to be understood (2) and the meaning of various managerial practices (e.g. top-down communication) needs to be understood (3). Pxrojecting values on people from other cultures that differ on these dimensions can create dysfunctional consequences in terms of employee motivation (1), interpersonal communication (2) and overall performance (3).
In collectivistic (vs. individualistic) cultures:
National culture influences people’s self-concept (1), norms about work ethic (2) and environmental factors
.....read moreBurnout refers to the exhaustion of employees’ capacity to maintain an intense involvement that has a meaningful impact at work. Later, burnout was defined as a state of exhaustion in which one is cynical about the value of one’s occupation and doubtful of one’s capacity to perform.
Burnout discussions began within human services because they were better able to give voice to issues of emotions, values and relationships with people. The roots of burnout are embedded within broad social, economic and cultural developments:
It is possible that ideological communities prevent burnout from happening because it provides a collective identity that prevents burnout from occurring because of social commitment (1), a sense of communion (2), contact with the collective whole (3) and shared strong values (4).
The lack of reciprocity refers to the discrepancy between professionals’ efforts and the rewards they received in terms of recognition and gratitude. This fosters burnout. Naïve idealism magnifies one’s vulnerability to a burnout but it is not an essential prerequisite.
A persistent imbalance of demands over resources leads to increased burnout as an increase of demands leads to insufficient opportunities to regenerate depleted energy. There are also value conflicts between the employee and organization and this misfit can lead to increased burnout.
Globalization, privatization and liberalization cause rapid changes in modern working life. Burnout occurs globally. The meaning of the term burnout differs per country, however. The medicalization of burnout is intertwined with debates of whether burnout is not mere exhaustion. Most burnout research uses a definition that includes exhaustion (1), inefficacy (2) and cynicism (3) (i.e. multidimensional view). The one-dimensional view of burnout is that it is exhaustion (e.g. psychological exhaustion, emotional exhaustion).
The definition of burnout is sometimes treated as being context-independent, although this is not possible for the multi-dimensional approach of burnout research. The definition of burnout is also dependent on medical practice as medical practitioners favour dichotomous diagnoses. The dichotomy of
.....read moreAn adequate violence risk assessment provides insight into risk and protective factors (1) and concrete guidelines for risk management and treatment (2). This can aid in preventing violent recidivism. The structured professional approach uses systematic collection (1), reviewing (2), combining (3), weighing (4) and integrating (5) information on risk factors.
The historical, clinical, risk management-20 version 2 (HCR-2o) is used for assessment of risk for future violence. The case conferences are used to develop risk management plans and to assist in decision-making regarding leave or entry into a new treatment phase. The risk management items and the final risk judgements are always coded for the context that applies for the coming year (1) and the ‘what-if’ context if mandatory treatment would be ended right away by court (2). This makes it easier for treatment staff to explain whether treatment is still necessary.
Treatment aimed at reducing violent recidivism should focus on reducing risk factors and reinforcing protective factors. There is a need for a more gender-sensitive risk assessment. The female additional manual (FAM) is an additional tool to the HCR-20 for assessing risk of violence in female offenders.
The HCR-2o has good interrater reliability and strong predictive validity for violent recidivism and incidents of violence during treatment for male violent and sexual offenders. It is sensitive to change and shows improvements on dynamic risk and protective factors.
There are seven steps of the HCR-20 V3:
There are several principles of risk management strategies:
Sexual recidivism is associated with deviant sexual interests (1) and antisocial orientation / lifestyle instability (2). Deviant sexual interests refer to enduring attractions to sexual acts that are illegal or highly unusual. Antisocial orientation refers to antisocial personality, antisocial traits and a history of rule violation.
Antisocial orientation facilitates sexual offending because individuals will not commit sexual crimes unless they are willing to hurt others (1), can convince themselves that they are not harming the victims (2) or feel unable to stop themselves (3).
Risk factors of the development of sexual offending are adverse family environments (1), lacking nurturance and guidance (2) and beliefs that permit non-consensual sex (3). Persistent sexual offenders may be characterized by a negative family background (1), problems forming affectionate bonds with friends and lovers (2) and attitudes tolerant of sexual assault (3).
The observed sexual recidivism rate is 13.7%. The violent non-sexual recidivism rate is 14.3%. General recidivism rate is 36.2%. Anti-social orientation is the major predictor of violent non-sexual recidivism and any recidivism. General problems with self-regulation (1), a history of non-violent crime (2), a history of non-sexual crime (3) and psychopathy (4) are predictors of recidivism.
For adolescent sex-offenders, recidivism was predicted by sexual deviancy (1) and anti-social orientation (2).
Most sexual offenders were more likely to recidivate with non-sexual offenses. Sexual deviancy and anti-social orientation are the major predictors of sexual recidivism. The factors that initiate sexual offending may not be the same as the factors associated with persistence. Sexual offenders are more likely to respond to stress through sexual acts and fantasies, thereby creating discrete time periods where they are at increased risk of sexual recidivism.
According to Mofitt, life-course persistent offenders have behaviour problems in childhood (1), engage in interpersonal violence (2) and have many sexual partners (3). Sexual offenders who attend treatment are less likely to recidivate than any comparison group.
For general offenders, treatment is effective only when it targets criminogenic needs (i.e. characteristics associated with offending).
Immigrant adolescents seem to be less likely to use mental health care. It is possible that problem identification is an explanation for differences in mental health service use between immigrant and non-immigrant populations.
It is possible that immigrant parents are less able to recognize mental health problems in their children than non-immigrant parents.
Dutch parents reported higher levels of mental health service use for their children’s internalizing problems than immigrant parents.
Differences in mental health service use between the three immigrant populations and native Dutch were mediated by ethnic differences in emotional problem identification. Immigrant adolescents identified fewer emotional problems.
Emotional problem identification is an important factor contributing to the mental health help-seeking process of adolescents. Differences in reported mental health use is mediated by emotional problem identification. Immigrant parents and adolescents identified fewer emotional problems than native Dutch parents and adolescents.
This may be due to ethnic differences in what is considered to be normal or abnormal. It may be possible that parents recognize the problem but do not label them as psychological.
The Dutch association of psychologists has made ethical guidelines based on responsibility (1), integrity (2), respect (3) and expertise (4). There are several important points of the guidelines for use of tests (AST):
External initiators refer to initiators that do not have direct contact with the client in a personal manner (e.g. insurance companies, court). Non-external initiators refer to initiators who have direct contact with the client in a personal manner (e.g. client himself). Expertise refers to the psychologist’s theoretical and practical knowledge and skills.
If there is little psychological information about a client, the following steps will follow:
The reporting of diagnostics involves written and oral reports. The purpose of the reports is to communicate the findings and results of the psychological examination as well as suggestions and recommendations on which these are based.
A written report is mandatory in all cases except for communication with the client.
.....read moreDuring the diagnostic phase, the psychologist employs interview (1), observation (2) and standardized measuring instruments (3). The intake interview refers to the initial contact between the psychologist and the client. The main objectives of the intake interview are the collection of information (1) and establishing a good working relationship (2).
There are several requirements for a diagnostic interview:
Developing a good rapport with a client requires the interviewer to conform to the client’s frame of reference. The purpose of the intake interview is to establish the client’s request for help (1), assess whether the organization is capable of adequately meeting this request for help (2), assess what type of treatment is deemed appropriate (3) and provide the details of the organization to which the client should preferably turn (4).
In somatic health care, exclusion criteria are used whereas mental health care employs inclusion criteria (i.e. collecting more information to get a complete picture of the client). A consequence of this is that the intake can be unnecessarily long (1) and time-consuming (2).
Age influences (for adults) the topics that are discussed according to the stage in which the client is in; early adulthood (1), middle adulthood (2), late adulthood (3) and old age (4). There are topics that are more relevant, depending on the stage. For older people (i.e. late adulthood and old age), a cognitive disorder is more likely, which may require the psychologist to interview a partner of the client to collect information too.
Collecting information prior to the interview (i.e. questionnaires) can make the intake interview more effective. Questionnaires can also be beneficial for the client, as they often find it more easy to disclose using a self-report questionnaire than in a direct conversation. A structured interview can be useful to collect as many relevant information as possible. A psychologist should examine the objective information of the client prior to the interview but the subjective information after forming an impression of the client.
Rating scales require the assessor to provide a standardized judgement on a number of predefined topics. The process is not determined in advance. The product of using rating scales is structured
.....read moreBasic knowledge of neuropsychological is required for the diagnostician because proper referral is necessary. Clinical neuropsychology refers to the scientific area that involves the study of the relationship between the brain and behaviour in patient-oriented research. In clinical neuropsychology, the focus on organic holism tends to change with lateralization and localization and vice versa.
The idea currently is that brain dysfunctions may have consequences that stem from both selective, localization-related disorders as well as more general consequences.
There are several misconceptions about neuropsychology:
There are three type of neuropsychological questions:
Test-retest reliability is important in neuropsychological tests because sometimes tests need to be made in a short span of each other to indicate improvement after treatment or surgery. There are four groups of neuropsychological tests:
A successful assessment answers the referral question. This kind of assessment typically involves a case conceptualization (i.e. clear description of problems). The goal of assessment is not necessarily diagnosis or reducing descriptions of a child’s functioning to a test score.
The model of evidence-based assessment is guided by three principles:
The use of the evidence-based approach to assessment involves the need to include an assessment of a child’s psychological context. In the meta-systems approach, an understanding of the various systems involved with the child or available to children and families are considered in a case conceptualization and ultimate intervention plans.
The child’s context is important for understanding the child’s adjustment (1) and for understanding the child’s assessment information (2). Testing should be construct-centred, rather than diagnostic centred or test-centred, in evidence-based assessment. Construct-focused testing means that there is a focus on the primary and secondary difficulties and their apparent underpinnings.
Regular assessment of change increases treatment fidelity and improves treatment outcomes. In child mental health settings, regular assessment should be the norm. The criteria by which treatment progress is evaluated should be measurable (1), only measures that are sensitive to change should be used for treatment monitoring (2), the criteria for evaluating treatment outcome should be meaningful (i.e. defined in child’s relative functioning) (3) and the criteria for evaluating treatment outcomes must be feasible (4).
Meaningful outcomes can be established using baseline data on the referral issues.
There are several ethical guidelines for psychological assessment with children:
Psychological assessment of children necessitate the use of multiple methods of gathering information on the constructs of interest. There is empirical evidence for the initial selection of instruments but not for the integration of the data from multiple instruments. The developmental context of the child should be taken into account when selecting methods. An instrument needs to be able to distinguish between typical and atypical development. Basic psychometric properties also need to be taken into account. The reliability of instruments should hold for the population of interest.
Clinical utility refers to the extent to which a measure will make a meaningful difference
.....read moreA treatment plan should be based on the best science available. This means that the therapist must be well-informed regarding recent scientific findings. The clinical hermeneutics error refers to the therapist losing track of the actual degree of pathology due to adopting the patient’s perspective. This means that high-level depth of processing or interpreting and explaining the behaviour leads to a loss of normative judgement.
The Neo-Kraepelinian diagnostic rubrics consist of ascertainment of facts to determine the presence or absence of relatively explicit diagnostic criteria (1), the making of differential and multi-axis diagnoses using the DSM (2) and the differential selection of treatment guided by differential diagnosis (3).
Diagnosis in the current practice misses the point that symptoms of presenting complaints and targets of treatment plan may be manifestations of personality traits. The features the diagnostician focuses on may be consequences of extreme levels of personality traits (1), problematic configurations of trait levels (2) or extreme adaptations to personality traits (3). A high degree of comorbidity may be the result of manifestations of the same few maladaptive personality traits (e.g. negative emotionality) which are interpreted as symptoms.
Personality traits influence how individuals interpret and construe life events. Science does not fully support the claim that major mental disorders are separate from personality. Constructive realism makes several statements:
Trait levels refer to an individual’s specific dispositions. There are major replicable trait dimensions and they are organized hierarchically. There are three trait dimensions:
Environmental effects consist of shared environmental factors and unshared environmental factors. Treatment planners should know about four things:
Neuroticism influences the intensity of a client’s distress. Extraversion influences the client’s enthusiasm for treatment. Openness to experience influences the client’s reactions to the therapist’s interventions. Agreeableness influences the client’s reaction to the person of the therapist. Conscientiousness influences the client’s willingness to do the work of psychotherapy.
Trait theory is helpful to the clinician by helping the therapist anticipate and understand the client’s private experience (1), it helps the therapist anticipate and understand the problems presented in treatment (2) and it helps the therapist formulate a practical treatment plan and anticipate the opportunities and pitfalls for treatment (3).
Trait | Treatment implications | Outcome implications |
Neuroticism | Treatment for a client with a low score on this trait needs to focus on relatively isolated, self-defeating behaviour pattern or a strong emotional reaction to a recent stressor. Treatment for a client with a high score on this trait needs to focus on generic difficulties and clear and realistic treatment goals are imperative. | It is likely that clients with high scores on this trait will keep some form of trouble due to the high neuroticism. It is unlikely that the score of this trait will decrease significantly. |
Extraversion | Treatment is generally based around conversation and people with a low score on this trait generally do not prefer this. Furthermore, people with a low score on this trait appear to dread the therapy and share less information, whereas the opposite appears true for people with high scores on this trait. | It is likely that extraversion is related to well-being. Extraversion is positively correlated with outcome. However, extraversion does not need to be increased but people with a certain score on this trait need to develop appropriate skills to deal with the situations they are dealing using their level of extraversion. |
Openness | People low on this trait are not eager to experience themselves in new and unusual ways. They expect therapy to be a reassuring, practical experience. The therapies that are tolerated depend on the |
Observation in clinical psychology refers to perception with the intention to draw conclusions. It can be used to gather information about others with whom a person communicates directly or indirectly (1), relationships and situations in which a person is either involved or not involved (2) and the person himself (3).
There is a distinction between every day observation and professional observation. Professional observation refers to goal-oriented observation on the basis of an observation question which leads to an informed decision to act. The method is first perception and then interpretation.
A rating scale refers to a written behavioural examination that draws on psychological knowledge (e.g. intake interview). An observation scale refers to a written behavioural examination that draws on observation. Subscales refer to components of the observation scale.
Behavioural aspects can be accurately observed in a test situation. Observation during an interview can be useful for generating hypotheses about a client’s problems. The leniency effect (1), the halo effect (2), the logic error (3), the contrast error (4), the primacy effect (5), the recency effect (6) and the tendency to mostly give average scores and to avoid making extreme judgments (7).
The logic error refers to the tendency to pass similar judgements on traits that seem to be logically linked instead of an isolated impression. The psychologist’s theoretical background may also influence the fundamental attribution error.
Heuristics refer to information processing strategies that people use to reduce complex assessment tasks to simpler operations. There are two heuristics that influence observation in a clinical context:
Standardized observation is generally selective (i.e. not everything is observed). The level at which the observation is observed needs to be determined. The molar level refers to larger, meaningful units. The molecular level refers to smaller behaviour units. The validity is high but the reliability is low at the molar level. The reliability is high but the validity is lower at the molecular level.
There are several potential settings for observation:
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