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Human Behavioral Development & Problems: Psychological Assessment Gary L. Davis, Ph.D. Dept. of Behavioral Sciences.

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Presentation on theme: "Human Behavioral Development & Problems: Psychological Assessment Gary L. Davis, Ph.D. Dept. of Behavioral Sciences."— Presentation transcript:

1 Human Behavioral Development & Problems: Psychological Assessment Gary L. Davis, Ph.D. Dept. of Behavioral Sciences

2 Learning Objectives Students will have a general understanding of the structure and organization of the psychological interview and assessment process. Students will be familiar with some specific psychological tests that physicians can use in their practice to help answer psychological diagnostic questions. Students will have a rudimentary understanding of the MMPI-2, the role tests play in the assessment process, and when to consider making a referral for psychological assessment.

3 Psychological Assessment Examples of roles of psychological assessment in medicine –Neurology-cognitive, motor, perceptual deficits; surgical readiness –Organ transplant-adjustment; coping resources; status –Cardiology-panic and anxiety disorders; rehabilitation adjustment –PM+R-somatoform disorder; chronic pain evaluation; adjustment and coping resources

4 Psychological Assessment Examples of roles of psychological assessment in medicine –Oncology-depression and anxiety; adjustment and coping resources –Pediatrics-cognitive and developmental status; family relationships –Family Practice-CD, depression, suicide, somatosizing, anxiety

5 Interview Current problems B – behavior A – affect S – sensations I – imagery C – cognitions I – interpersonal D – drugs/health

6 Typical Symptoms in Depressive Disorders Behavioral –Withdrawal –Insomnia –Agitation or retardation –Overeat, undereat –Inefficient –“Going through the motions” –Suicide attempts Affect –Sad –Guilty –Regretful –Hopeless –Helpless –Bored –Lonely –Apathy

7 Typical Symptoms in Depressive Disorders Sensations –Fatigue –Pain –Don’t like being touched –Absence of sensations (deadness) –No energy –Anhedonic Images –Failing –Helpless –Alone –Unlovable –Unattractive –Empty future

8 Typical Symptoms in Depressive Disorders Cognitive –Concentration difficulties –“Empty head” –Suicide thoughts –Negative focus on self, experiences and future –Dysfunctional thinking I am worthless I can’t do anything right No one loves me Other people are happier than I am It’s all my fault Interpersonal –Few relationships Excessive sense of responsibility in relationships –Dependency, vulnerability –Sabotage Drugs, Health –Alcohol –Absence of Exercise –Vague physical complaints –Poor eating habits

9 Interview Current symptoms/status Developmental history Family history School/work experiences Mental health history Legal problems

10 Review of records Medical Mental health Legal School/work

11 Psychological tests Reasons for use Unanswered questions Only way to get the information Multi-method validity Objective measurement Normative comparison Monitor treatment effectiveness ? malingering

12 Psychological Tests Types of tests Intellectual (WAIS-III, WISC-III) Neuropsychological –Visual-motor –Memory –Manual dexterity –Perceptual organization –etc.

13 Psychological Tests –Types of tests (cont’d) Forensic Tests –Rogers Criminal Responsibility Scales, –Comprehension of Miranda Rights Test of Memory Malingering, –MacArthur Competence Assessment Tool-Criminal Adjudication

14 Psychological Tests –Types of tests (cont’d) Personality/psychopathology –Projective »Disguise of purpose »Freedom of response »Ambiguous stimuli »Ex: Rorschach, Thematic Apperception Test

15 Psychological Tests –Types of tests (cont’d) Personality/psychopathology –Self-report/objective e.g. MMPI-2 (Global), Beck Depression Inv., Alcohol Use Disorders Identification Test, PHQ-9, GAD-7

16 MMPI-2 Overview History –First published in booklet form as the MMPI in 1943 –Contained 566 items originally intended to efficiently and objectively identify discrete psychiatric diagnostic groups –Developed at the University of Minnesota Hospital by Hathaway (psychologist) and McKinley (psychiatrist)

17 MMPI-2 Overview Test characteristics –Empirically keyed criterion validated scales supplemented by content scales –Validity scales –567 items in True/False format –Cost effective –Over 12,000 published works on the MMPI/MMPI-2; over 80% of the published research on self-report personality tests is on the MMPI –The best validated personality test in the world; translated into more than 70 languages

18 Sample MMPI-2 Items Item #ScaleItem 29L-LieAt times I feel like swearing (F) 24F-InfrequencyEvil Spirits possess me at times (T) 247Hs-HypochondriasisI have numbness in one or more places on my skin (T) 260D-DepressionOnce in a while, I laugh at a dirty joke (F) 219Pd-Psychopathic DeviateI have been disappointed in love (T) 220Pa-ParanoiaI tend to be on my guard with people who are somewhat more friendly than I had expected (F) 140Pt-PsychastheniaMost nights I go to sleep without thoughts or ideas bothering me (F) 316SchizophreniaI have strange and peculiar thoughts (T) 87Ma-HypomaniaI have met problems so full of possibilities that I have been unable to make up my mind about them (T)

19 Sample MMPI-2 Items Item #ScaleItem 106Si-Social IntroversionMy speech is the same as always (not faster or slower, no slurring or hoarseness) (F) 43APS-Addiction Potential ScaleMy judgment is better than it ever was (F) 489AAS-Addiction Admission ScaleI have a drug or alcohol problem (T) 82MAC-R MacAndrew Alcoholism Scale-RevisedI do many things which I regret afterwards (I regret more things than others seem to) (T)

20 MMPI-2 Overview MMPI-2 interpretation –Test-taking attitudes (e.g. cooperative candid, exaggerated, defense, faking) –Self concept--Self-esteem--Body image –Symptomatic complaints and behavioral problems –Self-control or acting-out –Quality of interpersonal relationships –Addiction problems –Suicide risk –Strengths, resources, coping capacity –Diagnostic possibilities –Accessibility to treatment


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