Psychological Assessment
Lecture 1 .................................................................................................................................................. 3
The diagnostic cycle ............................................................................................................................ 3
Intake ................................................................................................................................................... 4
Possible obstacles................................................................................................................................ 6
Lecture 2 .................................................................................................................................................. 6
Clinical interview ................................................................................................................................. 6
Phases of the intake interview ............................................................................................................ 7
Interpreting interview data ................................................................................................................. 7
From complaint to problem analysis ................................................................................................... 9
Diagnostic scenario/ case conceptualization ...................................................................................... 9
Problem analysis.................................................................................................................................. 9
Lecture 3 ................................................................................................................................................ 11
Formulation of a diagnostic hypothesis ............................................................................................ 11
Behavioral observation...................................................................................................................... 12
Observation in the Diagnostic Cycle .................................................................................................. 12
Systematic observation ..................................................................................................................... 13
Procedures......................................................................................................................................... 13
Threats to reliability .......................................................................................................................... 14
Lecture 4 ................................................................................................................................................ 14
Explanation analysis .......................................................................................................................... 14
Interpretation of test results ............................................................................................................. 15
Intelligence testing ............................................................................................................................ 15
Lecture 5 (7) .......................................................................................................................................... 17
Explanation analysis .......................................................................................................................... 17
Lecture 6 (8) .......................................................................................................................................... 18
Chapter 1: The diagnostic process ........................................................................................................ 23
Steps in the diagnostic process ......................................................................................................... 23
Five basic questions in clinical psychodiagnostics............................................................................. 24
The diagnostic cycle .......................................................................................................................... 25
The diagnostic process: from application to report .......................................................................... 25
Chapter 2: Diagnostic quality ................................................................................................................ 27
Quality requirements for frames of reference, models and tests .................................................... 27
The quality of the diagnostic process ................................................................................................ 29
Diagnostic quality: accountability to the public, the scientific community and the client ............... 31
Chapter 3: The interview ....................................................................................................................... 31
, The role and purpose of the interview in the diagnostic cycle ......................................................... 31
Requirements for the interview ........................................................................................................ 32
The content of the interview ............................................................................................................. 32
Rating scales and structured interviews ........................................................................................... 33
The actual implementation of the interview .................................................................................... 34
Potential obstacles during the interview .......................................................................................... 35
Other interviews during the intake phase......................................................................................... 35
Reporting ........................................................................................................................................... 36
Chapter 4: Behavioral observation ........................................................................................................ 36
Unstandardized observation ............................................................................................................. 36
Standardized observation ................................................................................................................. 37
Standardized observation of specific phenomena ............................................................................ 38
Conclusion ......................................................................................................................................... 39
Chapter 5: Indirect methods ................................................................................................................. 40
Characteristics of indirect methods .................................................................................................. 40
Types of indirect methods ................................................................................................................. 40
Interpreting and interpretation processes ........................................................................................ 42
Evaluating and using indirect methods ............................................................................................. 42
Chapter 6: Intelligence and intelligence tests ....................................................................................... 42
Introduction....................................................................................................................................... 42
Intelligence tests ............................................................................................................................... 43
Intelligence tests in actual practice ................................................................................................... 46
Chapter 8: Personality questionnaires .................................................................................................. 48
Characteristics and principles of personality questionnaires ........................................................... 48
Several personality questionnaires ................................................................................................... 48
The use of personality questionnaires in health care ....................................................................... 50
Chapter 9: Questionnaires for measuring problem areas..................................................................... 51
General psychopathology questionnaires ......................................................................................... 51
Specific questionnaires...................................................................................................................... 52
The use of general psychopathology questionnaires in health care................................................. 54
The use of specific questionnaires in health care ............................................................................. 54
Chapter 10: Computer-assisted clinical diagnostics .............................................................................. 54
Advantages and disadvantages of computer-assisted diagnostics ................................................... 55
Equivalence of computer-based tests and paper-and-pencil tests................................................... 56
Adaptive testing ................................................................................................................................ 56
Online tests........................................................................................................................................ 56
,Chapter 11: Ethical aspects and the reporting of diagnostics ............................................................... 56
Ethical guidelines for diagnostics ...................................................................................................... 56
Reporting of diagnostics .................................................................................................................... 57
Chapter 12: Dynamic personality diagnostics ....................................................................................... 59
Descriptive diagnostics vs. structural diagnostics ............................................................................. 59
The importance of trait models for personality diagnostics ............................................................. 59
The rationale behind the Dynamic Theory-driven Profile Interpretation (DTP) of the Dutch Short
Form of the MMPI (NVM) ................................................................................................................. 59
The method of the Dynamic Theory-driven Profile Interpretation of the NVM ............................... 60
Studies into the value of the DTP of the NVM .................................................................................. 61
Limitations ......................................................................................................................................... 61
Lecture 1
The diagnostic cycle
• The goal of psychological assessment depends on the referral question and help request
o Know the referrer
▪ Referrer vs. client’s requests
o Answer specific questions and make clear, specific, and reasonable recommendation
▪ To help improve functioning
o Evaluate the individual in a problem situation so that the information derived from
the assessment can help with the problem
o Test scores are means to generate and evaluate hypotheses
o Focus: problem-solving and decision-making
Where is our expertise?
• Experts in human behaviour
, o Problem areas, possible causes and explanations
• Sensitive to diverse contextual and cultural backgrounds
• Ethical issues
• Communication competency (and rapport)
• Knowledge about testing
• Integrating test scores
o Incremental and conceptual validity
• Cost-effectiveness and clinical relevance
• Knowledge about evidence-based treatments
Expertise and risks
• Attitude, contact, tuning, unbiased and active listening of the professional in the service of a
good relationship between professional and client
• Professionals and clients each have their own perspective on what constitutes good care
• Risk: thinking to be a guru or a prophet and to have really understood the other
o Losing the passion for what really is the gist of the job
▪ i.e., understanding one’s own complexity and the complexity of the other
Where are we?
• Continually changing perceptions
o Clinical judgement
• Type of questions asked, initial impression, liking/ disliking, overinterpretation, type of
rapport, theoretical perspectives, choice of tests, etc.
o Each of us influences the assessment in their own way
• Actuarial approach needs to be integrated by clinical knowledge and experience
o We want to provide personalized care
▪ Therefore, we need subjective components
Solutions
• Awareness of our own biases, issues, perspective, etc.
• Comprehensive, structured approach
• Consider evidence for and against diagnostic hypotheses
• Refer to diagnostic manuals
• Rely on notes, not memory
• Seek feedback
• Theoretical and empirical expertise
• Including expertise on clinical judgement
• Don’t lose your humanity
Intake
Purpose of the intake
• Assessment
• Relational objective
o Be a nice human being in the room with the client
o Treat your client the way that you would like to be treated if you were a client
o Accept that clients are supposed to be difficult
o Help clients feel safe with you
Lecture 1 .................................................................................................................................................. 3
The diagnostic cycle ............................................................................................................................ 3
Intake ................................................................................................................................................... 4
Possible obstacles................................................................................................................................ 6
Lecture 2 .................................................................................................................................................. 6
Clinical interview ................................................................................................................................. 6
Phases of the intake interview ............................................................................................................ 7
Interpreting interview data ................................................................................................................. 7
From complaint to problem analysis ................................................................................................... 9
Diagnostic scenario/ case conceptualization ...................................................................................... 9
Problem analysis.................................................................................................................................. 9
Lecture 3 ................................................................................................................................................ 11
Formulation of a diagnostic hypothesis ............................................................................................ 11
Behavioral observation...................................................................................................................... 12
Observation in the Diagnostic Cycle .................................................................................................. 12
Systematic observation ..................................................................................................................... 13
Procedures......................................................................................................................................... 13
Threats to reliability .......................................................................................................................... 14
Lecture 4 ................................................................................................................................................ 14
Explanation analysis .......................................................................................................................... 14
Interpretation of test results ............................................................................................................. 15
Intelligence testing ............................................................................................................................ 15
Lecture 5 (7) .......................................................................................................................................... 17
Explanation analysis .......................................................................................................................... 17
Lecture 6 (8) .......................................................................................................................................... 18
Chapter 1: The diagnostic process ........................................................................................................ 23
Steps in the diagnostic process ......................................................................................................... 23
Five basic questions in clinical psychodiagnostics............................................................................. 24
The diagnostic cycle .......................................................................................................................... 25
The diagnostic process: from application to report .......................................................................... 25
Chapter 2: Diagnostic quality ................................................................................................................ 27
Quality requirements for frames of reference, models and tests .................................................... 27
The quality of the diagnostic process ................................................................................................ 29
Diagnostic quality: accountability to the public, the scientific community and the client ............... 31
Chapter 3: The interview ....................................................................................................................... 31
, The role and purpose of the interview in the diagnostic cycle ......................................................... 31
Requirements for the interview ........................................................................................................ 32
The content of the interview ............................................................................................................. 32
Rating scales and structured interviews ........................................................................................... 33
The actual implementation of the interview .................................................................................... 34
Potential obstacles during the interview .......................................................................................... 35
Other interviews during the intake phase......................................................................................... 35
Reporting ........................................................................................................................................... 36
Chapter 4: Behavioral observation ........................................................................................................ 36
Unstandardized observation ............................................................................................................. 36
Standardized observation ................................................................................................................. 37
Standardized observation of specific phenomena ............................................................................ 38
Conclusion ......................................................................................................................................... 39
Chapter 5: Indirect methods ................................................................................................................. 40
Characteristics of indirect methods .................................................................................................. 40
Types of indirect methods ................................................................................................................. 40
Interpreting and interpretation processes ........................................................................................ 42
Evaluating and using indirect methods ............................................................................................. 42
Chapter 6: Intelligence and intelligence tests ....................................................................................... 42
Introduction....................................................................................................................................... 42
Intelligence tests ............................................................................................................................... 43
Intelligence tests in actual practice ................................................................................................... 46
Chapter 8: Personality questionnaires .................................................................................................. 48
Characteristics and principles of personality questionnaires ........................................................... 48
Several personality questionnaires ................................................................................................... 48
The use of personality questionnaires in health care ....................................................................... 50
Chapter 9: Questionnaires for measuring problem areas..................................................................... 51
General psychopathology questionnaires ......................................................................................... 51
Specific questionnaires...................................................................................................................... 52
The use of general psychopathology questionnaires in health care................................................. 54
The use of specific questionnaires in health care ............................................................................. 54
Chapter 10: Computer-assisted clinical diagnostics .............................................................................. 54
Advantages and disadvantages of computer-assisted diagnostics ................................................... 55
Equivalence of computer-based tests and paper-and-pencil tests................................................... 56
Adaptive testing ................................................................................................................................ 56
Online tests........................................................................................................................................ 56
,Chapter 11: Ethical aspects and the reporting of diagnostics ............................................................... 56
Ethical guidelines for diagnostics ...................................................................................................... 56
Reporting of diagnostics .................................................................................................................... 57
Chapter 12: Dynamic personality diagnostics ....................................................................................... 59
Descriptive diagnostics vs. structural diagnostics ............................................................................. 59
The importance of trait models for personality diagnostics ............................................................. 59
The rationale behind the Dynamic Theory-driven Profile Interpretation (DTP) of the Dutch Short
Form of the MMPI (NVM) ................................................................................................................. 59
The method of the Dynamic Theory-driven Profile Interpretation of the NVM ............................... 60
Studies into the value of the DTP of the NVM .................................................................................. 61
Limitations ......................................................................................................................................... 61
Lecture 1
The diagnostic cycle
• The goal of psychological assessment depends on the referral question and help request
o Know the referrer
▪ Referrer vs. client’s requests
o Answer specific questions and make clear, specific, and reasonable recommendation
▪ To help improve functioning
o Evaluate the individual in a problem situation so that the information derived from
the assessment can help with the problem
o Test scores are means to generate and evaluate hypotheses
o Focus: problem-solving and decision-making
Where is our expertise?
• Experts in human behaviour
, o Problem areas, possible causes and explanations
• Sensitive to diverse contextual and cultural backgrounds
• Ethical issues
• Communication competency (and rapport)
• Knowledge about testing
• Integrating test scores
o Incremental and conceptual validity
• Cost-effectiveness and clinical relevance
• Knowledge about evidence-based treatments
Expertise and risks
• Attitude, contact, tuning, unbiased and active listening of the professional in the service of a
good relationship between professional and client
• Professionals and clients each have their own perspective on what constitutes good care
• Risk: thinking to be a guru or a prophet and to have really understood the other
o Losing the passion for what really is the gist of the job
▪ i.e., understanding one’s own complexity and the complexity of the other
Where are we?
• Continually changing perceptions
o Clinical judgement
• Type of questions asked, initial impression, liking/ disliking, overinterpretation, type of
rapport, theoretical perspectives, choice of tests, etc.
o Each of us influences the assessment in their own way
• Actuarial approach needs to be integrated by clinical knowledge and experience
o We want to provide personalized care
▪ Therefore, we need subjective components
Solutions
• Awareness of our own biases, issues, perspective, etc.
• Comprehensive, structured approach
• Consider evidence for and against diagnostic hypotheses
• Refer to diagnostic manuals
• Rely on notes, not memory
• Seek feedback
• Theoretical and empirical expertise
• Including expertise on clinical judgement
• Don’t lose your humanity
Intake
Purpose of the intake
• Assessment
• Relational objective
o Be a nice human being in the room with the client
o Treat your client the way that you would like to be treated if you were a client
o Accept that clients are supposed to be difficult
o Help clients feel safe with you
