Task 4
Bron: Osmosis - Diagnostic Errors
System 1
- Fast
- Snap decision
- Needs to be self-monitored to avoid mistakes in diagnosing
→ pattern in a clinical presentation
System 2
- Slow
- Analytical
- Conscious effort
- Helps to avoid mistakes made by system 1
→ better analysis of person’s symptoms
Cognitive mistakes → diagnostic errors
● Premature closure
○ Initial diagnosis is heavily focused on
○ Mind becomes closed to other possibilities
● Representative bias
○ Looking for classic presentation of disease
○ Patient presents with atypical/variant pattern
○ Experienced clinicians know variants of common diagnosis are frequent
System 1
● More accurate as clinicians move through careers
● Recognize atypical/variant presentations
Bron: Bornstein
3 components of EBPP (Evidence-Based Practice in Psychology)
1. Research (Testing & Assessment)
2. Clinical expertise
3. Patient characteristics
Best available research
● Standards for Educational and Psychological Testing
○ Provides only minimal guidance in this area
○ Discusses issues related to test development, administration, and interpretation,
and strategies for validating test scores and establishing their reliability
○ Says little about procedures and strategies for psychological assessment
● International Test Commission Guidelines on Test Use
○ Greater attention to issues regarding psychological assessment as well as
psychological testing
, ○ Also does not discuss procedures for
■ Integrating psychological test data
■ Operationalizing assessment effectiveness and documenting clinical
utility
■ Interpreting test score discontinuities
■ Implementing debiasing strategies to reduce examiner expectancy effects
■ Providing test feedback in a way that facilitates patient engagement in the
treatment process
○ Also does not
■ Discuss the psycholical processes that underlie patients’ responses to
different types of test items and tasks
■ Consider the interpersonal dynamics of the assessment process
■ Discuss how competence and proficiency in psychological assessment
could be operationalized and evaluated
→ these issues are very important!!
● Testing
○ Extension of Messick’s integrative approach → Bornstein
■ Traditional outcome-focused validity assessment must be complemented
by process-focused validity assessment
● Assessment of the degree to which a given instrument engages in
the respondent his psychological processes that the test is
expected to engage, given the construct being measured and the
format of items and tasks that comprise that the test question
○ E.g. person with memory difficulties
■ Category: self-report
○ Psychological processes in testing
1. Engaging in introspection: turning their attention inward to determine if
the statement captures some aspect of their feelings, thoughts, motives,
or behaviors
2. Occurring of retrospective memory search: attempt to retrieve
instances wherein they experienced or exhibited the response(s)
described in the test item
3. Engaging in deliberate self-presentation: decideing whether, given the
context and setting in which they are being evaluated, it is better to
answer honestly or modify their response to depict themselves in a
particular way
● Table 1: classified assessment tools, grouped based on mental activities and behaviors
involved in responding to the tests
Bron: Osmosis - Diagnostic Errors
System 1
- Fast
- Snap decision
- Needs to be self-monitored to avoid mistakes in diagnosing
→ pattern in a clinical presentation
System 2
- Slow
- Analytical
- Conscious effort
- Helps to avoid mistakes made by system 1
→ better analysis of person’s symptoms
Cognitive mistakes → diagnostic errors
● Premature closure
○ Initial diagnosis is heavily focused on
○ Mind becomes closed to other possibilities
● Representative bias
○ Looking for classic presentation of disease
○ Patient presents with atypical/variant pattern
○ Experienced clinicians know variants of common diagnosis are frequent
System 1
● More accurate as clinicians move through careers
● Recognize atypical/variant presentations
Bron: Bornstein
3 components of EBPP (Evidence-Based Practice in Psychology)
1. Research (Testing & Assessment)
2. Clinical expertise
3. Patient characteristics
Best available research
● Standards for Educational and Psychological Testing
○ Provides only minimal guidance in this area
○ Discusses issues related to test development, administration, and interpretation,
and strategies for validating test scores and establishing their reliability
○ Says little about procedures and strategies for psychological assessment
● International Test Commission Guidelines on Test Use
○ Greater attention to issues regarding psychological assessment as well as
psychological testing
, ○ Also does not discuss procedures for
■ Integrating psychological test data
■ Operationalizing assessment effectiveness and documenting clinical
utility
■ Interpreting test score discontinuities
■ Implementing debiasing strategies to reduce examiner expectancy effects
■ Providing test feedback in a way that facilitates patient engagement in the
treatment process
○ Also does not
■ Discuss the psycholical processes that underlie patients’ responses to
different types of test items and tasks
■ Consider the interpersonal dynamics of the assessment process
■ Discuss how competence and proficiency in psychological assessment
could be operationalized and evaluated
→ these issues are very important!!
● Testing
○ Extension of Messick’s integrative approach → Bornstein
■ Traditional outcome-focused validity assessment must be complemented
by process-focused validity assessment
● Assessment of the degree to which a given instrument engages in
the respondent his psychological processes that the test is
expected to engage, given the construct being measured and the
format of items and tasks that comprise that the test question
○ E.g. person with memory difficulties
■ Category: self-report
○ Psychological processes in testing
1. Engaging in introspection: turning their attention inward to determine if
the statement captures some aspect of their feelings, thoughts, motives,
or behaviors
2. Occurring of retrospective memory search: attempt to retrieve
instances wherein they experienced or exhibited the response(s)
described in the test item
3. Engaging in deliberate self-presentation: decideing whether, given the
context and setting in which they are being evaluated, it is better to
answer honestly or modify their response to depict themselves in a
particular way
● Table 1: classified assessment tools, grouped based on mental activities and behaviors
involved in responding to the tests
