PSY401 Short Notes by VUBuddy

CLINICAL PSYCHOLOGY (PSY401) · Important notes for final term exams · Lecture 23:

•  L. H. Levy's (1963) statement that " Interpretation is the most important single activity engaged in by the clinician‖.
•  Interpretation is an inferential process (Nisbett & Ross, 1980) that takes where assessment leaves off.
•  Sundberg, Tyler, and Taplin (1973) have described three levels of inferences or interpretations.
•  interpretations involve two kinds‘ inferences: o Descriptive generalization: generalization-----still at the descriptive level. Thus, for a patient who fidgets, smokes cigarettes during the interview, and stammers the clinician may make a descriptive generalization----interview tension. If it turns out later that the patient has trouble relaxing at home, cannot sit through the meeting at the office. And is very worried about paying off the mortage, the clinician may go to a broader descriptive generalization. o Hypothetical construct: that suggests an inner state and takes the clinician a bit beyond descriptive generalization.
•  A preponderance of ‗blood‘ responses on the Rorschach might be interpreted as a sign of underlying aggression that may lead to future impulsive outbursts or loss of control.
•  Two distinct approaches to clinical judgment and interpretation. o First is the quantitative or statistical approach, which emphasizes objectivity and is presumably free from fuzzy thinking. o Second is the subjective or clinical approach, which adherents claim is the only method to offer truly useful interpretations and predictions.
•  The regression equation predictors were aptitude test scores and high school rank. The counselors had available to them the two preceding sources of data (but without their mathematical weighting), vocational interest scores, interview data, and biographical data. Sarbin (1943) found that the counselors were no better than the regression equation in their predictions even though they had the benefit of much mere information.
•  Meehl (1954) also observed that, in several studies, statistical predictions were made on the same data from which the regression equations were developed.
•  Dawes (1994) has outlined several of the major objections to large body- of evidence supporting the superiority of statistical prediction, along with response, such objection.
•  Dawes (1994) refers to this an "argument from a vacuum"-a possibility is raised, but there is no empirical demonstration supporting the possibility.
•  Garb (1997) recently reviewed the empirical evidence for race bias, social class bias, and gender bias in clinical judgment.
•  Interestingly, he found that many conventionally held beliefs about these types of bias were not supported. For example, there was little support for the beliefs that o lower-socioeconomic-class patients are judged to be more seriously disturbed than those from higher socioeconomic classes or o Women patients are judged to be more disturbed or dysfunctional than men patients. However, there was strong evidence to support the existence of several other types of biases:  Black and Hispanic patients who have psychotic mood disorders are more likely to be misdiagnosed with schizophrenia than are similar White patients.  Even when presenting the same constellation of symptoms, men are more likely to be diagnosed as antisocial and women are more likely to be diagnosed as histrionic.  Middle-class patients are more likely to be referred for psychotherapy than lower-class patients.  Black patients are more likely to be prescribed antipsychotic medications than members of other racial groups, even when the Black patients are not more psychotic.
•  Garb (1997) made the following recommendations to help clinicians overcome these and other bias o Be aware of and sensitive to the biases that have been documented in the literature. o Attend to the diagnostic criteria in diagnostic manuals. o Whenever possible, use statistical prediction rules instead of clinical judgment or prediction..

Lecture 24:

•  Garb (1998) points out that clinicians who do evaluate clients' strengths and assets in addition to assessing pathology and dysfunction are less likely to pronounce clients as maladjusted or impaired.
•  Garb (1998) recommends that clinicians use structured rating scales, objective personality tests, and behavioral assessment methods to form their clinical judgment and predictions.
•  Investigators such as Chase (1975), Ekehammar (1974), Megargee (1970), Mischel (1968), and Moos (1975) all agree that such data are subject to a ceiling effect that will allow correlations of no better than .30 to .40 between the data and subsequent behavior.
•  Intuitive predictions often ignore base rates, fail to consider regression effects, and assume that highly correlated predictors will yield higher validity (Garb, 1998; Kahneman & Tversky, 1973).
•  Regression concepts should lead one to expect that exceptionally tall parents will have a shorter child that brilliant students sometimes do poorly, and so on.
•  Kahneman and Tversky (1973) showed that individuals are more confident when they are predicting from correlated tests.
•  Golding and Rorer (1972) found that certain clinicians believed that anal responses on the Rorschach indicated homosexuality; and they w-ere extremely resistant to changing their preconceptions even in the face of intensive training to the contrary.
•  Appelbaum (1970) has characterized the role of the assessor as sociologist, politician, diplomat, group dynamicist, salesperson, artist, and yes, even psychologist.
•  The nature of the referral, the audience to which the report is directed, the kinds of assessment procedures used, and the theoretical persuasion of the clinician are just a few of the considerations that may affect the presentation of a clinical report.
•  The major responsibility of the report is to address the referral question.
•  The terms interest scatter and Erlebnistypus may be all right for another clinician, but they should not appear in a report sent to a junior high school counselor.
•  Barnum effect (a term applied in case where statements that appears to be valid self- descriptions in actually characterize almost everybody).

Lecture 25:

•  In a most general way, psychological intervention is a method of inducing changes in a person's behavior, thoughts, or feelings.
•  Psychotherapy involves intervention in the context of a professional relationship-a relationship sought by the client or the client's guardians.
•  Three types of interventions o Positive psychology," including the promotion of health and positive behaviors. o Prevent psychopathology and diseases. o Psychotherapy
•  Psychological interventions have been developed to change behaviors in order to reduce the risk for AIDS.
•  Psychological interventions also may be designed to change underlying biological processes.
•  Much of the work carried out by clinical psychologists is concerned with the prevention or treatment of specific forms of psychopathology as defined in the DSM-IV but clinical psychological interventions are also concerned with broader social problems and problems in living that are not included as specific diagnostic categories in the DSM-IV (Adelman, 1995).
•  A rather typical general definition of psychotherapy was provided years ago by Wolberg (1967): ―Psychotherapy is a form of treatment for problems of an emotional nature in 88which a trained person deliberately establishes a professional relationship with a patient with the