Clinical Assessment

Lecture 2
Dr Amna Khalid
Theoretical Orientation
1. Do you adequately understand the theoretical
construct the test is supposed to be
measuring?

2. Do the test items correspond to the theoretical

description of the construct?

Evaluating a psychological test

Practical Considerations
1. If reading is required by the examinee, does
his or her ability match the level required by
the test?

2. How appropriate is the length of the test?

Evaluating a psychological test

Standardization
1. Is the population to be tested similar to the
population the test was standardized on?
2. Was the size of the standardization sample
adequate?
3. Have specialized subgroup norms been
established?
4. How adequately do the instructions permit
standardized administration?

Evaluating a psychological test

Reliability
1. Are reliability estimates sufficiently high
(generally around .90 for clinical decision
making and around .70 for research
purposes)?

2. What implications do the relative stability of

the trait, the method of estimating reliability,
and the test format have on reliability?

Evaluating a psychological test

 Test-retest
 Alternate forms
 Split half
 Inter-scorer/inter-rater
 Internal consistency

Relaibility
Validity
1. What criteria and procedures were used to
validate the test?

2. 2. Will the test produce accurate

measurements in the context and for the
purpose for which you would like to use it?

Evaluating a psychological test

 Content (face)
 Criterion
Concurrent and predictive
 Construct
Discriminant and convergent

Sensitivity (true positives) and specificity

(true negatives)

Validity
 Is a test always valid?
 Generalizability: the similarity between the
population used during various stages of test
construction and the population and situation
that it is being used for in practice
 Incremental validity: the ability of tests to
produce information above what is already
known
 Conceptual validity: it involves creating a
conceptually coherent description of the
person

VALIDITY IN CLINICAL PRACTICE

 Primacy effect: clinicians might develop
incorrect hypotheses based on first
impressions
 hindsight bias: I would have known it all
along
 What can be done??
 Clinical vs actuarial predictions

Accuracy of clinical judgement

Phases in clinical assessment
Context of Clinical
Assessment
Week 3
Dr Amna Khalid
 Referral question
 Understanding the referral context
 Ethical guidelines,
 Identifying and working with test bias
 Selecting the most appropriate instrument
 Making appropriate use of interpretation

Context of Clinical Assessment :

INTRODUCTION
 Understanding the question
 Clarifying
 Relevant aspects

THE REFERRAL QUESTION

 Psychiatric Setting
 General Medical Setting
 Legal Context
 Educational Context
 Psychological Clinic

TYPES OF REFERRAL SETTINGS

These referrals typically come from a
psychiatrist

 Role of ward administrators

 Role of Psychotherapist
 Role of physician

Psychiatric Setting
 Psychological disorder
 Possible emotional factors associated with
medical complaints
 Assessment for neuropsychological deficit
 Presurgical evaluation to assess the
likelihood of a serious stress reaction to
surgery
 Psychological treatment for chronic pain
 The treatment of chemical dependency

General Medical Setting

 Reliability of a witness
 Evaluate the quality of another mental
health professional’s report
 Insanity
 Accused competence
 Dangerousness
 In jury selection

Legal Context
 Evaluating the nature and extent of a
child’s learning difficulties
 measuring intellectual strengths and
weaknesses
 Assessing behavioral difficulties
 Creating an educational plan
 Estimating a child’s responsiveness to
intervention
 Recommending changes in a child’s
program or placement

Educational Context
 decision maker
 self-referred
 children who are referred by their parents
 referrals from other decision makers

Psychological Clinic