Clinical Psychology PSYC 3145
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Chapter 18 These are the same important terms and ideas that are summarized at the end of the chapter Additional information that I39ve added to these will be in italicized text I have also added additional important terms and ideas at the end of the alphabetical list As you study pay particular attention to 1 the definitions for which the titles appear in BOLD print 2 the italicized information I39ve added and 3 the additional terms I39ve added at the bottom of the list These are the most important ideas and the ones most likely to appear on the exams Agnosia Impairment in sensory perception This includes abilities such as vision and hearing Aphasia Impairment in language ability Apraxia Impairment in the ability to perform certain voluntary movements Impairments in motor muscle control Cerebellum A subcortical structure associated with motor coordination and the control of muscle tone posture and equilibrium Cerebral Hemorrhage A situation in which a blood vessel ruptures and the blood escapes onto brain tissue either damaging or destroying it The symptoms ofa hemorrhage are determined by its site and severity Concussion Jarring ofthe brain suf cient to result in a momentary disruption of brain function A single concussion usually does not cause permanent damage but repeated ones may Jarring ofthe brain leading to temporary disruption of functioning Contusions Bruises In the brain contusions result when the brain has been shifted from its normal position and pressed against the skull Brain contusions may be severe and may result in delirious or comatose states Trauma from an impact would be a typical cause Degenerative Disease A group ofdisorders such as Alzheimer39s disease Parkinson39s disease and Huntington39s chorea that result from the degeneration of neurons in the central nervous system These disorders are characterized by progressive cerebral degeneration and disturbance in several behaviors or functions Delirium A disruption of consciousness often caused by exposure to toxins The delirious person will be confused often about where they are place and when time Difference Scores A method for interpreting neuropsychological test data that focuses on the difference between a patient39s scores on two separate tests Difference scores above a certain level are suggestive of impairment Equipotentiality The notion that the cortex functions as a whole and that all areas ofthe brain contribute equally to overall intellectual functioning On the basis of this perspective when one area of cortex is damaged the functions of that area may be assumed by another area of cortex In other words various brain areas have potential to learn or take over activities previously done by the now damaged area Flexible Approach Or HypothesisTesting Approach In this approach the neuropsychologist selects the tests to be administered to each patient based on his or her hypotheses about the case and may even alter the administration of one or more tests Frontal Lobes The most recently developed part ofthe human brain The frontal lobes are associated with executive functions such as formulating planning and carrying out goal directed behavior monitoring and controlling behavior and modulating emotions Functional Model A theory that integrates the localizationoffunction and equipotentiality perspectives This theory holds that any behavior is due to the interaction of several brain systems and that the nature of a behavioral de cit will depend on which functional system is affected as well as the localization of damage within that functional system The theory states that there is localization of function but that the brain functions as an integrated whole HalsteadReitan Battery The most widely used neuropsychological test battiy The HalsteadReitan consists of several measures and is used to provide data about speci c de cits the probable localization of lesions and whether lesions appearto be ofgradual or sudden onset Although the reliability and validity ofthis battery have been supported a significant disadvantage is the time required for administration Currently the most widely used test battery It is comprehensive but has the disadvantage of taking 6 hours or more to complete Houston Conference A conference on clinical neuropsychology training that convened in September 1997 As a result of this conference specific guidelines were offered for the graduate training predoctoral internship and postdoctoral training of future clinical neuropsychologists Lacerations Cuts tears or ruptures Lacerations of brain tissue may occur when the skull has been breached by a bullet or other object Left Hemisphere The hemisphere of the brain that controls the right side ofthe body and for most people is more involved in the language functions logical inference and detail analysis Math is also a left brain function all of this is true for quotmostquot people Localization Of Function The idea that certain portions of the brain are responsible for speci c functions or behaviors LuriaNebraska Battery A neuropsychological test battery that assesses abilities over 11 subtest groupings Studies have supported the reliability and diagnostic validity ofthe battery which takes less time to administerthan the HalsteadReitan Probably second only to the HalsteadReitan in popularity It has the advantage of being shorter about 25 hours to complete Neurodiagnostic Procedures Procedures eg spinal taps CAT scans and functional MRls for detecting the presence and location of brain damage These procedures vary in their expense their sensitivity their invasiveness and the risk they pose to the patient Neuropsychological Assessment The assessment of brain functioning based on a person39s performance on noninvasive standardized tests that are believed to be accurate and sensitive indicators of brainbehavior relationships 39 r 39 39 g The study of the relationship between brain function and behavior The eld s most dramatic growth was during and after the second world war as a result of numerous head injuries among soldiers Neuropsychologists study assess andor treat behaviors directly related to the functioning ofthe brain Occipital Lobes The portion of the cortex involved with visual processing and some aspects of visually mediated memory Occlusions Blockages in blood vessels caused by clots The vessels serving particular areas of the brain may become occluded resulting in one type ofquotstrokequot Parietal Lobes The portion ofthe cortex related to tactile and kinesthetic movement perception and understanding spatial perception and some language comprehension and processing Pathognomonic Indicative ofa speci c disease or condition One method for interpreting neuropsychological test data notes and draws inferences about pathognomonic signs Pattern Analysis A method of neuropsychological test interpretation in which the basic pattern of scores on tests is examined to see whether it matches a pattern that has been reliably associated with a speci c neurological injury or impairment Rehabilitation In the context of neuropsychology the treatment of patients with cognitive and behavioral impairment due to brain dysfunction or injury Rehabilitation may involve helping the patient quotrelearnquot skills andor changing the patient39s environment to best compensate forthe impairment Rehabilitation planningcoordination is a major function of neuropsychologists Right Hemisphere The hemisphere of the brain that controls the left side of the body and for most people is more involved in visualspatial skills the perception ofdirection creativity and musical activities Standard Battery Or Fixed Battery Approach In this approach all referred patients are administered the same set of neuropsychological tests Temporal Lobes The portion ofthe cortex that mediates linguistic expression reception and analysis and is involved in processing tones sounds rhythms and meanings that are nonlanguage in nature Tumors Abnormal tissue growths that may grow inside or outside the brain or spread to the brain from other areas ofthe body Symptoms are usually subtle at rst and become more noticeable as the tumor grows and exerts pressure on surrounding areas of the brain Chapter 16 These are the same important terms and ideas that are summarized at the end of the chapter Additional information that I39ve added to these will be in italicized text l have also added additional important terms and ideas at the end of the alphabetical list As you study pay particular attention to 1 the definitions for which the titles appear in BOLD print 2 the italicized information I39ve added and 3 the additional terms I39ve added at the bottom of the list These are the most important ideas and the ones most likely to appear on the exams ClientCentered Case Consultation A type of mental health consultation that focuses on helping to solve a current problem with a specific client Community Mental Health A movement arising in the 1950s that viewed mental health problems as emerging from failures in the social system This movement called for community control of mental health services and strong focuses on prevention early detection and the provision of services to populations who had traditionally been underserved Community Psychology A psychological approach that emphasizes the role of environmental forces in creating and alleviating problems Community psychology is preventive ratherthan remedial in orientation Furthermore it attends to the t between the person and the environment rather than the inadequacies ofeither and focuses on identifying and developing the strengths and resources of people and communities The focus is on quotpreventionquot where there exists a quotpoor quot between the person and the environment Consultation The act by which a person who provides services to others or oversees the provision of services enlists the help of an expert for the purpose of improving these services In general a highly trained professional can provide knowledge and information to others who can in turn serve a larger clientele than the one professional could ConsulteeCentered Administrative Consultation A type of mental health consultation that focuses on helping an administrator enhance his or her skills so that he or she will be able to function more effectively in the future ConsulteeCentered Case Consultation A type of mental health consultation that focuses on helping the consultee enhance the skills he or she will need to deal effectively with future cases Diversity Dimensions along which individuals differ It is important to be aware of these differences to better understand and to better serve individuals Ecological Analysis The examination of issues and problems at different levels ofthe human ecosystem ranging from the individual to macrosystems eg cultures or societies Basically identifying factors in the environment that influence the person 393 condition Empowerment Providing individuals with the sense that they are in control of their own destinies or enhancing existing feelings of control Gun39n et al and Rappaport stress the importance of the individual feeling a sense of control regarding the future Head Start Programs Primary prevention early childhood programs designed to prepare preschool children from disadvantaged backgrounds for elementary school by focusing on their basic learning skills among other things Indicated Preventive Interventions Preventive interventions that target people at high risk for developing the disorder as determined by the presence of subthreshold symptoms or biological markers indicating a predisposition for developing the disorder Paraprofessionals Persons with no formal clinical training who have been trained to assist professional mental health workers The use of paraprofessionals has been growing in community psychology and in the mental health field as a whole and the results of meta analyses suggest that paraprofessionals may be as effective or in some cases even more effective than professionals Prevention The principle that in the long run preventive activities will be more ef cient and effective than individual treatment administered after the onset of disease or problems The main goal of community psychology is prevention to stop problems before they begin Primary Prevention Correcting negative conditions before signi cant problems emerge as a consequence ofthese conditions The application of this prevention model often necessitates a degree of social change The idea is to stop problems before they begin An example is the HighScope Perry Preschool Program see Box 16 1 ProgramCentered Administrative Consultation A type of mental health consultation that focuses on helping with the institution or management of a speci c program Secondary Prevention Detecting and correcting problems early while they are still amenable to intervention This prevention model often entails screening large numbers of people including people who are not seeking help and may not even appearto be at risk Selective Preventive Interventions Preventive interventions that target individuals or subgroups of the population with a higher than average chance for developing the disorder in question as determined by the presence of certain biological psychological or social risk factors The goal is to identify cases of mental disorder early in their development and treat them promptly so they don t develop into more severe and chronic conditions SelfHelp Groups lnformal groups that provide support for individuals facing speci c problems and may stave off the need for professional intervention Functions of selfhelp groups include providing important and relevant information to members providing role models individuals who have successfully confronted the problem at hand providing emotional support and ideas for coping and giving members an increased sense of mastery and control over their problems These groups can be of great utility These groups are not meant to be run by a mental health professional but they should have access to a professional who can serve as a consultant Tertiary Prevention Reducing the duration and negative effects of problems after they have occurred This prevention model most often involves treating disorders that have had a chance to fully develop Universal Preventive Interventions Preventive interventions that target the entire population Below are some additional ideas and terms from Chapter 16 you should know Community psychology approach Problems are seen as arising from a poor t between the individual and environment Above all the goal is to prevent problems before they develop or intervene at as early a stage as possible Birth of Community Psychology most believe this can be traced to the Swampscott Chapter 8 These are the same important terms and ideas that are summarized at the end of the chapter Additional information that I39ve added to these will be in italicized text l have also added additional important terms and ideas at the end of the alphabetical list As you study pay particular attention to 1 the definitions for which the titles appear in BOLD print 2 the italicized information I39ve added and 3 the additional terms I39ve added at the bottom of the list These are the most important ideas and the ones most likely to appear on the exams Base Rates Prevalence rates Computerbased assessment The use of computers to administer and possibly interpret responses to clinical interviews IQ tests selfreport inventories and so on ComputerBased Test Interpretations CBTls The interpretive pro les generated by computer scoring programs for various psychological tests The use of such pro les has been the subject of intense debate Construct Validity Approach An approach to test construction in which scales are developed based on a speci c theory re ned using factor analysis and other procedures and validated by showing through empirical study that individuals who achieve certain scores behave in ways that could be predicted by their scores Most comprehensive and desirable approach to personality test construction However not the most widely used because it is time consuming laborintensive and expensive Content Validation The process by which one ensures that a test will adequately measure all aspects of the construct of interest Methods of content validation include carefully defining all relevant aspects of the construct consulting experts having judges assess the relevance of each potential item and evaluating the psychometric properties of each potential item The quotContent Validity Approach quot is the simplest approach to test design and involves creating questions relevant to the construct you have decided to assess Empirical Criterion Keying An approach to test development that emphasizes the selection of items that discriminate between normal individuals and members ofdifferent diagnostic groups regardless of whether the items appear theoretically relevant to the diagnoses of interest The MMPI was created this way there are no theoretical assumptions made atheoretical lf most members of a diagnostic group eg depressives endorse a statement eg I feel tired then that will be a good depression question Factor Analytic Approach A statistical method often used in test construction to determine whether potential items are or are not highly related to each other Currently the most popular approach to test construction Exploratory factor analysis mines data for what factors might be there Con rmatory factor analysis sees if the factor structure of questions agrees with the theory they were based on The construct validity approach is preferable but time and cost make it less practical FiveFactor Model FFM A comprehensive model of personality that comprises the dimensions of Neuroticism Extraversion Openness Agreeableness and Conscientiousness as well as six facets belonging to each dimension Currently the most agreed upon by psychologists model of personality Illusory Correlation In the context of projective testing the phenomenon by which certain test responses become associated with speci c personality characteristics These responses come to be viewed as signs ofthe trait in question and may be given undue weight when interpreting the test This will most likely be a problem for clinicians using projective tests like the Rorschach A particular response man with arm raised is incorrectly taken to be a sign of a particular trait violence based on only one or two instances Incomplete Sentences Blank ISB The best known and most widely used of the sentence completion techniques consisting of 40 sentence stems Developed by Julian Rotter and the most popular sentence completion test A projective test that uses words instead of pictures Incremental Validity The extent to which a scale score provides information about a person39s behavior personality features or psychopathology features that is not provided by other measures To be useful a test must provide useful information we don t already have If we have a valid MMPI we would likely not gain much from a NEO administration MMPlZ A measure of psychopathology that was developed using the empirical criterion keying approach The MMPI2 consists of 567 true false items and provides scores on ten clinical scales seven validity scales and several content and supplementary scales Interpretation of the MMPI2 is usually based on an analysis ofthe entire pro le rather than on selected scores Like the MMPI before it the MMPI2 has been used for many different purposes across multiple settings and it remains one of the primary selfreport inventories of personality and psychopathology Developed by Hathaway and McKinley in the 19403 most widely used and highly respected of all personality tests ll th so many questions it was easy to add new scales such as the quotFamily Problems Content Scalequot to the original 10 clinical scales Objective Personality Measures Personality assessment tools in which the examinee responds to a standard set ofquestions or statements using a xed set of options eg true or false dimensional ratings Projective Techniques Psychological testing techniques that use people39s responses to ambiguous test stimuli to make judgments about their adjustment maladjustment Proponents believe that examinees quotprojectquot themselves onto the stimuli thus revealing unconscious aspects of themselves Generally these are resistant to the application of psychometrics statistical methods so reliability and validity have not been demonstrated Advocates of projectives say that objective tests like the MMPI fail to capture the motives and dynamics of personality Revised NEOPersonality Inventory NEOPlR A selfreport measure ofthe FFM that consists of 240 statements each of which is rated on a 5point scale This test yields scores on all ve domains ofthe FFM Neuroticism Extraversion Openness Agreeableness and Conscientiousness as well as the six facets corresponding to each domain Personality inventory developed by Costa and McCrae based on the ve factor model some advocate its use for diagnosis but Dr Richman disagrees It was designed to assess NORMAL personality and it is doubtful that any amount of change would make it as good as the MMPI for clinical assessment Rorschach A projective technique that interprets people39s responses to a series of 10 inkblots Sentence Completion Method A simple projective technique in which people are asked to complete in writing a number of sentence stems eg quotI often believe quot See quot83quot above Test Bias The situation in which different decisions or predictions are made for members of two groups even when they obtain the same score on an instrument Thematic Apperception Test A projective technique that purports to reveal patients39 personality characteristics by interpreting the stories they produce in response to a series of pictures Validity Of Cutoff Scores Thresholds The extent to which a particular cutoff score accurately classifies people as either possessing or not possessing the disorder or trait in question Validity Scales Test scales that attempt to shed light on the respondent39s testtaking attitudes and motivations eg to present themselves in an overly favorable light to exaggerate their problems or symptoms to engage in random responding A strength of MMPI is its 7 validity scales High F suggests faking bad high L and K suggest faking good TRIN suggests agreeabeness and VRIN suggests random responding see pg 213 Below are some additional ideas and terms from Chapter 8 you should know Content and Supplementary Scales additional scales added to the MMPl s original 10 clinical scales ex family problems fam John Exner Developed a comprehensive and complicated scoring system for the Rorschach which is currently the most widely accepted method see Pro le 8 2 Rorschach vs TAT Many clinicians myself included have fewer quotissuesquot with the TAT than the Rorschach It is not nearly as complex and labor intensive Also its results seem more straightfonNard and of practical use Compare the example clinician reports for the two tests MMPI Patterns or Profiles Based on a person s highest 2 or 3 clinical scales are commonly used to interpret the MMPI See Ed s pro le in Box 8 1 and description His high 2 scale suggests depression while high 7 suggests anxiety high 4 suggests hostility and family problems high 5 in not of major importance Chapter 7 These are the same important terms and ideas that are summarized at the end of the chapter Additional information that I39ve added to these will be in italicized text l have also added additional important terms and ideas at the end of the alphabetical list As you study pay particular attention to 1 the definitions for which the titles appear in BOLD print 2 the italicized information I39ve added and 3 the additional terms I39ve added at the bottom of the list These are the most important ideas and the ones most likely to appear on the exams Behavioral Genetics A research specialty that evaluates both genetic and environmental in uences on the development of behavior Chronological Age What we commonly refer to as age years of life Concordance Rate or Similarity Index An index of similarity between individuals The simplest form of concordance rate is the percentage of instances in which two individuals exhibit similar behaviors or characteristics Similarin principal to correlation Twin study results are usually reported in terms of their concordance rates If both twins of a pair are similar on IQ have nearly the same IQ score we say they are quotconcordantquot Concurrent Validity The extent to which test scores correlate with scores on other relevant measures administered at the same time Construct Validity The extent to which test scores correlate with other measures or behaviors in a logical and theoretically consistent way Construct validity requires a demonstration of all aspects ofvalidity To be construct valid the test mustbe measuring what we think it is measuring For example there is debate as to whetherQ tests really measure quotintellectual potentialquot or are just measuring differences in quotachievementquot If the latteris true then the tests are NOT construct valid Content Validity The degree to which test items adequately measure all aspects ofthe construct of interest Crystallized Ability One of two higher order factors of intelligence conceived by Cattell Crystallized ability refers to the intellectual capacities obtained through culturebased learning Deviation IQ A concept introduced by Wechsler to address problems observed when applying the ratio IQ to older individuals An individual39s performance on an IQ test is compared to that of her or his age peers Dizygotic DZ Twins Fraternal twins or twins that share about 50 oftheir genetic material EquivalentForms Reliability The extent to which an individual obtains similar scores on equivalent or parallel forms of the same test Fluid Ability One of two higher order factors of intelligence conceived by Cattell Fluid ability refers to a person39s genetically based intellectual capacity G The term introduced by Charles Spearman to describe his concept ofa general intelligence Genotype The genetic makeup ofan individual Index Scores Scores that correspond to the major ability factors that underlie the WAISlll subtest scores ie Verbal Comprehension Perceptual Organization Working Memory and Processing Speed Intelligence There is no universally accepted definition of intelligence However many de nitions of intelligence emphasize the ability to think abstractly the ability to learn and the ability to adapt to the environment Intelligence Quotient A term developed by Stern in 1938 to address problems with using the difference between chronological age and mental age to represent deviance Typically a deviation IQ score is used The original ratio IQ was computed as IQ mental agechronological age X 100 You can see how this resulted in the establishment of 100 as average intelligence Wechsler saw that this was subject to the unwanted in uence of increasing age He popularized the use of deviation IQ which compares an individual to others of hisher age group It relies on the fact that IQ like many human traits is normally distributed Use of deviation IQ eliminates the age problem Internal Consistency Reliability The extent to which the items of a test quothang togetherquot most often assessed by computing Cronbach39s alpha High internal consistency is a necessity This means that all questions in a given scalequestionnaire relate to the same single construct lnterrater or lnterjudge Reliability The level of agreement between two or more raters who have evaluated the same individual independently Agreement can refer to consensus on behaviors attributes and so on Mental Age A term introduced by Binet as an index of mental performance This idea was based on the notion that individuals of a certain age should have mastered certain abilities Monozygotic MZ Twins Identical twins or twins that share 100 oftheir genetic material Hard to come by M2 twins reared apart provide our best opportunity to help understand the roles of heredity and environment see Table 7 3 Phenotype The observable characteristics ofan individual The phenotype is a product of both the genotype and the environment Predictive Validity The extent to which test scores correlate with scores on other relevant measures administered at some point in the future When colleges use SAT scores to help decide which applicants to accept they are relying on predictive validity SAT scores are assumed to predict academic performance in college Primary Mental Abilities Seven factors of intelligence derived by Thurstone on the basis of his factor analytic work Number Word Fluency Verbal Meaning Perceptual Speed Space Reasoning and Memory Reversal Items A feature on several subtests ofthe WAISlll that allows the examiner to determine the examinee39s ability level without having to administer items markedly below that ability level SplitHalf Reliability The extent to which an individual39s scores on one half ofa test eg the even numbered items are similar to his or her scores on the other half eg the odd numbered items Stability of IQ Scores The similarity of IQ scores measured at different points in time Based on test retest correlations IQ scores tend to be less stable for young children than for adults StanfordBinet Fourth Edition SB4 An intelligence test based on a hierarchical model of intelligence The SB4 contains four general classes of items verbal reasoning quantitative reasoning abstract visual reasoning shortterm memory each of which consists of several subtests Structure of the Intellect model A model proposed and tested by Guilford that asserts that the components of intelligence may be organized into three dimensions operations eg memory contents eg symbolic and products eg relations In Guilford39s model a particular mental operation is applied to a specific type of content resulting in a product Test Retest Reliability The extent to which an individual makes similar responses to the same test stimuli on repeated occasions Theory of Multiple Intelligences A theory fonNarded by Gardner that posits the existence of six intelligences linguistic musical logicalmathematical spatial bodilykinesthetic and personal Triarchic Theory of Intelligence A theory proposed by Sternberg that maintains that people function on the basis of three aspects of intelligence componential refers to analytical thinking experiential creative thinking and contextual quotstreet smartsquot or the ability to successfully manipulate one39s environment Twins Reared Apart M2 or DZ twins separated from each other shortly after birth such twins share genetic material but not specific environmental influences Studying twins reared apart especially identical or monozygotic twins provides our best tool for separating out the in uences of heredity and environment Twins Reared Together M2 or DZ twins reared in the same family environment such twins share both genetic material and speci c environmental in uences Comparing the concordance rates oftwins reared apart and twins reared together can help tease apart the genetic and environmental in uences on a particular behavior or characteristic Validity The extent to which an assessment technique measures what it is supposed to measure There are several forms of validity content construct Wechsler Adult Intelligence ScaleThird Edition WAlSlll An adult intelligence test comprised of both a Verbal Scale and a Performance Scale each ofwhich consists of several subtests The WAISIII yields a Verbal Q a Performance IQ and a Full Scale Q in addition to Index scores Wechsler Intelligence Scale for ChildrenFourth Edition WISCIV An intelligence test designed for children between the ages of 6 and 16 The WISCIV scores include the Verbal Comprehension Index Perceptual Reasoning Index Working Memory Index Processing Speed Index and Full Scale Q Below are some additional ideas and terms from Chapter 7 you should know David Wechsler probably the most influential person in IQ testing of the 20th century Contributions include 1 a test designed for adults 2 popularizing the use of deviation Q scores and 3 a test model with two area Qs verbal and performance g Spearman s concept of a general mental energy or ability Heritability Recent reviews suggest that heritability genetic factors account for about 50 80 percent of the variance in IQ scores The Bell Curve Herrnstein and Murray s controversial book suggests that there are considerable culturalethnic differences in IQ and that current social policies directed are providing equal opportunities are misguided Nature vs Nurture The most persistent and debated argument relating to Q involves the roles of genes and environment Regarding research ifwe equalize environment raised in same home differences seen re ect genetics fwe equalize genetics sets of reared apart MZ twins differences seen re ect environment see Box 7 3 Reification s unsound circular reasoning using a to prove b while b is being used to prove a This is one of Stephen Gould s arguments against Q testing