chapter 5: behaviour assessment

PSYC4030 6.0DPSYC4030 6.0D CBT Chapter 5CBT Chapter 5

Chapter 5:Chapter 5:Behaviour AssessmentBehaviour Assessment


Purpose of AssessmentPurpose of Assessment

1.1. Clarify the problemClarify the problem

2.2. Set initial goalsSet initial goals

3.3. Select/define target behavioursSelect/define target behaviours

4.4. Identify maintaining conditionsIdentify maintaining conditions

5.5. Design treatment planDesign treatment plan

6.6. Monitor client’s progressMonitor client’s progress


Test Results and Test Results and InterpretationInterpretation Test score are approximations to actual Test score are approximations to actual

phenomena.phenomena. Any type of assessment method is Any type of assessment method is

subject to error.subject to error. Systematic error or Systematic error or biasbias..


Standards for AssessmentStandards for Assessment1. Reliability1. Reliability: repeatability; comparable scores : repeatability; comparable scores

each time a test is administeredeach time a test is administeredWhen is a test unreliable?When is a test unreliable?• Ambiguous assessment procedures Ambiguous assessment procedures • Poorly trained evaluatorsPoorly trained evaluators• Varying behaviour of the patientVarying behaviour of the patient• Growth and developmentGrowth and development• Varying assessment conditionsVarying assessment conditions• Learning effectsLearning effects


Standards for AssessmentStandards for Assessment

2. 2. ValidityValidity: Is test accurately assessing what is : Is test accurately assessing what is was designed to assess?was designed to assess?

• ConcurrentConcurrent: vary with other measures of the : vary with other measures of the same phenomenonsame phenomenon

• ContentContent: how comprehensive the measure is: how comprehensive the measure is• PredictivePredictive: future outcomes (GRE, LSAT, : future outcomes (GRE, LSAT,

MCAT)MCAT)


ValidityValidity

What can affect validity?What can affect validity?1.1. Sampling the wrong or irrelevant content Sampling the wrong or irrelevant content

areaarea2.2. The measure’s The measure’s reactivityreactivity – extent to which – extent to which

the measure makes the patient want to the measure makes the patient want to respond a certain wayrespond a certain way

3.3. A mismatch between test difficulty and A mismatch between test difficulty and developmental level (ceiling or floor effects).developmental level (ceiling or floor effects).

4.4. Low reliability = lowers validityLow reliability = lowers validity


Standards for AssessmentStandards for Assessment3. Utility: usefulness, impact on appropriate placement 3. Utility: usefulness, impact on appropriate placement

and treatmentand treatment• issues of time and money.issues of time and money.

Three Questions of UtilityThree Questions of Utility1.1. What is the percentage of correct decisions made What is the percentage of correct decisions made

using this instrument?using this instrument?2.2. What are the costs involved in getting the What are the costs involved in getting the

assessment information? assessment information? 3.3. What are the What are the valuesvalues or costs associated with making or costs associated with making

a correct decision?a correct decision?


How do you reduce How do you reduce assessment error?assessment error?Rule of Multiples:Rule of Multiples:

• Multiple Tests – use more than one testMultiple Tests – use more than one test Multiple EvaluatorsMultiple Evaluators Multiple Times –more than once, if Multiple Times –more than once, if

possiblepossible


A. Behavioural InterviewsA. Behavioural Interviews

1.1. Establish rapportEstablish rapport

2.2. Understanding problem, selecting Understanding problem, selecting target behaviour(target behaviour(s)s)

3.3. Identifying maintaining conditionsIdentifying maintaining conditions

4.4. Educating the client on the Educating the client on the behavioural approach, confidentialitybehavioural approach, confidentiality

• No “why” questions allowed !No “why” questions allowed !


B. Self Report InventoriesB. Self Report Inventories


Persecutory Ideation Persecutory Ideation Questionnaire (PIQ):Questionnaire (PIQ):1. I sometimes feel as if there is a conspiracy 1. I sometimes feel as if there is a conspiracy

against me.against me.2. I feel at times that I am deliberately ill-treated 2. I feel at times that I am deliberately ill-treated

by others.by others.3. I often feel that others have it in for me.3. I often feel that others have it in for me.4. People mean to do and say things to annoy 4. People mean to do and say things to annoy

me.me.5. I sometimes feel that people are plotting 5. I sometimes feel that people are plotting

against me.against me.


Persecutory Ideation Persecutory Ideation Questionnaire (PIQ):Questionnaire (PIQ):6. I sometimes feel that people are laughing at 6. I sometimes feel that people are laughing at

me behind my back.me behind my back.7. Some people try to steal my ideas and take 7. Some people try to steal my ideas and take

credit for them.credit for them.8. I sometimes feel that I am being persecuted 8. I sometimes feel that I am being persecuted

in some way.in some way.9. I often pick up hidden threats or put-downs 9. I often pick up hidden threats or put-downs

from what people say or do.from what people say or do.10. Some people harass me persistently.10. Some people harass me persistently.

McKay et al. (2006)


B. Self Report InventoriesB. Self Report Inventories

• Questionnaire formatQuestionnaire format

• Usually address a particular type of Usually address a particular type of problem behaviour (covert or overt)problem behaviour (covert or overt)

• Highly efficient, easy to scoreHighly efficient, easy to score

• However, more specialized follow-up However, more specialized follow-up assessments are typically requiredassessments are typically required


C. Self RecordingC. Self Recording

• Client observing and recording own Client observing and recording own behavioursbehaviours

• Efficient, especially for infrequent Efficient, especially for infrequent behavioursbehaviours

• Appropriate for overt and covert Appropriate for overt and covert behavioursbehaviours

• Record number of times targer Record number of times targer behaviour is performedbehaviour is performed


LimitationsLimitations

1.1. Accuracy of recordingAccuracy of recording

2.2. Interruption of ongoing activityInterruption of ongoing activity

3.3. Reactivity--self recording changes the Reactivity--self recording changes the behaviour itselfbehaviour itself


ReactivityReactivity

• Awareness of recording own behaviours Awareness of recording own behaviours affects their frequencyaffects their frequency

• Especially with deceleration target Especially with deceleration target behavioursbehaviours

• With acceleration target behaviours, With acceleration target behaviours, may be used as a component of therapymay be used as a component of therapy


D. Checklists, Rating ScalesD. Checklists, Rating Scales

• Completed by someone other than the Completed by someone other than the client client retrospectivelyretrospectively

• Usually a list of problem behaviours, Usually a list of problem behaviours, and maintaining conditionsand maintaining conditions

• Especially useful for children’s Especially useful for children’s behaviours behaviours — scored by parents or teachersscored by parents or teachers— Child Behaviour Checklist (CBCL)Child Behaviour Checklist (CBCL)


E. Naturalistic ObservationE. Naturalistic Observation

• Observing and recording specific and Observing and recording specific and predetermined behaviourspredetermined behaviours

• Usually involves considerable Usually involves considerable investment on the part of observerinvestment on the part of observer— Training nonprofessional agentsTraining nonprofessional agents

• ““Time Sampling”: Observation during Time Sampling”: Observation during limited intervalslimited intervals


LimitationsLimitations

1.1. Reactivity from being observedReactivity from being observed• Counter this with inclusion of Counter this with inclusion of adaptation adaptation

periodperiod

2.2. Observer error/biasObserver error/bias• Cultural factorsCultural factors

3.3. PracticalityPracticality• May require a simulated environmentMay require a simulated environment


F. Simulated ObservationF. Simulated Observation

• Study conditions resemble natural Study conditions resemble natural environmentenvironment

• Use of-one way mirror and intercomUse of-one way mirror and intercom

• Ideally is near-identical to natural Ideally is near-identical to natural observationobservation

• Limited by generalizability: How similar Limited by generalizability: How similar is it to natural conditions?is it to natural conditions?


G. Role PlayingG. Role Playing

• Enacting problem situationEnacting problem situation

• Imagining physical arrangements and Imagining physical arrangements and eventsevents

• Limited by generalizability and Limited by generalizability and awkwardness of clientawkwardness of client

• Reactivity may also be a concernReactivity may also be a concern


H. Physiological MeasuresH. Physiological Measures

• Measure processes that readily Measure processes that readily measures of behaviourmeasures of behaviour

Heart rate, respiration rate, blood Heart rate, respiration rate, blood pressure, muscle tension, skin pressure, muscle tension, skin conductivityconductivity


Role of DSM-IV DiagnosisRole of DSM-IV Diagnosis

• Is a diagnosis really necessary if all we Is a diagnosis really necessary if all we are looking at are specific, are looking at are specific, individualized behaviours?individualized behaviours?

• DSM is “trait” based.DSM is “trait” based.

• Other than for insurance or health care Other than for insurance or health care reasons, is there any need for these reasons, is there any need for these labels?labels?

chapter 5: behaviour assessment

Documents

mcatcbt chapter

performedcbt chapter

requiredcbt chapter

possiblecbt chapter

lowers validitycbt chapter

assessment error

test difficulty

test results