1. Reliability and validity (p. 73) Evaluation of information about an individual leads to a psychodiagnosis, which involves describing and drawing inferences about the persons psychological state. The psychodiagnosis clarifies the picture of that state, may lead to a treatment program, provides a way of communicating about disorders, and serves to standardize assessment procedures. To be useful, assessment tools must show reliability, the degree to which a procedure or test will give the same results repeatedly under the same circumstances. Three types of reliability are test-retest reliability, internal consistency, and interrater reliability. Measures that are reliable can also demonstrate validity, the degree to which a procedure or test actually performs the function it was designed to perform. Predictive validity indicates how well a measure predicts future behavior. Three other aspects of validity are criterion-related, construct, and content validity. Standardization in administration and the presence of standardization samples affect reliability and validity.
2. The assessment of abnormal behavior (p. 74) Assessment is the process of gathering information and drawing conclusions about a persons traits, skills, abilities, functioning, and emotional problems to use in developing a diagnosis. It requires obtaining information from many sources: observations in either controlled or naturalistic settings are usually made in conjunction with an interview and can have diagnostic significance. A person who is aware of being observed may show reactivity, altering normal responses. Interviews stress different information depending on the interviewers theoretical orientation. Standardized interviews, such as the highly structured Composite International Diagnostic Interview and the Structured Clinical Interview for DSM-IV-TR Internal Consistency and Interrater reliability, and the less structured mental status examination are widely used. Straightforward questions may not yield usable or accurate information.
3. Psychological tests and inventories (p. 77) Psychological tests have a wide range of application. They provide a standard situation for responses and allow comparison of results with normative samples. Projective personality tests present ambiguous stimuli and ask for responses that project the person's motives. The Rorschach technique is a series of cards displaying inkblots. What people see in the blots and why they see what they do are interpreted in terms of psychoanalytic symbolism. The Thematic Apperception Test (TAT) uses pictures of people and asks the person to tell a story about each picture. The style and themes of the stories are used to gain insight into conflicts and personality. The sentence-completion test and the draw-a-person test are other examples of projective tests. Projective tests tend to have low reliability and validity.
   Self-report inventories supply the test taker with a list of alternative answers. The Minnesota Multiphasic Personality Inventory (MMPI) consists of 567 statements that are answered true,false, or cannot say, and was revised to become the MMPI-2. MMPI-2 responses are scored on ten clinical and three validity scales. Profiles of scale results indicate personality styles. The Beck Depression Inventory (BDI) is an example of a test focused on a particular trait or problem. Inventories have been criticized for being restrictive, pathology oriented, and easily faked. Still, inventories are widely used, and some show both reliability and validity since the techniques used in making mental measurementpsychometricsare becoming increasingly sophisticated.
   Intelligence tests are designed to measure cognitive functioning, called the intelligence quotient (IQ), and to detect organic brain disorders. The Wechsler Adult Intelligence Scale (now revised in its third edition as the WAIS-III) and two other forms for children (WISC-III) and preschoolers (WPPSI-III) are widely used. Also used is the Stanford-Binet Scale. Ethnic groups have attacked IQ tests for being culturally biased, and it is clear that reliance on IQ has led to discrimination. Social competency cannot be adequately assessed with IQ tests. The System of Multicultural Pluralistic Assessment (SOMPA) and the Kaufman Assessment Battery for Children (K-ABC) are tests that address this and other criticisms.
   Tests for cognitive impairment are tests to detect and assess brain damaged to the central nervous system (organicity) include the WAIS-III, the Bender-Gestalt Visual-Motor Test, the Halstead-Reitan Neuropsychological Test Battery, and the Luria-Nebraska Neuropsychological Battery.
   Neurological tests are neurological medical procedures such as computerized axial tomography (CAT scan), positronemission tomography (PET scan), the electroencephalograph (EEG), and magnetic resonance imaging (MRI) are also used to assess brain conditions. Functional MRIs provide high resolution, noninvasive views of neural activity detected by a blood oxygen level dependent signal.
4. The ethics of assessment (p. 88) There is a strong antitesting movement in the United States. Criticisms include the undesirable social consequences of using test results and problems of using tests on people from non-Western cultures. Computer assessment has been viewed as a potential substitute for some testing. Studies of computer assessment have yielded encouraging results, but its validity must be established.
5. The classification of abnormal behavior (p. 89) The goal of a classification system is to provide distinct categories for different behavior problems. Classification systems should provide distinct categories that are used consistently but that still accommodate imperfect cases.
   Problems with early diagnostic classification systems (p. 90-91) Kraepelin's system and the original DSM were based on medical model principles and the hope that similar disorders would have a common etiology (cause). The Diagnostic and Statistical Manual of Mental Disorders (DSM) was first published in 1952 and is now revised for the sixth time (DSM-IV-TR). Interrater reliability of recent editions of the DSM has been good for broad categories, but less reliable for specific diagnoses. Older editions of the DSM were criticized for having poor reliability and validity, including an inability adequately to predict the future course of a disorder (prognosis).
6. The current system: DSM-IV-TR (p. 92) This newest version (2000) evaluates an individual on five dimensions or axes: Axis I, clinical syndromes; Axis II, personality or specific development disorders; Axis III, general medical conditions; Axis IV, psychosocial problems; and Axis V, global assessment of the highest level of adaptive functioning at the present time and over the past year. The five axes are intended to provide comprehensive and useful information.
7. DSM-IV-TR mental disorders (p. 93) The broad categories of mental disorders discussed in the text are: disorders usually first diagnosed in infancy, childhood, or adolescence; delirium, dementia, amnestic, and other cognitive disorders; mental disorders due to a general medical condition; substance-related disorders; schizophrenia and other psychotic disorders; mood disorders; anxiety disorders; somatoform disorders; factitious disorders; dissociative disorders; sexual and gender identity disorders; eating disorders; sleep disorders; impulse control disorders not elsewhere classified; adjustment disorders; and personality disorders. The DSM-IV-TR addresses cross-cultural assessment more than previous DSM versions.
8. Evaluation of the DSM classification system (p. 97) It is too soon to provide an evaluation of DSM-IV-TR; however, critics of past DSMs argue it is biased toward the medical model, lacks a theoretical basis for classifying disorders, does not adequately address psychopathology in non-Western cultures, and classifies people into categories rather than seeing them as having more or less of certain characteristics. There is also controversy over some proposed conditions, such as premenstrual dysphoric disorder, as sexist diagnoses. The debates, however, have been valuable in suggesting new research issues.
9. Objections to classification and labeling (p. 99) Classification can exaggerate the differences between normal and abnormal. It can also lead people to misinterpret normal behavior as pathological, affect the way people treat those who are labeled, change the behavior of people who are labeled (self-fulfilling prophecies), and fail to provide the information emphasized by managed-care organizations. Rosenhans study with pseudopatients illustrates some of these problems.