Deck 10: Clinical Judgment

Question 1

There is a widely held belief that adult children of alcoholics (ACOAs)possess certain personality characteristics.A study to determine whether the acceptance of such descriptors is due,at least in part,to the Barnum effect showed that

A) typical descriptors of ACOAs appear to discriminate this group of individuals from people who are not ACOAs.
B) typical descriptors of ACOAs do not appear to discriminate this group of individuals from people who are not ACOAs.
C) the usual descriptors of ACOAs do appear to possess a Barnum-like quality.
D) more than one of the above

Answer 1

more than one of the above

Question 2

Clinicians who approach patient data statistically and predict patient behavior according to correlations between objective variables should be aware of the fact that significant correlations may not apply to patients

A) with different comorbid diagnoses.
B) living in different communities.
C) of different cultures or subcultures.
D) all of the above

Answer 2

all of the above

Question 3

A clinician makes a clinical judgment based on his/her experience.He/she cannot identify specifically what the patient did or said to lead to this judgment.This clinician is utilizing the __________ approach to clinical judgment.

A) actuarial
B) mechanical
C) clinical
D) statistical

Answer 3

clinical

Question 4

A clinician uses interview data to make the clinical judgment that a client "is competent in many areas,but in other areas her performance may be hindered by a lack of confidence." Although the client may acknowledge the accuracy of this statement,its lack of specificity suggests that it exemplifies

A) the Stroop effect.
B) the Barnum effect.
C) stereotyped beliefs.
D) illusory correlation.

Question 5

The psychometric approach to clinical judgment and interpretation best characterizes __________ clinicians.

A) behavioral
B) empirical/objective
C) psychodynamic
D) humanistic

Question 6

Dr.Humboldt adheres to the quantitative,statistical approach to clinical judgment and interpretation.Furthermore,he knows that there is a strong association between childhood sexual abuse and borderline personality disorder.Which of the following is a safe assumption for Dr.Humboldt to make?

A) If Patient A reports a history of sexual abuse during childhood, then he or she is guaranteed to have borderline personality disorder.
B) If Patient A reports a history of sexual abuse during childhood, then there is a 75% chance that he or she has borderline personality disorder.
C) If Patient A reports a history of sexual abuse during childhood, then there is an increased probability that he or she has borderline personality disorder, relative to patients without that history.
D) If Patient A reports a history of sexual abuse during childhood, then he or she is more likely than not to have borderline personality disorder.

Question 7

A clinical psychologist interprets a client's phobic behavior as a sign of underlying pathology in the client.This clinical psychologist is most likely

A) psychodynamic.
B) behavioral.
C) a Ph.D. rather than a Psy.D.
D) cognitive-behavioral.

Question 8

Some clinical psychologists resist the statistical approach because,in their opinion,

A) it is based on short-term prediction.
B) it is inferior to the judgment of experts in the field.
C) it dehumanizes clients.
D) all of the above

Question 9

A clinical psychologist interprets a client's phobic behavior as a sample of that client's typical behavior.This clinical psychologist is most likely

A) psychodynamic.
B) a group therapist.
C) behavioral.
D) humanistic.

Question 10

A clinician who uses the clinical approach to clinical judgment is likely to base his/her judgments on

A) actuarial data.
B) intuition.
C) empirical literature.
D) computer-generated predictions.

Question 11

A clinician who is more comfortable making predictions mechanically,based upon correlations between variables,rather than intuitively,based upon clinical impressions,exhibits a __________ approach to clinical judgment.

A) quantitative
B) qualitative
C) subjective
D) clinical

Question 12

When psychologists make clinical judgments or interpretations,they may view patient data as

A) samples of behavior outside the psychologists' office.
B) correlates of other behaviors or emotions.
C) signs of an underlying state or condition.
D) all of the above

Question 13

According to Meehl (1957),what is one of the biggest roadblocks to adopting the statistical approach to judgment and interpretation?

A) Clinicians are generally not very adept at statistical analysis.
B) Most decisions required of clinicians are too complex to be addressed though statistical means.
C) There are currently too few well-validated formulas available to assist, in a meaningful way, with clinical interpretation and prediction.
D) none of the above

Question 14

Clinical interpretation may be influenced by ALL BUT WHICH of the following?

A) the patient's gestures
B) the patient's test scores
C) the clinician's theoretical orientation
D) All of the above may influence clinical interpretation.

Question 15

In which situation below is a clinical approach to judgment and interpretation most likely to be helpful?

A) A clinician is helping a technical training program identify the individuals, from a diverse application pool, that are likely to succeed in the program.
B) A clinician is helping a security company choose the best job candidate from a homogenous group of highly selective applicants.
C) A clinician has been contacted by a public school district to determine which children make the first cut for a free after-school tutoring program.
D) The clinical approach to judgment will be equally helpful (or unhelpful) across all of the situations described.

Question 16

The statistical approach to clinical judgment is best used when

A) the percentage of correct predictions is more important than the correct prediction of the performance of any one individual.
B) the outcome to be predicted is not very specific.
C) both of the above
D) neither of the above

Question 17

The statistical approach to clinical judgment relies on ALL BUT WHICH of the following?

A) inductive and deductive reasoning
B) explicit norms
C) specific predictors
D) regression equations

Question 18

"Barnum" statements

A) are overly positive in tone.
B) exaggerate people's characteristics, similar to fun-house mirrors.
C) are so general as to be true of almost everyone.
D) are more negative or pessimistic than warranted.

Question 19

Which of the following is true of the clinical approach to judgment and interpretation?

A) The clinician functions like an actuary, adjusting the likelihood of various outcomes up and down based on objective factors.
B) The clinician attends to only the most important aspects of the patient's circumstances (e.g., level of education, history of trauma) in arriving at a judgment.
C) The clinician often assumes a certain similarity between the patient and him- or herself in interpreting the patient's behaviors.
D) The clinician is as likely to recall his or her misinterpretations as his or her valid predictions.

Question 20

In general,empirical/objective clinicians regard patient data as

A) correlates.
B) projective.
C) samples.
D) signs.

Question 21

Compared to clinical prediction,statistical prediction typically

A) is more expensive.
B) places greater demands on personnel.
C) both of the above
D) neither of the above

Question 22

Research investigating the validity of judgments about mental health diagnoses has found that

A) medical practitioners are more accurate than nonmedical practitioners.
B) there is no difference in the accuracy of medical and nonmedical practitioners.
C) nonmedical practitioners are slightly more accurate than medical practitioners.
D) nonmedical practitioners are much more accurate than medical practitioners.

Question 23

A recent,large-scale meta-analysis of clinical judgment studies (Spengler et al.,2009)suggests that higher levels of clinical experience

A) are associated with greatly improved prediction.
B) are associated with slightly improved prediction.
C) have no impact on prediction quality.
D) are negatively associated with prediction quality.

Question 24

The clinical approach to clinical judgment is especially valuable in all of the following cases EXCEPT

A) when information is needed about areas for which no adequate assessments are available.
B) when the task involves predicting outcomes for large, heterogeneous samples, and interest in individual cases is minimal.
C) when the clinical judgment involves predictions for which no statistical equations have been developed.
D) when the clinical judgment involves the prediction of rare, unusual events of a highly individualized nature.

Question 25

In the last few decades,a variety of reviews of studies comparing clinical and statistical prediction have

A) demonstrated the superiority of statistical prediction.
B) demonstrated the superiority of clinical prediction.
C) suggested that the two are roughly equivalent.
D) suggested that neither of the two should be used in isolation.

Question 26

In a comprehensive review of studies comparing clinical and statistical prediction,Grove et al.(2000)reported that

A) statistical prediction was superior to clinical prediction only when the judges were psychologists.
B) statistical prediction was superior to clinical prediction only when the judges were physicians.
C) statistical prediction was superior to clinical prediction only when the prediction did not involve psychotherapy outcome.
D) statistical prediction was superior to clinical prediction across a wide variety of conditions.

Question 27

According to a review of the empirical evidence for bias in clinical judgment (Garb,1997),

A) Black and Hispanic patients who have psychotic mood disorders are more likely to be misdiagnosed with schizophrenia than are similar White patients.
B) Black patients are less likely to be prescribed anti-psychotic medications than other racial groups, even when the Black patients are more psychotic.
C) both of the above
D) neither of the above

Question 28

In a 1954 paper summarizing studies that had compared clinical and statistical prediction,Meehl observed that statistical predictions often were made on the same data from which the regression equations were developed.In other words,the efficiency of the formulas __________ because they __________,

A) was overestimated; were not cross-validated.
B) was overestimated; did not fit the data.
C) was underestimated; were not cross-validated.
D) was underestimated; did not fit the data.

Question 29

Garb (1997)reviewed the empirical evidence for social class bias,race bias,and gender bias in clinical judgment.Based on this review,the author recommended that clinicians should

A) use statistical prediction rules instead of clinical prediction or judgment whenever possible.
B) accept only clients who are similar to the therapist in terms of race, social class, and gender to the extent possible.
C) both of the above
D) neither of the above

Question 30

Goldberg's (1965)study,in which the accuracy of clinical judgments by Ph.D.-level and predoctoral clinicians was compared to those based on statistical indices,concluded that

A) doctoral-level clinicians were significantly superior to predoctoral clinicians.
B) clinicians in general were significantly superior to statistical indices.
C) both of the above
D) neither of the above

Question 31

According to a review of the empirical evidence for bias in clinical judgment (Garb,1997),

A) women patients are judged to be more dysfunctional than men patients.
B) 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.
C) both of the above
D) neither of the above

Question 32

According to the text,clinical psychologists do not appear to be particularly good at predicting future behavior.For instance,many studies show that violence is often overpredicted for both __________ and __________.

A) men; convicted felons
B) men; African Americans
C) African Americans; convicted felons
D) men; adolescents

Question 33

Dr.Krupp,a clinical psychologist,has a strong need for order,and believes that he world is a predictable place.Knowing only this and Dawes's (1994)theorizing,how would you guess she regards the different approaches to clinical judgment and interpretation?

A) Dr. Krupp is likely to adhere to the clinical approach to judgment and interpretation.
B) Dr. Krupp is not likely to adhere to the clinical approach to judgment and interpretation.
C) Dr. Krupp is likely to adhere to the statistical approach to judgment and interpretation.
D) more than one of the above

Question 34

According to a review of the empirical evidence for bias in clinical judgment (Garb,1997),

A) lower socioeconomic status patients are judged to be more seriously disturbed than those of higher socioeconomic status.
B) middle class patients are more likely to be referred for psychotherapy than lower-class patients.
C) both of the above
D) neither of the above

Question 35

Research has shown that clinical experience increases only slightly the accuracy of one's clinical predictions.ALL BUT WHICH of the following did the textbook offer as an explanation for this finding?

A) The measures upon which mental health professionals base their predictions do not have high validity, so they are no more valid in experienced hands than in inexperienced ones.
B) Once clinicians obtain job security, any enhanced accuracy from their experience is canceled out by a corresponding decrease in effort.
C) Clinicians often receive no feedback about their predictions, so they cannot learn from their experience.
D) Clinicians are biased toward remembering their accurate predictions and forgetting their inaccurate ones.

Question 36

Those who refute the finding that statistical judgment is better than clinical judgment argue that

A) some individuals (the most "expert" clinicians) are in fact as good as statistical formulas.
B) the tasks utilized in clinical prediction studies are not representative of the prediction situations facing clinicians.
C) many of the clinical prediction studies reviewed have significant design flaws.
D) all of the above

Question 37

Among the following,the name most closely associated with support for the statistical or actuarial approach to prediction is

A) Murray.
B) Meehl.
C) Exner.
D) Millon.

Question 38

Given what we know about the clinical approach to judgment and interpretation,clinicians are LEAST likely to excel at

A) integrating large amounts of information in their heads to arrive at a sound judgment.
B) deciding what clinical information may have a bearing on a particular judgment.
C) gathering data from clients that is likely to be useful for purposes of prediction.
D) helping discriminate among individuals after initial screenings have been completed.

Question 39

Which of the following illustrates bias in clinical judgment?

A) Women and men endorse different combinations of depressive symptoms.
B) A higher percentage of women than men are diagnosed with major depression.
C) A higher percentage of women than men are diagnosed with major depression even when both exhibit precisely the same symptoms.
D) more than one of the above

Question 40

In a comprehensive review of studies comparing clinical and statistical prediction,Grove et al.(2000)reported that

A) statistical prediction was superior in about 50% of the studies.
B) statistical prediction was superior in none of the studies.
C) statistical and clinical prediction were roughly equal in almost all of the studies.
D) clinical prediction was superior in about 25% of the studies.

Question 41

Describe a position that integrates the clinical and actuarial approaches to clinical judgment and interpretation.What role(s)does the clinician play in such an approach?

Question 42

ALL BUT WHICH of the following is an accurate statement about prediction?

A) Clinicians are often asked to make specific predictions about client behavior.
B) It is usually possible to make valid, specific predictions on the basis of diagnostic and general background information.
C) Sometimes predictions may appear invalid because people change their behavior in response to them.
D) All of the above are accurate statements about prediction.

Question 43

What are the advantages and disadvantages of the subjective,clinical approach to clinical judgment and interpretation? When is it especially valuable?

Question 44

Summarize Dr.Paul Meehl's primary complains in his paper,"Why I Do Not Attend Case Conferences." You need not use the terms he used,as long as you accurately convey the concepts.

Question 45

Explain how stereotyped beliefs may affect one's clinical judgment,providing one example.What are three ways that clinical psychologists may try to combat the effects of bias on their clinical judgments?

Question 46

How are clinical reports typically organized? What major sections should be included in most types of reports?

Question 47

In what ways might clinical judgment and interpretation be improved?

Question 48

Summarize the results of empirical research comparing clinical and actuarial approaches to clinical judgment and prediction.

Question 49

ALL BUT WHICH of the following is good advice when it comes to report writing?

A) Make sure the report addresses the referral question(s).
B) Include information that is detailed and specific to the client.
C) Write more than one version of the report in certain special situations.
D) All of the above is good advice.

Question 50

Dr.Doyle is meeting a client for an assessment.While testing the client and gathering data about her history,a number of contradictions arise-contradictions that Dr.Doyle is unable to resolve.When it comes time to write his report,what should Dr.Doyle do?

A) He shouldn't bother noting the presence of contradictions at all, so as not to confuse the reader.
B) He should mention the contradictions briefly, but play down their importance.
C) He should describe the contradictions in adequate detail for the reader.
D) How he handles this situation will depend upon the specific referral source.

Question 51

Which of the following is true according to Golden's (1964)research regarding clinicians' predictions?

A) When clinicians make predictions based on three personality tests rather than one, the clinicians tend to be more confident.
B) When clinicians make predictions based on three personality tests rather than one, the predictions tend to be more valid.
C) both of the above
D) neither of the above

Question 52

Intuitive predictions of patient behavior often

A) ignore base rates.
B) fail to consider regression effects.
C) assume that highly correlated predictors will yield higher validity.
D) all of the above

Question 53

Which of the following interpretive fallacies,as described by Meehl (1977),is best illustrated by the clinician who argues that a patient's psychotic delusions are real to him/her,and therefore non-pathological?

A) Uncle George's pancakes fallacy
B) sick-sick fallacy
C) multiple Napoleons fallacy
D) me-too fallacy

Question 54

Clinical judgment and interpretation can be improved by

A) resisting the temptation to oversimplify inherently complex patients.
B) recording and evaluating the validity of predictions.
C) using structured rating scales and objective tests.
D) all of the above

Question 55

Which of the following interpretive fallacies,as described by Meehl (1977),is best illustrated by the clinician who deems a patient non-pathological when in fact the patient demonstrates the same pathology as the clinician?

A) sick-sick fallacy
B) multiple Napoleons fallacy
C) me-too fallacy
D) understanding it makes it normal fallacy

Question 56

What is the relationship between clinical experience and the accuracy of clinical predictions? Explain.

Question 57

Dr.Dougherty is a clinical psychologist.If he is like many other clinical psychologists when making clinical judgments,Dr.Dougherty will

A) often err by interpreting benign cues as indicative of psychopathology.
B) often err by failing to take a person's strengths into account.
C) both of the above
D) neither of the above

Question 58

The statistical approach to clinical judgment is especially valuable when

A) the outcome to be predicted is objective and specific.
B) there is reason to be particularly concerned about human judgmental error or bias.
C) both of the above
D) neither of the above

Question 59

What are the advantages and disadvantages of the quantitative,statistical approach to clinical judgment and interpretation? When is it especially valuable?

Question 60

What is the purpose of the clinical report? How should reports be written to best achieve this purpose?