Chapter 10

Clinical Judgment

MULTIPLE CHOICE

1.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.

2.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

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

a. behavioral

b. empirical/objective

c. psychodynamic

d. humanistic

4.In general, empirical/objective clinicians regard patient data as

a. correlates.

b. projective.

c. samples.

d. signs.

5.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.

6.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.

7.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

8.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.

9.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

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.

11.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

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12.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.

13.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

14.“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.

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15.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.

16.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

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

18.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

19.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

20.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.

21.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.

22.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.

23.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

24.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.

25.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.

26.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.

27.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

28.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.

29.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

30.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