Clinical Assessment of Child and Adolescent Personality and Behavior

Transcription

1 Clinical Assessment of Child and Adolescent Personality and Behavior

2 Clinical Assessment of Child and Adolescent Personality and Behavior Third Edition Paul J. Frick University of New Orleans, New Orleans, LA, USA Christopher T. Barry University of Southern Mississippi, Hattiesburg, MS, USA Randy W. Kamphaus Georgia State University, Atlanta, GA, USA

3 Paul J. Frick University of New Orleans New Orleans, LA USA Christopher T. Barry University of Southern Mississippi Hattiesburg, MS USA Randy W. Kamphaus Georgia State University Atlanta, GA USA ISBN e-isbn DOI / Springer New York Dordrecht Heidelberg London Library of Congress Control Number: Springer Science+Business Media, LLC st edition: Allyn & Bacon, nd edition: Springer Science+Business Media, LLC 2005 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (

4 To my inspiration, Vicki, Josh, Jordan, and Jacob (PJF) To my home team, Tammy and Andersen (CTB) To the memory of my parents, Richard and Nancy Kamphaus (RWK)

5 C o n t e n t s Preface xi Part I Basic Issues Chapter 1 Historical Trends 3 Chapter Questions 3 Definitions of Terms in Personality Assessment 4 Early History of Personality Assessment 6 Projective Techniques 7 The Diagnostic and Statistical Manual of Mental Disorders Diagnostic Systems 16 IDEA and Special Education 17 Future Trends 19 Chapter Summary 19 Chapter 2 Measurement Issues 21 Chapter Questions 21 Defining Personality Tests 22 Scores, Norms, and Distributions 25 Reliability 34 Construct Validity 37 Utility 44 Conclusions 45 Chapter Summary 45 Chapter 3 Classification and Developmental Psychopathology 47 Chapter Questions 47 Science and Assessment 47 Classification 48 Developmental Psychopathology 58 Conclusions 64 Chapter Summary 65 Chapter 4 Standards and Fairness 67 Chapter Questions 67 APA Ethical Principles of Psychologists 68 Test Standards 69 Conclusions 79 Chapter Summary 79 Chapter 5 Planning the Evaluation and Rapport Building 81 Chapter Questions 81 Non-specifics in Clinical Assessment 81 Clarifying the Referral Question 82 Designing the Evaluation 85 To Test or Not to Test 88 Rapport Building 89 Conclusions 96 Chapter Summary 97 vii

6 viii contents Part II Assessment Methods Chapter 6 Self-Report Inventories 101 Chapter Questions 101 Omnibus Personality Inventories 101 Single Construct Personality Inventories 138 Conclusions 138 Chapter Summary 139 Chapter 7 Parent and Teacher Rating Scales 141 Chapter Questions 141 Evaluating Children via Parent Ratings 141 Evaluating Children via Teacher Ratings 143 Overview of Omnibus Parent and Teacher Rating Scales 144 Behavior Assessment System for Children, 2nd Edition (BASC-2) 145 Achenbach System of Empirically Based Assessment (Achenbach & Resorla, 2000, 2001) 156 Child Symptom Inventory-4 (CSI-4) 166 Conners, 3rd Edition (Conners-3) 170 Personality Inventory for Children-2 (PIC-2); Student Behavior Survey (SBS) 174 Sample Impairment-Oriented Scales 183 Conclusions 185 Chapter Summary 187 Chapter 8 Behavioral Observations 189 Chapter Questions 189 Basics of Observational Systems 192 Examples of Observational Systems 200 Conclusions 207 Chapter Summary 208 Chapter 9 Peer-Referenced Assessment 211 Chapter Questions 211 Ethics of Peer-Referenced Strategies 212 Types of Peer-Referenced Techniques 214 Other Peer-Referenced Techniques 223 Conclusions 223 Chapter Summary 223 Chapter 10 Projective Techniques 225 Chapter Questions 225 The Controversy Surrounding Projective Techniques 225 Inkblot Techniques 231 Thematic (Storytelling) Techniques 236 Sentence Completion Techniques 243 Drawing Techniques 245 Conclusions 250 Chapter Summary 250 Chapter 11 Structured Diagnostic Interviews 253 Chapter Questions 253 History 253 Overview 254 Evaluation of Diagnostic Interviews 259 Recommendations for Use of Structured Interviews 261 Focus on the NIMH Diagnostic Interview Schedule for Children (DISC-iv) 265 Conclusions 269 Chapter Summary 269

7 contents ix Chapter 12 Assessing Family Context 271 Chapter Questions 271 Introduction 271 Assessing Family Functioning: General Issues 276 General Considerations in Assessing Family Functioning 277 Parenting Styles and Practices 280 Parenting Stress 288 Marital Conflict 291 Parental Adjustment 293 Conclusions 296 Chapter Summary 296 Chapter 13 History Taking 299 Chapter Questions 299 Content 307 Formats 307 Conclusions 313 Chapter Summary 314 Chapter 14 Adaptive Behavior Scales 315 Chapter Questions 315 History of the Construct 315 Characteristics of Adaptive Behavior Scales 318 Omnibus Adaptive Behavior Scales 322 General Recommendations 327 Measuring Social Skills 332 Conclusions 334 Chapter Summary 334 Part III Advanced Topics Chapter 15 Integrating and Interpreting Assessment Information 339 Chapter Questions 339 Introduction 339 Integrating Information across Informants 342 A Multistep Strategy for Integrating Information 347 Step1: Document all Clinically Significant Findings Regarding the Child s Adjustment 349 Step2: Look for Convergent Findings Across Sources and Methods 349 Step3: Try to Explain Discrepancies 353 Step4: Develop a Profile and Hierarchy of Strengths and Weaknesses 353 Step5: Determine Critical Information to Place in the Report 354 Conclusions 355 Chapter Summary 355 Chapter 16 Report Writing 357 Chapter Questions 357 Reporting Problems and Challenges 357 Report Writing as Part of Evidence-Based Assessment 359 Pitfalls of Report Writing 360 Suggested Practices 365 Adapting Reports to Audience and Setting 368 The Sections of the Psychological Report 369 Communicating Results Orally 373 Conclusions 375 Chapter Summary 376

8 x contents Chapter 17 Assessment of Attention Deficit Hyperactivity and Disruptive Behavior Disorders 377 Chapter Questions 377 Introduction 377 Attention-Deficit Hyperactivity Disorder 378 Conduct Problems 398 Conclusions 410 Chapter Summary 412 Chapter 18 Assessment of Depression and Anxiety 413 Chapter Questions 413 Internalizing Disorders 413 Childhood Depression 414 An Assessment Strategy for Depression 422 Anxiety Disorders of Childhood 425 An Assessment Strategy for Anxiety 431 Conclusions 434 Chapter Summary 434 Chapter 19 Assessment of Autism Spectrum Disorders 437 Chapter Questions 437 Definitional Issues 437 Specialized Measures of Autism 439 An Assessment Strategy for Autism 445 A Sample Case of Autism in a Child with Neurological Impairment 447 Conclusions 452 Chapter Summary 452 References 453 Author Index 491 Subject Index 503

9 P r e f a c e Psychologists offer an increasing variety of serv ices to the public. Among these services, psychological assessment of personality and behavior continues to be a central activity. One main rea son is that other mental health professionals often do not possess a high level of competence in this area. When one views psychologists who serve children and adolescents, psychological, assessment seems to take on an even greater role. It follows, then, that comprehensive and enlightened graduatelevel instruction in assess ment should be a high priority for educators of psychologists who are destined to work with youth. This book is an outgrowth of our efforts to improve our own instruction of child and adoles cent assessment skills. We found that existing textbooks were not serving us well. Most of them were encyclopedic, edited volumes that were (1) uneven in the quality across chapters and/or (2) not geared either in format or level of presentation for beginning graduate instruction. The few single- or co-authored volumes available tended to lack the breadth of coverage we deemed necessary. Some focused largely on the oretical issues related to psychological testing, with minimal discussion of practical applications and use of specific tests. Others focused solely on summaries of individual tests, without reviewing the theoretical or empirical context within which to use the tests appropriately. Hence, this volume reflects our desire to provide a more helpful tool for instruction - one that provides a scien tific context within which to understand psychological testing with children and adolescents and that translates this scientific context into practi cal guidelines for using individual tests in clinical practice. Among our specific objectives for this volume are the following: To focus on measures specifically designed to assess the emotional, behavioral, and social functioning of children and adolescents To provide current research findings that enable students to draw heavily on science as the basis for their clinical practice To help in the translation of research into practice by providing specific and practical guidelines for clinical practice To include a broad coverage of assessment methods from a variety of theo retical, practical, and empirical traditions To systematically compare tests and assess ment methods using research findings, reviews, and our own synthesis of positions To provide a readable volume that would en hance the interest and retention of students through the use of numerous xi

10 xii case examples, tables, research notes, and other boxes containing practical advice In writing a readable text that goes beyond a cursory survey of available instruments, we were faced with the difficult task of determining what specific instruments to include in the book. As we struggled with this decision, we eventually chose several selection criteria. Our main crite rion for inclusion was a test s ability to serve as an exemplar of some specific type of assessment in strument or theoretical approach to assessment. In many cases we looked for prototypes that we thought would highlight some key points to the reader that could then be used in evaluating other assessment instruments not covered specif ically in the text. Other criteria included a test s popularity or our estimate of a new test s poten tial impact on the field. Granted, this decision- making was highly subjective, but we strove to be analytic and to limit to the extent possible our personal feelings and biases. Fortunately, several external anonymous reviewers of earlier drafts of the text helped us to be more objective. A final point that should be clearly outlined is our basic orientation to psychological assess ment. We feel that the goal of psychological as sessment is the measurement of psychological constructs and, for clinical practice, measurement of psychological constructs that have important clinical implications, such as documenting the need for treatment or the type of intervention that is most appropriate. For an individual child the constructs that need to be assessed will vary from case to case and depend on the referral question. But what is important from this con ceptualization is that our view of psychological assessment is not test-driven but construct-driven. Without exception, assessment techniques will measure some constructs well and other psychological dimensions less well. Another important implication from preface this view of testing is that it is critical that assessors become familiar with and maintain familiarity with research on the constructs they are trying to assess. In short, the most critical component in choosing a method of assessment and in interpreting assessment data is understanding what one is trying to measure. In this volume, we have focused on the meas urement of psychological constructs that em phasize a child s emotional, behavioral, and social functioning. There is still a great debate over definitional issues in this arena of psychological functioning in terms of what should be called personality, temperament, behav ior, or emotions, with distinctions usually de termined by the level of analysis (e.g., overt behavior vs. unconscious motivational processes), assumed etiology (e.g., biologically determined vs. learned), or proven stability (e.g., transient problems vs. a stable pattern of functioning) (see Frick, 2004; Martin, 1988). Unfortunately, people often use the same terms with very different connotations. In writing this text, we tried to avoid this debate by maintaining a broad focus on psychological constructs, which often vary on the most ap propriate level of analysis, assumed etiol ogy, or stability. This definitional variability adds a level of complexity to the assessment process because assessors must always consider what they are attempting to measure in a partic ular case and what research suggests about the best way of conceptualizing this construct before they can select the best way of measuring it. It would be much easier if one could develop ex pertise with a single favorite instrument or a sin gle assessment modality that could be used in all evaluations to measure all constructs. Because this is not the case, psychologists must develop broad-based assessment expertise. Hence, our overriding objective in writing this volume is to provide the breadth of coverage that we feel is needed by the psychologist in training.

11 preface xiii We have organized the text into three sec tions consistent with our approach to teaching. Part I provides students with an introduction to the psychological knowledge base necessary for modern assessment practice including historical perspectives; meas urement science; research in developmental psychopathology; ethical, legal, and cultural issues; and the basics of beginning the assessment process (e.g., planning the evaluation, rapport building). Part II gives students a broad review of the specific assess ment methods used by psychologists, accompa nied by specific advice regarding the use and the strengths and weaknesses of each method. In Part III we help students perform some of the most sophisticated of assessment practices: inte grating and communicating assessment results and infusing assessment practice with knowledge of child development and psychopathology. We think that, on completion of this volume, and a similar one covering aspects of cognitive assess ment (Kamphaus, 2001 and in press), that the student psy chologist has the background necessary for supervised practicum experiences in the assessment of chil dren and adolescents. Paul J. Frick Christopher T. Barry Randy W. Kamphaus