By Julie A. Suhr PhD
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Additional info for Psychological Assessment: A Problem-Solving Approach
Interestingly, Graber (2009) argued that, to become an expert, an assessor needs subspecialization training to become an expert in one particular type of condition. Given the potential for this kind of limited and focused condition-specific experience to contribute to decision-making biases (as discussed above), this seems a dangerous suggestion. In fact, researchers 26 PSYCHOLOGICAL ASSESSMENT have shown that subspecialists tend to overdiagnose pathology in the particular organ system in which they specialize (Hashem, Chi, & Friedman, 2003), consistent with the representativeness bias.
Furthermore, there is often little to no consideration of the multitude of factors that might contribute to the client’s presenting concerns or areas of dysfunction—factors that might not only rule out a diagnosis completely and/or lead to other nonpsychological diagnoses, but might also have important treatment implications. Interestingly, one stated advantage of diagnoses is that, when done correctly, they “tell the story”; that is, they quickly communicate information about potential etiological factors, contributing concerns, and treatment recommendations.
As the evaluation commences, listing all possible diagnoses (and their base rates) 32 PSYCHOLOGICAL ASSESSMENT will give the assessor a priori weights with which to consider any further observations and data points as the assessment progresses (Millis, 2009). In the interview and through the entire assessment, the assessor should consider base rates of symptoms and symptom sets and how their presence (or absence) affects the weighting of any of the various diagnoses under consideration. The assessor should be careful to consider both confirmatory and disconfirmatory data for each hypothesis.