Psychodiagnostic Assessment

UNIT 5.5
Assessment tools – screening tools

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 Screening tools
▷ Screening tools are brief, symptom-focused instruments and can be used to check for
a broad range of possible issues that may need clinical attention.
▷ These tools represent a “first pass” over the variety of issues that may concern a
person who seeks mental health assistance.
▷ They are meant to provide a gross indication of level of symptom severity in select
areas and, often, to indicate where to focus subsequent assessment efforts.
▷ Screening measures are not validated for use as diagnostic instruments.
▷ Rather, these measures provide additional information on the nature and intensity of
a client’s concerns.

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 Beck Depression Inventory (BDI)
▷ The BDI is one of the most widely used psychometric tests for measuring attitudes
and symptoms of depression (Beck, et al., 1961).
▷ It is a self-report rating inventory with 21 items and takes approximately 10 minutes
to complete
▷ It might be used
○ to detect the possible presence of depression
○ to determine the baseline level of depression severity for a client
○ to determine the effectiveness of interventions targeted to treat the depression
(repeated administration pre-post)

Scoring: sum of raw scores

14 – 19 Mild depression
20 - 28 Moderate depression
29 – 63 Severe depression
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 STATE TRAIT ANXIETY INVENTORY (STAI)
▷ The STAI (Spielberger et al., 1983) is a brief (40-item), self-report inventory that is
sensitive to transitory episodes of anxiety (states) as well as more stable personality
features that predispose a client to experiencing more chronic levels of anxiety
(traits).
▷ Respondents are asked to respond on a 4-point scale (“Almost Never” to “Almost
Always” for the trait scale and “Not at All” to “Very Much” for the state scale) to
items related to their current anxiety and their general state of worry.
Interpretation
▷ The interpretation is mainly composed of descriptions for the variables being
measured. Interpretation should consider both the variable itself and the relative
magnitude of the person’s score (Growth-Marnat & Wright, 2016)

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 STATE TRAIT ANXIETY INVENTORY (STAI)
Interpretation
High T-Anxiety
▷ The person is likely to perceive a wide number of situations as threatening or dangerous; the person is
especially likely to be concerned with being evaluated by other people, with corresponding threats to self-
esteem.
High S-Anxiety
▷ The person has feelings of apprehension, worry, nervousness; unpleasant, consciously perceived feelings of
tension; the person is also likely to report corresponding activation of the autonomic nervous system.
High S-Anxiety/Low T-Anxiety
▷ The anxiety the person is reporting is likely to be caused by some external threat or a current situational
stressor. As a result, it is likely to resolve itself.
High T-Anxiety/Low S-Anxiety
▷ Although the person is not currently reporting anxiety, he or she is prone to reacting to situations in such a way
as to easily become anxious. He or she is likely to be extremely concerned with threats to self-esteem and, as a
result, might be apprehensive in any interpersonal situation in which he or she might be judged.

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 SYMPTOM CHECKLIST–90–R
▷ The Symptom Checklist–90–R (SCL-90-R; Derogatis, 1994) and its shortened
version, the Brief Symptom Inventory (BSI; Derogatis, 1993), are ideally suited to
quickly assess a client’s type and severity of self-reported symptoms.
▷ It is not a personality measurement; but an assessment of the current level of a variety
of symptoms experienced over a 1-week interval.
▷ The inventory consists of 90 items, using a 5-point scale.
▷ The SCL-90-R yields scores on nine scales and three global scores (Global Severity
Index, Positive Symptom Total, and Positive Symptom Distress Index).
▷ Norms are differentiated by age (adolescent and adult) for nonpatients and by
psychiatric patient status (nonpatient, inpatient, and outpatient) for adults, with each
norm keyed by gender.
Test-retest reliability 0.78 – 0.9
Internal consistency 0.79 – 0.9
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 SYMPTOM CHECKLIST–90–R
Global indexes

Global Severity Index (GSI) Overall psychological distress

Positive Symptom Distress Index

Intensity of symptoms
(PSDI)

Positive Symptom Total (PST) Number of symptoms

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 SYMPTOM CHECKLIST–90–R
SCORING

Total score of symptoms

2. Global Severity Index (GSI)
90
Number of items with a value
3. Positive Symptom Total (PST)
different from 0

4. Positive Symptom Distress Index GSI ∙ 90

(PSDI) PST

Convert to T score
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 SYMPTOM CHECKLIST–90–R
Symptomatic dimensions

Total score of symptoms of each dimension

Total items of each dimension

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 SYMPTOM CHECKLIST–90–R
Symptom scales
▷ SOM - Somatization ▷ T scores above 63 on two or more of the
▷ O-C - Obsessive-Compulsive dimensions suggest that the person has
clinically significant levels of
▷ I-S - Interpersonal Sensitivity
psychological distress
▷ DEP - Depression
▷ ANX - Anxiety
▷ HOS - Hostility
▷ PHOB - Phobic Anxiety
▷ PAR - Paranoid Ideation
▷ PSY - Psychoticism

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 SYMPTOM CHECKLIST–90–R
▷ Search in the tables the corresponding percentile for the scores (the most proximate
value). The tables indicate the percentile and the T value:

○ Percentile: indicates the percentage of subjects that score inferior in relation to

the evaluated person. E.g. a percentile of 80 in Somatization indicates that the
person scores higher in that domain than 80% of the referent group.

○ T value: T values constitute a scaled value of the score, with a mean of 50 and
SD of 10. This means that two thirds of the population score between 40 and 60,
and that 95% score between 30 and 70.

▷ A person who scores above the highest score in the table receives a percentile of 99%
and a T value of 75.
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SYMPTOM CHECKLIST–90–R

80% 20%

Individual´s score:
percentile 80 14
Healthy population - males

Percentile

T-score

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Healthy population - females

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Patients with psychosomatic-
temporomandibular dysfunction

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Psychiatric sample - males

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Psychiatric sample - females

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