Chapter 15
Psychological Assessment and Diagnosis
249
et al., 2007), or pregnant and postpartum women’s psychosocial risks
(Bernazzani et al., 2005).
3
To illustrate, if I’m concerned that Mr. Smith is a xenophobe, I can
do one or more of four things: (a) I can observe Mr. Smith in interaction
with strangers; (b) I can ask Mr. Smith whether he’s afraid of strangers;
(c) I can ask people who know Mr. Smith to report their experience
of his attitudes about and behavior toward strangers; or (d) I can collect
data from a group of known xenophobes, establish that these data
distinguish them from a (control) group of “normal” (non-xenophobic)
people and from (comparison) groups of agoraphobes and other anxiety
disorders, assemble these distinguishing items in the form of a test,
and then administer this test to Mr. Smith. The test might be a list of
questions, or, if I discover that xenophobes reliably and uniquely mold
Play-doh
®
into kumquats, I might ask Mr. Smith to make something
with Play-doh
®
.
These four options correspond to the levels of inference described
by Tippins and Wittman (2005), from (a) the most robust, direct obser-
vation to (b) direct report to (c) indirect report, to the fourth and
weakest, (d) statistical inference. We fall back on statistical inference
as a practical necessity because resources (time, effort, and money)
often preclude sufficient direct observation, because individuals who
know that they are being observed behave differently,
4
because people
lie, and because character references usually come in equal and opposite
numbers. None of this is sufficient reason, however, to overlook the
weaknesses associated with statistical inference or to overstate the out-
comes thus derived. In fact, psychologists are ethically bound to clarify
the limitations associated with their methods,
5
in this case the relative
probabilities associated with test-derived hypotheses.
Is Mr. Smith a xenophobe? With no opportunity to observe him
in direct interaction with strangers, I ask him that directly and repeatedly
over several interviews in several different ways. He says “No.” I collect
references that he provides to me, all of which say “No” (of course
those provided by his estranged wife all say “Yes”). As a last resort, I
ask him to make something out of Play-doh
®
. He looks confused,
objects to the smell on his hands, but—eager to please the examiner—he
proceeds to make a kumquat. Even though I know that 999 out of
1,000 xenophobes are kumquat molders, I don’t know what percentage
of kumquat molders are xenophobes. I have to allow that he may have
had a kumquat for lunch or was once traumatized by a kumquat and
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