Health Behavior Assessment

Health Behavior Assessment

Mr. Lema, IsaacClinical Psychologist

23rd November 2015

Learning Objectives Understand the meaning of assessment and

principle of measurement

Familiarize with different methods used in behavioral assessment

23 November 2015 Health Behavior Assessment 2

Outline Introduction Behavioral Assessment Context in Clinical

Setting Assessment Tools Principles of Measurement Assessment on Learning Theories Skinner’s Analysis of Behavior Problems in Assessment23 November 2015 3Health Behavior Assessment

Introduction Assessment is the process of gathering

information about peoples symptoms and the possible causes of those symptoms

Information to inform diagnosis

Diagnosis label attached to a set of symptoms that tend to occur with one another


Behavioral Assessment Context in Clinical Setting

Differs from traditional assessment in 3 ways1. Interested in samples of behavior, not

behavior as a sign of internal processes In behavioral assessment, test / interview

responses are interpreted as “samples” of behavior that are thought to generalize to other situations

In traditional assessment, interpret test data as “signs” of internal processes


Behavioral Assessment Context in Clinical Setting …

2. Functional Analysis, a very concrete method, is employed to understand behavior

3. Assessment is an ongoing, active part of all phases of treatment

Not just always in the back of clinician’s mind, as in other types of treatment

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Functional Behavioral Analysis / Functional Analysis

Derived from Skinner’s work with SR learning SORC model ABC model (very similar) Isolates a target behavior for analysis and

understanding in a very concrete, prescript manor


SORC Model for Conceptualizing a Behavior

S = stimulus or “antecedent” factors which occur before target behavior

O = organismic variables relevant to target behavior Physical / medical / cognitive / psychological

aspects of the client; that are relevant to treating the target behavior

R = the response; the target behavior C = consequences of target behavior23 November 2015 8Health Behavior Assessment

Example of SORC model S – Stimulus: a child is ignored by her peers in

class O – Organismic: the child has previously been

diagnosed with ADHD) R – Response: She increases the volume of her

voice (i.e., yells) C – Consequences: her peers pay attention to

her, some role their eyes


Skinner’s Analysis of Behavior

ABC of operant conditioning Antecedents (the stimulus conditions)

Behaviors (or operant)

Consequences (what happens as a result of the operant behavior – reinforcement or punishment)


Assessment Tools Clinical interviews or initial interview

Unstructured Structured

Test / screening tools Checklists, rating scales, self rating scale


Method Studying Behavior Observation

Naturalistic or Controlled Observation Assess deficits in skills or way of handling

situations Controlled Performance Techniques Self-Monitoring Role-playing Inventories, Checklists Cognitive-Behavioral Assessments


Method Studying Behavior … Self monitoring

Keep track of the number of times per day s/he engages in a specific behavior and the conditions under which this behavior happens


Behavioral Interviews Behavioral interviews: ask questions focused

on target behaviors Goal: help clinician gain general perspective of

problem behavior and the variables that perpetuate it

Understand antecedent factors May use structured diagnostic interview

Not different from traditional interview in format, only in focus


Principles of Measurement Reliability

Consistency of an individual’s score on repeated testing provided that the property being tested has not changed (Sims & Hume,1984)

Validity Ability of a test to measure what is claimed to

measure (Sims & Hume,1984)


Principles of Measurement … Prevalence

The total number of existing cases among the whole population

Incidence Number of new cases of a disease during a

specified period of time related to the number of persons at risk of contracting the disease


Principles of Measurement …

Prevalence A single point in time (point prevalence) or Over a period of time (period prevalence) and

expressed as a percentage or when very small, as per 1000 population

Prevalence is expressed as a percent, e.g. the prevalence of smoking in the S.A. in 1999 was 24%, or as a decimal, 0.24


Principles of Measurement … Prevalence is a “cross-sectional” measure, i.e.

it is measured at one point in time

Prevalence includes both “old” and “new cases”, i.e. both people who began smoking prior to 1999 and those who just began in 1999


Principles of Measurement … Prevalence is a measurement of the burden of

illness Unlike incidence, it provides an estimate of

the burden of disease If the prevalence of Type II diabetes is 3% in

the U.S, that suggests that 7.65 million (0.03 X 255 million) people have this disease, a substantial number


Principles of Measurement …Incidence It may be measured either as a risk or as a rate Is the probability that a person initially free

from the disease develops it at some time during the period of observation

Expressed as a percentage or per 1000 persons


Principles of Measurement … The incidence rate is the rate of contracting

the disease among those still at risk e.g. diarrhea

Because the incidence measures the number of NEW events, it provides an index of the speed or velocity of propagation of a disease in a population


Principles of Measurement … Changes in incidence over time, either up or

down, suggest that a disease may be waxing or waning in importance.


Challenges to validity and Reliability

Reliability & validity influenced by complexity of behavior observed level of training, experience of observer(s) unit of analysis chosen & coding system used influence of observation on target

(problematic) behavior generalizability of observations to other

settings/situations


How to Study Child Behavior

1. Chart method Plotting a misbehavior

2. Graph method


Problems in Assessment It is often difficult to obtain accurate

information on children’s problems because children are unable to report their thoughts and feelings

Parents and teachers may provide information about children They can be biased in their own assessment of

children’s symptoms and needs 23 November 2015 Health Behavior Assessment 25

Problems in Assessment … When the clinician and patient / client are

from: Different culture Language difficulties Cultural expectations


Conclusion Grows from Behavior Theory / Learning

Theory

Aspects of it can be easily combined with other forms of assessment


References Gross, R. (2010) Psychology the Science of Mind and

Behaviors 6th edition; Macmillan Company

Richard, G (2010) Psychology The Science of Mind and Behaviour; 6th Edition. Hodder education

Santrock John W. (2006) Educational Psychology; second edition. Mc Graw Hill Publisher

Sims, ACP & Hume, WI (1984) Lecture Notes on Behavioral Sciences


Health Behavior Assessment

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