Clinical and statistical prediction: A reformulation and some new data.

A discussion of the controversy aroused by P. E. Meehl's Clinical Versus Statistical Prediction, in which the writer analyzes the predictive process and suggests the remedies as he sees them. "We should try to find the optimal combination of actuarially controlled methods and sensitive critical judgment for any particular predictive enterprise… . We can do this only if clinically and statistically oriented workers… seek to learn from each other." 16 references. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Clinical Versus Statistical Prediction.

Reviews the book "Clinical versus statistical prediction," by Paul Everett Meehl (see record 1996-97896-000). Meehl attempts to plot a course to the port of valid prediction through the "rigorous" channels of statistical methods and the "sophisticated" undercurrents of clinical dynamics. Most of the book is devoted to a thoughtful but discursive analysis of the alternative strategies for prediction of statistical or actuarial methods as compared with clinical or casestudy methods. Meehl believes that much confusion could be avoided if careful distinction were made between two different uses of statistics, the types of data involved in prediction, and the methods of combining data in making predictions. Meehl does an excellent job of raising some of the basic problems and issues which have to be considered in carrying out research in this area. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the equivalence of clinical and statistical methods.

Based on material from a doctoral thesis, an attempt was made to resolve an inconsistency in Meehl's analysis of statistical vs. clinical methods of assessment (see 29: 3991). "Eight interviewers assessed from 14 to 50 Canadian Army applicants using information obtained from biographical and test data, and from interview conversation. Each applicant was described on a 120-item Q-sort check list. These data were quantified and combined into composite statistical scores (biographical and test data) and clinical scores (Q-sort data). The results indicated that: (a) clinical scores were associated more closely with decisions than were statistical scores; (b) statistical and clinical scores correlated at a low level; (c) the decisions of different interviewers were associated with the same Q-sort, biographical, and test data; and (d) statistical and clinical scores were comparable in reliability." "… this study… strengthens the status of the clinical assessment." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measurement and prediction, clinical and statistical.

Clinical vs. statistical prediction is only ? the problem—and the last ? at that. The prior problem, largely neglected, is clinical vs. mechanical measurement—for data can be collected, as well as combined, in either way. Such neglect promotes an incomplete and mismatched dialogue where "clinical" and "statistical" may have different meanings to different persons. Examining clinical and mechanical methods of both measurement and prediction provides a broadened framework that defines the several possible "clinical" and "statistical" methods, and their combinations. Applying this framework to 45 studies shows an apparent superiority for mechanical modes of both data collection and combination, and also suggests that the clinician is more likely to contribute through observation than integration. Grossly uncontrolled differences, however, in clinical training, Ss, criteria, etc., prevent definitive conclusions. To achieve more adequate comparison requires certain specified methodological improvements. (3 p. ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Why we still use our heads instead of formulas: Toward an integrative approach.

This review begins with a discussion of P. E. Meehl's (see record 1959-06148-001) query regarding when to use one's head (i.e., intuition) instead of the formula (i.e., statistical or mechanical procedure) for clinical prediction. It then describes the controversy that ensued and analyzes the complexity and contemporary relevance of the question itself. Going beyond clinical inference, it identifies select cognitive biases and constraints that cause decision errors, and proposes remedial correctives. Given that the evidence shows cognition to be flawed, the article discusses the linear regression, Bayesian, signal detection, and computer approaches as possible decision aids. Their cost–benefit trade-offs, when used either alone or as complements to one another, are examined and evaluated. The critique concludes with a note of cautious optimism regarding the formula's future role as a decision aid and offers several interim solutions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Paul Meehl as methodologist-philosopher of science: The formulation of metascience.

Paul Meehl's contributions to methodology and the philosophy of science extend well beyond his widely known writings in such areas as construct validity and statistical significance testing. I describe one of Meehl's less well-known, but potentially most important, methodological undertakings: his work on metascience, or the science of science. Metascience could ultimately revolutionize our conceptualizations and understanding of science and provide considerable help to practicing scientists and scientific endeavors, including efforts to advance the development and appraisal of theories in psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Statistical versus clinical prediction: Length of neuropsychiatric hospital stay.

Statistical and clinical prediction methods are compared in a "field" situation, predicting patient stay in a psychiatric hospital. 5 statistical methods from a previous report averaged 71.92% accuracy on the cross-validation sample. 12 clinicians predicting independently in the same hospital over the following 18-mo period achieved an average accuracy of 71.94% on 499 patient predictions. Summaries of the clinicians' reasons for their judgments show some differences between the most and least accurate judges. Neither professional background nor years of professional experience of clinicians was related to predictive accuracy. Actuarial and clinical prediction were not demonstrably different in accuracy. Practical and economic aspects of this prediction problem favor clinical prediction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Schizotaxia, schizotypy, and schizophrenia: Paul E. Meehl's blueprint for the experimental psychopathology and genetics of schizophrenia.

Paul E. Meehl proposed a model of the cause and pathogenesis of schizophrenia and related states in the early 1960s (Meehl, 1962), which he later revised in 1990 (Meehl, 1990). His model emphasized a genetically influenced aberration in neural transmission that could eventuate in clinical schizophrenia, nonpsychotic schizotypic states, or apparent normalcy depending on the coexistence of other factors. His model embodied the core ideas of the diathesis-stressor framework that would come to dominate experimental and developmental psychopathology for the next 40 years. The author reviews Meehl's model of schizotaxia, schizotypy, and schizophrenia and reviews and clarifies some frequent misunderstandings of the model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comment on Hitt's analysis.

W. D. Hitt's (see record 1969-16600-001) analysis of a 1963 symposium, while ostensibly directed at the behaviorism–phenomenology controversy, aimlessly gathers remnants of the Würzburg controversy, the nomothetic–idiographic debates of the 1950s, clinical–statistical arguments about prediction, and C. P. Snow's 2 cultures. It also fails to characterize phenomenology accurately by describing it as American. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multidimensional assessment of criminal recidivism: Problems, pitfalls, and proposed solutions.

All states have statutes in place to civilly commit individuals at high risk for violence. The authors address difficulties in assessing such risk but use as an example the task of predicting sexual violence recidivism; the principles espoused here generalize to predicting all violence. As part of the commitment process, mental health professionals, who are often psychologists, evaluate an individual's risk of sexual recidivism. It is common for professionals conducting these risk assessments to use several actuarial risk prediction instruments (i.e., psychological tests). These tests rarely demonstrate close agreement in the risk figures they provide. Serious epistemological and psychometric problems in the multivariate assessment of recidivism risk are pointed out. Sound psychometric, or in some cases heuristic, solutions to these problems are proffered, in the hope of improving clinical practice. The authors focus on how to make these tests' outputs commensurable and discuss various ways to combine them in coherent, justifiable fashions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

If Kant was director of Clinical Training.

While Immanuel Kant is recognized as one of history's most influential philosophers and ethicists, his thought and writings also contain significant clinical implications that deserve attention. His philosophy is briefly explained and shown to anticipate modern developments in understanding human consciousness and many principles for effective psychotherapy. Kant's "categorical imperative," in particular, implies and anticipates valuable clinical interventions. Kant's principles that are ethically "right" for clients turn out to be clinically "good" for them as well. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical Judgment in Science: Reply.

Replies to comments published by M. S. Schulz and R. J. Waldinger (see record 2005-11115-010), J. M. Wood and M. T. Nezworski (see record 2005-11115-011), and H. N. Garb and W. M. Grove (see record 2005-11115-012) on the original article by D. Westen and J. Weinberger (see record 2004-19091-002). Schulz and Waldinger (2005) make the important point that just as researchers can capitalize on the knowledge of experienced clinical observers through aggregation, they can aggregate the judgment of lay observers in assessing phenomena such as emotion. The reason, as they articulate, is that skills such as "reading" emotion from facial expression, tone of voice, posture, and the constellation of cues provided in everyday life are an area of expertise for most people, one that is now often called social or emotional intelligence. As psychometricians have known for years, one can increase reliability in many different ways. The comments by Wood and Nezworski (2005) and Garb and Grove (2005) do not address our central thesis--namely, the importance of distinguishing two meanings of clinical. The point of the sentence around which Wood and Nezworski (2005) build their comment was simply that the same biases widely attributed to clinicians are common in scientists as well--a point for which we would be delighted to take credit, but it is one that was actually made much more elegantly by the historian and philosopher of science Thomas Kuhn (1962). The authors respond to Wood and Nezworski's (2005) specific concerns about misrepresentation. In their comment, Garb and Grove (2005) challenge us to document our view that anticlinician prejudice is widespread among many academic clinical psychologists. As research on implicit prejudice suggests, surveys of academic clinical psychologists might indicate little about their implicit attitudes, as evident in Garb and Grove's apparent lack of recognition of the offensive nature of comparing a clinician's attempt to revise his or her understanding when the patient says "I don't think what you just said is right" to astrology and Barnum effects. We appreciate Garb and Grove's (2005) point about potential differential effects of training and experience on reliability and validity of clinical judgment. The data they cite are important and bear consideration. We would offer two caveats, however. Finally, we cannot help but note that this series of comments and our reply to them provide a prototypical example of "clinical" judgment in science--that is, subjective, informal aggregation of data, often leading to a "gestalt" judgment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reply to Dr. Spitz.

Spitz (see 30: 5830) is commended for providing clinical hunches and hypotheses, including his use of statistical materials, but it is claimed nevertheless that Spitz's conclusions are not warranted by the data reported. Perhaps the uncritical acceptance of Spitz's research is the fault of those who have acclaimed his work, rather than that of Spitz himself. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nonlinear models of clinical judgment: Meehl's data revisited.

Previous attempts to detect nonlinearity in clinical judgments have not succeeded because of a lack of good nonlinear models. Much research in this area was based on data collected by P. Meehl, which include clinicians' judgments of mental disorder on the basis of MMPI profiles. In this article, Meehl's data are reanalyzed using several versions of the scatter model in which nonlinearity is represented by the within profile scatter(s) of the cues. The author finds that these versions give a better fit to the data than does the linear model. He also finds systematic patterns of nonlinearity that lend themselves to psychological interpretation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Arthur Benton (1909-2006).

Presents an obituary for Arthur Benton, who was one of the pioneers of clinical neuropsychology. Benton introduced novel and objective neuropsychological assessment techniques that expanded psychologists' understanding of the deficits manifested by neurologically compromised patients, both adults and children. Benton also contributed important findings concerning hemispheric specialization. His studies, including innovative clinical assessment techniques, normative data, and examiner manuals, facilitated the emergence of neuropsychology as a separate field of research and stimulated the development of clinical neuropsychology practice in the United States and around the world. His work also exemplifies the cross-fertilization of neurology with cognitive psychology and neuropsychology, a direction that continues today. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The psychologist as an instrument of prediction.

This selection system is meant to be a synthesis of a statistical and a clinical approach. Psychologists administered group and individual tests to applicants for copilot courses in the Scandinavian Airlines System. "During the years 1951-56 a total of 780 applicants were examined." Remaining and dismissed pilots were compared and the resulting data served as the criteria of the validity of the selection system. The psychologists discussed their evaluations until they agreed on ratings. The results suggest that in this instance clinical prediction was better than statistical. "There is no magic in the fact that psychologists, when given this leading role, can be more effective as predictors than batteries of tests." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

High school yearbooks: Further explication and reply to Meehl.

Responds to P. Meehl's (see pa, vol. 46:3448) criticisms with a further explication in terms of case matching and statistical suppression as methods of controlling for trait-irrelevant variance in archival measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Awards for Distinguished Professional Contributions 1986: Wilbert E. Fordyce.

Wilbert E. Fordyce, one of the 1986 recipients of the Distinguished Professional Contributions Award, is recognized for his "seminal work on using behavioral methods with clinical pain has revolutionized the treatment of pain and helped reshape the health care delivery system. His earlier work pioneered a new view of chronic disease and disability in behavioral terms. He reasoned that pain was not just a symptom of body damage, but could be better understood as behavior and subject to all of the influences that affect behavior. His first data paper on treating pain by applying operant principles was rejected as irrelevant. As the studies continued, and others took up the theme, specialized pain clinics emerged throughout the world; more than one thousand in the United States alone--virtually all of them utilizing the methods he first set forth. His sensitive clinical skills have made him effective as a clinician and a teacher. He has been tireless in his efforts to bring his knowledge to bear on practical problems by seminars and lectures worldwide." (PsycINFO Database Record (c) 2010 APA, all rights reserved)