More recently, Armstrong, Sarawgi, and Ola-
tunji (2011) used a controlled performance tech-
nique called a behavioral avoidance task to assess
the level of behavioral avoidance and distress in a
group of individuals with contamination fears, a
symptom characteristic of obsessive compulsive dis-
order. Specifically, the researchers had participants
enter a public restroom and progressively perform
the following tasks: (1) touch inside the restroom
sink; (2) touch inside the restroom trashcan; (3)
touch the toilet seat; (4) touch the rim below the
toilet seat; and finally (5) touch the inside of the
toilet itself. After each step (1–5) the participants
rated their level of distress and if they refused a
step rated their perceived level of distress when
they imagined themselves doing the step. In this
way, the researchers were able to quantify behav-
ioral avoidance (number of steps completed) and
distress (total distress ratings). Therefore, in this
controlled situation, the clinical researchers were
able to get perhaps a more realistic idea of how
severe the avoidance behavior and distress was for
each individual because each person was actually
faced with situations that invoked contamination
fears.
Despite their appeal, it is important that the
demand characteristics of these controlled situations
be carefully examined. Behavior in these stressful
situations may not always be typical of a patient’s
real-life behavior. For example, some patients may
be influenced by the presence of the clinician or
researcher, and, combined with a trusting attitude
that such a clinician or researcher will not permit
harm to come to the patient, may, for example,
take more risks or report less distress than would
be typical without such a companion.
In some cases, psychophysiological assessment
procedures have been employed for both clinical and
research purposes.Psychophysiological measuresare used
to assess unobtrusively central nervous system, auto-
nomic nervous system, or skeletomotor activity
(Cacioppo, Tassinary, & Berntson, 2007). These mea-
sures have been used in the assessment of a host of
clinical conditions, including anxiety, stress, and
schizophrenia. Clinical psychologists typically use
psychophysiological measures to complement other,
more traditional forms of assessment. The advantage
of psychophysiological measures is that they may assess
processes (e.g., emotional responsivity) that are not
directly assessed by self-report or behavioral measures,
and they tend to be more sensitive measures of these
processes than alternative measures. Examples of
psychophysiological measures include event-related
potentials (ERPs), electromyographic (EMG) activity,
electroencephalographic (EEG) activity, and electro-
dermal activity (EDA). Although these measures do
offer some advantages to the clinician, they are still
subject to the same psychometric considerations of
reliability and validity as other more traditional clinical
assessment techniques (Strube & Newman, 2007).Self-Monitoring
In the previous discussion of naturalistic observa-
tion, the observational procedures were designed
for use by trained staff: clinicians, research assistants,
teachers, nurses, ward attendants, and others. But
such procedures are often expensive in both time
and money. Furthermore, it is necessary in most
cases to rely on time-sampling or otherwise limit
the extent of the observations. When dealing with
individual clients, it is often impractical or too
expensive to observe them as they move freely
about in their daily activities. Therefore, clinicians
have been relying increasingly onself-monitoring,in
which individuals observe and record their own
behaviors, thoughts, and emotions.
In effect, clients are asked to maintain behav-
ioral logs or diaries over some predetermined time
period. Such a log can provide a running record of
the frequency, intensity, and duration of certain
target behaviors, along with the stimulus conditions
that accompanied them and the consequences that
followed. Such data are especially useful in telling
both clinician and client how often the behavior in
question occurs. In addition, it can provide an
index of change as a result of therapy (e.g., by com-
paring baseline frequency with frequency after 6
weeks of therapy). Also, it can help focus the cli-
ent’s attention on undesirable behavior and thus aid
in reducing it. Finally, clients can come to realize
the connections between environmental stimuli,BEHAVIORAL ASSESSMENT 267