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Psy631Psychological Assessment

William P. Wattles, Ph.D.

• Without _____, most psychological tests are meaningless. (p. 69)a. the MMPI-2 b. interview datac. structured. DSM-IV e. construct validity

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Psychological assessment

• Psychological assessment is a process that involves the integration of information from multiple sources, such as psychological tests, personal history, description of current symptoms and problems by either self or others, and collateral information.

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Psychological testing

• the use of samples of behavior in order to infer generalizations about a given individual.

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Issues in assessment

• Referral Question• Who will read report• Ethical guidelines• Test bias• Test selection• Computer-assisted

tests

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Context of assessment

• Referral Setting plays key role type of assessment

• Many different settings

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The Psychiatric Setting

• Psychiatrist as administrator (beyond diagnosis and treatment)– Custody– freedom of the patient– safety of society

• Psychiatrist as therapist– ward– type of treatment

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General Medical Setting

• As many as 2/3 of patients seen by physicians have primarily psychosocial difficulties

Somatization

• Somatization is one of the oldest of all known psychological diagnoses. The first reference to this kind of phenomena appears about 1900 B.C. in Egyptian documents,

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Why somaticize?

• in our society, psychological diagnoses become curse words

• Pathological• Neurotic

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Somatization

• As we understand it today, somatization is a phenomena where a person becomes somatically preoccupied.

• Typically, there are underlying feelings of depression, anxiety or other feelings, which are not recognized or acknowledged by the person.

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Somatization

• Instead, what the person may be aware of is all the physical correlates of these underlying difficulties.

• The very fact that psychological difficulties are seen as weaknesses, makes it shameful for a person to admit that he or she has such a problem

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Somatization

• This lucidly written guide presents an innovative approach for treating somatization disorder and related problems, such as fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome.

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Somatization

• The causes of somatization that we are able to implicate are neither proximate nor somatic, seeming instead to be indirect and to reside in the patient’s mind or culture.

• Somatization appears to be universal.

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DSM-IV

• Somatoform Disorders– Physical symptoms

that suggest a general medical condition and are not fully explained by a general medical condition.

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Somatization Disorder

• A pattern of recurring, multiple, clinically significant somatic complaints, not fully explained by any known general medical condition.

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Hypochondriasis

• Preoccupation with fears of having a serious disease based on a misinterpretation of one or more symptoms.

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General Medical Setting

• Mental disorders in addition to physical

• Behavioral aspects of physical illness

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General Medical Setting

• Most common psychological referrals– emotional factors– neuropsychological assessment

• How the person is functioning

– chronic pain– chemical dependency

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The Legal Context

• Variety of uses• child custody• competency• juvenile commitment• personal injury

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The Legal Context

• We equivocate; they decide

• Legal terms =/= everyday or psychological meanings

• May not understand the scientific method– Competency – Insanity– Dangerousness

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Dangerousness

• Problem area• Low base rate

– High false positives

• Text: err on the side of caution

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Miss Type I error

False PositiveType II error

TruthNot

DangerousDangerous

Test

Not Dangerous

Dangerous Hit

Correct Rejection

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The Scientific Method

• Fixation of Belief –Peirce– “Doubt is an uneasy and dissatisfied state from

which we struggle to free ourselves and pass into the state of belief…”

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Fixation of Belief

• Charles Saunders Peirce

• Method of Tenacity

• Method of Authority

• A priori

• Method of science

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The Scientific Method

• empirical:

• a. Relying on or derived from observation or experiment: empirical results that supported the hypothesis.

• b. Verifiable or provable by means of observation or experiment: empirical laws

• others can arrive at the same results.

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Empirical Example

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Child Custody

• Mental health of the parent

• quality of love between parent and child

• nature of parent-child relationship

• long-term effect of different decisions

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Education Context

• Learning difficulties

• Measuring intellectual strengths

• Identifying intellectual problems

• Assessing behavioral difficulties

• estimating responsiveness to intervention

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Psychological Clinic

• The decision maker– appropriate for the

setting?

– Which therapist or group?

– Best treatment

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Ethics of Assessment

• http://www.apa.org/ethics/code2002.html#9

• Developing a professional relationship– signed consent– discussion of procedures– discussion of results

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Competence and Appropriate Use of Assessments and

Interventions• Psychologists refrain from misuse of

assessment techniques, interventions, results, and interpretations and take reasonable steps to prevent others from misusing the information these techniques provide.

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Test Construction.

• Psychologists who develop and conduct research with tests and other assessment techniques use scientific procedures and current professional knowledge for test design, standardization, validation, reduction or elimination of bias, and recommendations for use.

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Use of assessment

• familiar with the reliability, validation, and related standardization or outcome studies of, and proper applications

• recognize limits to the certainty with which diagnoses, judgments, or predictions can be made about individuals.

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Interpreting Assessment Results

• They indicate any significant reservations they have about the accuracy or limitations of their interpretations.

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Unqualified Persons.

• Psychologists do not promote the use of psychological assessment techniques by unqualified persons.

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Obsolete Tests and Outdated Test Results

• Do not use old tests or old results

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Test Scoring and Interpretation Services.

• Retain responsibility for reliability and validity as well as appropriate use of tests.

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Explaining Assessment Results

• Psychologists ensure that an explanation of the results is provided using language that is reasonably understandable to the person assessed or to another legally authorized person on behalf of the client.

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Maintaining Test Security.

• Psychologists make reasonable efforts to maintain the integrity and security of tests and other assessment techniques

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Privacy

• Psychologists accord appropriate respect to the fundamental rights, dignity, and worth of all people.

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Personnel Selection

• Lovell: – tests for hiring lack

adequate validity.

– Do not serve the public’s interest

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Personnel Selection

• Text:– “If a position requires

careful screening … may warrant careful testing.”

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TruthDishonestHonest

Test

Dishonest

Honest Hit

Correct Rejection

False Alarm

type I error

MissType II

error

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Bias in testing minority groups

• Does validity extend to minority groups?– Adverse impact– Must demonstrate utility of assessment

• Sensitivity to attitudes towards testing

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Selecting psychological tests

• Referral question

• Practical considerations of time, cost and availability

• Practitioner training

• Short forms

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The End