A psychological assessment consists of more than just administering and interpreting tests. It is a complex intellectual activity that includes formulating hypotheses about a person, deciding what data are necessary to confirm or disconfirm these hypotheses, gathering the required data, interpreting them, and, finally, drawing conclusions. At each stage in the assessment process, the psychologist must be alert to factors that could compromise the integrity of the assessment. For example, interviews and tests may not always provide accurate information, adherence to a particular paradigm may blind a clinician to contradictory data, and clinical inference may not always be justified. An important aspect of clinical expertise is knowing how much weight to give to different data sources and much confident to put in clinical inferences.
Whatever paradigm a clinical psychologist adopts, interviews almost always plays an important role in the assessment process. The goals of an assessment interview are to gather information about a client’s history, life situation, personal relationships, and outlook for the future; to assess the client’s current functioning; and often, to make a clinical diagnosis. Good interviewers gain information, not only from what people say, but also from their general appearance, tone voice, facial expression, body posture and eye contact.
People find it easiest to speak frankly and freely with clinicians with whom they establish report (warm and trusting relationship). Establishing a report can take considerable time, so clinicians must learn to be patient. The process is too important to be rushed.
The quality of information gained from an interview is in part determined by the “match” between the interviewer and the interviewee. Female clients, for example, may be reluctant to talk frankly about sexual matters with male psychologists (and vice versa). Mismatches between clients and clinicians can lead to miscommunication.
Cultural differences may be interpreted as signs of disordered behavior. Or, bending over backward to be culturally sensitive, clinicians may make the opposite error: They may mistakenly attribute abnormal behavior to cultural differences. Clearly, good interviewers are always vigilant for signs of cultural, sexual or other biases.
Unstructured interviews are largely spontaneous. The therapist and the client may change the topic whenever a new direction is warranted. Although. The unstructured format of such interviews gives psychologists the freedom to explore important matters as they arise; the conversations are not really random. Clinicians focus the issues that their preferred paradigm deems relevant to understanding and helping troubled people. For example, a psychologist working in the psychoanalytic paradigm might concentrate on a client’s interesting dream, whereas a humanistic psychologist might try to steer the conversation around to the person’s self-concept.
Because unstructured interviews follow unpredictable paths, it is not surprising that independent psychologists, assessing the same person, may reach different conclusions.
A structured Interview is one in which the questions are set out in a prescribed fashion for the interviewer. It forces all interviewers to cover the same material in the same sequence, thereby increasing the probability that they will reach the same conclusion.
Validity of Interviews:
Validity largely depends on the skill and experience of the interviewer but even skilled interviewers may be misled.
- Members of minority groups may react to interview questions in unexpected ways.
- Clients being assessed as result of court order or because their parents, teachers, or spouses insisted on it may not wish to reveal their true feelings. Even “voluntary” clients may produce distorted information.
- Some clients provide misleading information because they are genuinely unaware of their own behavior; others exaggerate their problems.
- Inaccuracies may sometimes arise in subtle ways. For example, medical researchers have found that patients vary greatly in their definitions of pain. Patients with the same condition may answer differently if they have different subjective ideas about pain. Similarly, psychologists who inquire about “anxiety” should expect considerable variability in the replies they receive.
In summary, clients perceptions, their interpretations of psychologists questions; their background, education, and attitudes toward. Psychological problems all affect their answers to interviews questions. Ofcourse, interviews may be biased as well. They may emphasize information that is consistent with their preferred paradigm, discounting or even ignoring inconsistencies.
For all these reasons, psychologists rarely rely solely on interviews for clinical information. Most prefer to supplement interviews with psychological tests.
An intelligence test, often referred as an IQ test, is a standardized means of assessing a person’s current mental ability.
Intelligence tests are used:
- To predict how well a person will perform in school.
- To diagnose learning disabilities and to identify areas of strengths and weaknesses for academic planning.
- To help determine whether a person is mentally retarded.
- To help identify intellectually gifted children so that appropriate instructions can be provided to them in school.
- As part of neuropsychological evaluations, for example, periodically testing a person believed to be suffering from degenerative dementia so that deterioration of mental ability can be followed over time.
Alford Binet, a French psychologist, originally constructed mental tests to help Parisian school board predict which children were in need of special schooling. Binet compiled a “battery” of 30 tests covering communication memory, and numerical skills, as well as the ability to understand and reason about common situation.
Binet, later introduced the concept of mental age, which he contrasted with actual, chronological age. A child of 10 with a mental age of 15 is above average in intelligence, whereas a child of 10 with a mental age of 5 is below average. In 1916, the standard university psychologist Lewis Terman published a modified version of Binet’s scale (the Stanford Binet) that became widely used in USA. It was Terman who inverted the term intelligence quotient as well as its abbreviation, IQ.
Introduced first test in 1939, the Wechsler- Bellevue intelligence test was divided into two scales verbal and performance each consisting of several subsets (vocabulary, arithmetic, arranging blocks into designs, and so on). Each of the two scales yielded an IQ score (in addition to a full scale IQ score).
Wechsler’s most widely used adult test is the Wechsler Adult intelligence Scale III (WAIS-III). The test is popular because it has high reliability (WAIS-III produced similar score when administered twice to the same person in similar circumstances). It also has high validity.
Other Wechsler test include
- Wechsler Intelligence scale for children-III (WISC-III) age 6 and 16.
- Wechsler preschool and primary scale of Intelligence Revised (WPPSI-R) aimed at younger children 1,2 and WAIS-III are most widely used tests.
Measuring personality traits should allow us to predict how a person will act in a various situations. For example, shy people should avoid social contact; heroes should act courageously Alas, people are rarely so simple. Cowards may act courageously; and sociable people may occasionally prefer to be alone.
Projective Personality Traits:
American psychologists developed the “projective hypothesis” in the early part of 20th century. According to this hypothesis, people “project” their unconscious drives, feelings, wishes and conflicts onto the “screen” provided by ambiguous stimuli. Tests using stimuli that elicit a wide range of different responses became known as projective tests or techniques.
Rorschach’s Inkblot Test:
The Rorschach Inkblot test is perhaps the best known projective technique. In the Rorschach test, a person is shown ten inkblots, one at a time and asked to tell what the blots look like. Half the inkblots are in black, while, and shades of gray, two also have red splotches, and three are in pastel colors.
Rorschach was not the first to study inkblots; Aflred Binet used inkblots in his work on intelligence testing. However, Binet focused on the shapes and forms that people see in inkblots, whereas Rorschach set out to develop a measure of unconscious conflict. Rorschach did not believe he could learn about unconscious conflicts from the shapes people reported seeing in inkblots because, as a psychoanalyst, he accepted that overt reports are censored by the age. He believed that psychologists could uncover repressed conflicts by noting which aspects of an inkblot elicit a person’s reaction.
- Suppose a client respond to peripheral details rather than the overall appearance of the stimulus cards. This focus on minor details may indicate an inwillingness to confront his/her problems. He/she may prefer to dwell instead on unimportant details as a way of avoiding her/his main difficulties.
- Frequently affected by colors suggests strong emotions that might affect judgments.
- Does not perceive any human movement depression.
Although Rorschach claimed to find relationships between personality and inkblot characteristics, these relationships are not straight forward. For example, non-patients who reported seeing relatively common shapes (people, for example) often reported perceived movement (“people dancing”). In contrast, people with mood disorders also reported seeing people but they did not perceive any movement (“people standing still”). Rorschach concluded that personal assessment could not be based on a single perception (both groups saw people) but only on the simultaneous consideration of all of a person’s perception, and the characteristics of the inkblot that elicited them. He admitted that this was difficult to do, but he believed the effort to be worthwhile because inkblot interpretation offered a way of bypassing the ego’s defences.
Thematic Apperception Test (TAT): Developed by Henry Murray
“In this test, a person is shown a series of black and white vague pictures one by one and asked to tell a story related to each.”
According to Murray, patients will elicit stories about basic human “needs” (dominance, achievement & soon) and about social & interpersonal problems.
Although, Murray intended that a minimum of 20 cards be administered, most clinicians use only those cards which they deem relevant to a specific case and ask clients to produce more than one story. Typically, a client is asked to say what is happening in the picture, what the people are thinking or feeling and what will be the final outcome.
Most clinicians used the test as a supplement to interviews to uncover potential problems and make impressionistic judgments. One common technique is to look for persistent themes. Is oppression (or guilt or dependence) appeared in several stories?
In line with projective hypothesis, Murray assumed that people projects their own feelings and needs onto the “hero” of their story. So, clinicians try to access the adequacy of the hero. Is the hero assertive or passive? Successful or unsuccessful? Happy or depressed?
Although, creativity is an important trait, a story that is too distant from the picture might suggest that a person has lost contact with reality.
- CAT (Children Apperception Test) picture of household animals to simulate children to make up stories.
- Versions of TAT depicting Black or Hispanic People these versions has almost same reliability as standard TAT.
- Sentence Completion Test.
I wish ……, My father….. I Love……
- Draw a person (DAT):
Evaluating Projective Tests:
Rorschach claimed that
Creative people see human movements e.g., “ballerinas dancing”
To test this assertion, psychologists administered the Rorschach to artist and non-artists. They found no difference; artists did not report human movements more frequently than non-artists.
Then Why People Still Use?
Many clinicians do not use then as test at all, but as extensions of interviews, as way of generating, rather than confirming, hypotheses. These hypotheses must be confirmed using valid measures of personality and behavior.
Personality Inventories/ Self-report Tests.
In P.I, the person is asked to complete a self-report questionnaire indicating whether statements assessing habitual tendencies apply to him or her.
- Best known Minnesota Multi-phasic personality Inventory (MMPI)
Developed by Hathaway & McKinley.
- MMPI is called multi-phasic because it was designed to detect a number of psychological problems.
In developing the test, the investigators relied on factual information. First, many clinicians provided statements that they considered indicative of various mental problems. Secondly, these items were rated as self-descriptive or not by patients already diagnosed as having a particular disorder and by a large group of individuals considered normal. Items that discriminated among the patients were retained; that items were selected if patients in one clinical group responded to them more often in a certain way than did those in other groups.
With additional refinements, set of these items were established as scales for determining whether a respondent should be diagnosed in a particular way. If an individual answered a large number of items in a scale in the same way as had a certain diagnostic group, his or her behavior was expected to resemble that of a particular diagnostic group.
Behavior assessment is concerned with describing the environmental conditions that elicit and maintain problem behaviors.
The essential information required for behavioral assessment is summarized by the acronym SORC.
- S – Stimuli that elicit maladaptive behavior.
Most often these stimuli are found in the social and interpersonal environment.
- O—Organismic (individual) characteristics that may affect behavior (physical disabilities for instance)
- R—Responses or actual problem behaviors. These problem “behaviors may be overt motor acts, cognitions or psycho-physiological responses such as high blood pressure.”
- C – Consequences (positive & negative) that follow a problem behavior.
To obtain necessary information for SORC analysis, behavioral psychologist use following procedures.
The questions asked in a behavioral interview are often indistinguishable from those asked in any other type of interview. However, the similarity is superficial, because the goals of a behavioral interview are different from the goals of, say, a psychoanalytic interview. Instead of attempting to uncover unconscious conflicts, the behavioral Interviewer seeks answer to specific “what” question: “What” behaviors, occurring in “what” situations, with “what” consequences are causing a problem?
Although behavioral assessment often makes use of self-report scales, these are not employed to infer underlying personality traits or psychodynamic conflicts. Instead, behavioral psychologists use self-reports to learn more about the antecedents and consequences of problem behaviors. Self-report inventories may also be used to learn about a person’s thoughts in different situations. Instead of self-reports, psychologists often use behavior problem checklists to identify problem behavior in children having problems (“cries a lot”, “hit others”, “has nightmares”) are given to parents, caregivers and teachers, who must then indicate those that are problems for child and how frequently those problem occur.
Direct observation of Behavior:
Although interviews and self-reports are important sources of information, they are subject to various biases. People may not always be willing (or able) to say what is troubling them. In these cases, observation of actual behavior can provide clinicians with information which they cannot obtain in any other way. These observations can be made naturalistically or they can be made in a clinic. Clinic observations are easy to arrange and control but it (would be kept in mind that clinic environment is artificial. People may act one way in the clinic and another way in their everyday environment. Another problem with direct behavior is that observer can get tired, miss or incorrectly observe behaviors. To avoid this, behavioral observations are often confined to brief periods.
Because many behavioral problems can be brought on by brain abnormalities, devices have become available that allow clinicians and researchers a much more direct look at both the structure and functioning of the brain.
CAT (computerized Axial Tomography):
CAT scan helps to assess structural brain abnormalities. A moving beam of X-rays passes into horizontal cross-section of the patient’s brain, scanning it through 360 degrees; the moving X-ray detector on the other side measures the amount of radioactivity that penetrates, thus defecting subtle differences in tissue density. A computer constructs a 2-D detailed image of cross-section. Then patient’s need is moved and the machine scans another cross-section of the brain. The resulting images can show the enlargement of verticals, which signals degeneration of tissue and the locations of tumors and blood clots.
MRI (Magnetic resonance Imaging).
- Superior to CAT – higher quality images and does not rely on even small amount of radiation required by CAT.
- It allowed physicians to locate and remove brain tumors that would have been considered inoperable without such sophisticated methods of viewing brain structures.
MRI (Function MRI)
It allows researchers to take MRI pictures so quickly that metabolic changes can be measured, providing a picture of the brain at work rather than its structure alone.
Using this, researches have ground less activation in the frontal lobes of patients of schizophrenia than in the frontal lobes of normal people as they performed a cognitive test.
PET (Positron Emission tomography) sean:
More expensive and invasive procedure allows measurement of both brain structure and functioning.
Produce color images; fuzzy spots of lighter and warmer colors and areas in which metabolic rates for the substance or higher.
Visual images can indicate sites of
- Epileptic seizures, brain cancers, strokes and trauma from head injuries.
- Distribution of psychoactive drugs in the brain.
- Possible abnormal biological processes that underlie disorders, such as the failure of the frontal cortex of patients with schizophrenia to become activated will they attempt to perform cognitive tech.
- PET scanning has made it possible to assess the amount of particular neurotransmitter in the brain.
- Another common method of N.A involves analyzing the metabolites of neurotransmitter that have been broken down by enzymes. A metabolite, typically an acid, is produced when a neurotransmitter is deactivated.
- Depressive people have low levels of the main metabolite of serotonin a fact that has played an imported role in serotonin theory of depression.
- A Neuropsychologist is a psychologist who studies how dysfunctions of the brain affect the way we think, feel and behave.
- Neuropsychological tests to asses behavioral disturbances caused by brain dysfunctions. Often used in conjunction with the brain scanning techniques.
- These tests are based on the idea that different psychological functions (e.g., motor speed, memory, language) are localized in different areas of the brain. Thus, finding a deficit on a particular test can provide dues about where in the brain some damage may exits.
Halstead Reitan battery.
Tactile performance test time.
Blindfolded patient tries to fit variously shaped blocks into spaces of a form board, first using the preferred hand, then the other and finally both.
- Tactile performance Test-Memory:-
After completing the timed test, the participant is asked to drawn the form board from memory, showing the blocks in their proper location. Both (i) & (ii) are sensitive to damage in right parietal lobe.
Speech Sound Perception Test:
Participants listen to a series of nonsense words each comprising two consonants with a long a sound in the middle. Then they the select the “word” they heard from a set of alternatives. This test measures left-hemisphere function especially temporal and parietal areas.
Extensive research demonstrated valid for detecting brain damages rerolling from a variety of conditions such as tumor, stroke and head injury.
- Luria Nebraska Battery:
A battery of 269 items makes up of 11 sections to determine basic and complex motor skills, rhythm and pitch abilities, tactile and kinesthetic skills… The patterns of scores of these sections as well as on the 32 items found to be the most discriminating and indicative of overall impairment helps reveal damage to the frontal, temporal, sensori-motor, or parietal occipital area of the right or left hemisphere.
is concerned with bodily changes that accompany psychological events. Like brain imaging techniques, they are not sensitive enough for diagnosis but provide important information.
Autonomic nervous System:
- The activities of ANS are frequently assessed by electrical and chemical measurements in an attempt to understand the nature of emotion. One important measure is heart rate. Each heartbeat generates changes in electrical potential which can be recorded by an elector cardiograph or on a suitably turned polygraph and graphically depicted in an electrocardiogram (EKG).
- Electro dermal responding/skin conductance:
Anxiety, fear, anger and other emotions increase activity in sympathetic nervous system, which they boost sweat gland activity. Increased sweat gland activity increases the electrical conductance of the skin. Since, sweat stands are activated by sympathetic nervous system, increased sweat gland activity indicates sympathetic autonomic excitation and is often as measure of emotional around.
Central Nervous System:
Brain activity can be measured with electroencephalogram (EEG). Electrodes placed on the scalp record electrical activity in the underlying brain area. Abnormal patterns of activity can indicate epilepsy or help in locating brain lesions or tumors.