Psychological Assessment

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Psychological Assessment

• Projective Personality Tests

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Projective Tests Essential Features

• Individuals must impose their own structure which
  is meaningful
• Stimulus material is unstructured
• Indirect (disguised) method
• Freedom of response
• Interpretation is broad

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Projective Tests

• Rorschach Inkblot Test
• Thematic Apperception Test

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Rorschach Inkblot Test

• Hermann Rorschach (1884-1922)
• Nicknamed Kleck or inkblot
• Talented art student who decided to study science
  
• Dream convinced him of relationship between
  perception and unconscious
• 1921 published Psychodiagnostik
• Died in 1922

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Rorschach Inkblot Test
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Rorschach Historical

• 5 Scoring Systems
• Adopted by 5 American psychologists with very
  different theoretical backgrounds
• Shared common features (same blots were used,
  response phase followed by inquiry)
• 5 different systems of administration, scoring
  and interpretation emerged
• Two most popular (Beck, Klopf)

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Rorschach Validity and Reliability

• Poor psychometric reputation
• Lack of standardized rules for administration and
  scoring
• Poor inter-rater reliability
• Lack of adequate norms
• Unknown or weak validity

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Rorschach Contemporary Use

• John Exner
• Established Rorschach Research Foundation in 1986
• Integrated five scoring and interpretation
  systems
• Established empirical support for new system
• Provide a center for training

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Contemporary Use Administration

• Association Phase
• What might this be?
• Present all the cards
• Record response verbatim
• Note location of response

• Inquiry Phase
• I want you to help me see what you saw. Im going
  to read what you said, and then I want you to
  show me where on the blot you saw it and what
  there is there that makes it look like that so
  that I can see it too. Id like to see it just
  like you did, so help me now.

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Rorschach Inkblot Test

• A psychometrically sound test?
• An in-class exercise

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Contemporary Use Scoring

• Exner scoring system The Structural Summary
• Location
• Location (W, D, Dd)
• Use of white space (S)
• Determinants
• Form (good, poor, bad quality)
• Movement (active and passive)
• Color
• Texture
• Shading

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Rorschach Inkblot Test

• A psychometrically sound test?
• Particularly useful in assessing thought processes

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Thematic Apperception Test (TAT)

• Developed by Henry Murray and colleagues at
  Harvard Psychological Clinic
• 31 TAT cards depicting people in a variety of
  ambiguous situations (one blank card)
• Examinee is asked to create a story about each
  picture

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TAT Administration

• Now I want you to make up a story about each of
  these pictures. Tell me who the people are, what
  they are doing, what they are thinking or
  feeling, what led up to the scene, and how it
  will turn out.

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TAT Scoring/Interpretation

• Content analysis of themes that emerge from the
  stories

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TAT Psychometric Critique

• Selection of cards is not standardized
• Lack of norms
• Clinicians rely on qualitative impressions

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Thematic Apperception Test

• Used to assess
• Locus of problems
• Nature of needs
• Quality of interpersonal relationships

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Psychological Assessment cont.

• Objective Personality Testing

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What is Personality?

• characteristic pattern of thinking, feeling, and
  acting
• emerges in informal, familiar situations in which
  we feel unconstrained
• principle of aggregation
• personality is the sum of the best descriptors
  and predictors of our actions over time in a
  number of situations

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Objective Personality Tests

• Material Covered
• 4 major approaches to test construction
• Examples of test based on first three test
  construction procedures
• Use of personality tests in modern clinical
  practice

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Characteristics Objective Personality Tests

• Standard set of questions
• Standardization as a concept given to large 's
  of people--yield norms to which an individual's
  scores can be compared
• Norms are defined as a set of scores from a large
  group of people who have completed the measure.
• Fixed response options

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Objective Personality Tests Advantages

• Individual or groups (economical)
• Administration is simple/objective
• Scoring is simple/objective
• Interpretation of results requires less
  interpretative skill than projective tests
• Apparent increased objectivity and reliability

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Objective Personality Tests Disadvantages

• Items limited to behavior
• Single overall score
• Transparent meaning of items
• Forced choice approach

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Test Construction Approaches

• Logical or content validation
• Empirical Criterion Keying (MMPI)
• Factor Analysis (NEO Personality Inventory)
• Construct Validity (Combines all of the above)

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Approaches to Test Construction Content
Validation

• Defining all aspects of the construct
• Consulting experts about the constructs
• Having expert judges assess each potential item
• Perform psychometric analyses of items

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Content Validation An Example

• Goal Construct a test designed to measure
  attitudes toward school
• Answer true or false
• I enjoy getting up in the morning for school
• I like my teacher(s)
• I enjoy seeing my friends at school
• I enjoy the subjects I learn about at school

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Content Validation Advantages and Disadvantages

• Advantages
• Face validity with test takers

• Disadvantages
• Easy to fake good or bad

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Content Validation The Mooney Problem Checklist

• Assesses emotional functioning in the following
  areas
• Home and family
• Interpersonal relationships
• Courtship and marriage
• Morals an religion
• School/occupation
• Economic security
• social skills and recreation
• Health and physical development

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Approaches to Test Construction Empirical Keying

• Create test items to measure one or more traits
• Administer test items to a criterion and
  control group
• Select items that distinguish between these two
  groups
• Content of the item is not considered important

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Empirical Keying Minnesota Multiphasic Inventory
(MMPI)

• Developed in 1930s
• Starke Hathaway Ph.D. J. Charnley McKinley, MD.
• Needed test to identify diagnosis
• Developed an item pool
• Identified a group of patients and nonpatients
• Resulting scale of 550 items (true/false/cannot
  say)

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MMPI Clinical Scales
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MMPI Validity Scales

• ? (Cannot say)
• Unanswered items
• L (Lie)
• Faking good
• F (Infrequency)
• Faking bad
• K (Defensiveness)
• Defensiveness in admitting to problems

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Interpreting MMPI

• Validity Scales
• Single scales
• Profile analysis

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MMPI Shortcomings

• Unrepresentative normative sample
• Language of items was outdated (including sexist
  language)
• Inadequately addressed difficulties such as
  suicide or drug use

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MMPI Revision

• Assembled team of MMPI experts
• Rewrote some items
• Added new items
• Administered new item pool (n704) to a
  standardization sample (representative)
• Retained 567 items from the item pool

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Continued problems

• failure of some items to reliably discriminate
  between groups
• dimensions based on pre-conceived theory about
  structure of personality,
• scales correlate highly and thus provide
  redundant information
• they are highly influenced by state at the time
  of taking, and the test and re-test stability may
  therefore be lower than desired (a problem for
  many/most trait measures)

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MMPI-2 Content Scales

• Anxiety
• Fears
• Obsessiveness
• Depression
• Health Concerns
• Bizarre Thoughts
• Anger
• Cynicism

• Antisocial Practices
• Type A
• Low Self-Esteem
• Social Discomfort
• Family Problems
• Work Interference
• Negative Treatment Indicators

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• Millon Clinical Multiaxial Inventory (MCMI)
• more useful than the MMPI-2 for diagnosis
• The purpose of the MCMI is to help the clinician
  make a diagnosis of personality disorder.
• These disorders are pervasive and stable patterns
  of maladaptive behavior that are deeply ingrained
  and influence the individual's thinking, feeling,
  and acting in a wide range of situations.
• The MCMI is primarily used for clinical
  populations it is not intended for normal
  subjects.

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Approaches to Test Construction Factor Analysis
(Internal Consistency)

• Correlational technique used to determine whether
  a group of items are correlated with one another

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Revised NEO Personality Inventory (NEO-PI-R)

• Based on five factor model of personality
  (Neuroticism, Extraversion, Openness,
  Agreeableness, and Conscientiousness)
• Name derived from initials of the first three
  traits
• Assesses all five traits
• Emphasizes assessment of normal personality style
  rather than psychopathology
• Parallel forms

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• The Schedule for Nonadaptive and Adaptive
  Personality (SNAP)
• a factor-analytically derived instrument designed
  to assess traits important in personality
  disorders
• 15 scales
• 12 trait scales assess specific or primary traits
  and
• 3 temperament scales measure more general
  affective traits.
• 5 validity scales plus an overall validity index
• items to assess the personality disorder criteria
  in the DSM
• follows the three-factor model of personality
• Neuroticism/Negative Emotionality,
  Extraversion/Positive Emotionality, and
  Disinhibition vs. Constraint.

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Approaches to Test Construction Construct
Validity

• Combines aspects of content validity, empirical
  criterion keying and factor analytic approaches
  in developing assessment devises (Clark and
  Watson, 1995)

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The Place of Personality Assessment in
Contemporary Clinical Psychology

• Or
• Why do we use these tests?

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Psychological Assessment Purpose (Textbook
Response)

• Classification (diagnosis)
• Description
• Prediction

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Classification

• Results from psychological testing assists in
  making a diagnosis
• Critics of psych testing- tests are not reliable
  or valid diagnostic instruments
• Defenders test information is used in
  conjunction with other clinical data

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Description
Testing provides a time efficient means of
developing a broader understanding of the
patient.
Dependent Depressed Client
Narcissistic Depressed Client
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Prediction

• Test findings can be used to make predictions
  about behavior
• Whether client will benefit from psychotherapy
• What type of psychotherapy would be best
• Suicidal risk
• Risk for violence

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The Place of Personality Assessment in
Contemporary Clinical Psychology

• Or
• Why do we use these tests?

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Psychological Assessment Purpose Typical
Referral Question

• Please evaluate for organic brain damage (patient
  has history of polysubstance abuse) and evaluate
  for psychotic thinking

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Tests Administered

• Evidence of Organic Damage
• Weschler Memory Scale
• Trail Making Test
• Rey-Osterieth Complex Figure Test
• Benton Test of Visual Memory

• Evidence of Psychotic Thought
• MMPI
• Rorschach
• Beck Depression Inventory

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Interpretation of Results

• Normal performance on tests of memory,
  concentration and attention
• Personality testing suggested the primary
  etiological role of emotional turmoil.
• Presence of both acute distress and chronic
  characterological problems.
• Acute distress severe depression and a risk for
  suicide
• Reality testing in the normal range
• Significant ego regression when faced with
  affective arousal was noted.

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Projective and Objective Personality Tests
Incremental Validity

• Degree to which assessment increases prediction
  based on base rates (prevalence) or other sources

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Incremental Validity Current Findings

• Tentative support for the incremental validity of
  the MMPI-2 scales in prediction of personality
  disorder, aggression, and differentiation between
  depressed patients and substance abuse patients
• NEO-PI-R personality disorder, maternal
  responsiveness to infants and violence
• Rorschach thought disorder but not other scores
• TAT not adequately investigated

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Objective Tests Summary

• Material Covered
• 4 major approaches to test construction
• Examples of test based on first three test
  construction procedures
• Use of personality tests in modern clinical
  practice