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Psychological Testing: II. Tests in Clinical Use

Tests used by clinicians

Assessment techniques and formal tests are tools used to gather information. ... The score or

performance on a test helps the clinician understand something about the person, and during the

assessment process, it contributes to understanding what the potential diagnostic issues may be.

The ten most commonly used tests included: Wechsler adult intelligence scale, Wechsler

intelligence scale for children; five projective techniques (Rorschach, Thematic Apperception

Test, Mach over draw-a- person, house-tree-person, rotter incomplete sentences blank); one

personality inventory (MMPI); and the bender –gestalt visual motor test.

General intellectual functioning

Intellectual assessment and intelligence testing refer to the evaluation of an individual's general

intellectual functioning and cognitive abilities. ... Higher IQ scores are assumed to mean that the

individual has higher intellectual functioning.

It is necessary to eliminate low intelligence as a contributing factor when making a diagnosis of a

specific learning disorder. The information obtained from an IQ assessment can also identify

specific areas of high or low functioning which can provide an initial estimate of the individual’s

aptitude for specific vocations.

A comprehensive cognitive battery such as the WISC-V provides insight into the client’s

performance across a number of areas, including verbal comprehension, visual/spatial reasoning,

logical inductive reasoning, working memory and processing speed. Identification of deficit
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areas can provide useful information for providing compensations, adaptations and modifications

for the client.

Early intelligence and psychological development

A number of procedures exist for the study of infants and very young children. The more

commonly used include the Cattell infant intelligence scale, Bayley scale and Gesell

development schedule. These procedures involve observation of child which yield ratings of

development in perceptual, motoric, language, personality band social functioning.

Abilities, aptitude, and achievement:

Achievement. Aptitude tests evaluate a distinct aspect of a person's cognitive abilities. ...

While aptitude is the potential to learn, achievement is learning itself. An achievement

test evaluates the information or skills a student has already learned. An aptitude test is designed

to assess what a person is capable of doing or to predict what a person is able to learn or do given

the right education and instruction.

Interest, values, and social attitude

Related are those procedure which asses the subject’s interest and orientation toward, rather than

particular aptitude for occupational roles. Two well-known procedure are the Kuder preference

and the strong vocational interest blank (SIVB) which ask the subject to express preference for

particular types of activities.

More general orientation toward social values are measured by the Allport-Vemon-Lindezy

study of values Morris paths of life is similar attempt to get a basic value orientation.
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Personality assessment, broad focus

In general .clinicians work more with broad-scaled, multicellular procedures, personality and

clinical research.

There are two types

Projective personality test

These are tests that provide some sort of ambiguous stimulus or task, and the individual is

required to give a subjective opinion of the stimulus or to complete the task, such as a drawing

task. There are no rights or wrong answers to these tests; the data gleaned from these tests

consists of the individual’s interpretation and expression to the stimulus or task. These tests are

designed to tap personality variables that individuals are not overtly aware of (in the unconscious

mind). The most well-known of these tests is the Rorschach or ink blot test.children apperception

test, picture arrangement test.

Self –report measures and inventories

By far the most commonly used inventory is the MMPI .a related technique develop for

assessment of normal and more tuned to the healthy dimensions of personality, is gouge’s

California psychological inventory.

Other inventories are sixteen personality factor questionnaire, the Edward personal preference

schedule.Both ACL and Q-sort can be used equally well for self-report or to describe a patient.

Specific personality variables

The NEO PI-R (same revised) is a psychological personality inventory; a 240-questionnaire

measure of the Five Factor Model: Extraversion, Agreeableness, Conscientiousness,

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Neuroticism, and Openness to experience. Additionally, the test measures six subordinate

dimensions of each of the "Big Five" personality factors. the measurement of personal

characteristics. Assessment is an end result of gathering information intended to advance

psychological theory and research and to increase the probability that wise decisions will be

made in applied settings (e.g., in selecting the most promising people from a group of job

applicants). The approach taken by the specialist in personality assessment is based on the

assumption that much of the observable variability in behavior from one person to another results

from differences in the extent to which individuals possess particular underlying personal

characteristics (traits). The assessment specialist seeks to define these traits, to measure them

objectively, and to relate them to socially significant aspects of behaviour.

Other assessment measures

Attention should be drawn to other procedures of value to clinical assessment which are not tests,

in the usual sense. The patient does not describe himself or perform test task in standard

situation. These include the lorr and Klett inpatient multidimensional psychiatric scale, spitzer’s

psychiatric status scale. Interpersonal checklists, peer rating, stoichiometric rating is also used.

The Wechsler adults intelligence scale (SCALE)

The test is scored in terms of intelligence quotient, or IQ, a concept first suggested by German

psychologist William Stern and adopted by Lewis Term an in the Stanford-Binet Scale. The IQ

was originally computed as the ratio of a person’s mental age to his chronological (physical) age,

multiplied by 100. Thus, if a child of 10 had a mental age of 12 (that is, performed on the test at

the level of an average 12-year-old), then the child was assigned an IQ of (12/10) X 100, or 120.

A score of 100, for which the mental age equaled the chronological age, was average; scores
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above 100 were above average, scores below 100 were below average. The concept of mental

age has fallen into disrepute, however, and few tests now involve the computation of mental

ages. Yet many tests still yield an IQ; this figure is now computed on the basis of the statistical

percentage of people who are expected to have a certain IQ. Intelligence test scores follow an

approximately “normal” distribution, with most people scoring near the middle of the

distribution curve and scores dropping off fairly rapidly in frequency away from the curve’s

centre. For example, on the IQ scale about 2 out of 3 scores fall between 85 and 115 and about

19 out of 20 scores fall between 70 and 130. A score of about 130 or above is considered gifted,

while a score below about 70 is considered mentally deficient or retarded.

Intelligence tests have provoked a great deal of controversy about what kinds of mental

abilities constitute intelligence and whether the IQ adequately represents these abilities, with

debate centring on cultural bias in test construction and standardization procedures. Critics have

charged that intelligence tests favour groups from more affluent backgrounds and discriminate

against less privileged racial, ethnic, or social groups. Consequently, psychologists have

attempted to develop culture-free tests that would more accurately reflect an individual’s native

ability. One such test, the Johns Hopkins Perceptual Test, developed by Leon Rosenberg in the

early 1960s to measure the intelligence of preschool children, has a child try to match random

forms (ordinary geometric forms, such as circles, squares, and triangles, are avoided because

some children may be more familiar with the forms than are others). Another attempted solution

to the problem was to use test material pertinent to a child’s living environment; for example, for

inner-city children, urban and not pastoral scenes are appropriate.

The Wechsler-Bellevue test quickly became the most widely used adult intelligence test in the

United States, and in 1942 Wechsler issued his first revision. The Wechsler Intelligence Scale for
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Children was published in 1949 and updated in 1974. In 1955 Wechsler developed yet another

adult intelligence test, the Wechsler Adult Intelligence Scale (WAIS), with the same structure as

his earlier scale but standardized with a different population, including 10 percent nonwhites to

reflect the U.S. population. (The earlier test had been standardized for an all-white population.)

He contributed to the revision of the WAIS in 1981, shortly before his death. The last of his

intelligence tests, the Wechsler Preschool and Primary Scale of Intelligence, was issued in 1967

as an adaptation of the children’s scale for use with very young children. His intelligence tests

continue to be updated for contemporary us.

The subtest and their interpretative rationale

Verbal scale

Information consist of twenty-nine question covering a variety of topics which adults should

know about by virtue of having lived in our culture .specialized and technical information is

avoided.

Performance scale

Test which has often been used in non-verbal test procedures. There are nine symbols paired

with nine numbers. With the key before him the subject must fill in as many of blanks on the

answer sheet as he can in one-and-a-half minutes. There is a little learning, memory, problem

solving, or more abstract ability involved in this task.

The Minnesota multiphasic personality inventory (MMPI)

The ten clinical scales of MMPI include:

 Hypochondriasis

 Depression
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 Hysteria

 Psychopathic deviate

 Masculinity-femininity

 Paranoia

 Psychoasthenia

 Schizophrenia

 Hypomania

 Social introversion

The Minnesota Multiphasic Personality Inventory (MMPI), is probably the personality inventory

in widest use in the English-speaking world. Also available in other languages, it consists in one

version of 550 items (e.g., “I like tall women”) to which subjects are to respond “true,” “false,”

or “cannot say.” Work on this inventory began in the 1930s, when its construction was motivated

by the need for a practical, economical means of describing and predicting the behavior of

psychiatric patients. In its development efforts were made to achieve convenience in

administration and scoring and to overcome many of the known defects of earlier personality

inventories. Varied types of items were included and emphasis was placed on making these

printed statements (presented either on small cards or in a booklet) intelligible even to persons

with limited reading ability.

Earlier inventories lacked subtlety; many people were able to fake or bias their answers since the

items presented were easily seen to reflect gross disturbances; indeed, in many of these

inventories maladaptive tendencies would be reflected in either all true or all false answers.

Perhaps the most significant methodological advance to be found in the MMPI was the attempt
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on the part of its developers to measure tendencies to respond, rather than actual behavior, and to

rely but little on assumptions of face validity. The true-false item “I hear strange voices all the

time” has face validity for most people in that to answer “true” to it seems to provide a strong

indication of abnormal hallucinatory experiences. But some psychiatric patients who “hear

strange voices” can still appreciate the socially undesirable implications of a “true” answer and

may therefore try to conceal their abnormality by answering “false.” A major difficulty in

placing great reliance on face validity in test construction is that the subject may be as aware of

the significance of certain responses as is the test constructor and thus may be able to mislead the

tester. Nevertheless, the person who hears strange voices and yet answers the item “false” clearly

is responding to something—the answer still is a reflection of personality, even though it may

not be the aspect of personality to which the item seems to refer; thus, careful study of responses

beyond their mere face validity often proves to be profitable.

Their approach does not depend heavily on theoretical predilections and hypotheses. For this

reason the inventory has proved particularly popular with those who have strong doubts about

the eventual validity that many theoretical formulations will show in connection with personality

measurement after they have been tested through painstaking research. The MMPI also appeals

to those who demand firm experimental evidence that any personality assessment method can

make valid discriminations among individuals.

In recent years there has been growing interest in actuarial personality description—that is, in

personality description based on traits shared in common by groups of people. Actuarial

description studies yield rules by which persons may be classified according to their personal

attributes as revealed by their behavior (on tests, for example). programs are now available for

diagnosing such disorders as hysteria, schizophrenia, and paranoia on the basis of typical group
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profiles of MMPI responses. Computerized methods for integrating large amounts of personal

data are not limited to this inventory and are applicable to other inventories, personality tests

(e.g., inkblots), and life-history information. Computerized classification of MMPI profiles,

however, has been explored most intensively.

Projective techniques

One group of assessment specialists believes that the more freedom people have in picking their

responses, the more meaningful the description and classification that can be obtained. Because

personality inventories do not permit much freedom of choice, some researchers and clinicians

prefer to use projective techniques, in which a person is shown ambiguous stimuli (such as

shapes or pictures) and asked to interpret them in some way. (Such stimuli allow relative

freedom in projecting one’s own interests and feelings into them, reacting in any way that seems

appropriate.) Projective techniques are believed to be sensitive to unconscious dimensions of

personality. Defense mechanisms, latent impulses, and anxieties have all been inferred from data

gathered in projective situations.

Personality inventories and projective techniques do have some elements in common; inkblots,

for example, are ambiguous, but so also are many of the statements on inventories such as the

MMPI. These techniques differ in that the subject is given substantially free rein in responding to

projective stimuli rather than merely answering true or false, for example. Another similarity

between projective and questionnaire or inventory approaches is that all involve the use of

relatively standardized testing situations.

While projective techniques are often lumped together as one general methodology, in actual

practice there are several approaches to assessment from a projective point of view. Although

projective techniques share the common characteristic that they permit the subject wide latitude
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in responding, they still may be distinguished broadly as follows: (1) associative techniques, in

which the subject is asked to react to words, to inkblots, or to other stimuli with the first

associated thoughts that come to mind; (2) construction techniques, in which the subject is asked

to create something—for example, make up a story or draw a self-portrait; (3) completion

techniques, in which the subject is asked to finish a partially developed stimulus, such as adding

the last words to an incomplete sentence; (4) choice or ordering techniques, in which the subject

is asked to choose from among or to give some orderly sequence to stimuli—for example, to

choose from or arrange a set of pictures or inkblots; (5) expressive techniques, in which the

subject is asked to use free expression in some manner, such as in finger painting.

Hidden personality defense mechanisms, latent emotional impulses, and inner anxieties all have

been attributed to test takers by making theoretical inferences from data gathered as they

responded in projective situations. While projective stimuli are ambiguous, they are usually

administered under fairly standardized conditions. Quantitative (numerical) measures can be

derived from subjects’ responses to them. These include the number of responses one makes to a

series of inkblots and the number of responses to the blots in which the subject perceives what

seem to him to be moving animals.

The Rorschach test

The Rorschach inkblots were developed by a Swiss psychiatrist, Hermann Rorschach, in an

effort to reduce the time required in psychiatric diagnosis. His test consists of 10 cards, half of

which are in colour and half in black and white. The test is administered by showing the subject

the 10 blots one at a time; the subject’s task is to describe what he sees in the blots or what they
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remind him of. The subject is usually told that the inkblots are not a test of the kind he took in

school and that there are no right or wrong answers.

Rorschach’s work was stimulated by his interest in the relationship between perception and

personality. He held that a person’s perceptual responses to inkblots could serve as clues to basic

personality tendencies. Despite Rorschach’s original claims for the validity of his test,

subsequent negative research findings have led many users of projective techniques to become

dubious about the role assigned the inkblots in delineating relationships between perception and

personality. In recent years, emphasis has tended to shift to the analysis of nuances of the

subject’s social behaviour during the test and to the content of his verbal responses to the

examiner—whether, for example, he seeks to obtain the assistance of the examiner in “solving”

the inkblots presented to him, sees “angry lions” or “meek lambs” in the inkblots, or is

apologetic or combative about his responses.

Over the years, considerable research has been carried out on Rorschach’s inkblots; important

statistical problems in analyzing data gathered with projective techniques have been identified,

and researchers have continued in their largely unsuccessful efforts to overcome them. There is a

vast experimental literature to suggest that the Rorschach technique lacks empirical validity.

Recently, researchers have sought to put the Rorschach on a sounder psychometric (mental

testing) basis. New comprehensive scoring systems have been developed, and there have been

improvements in standardization and norms. These developments have injected new life into the

Rorschach as a psychometric instrument.

A similar method, the Holtzman Inkblot Test, has been developed in an effort to eliminate some

of the statistical problems that beset the Rorschach test. It involves the administration of a series

of 45 inkblots, the subject being permitted to make only one response per card. The Holtzman
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has the desirable feature that it provides an alternate series of 45 additional cards for use in

retesting the same person.

Research with the Rorschach and Holtzman has proceeded in a number of directions; many

studies have compared psychiatric patients and other groups of special interest (delinquents,

underachieving students) with ostensibly normal people. Some investigators have sought to

derive indexes or predictions of future behavior from responses to inkblots and have checked, for

example, to see if anxiety and hostility (as inferred from content analyses of verbal responses)

are related to favorable or unfavorable response to psychotherapy. A sizable area of exploration

concerns the effects of special conditions (e.g., experimentally induced anxiety or hostility) on

the inkblot perceptions reported by the subject and the content of his speech.

The Thematic Apperception Test (TAT)

There are other personality assessment devices, which, like the Rorschach, are based on the idea

that an individual will project something of himself into his description of an ambiguous

stimulus.

The TAT, for example, presents the subject with pictures of persons engaged in a variety of

activities (e.g., someone with a violin). While the pictures leave much to one’s imagination, they

are more highly specific, organized visual stimuli than are inkblots. The test consists of 30 black

and white pictures and one blank card (to test imagination under very limited stimulation). The

cards are presented to the subject one at a time, and he is asked to make up a story that describes

each picture and that indicates the events that led to the scene and the events that will grow out

of it. He is also asked to describe the thoughts and feelings of the persons in his story
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Although some content-analysis scoring systems have been developed for the TAT, attempts to

score it in a standardized quantitative fashion tend to be limited to research and have been fewer

than has been the case for the Rorschach. This is especially the state of affairs in applied settings

in which the test is often used as a basis for conducting a kind of clinical interview; the pictures

are used to elicit a sample of verbal behaviour on the basis of which inferences are drawn by the

clinician.

In one popular approach, interpretation of a TAT story usually begins with an effort to determine

who is the hero (i.e., to identify the character with whom the subject seems to have identified

himself). The content of the stories is often analyzed in terms of a so-called need-press system.

Needs are defined as the internal motivations of the hero. Press refers to environmental forces

that may facilitate or interfere with the satisfaction of needs (e.g., in the story the hero may be

physically attacked, frustrated by poverty, or suffer the effects of rumors being spread about

him). In assessing the importance or strength of a particular inferred need or press for the

individual who takes the test, special attention is given to signs of its pervasiveness and

consistency in different stories. Analysis of the test may depend considerably on the subjective,

personal characteristics of the evaluator, who usually seeks to interpret the subjects’ behavior in

the testing situation; the characteristics of his utterances; the emotional tone of the stories; the

kinds of fantasies he offers; the outcomes of the stories; and the conscious and unconscious

needs speculatively inferred from the stories.

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References

 Gregory, Robert (2007). Psychological Testing: History, Principles, and Applications.

Boston: Pearson. pp. 391–ISBN978-0-205-46882-9
 Telligent, A., Ben-Porath, Y. S., Sellbom, M., Arbisi, P. A., McNulty, J. L., & Graham, J.
R. (2006). Further evidence on the validity of the MMPI-2 Restructured Clinical (RC)
Scales: Addressing questions raised by Rogers et al. and Nichols. Journal of Personality
Assessment, 87, 148-171.
 Hertz, Marguerite R. (September 1986). "Rorschach bound: A 50-Year Memoir". Journal
of Personality Assessment. 50 (3): 396–
416. doi:10.1207/s15327752jpa5003_9. ISSN 0022-3891. PMID 16367435.
 Meyer, Gregory J. and Kurtz, John E.(2006) 'Advancing Personality Assessment
Terminology: Time to Retire "Objective" and "Projective" As Personality Test
Descriptors', Journal of Personality Assessment, 87: 3, 223 — 225
 Hibbard, S., Mitchell, D., & Porcerelli, J. (2001). Internal consistency of the object
relations and social cognition scales for the Thematic Apperception Test. Journal of
Personality Assessment, 77(3), 408-419.
 Wildman, R.W., & Wildman, R.W. II. (1975). An investigation into the comparative
validity of several diagnostic tests and test batteries.