Psychological Assessment

Psychological Tests

Psychological tests are written, visual, or verbal evaluations administered to assess the cognitive and emotional functioning of clients or patients. These tests can include questionnaires and interviews, which are also designed to measure unobserved constructs. As we mentioned earlier, useful psychological test/scale must be both valid (i.e., there is evidence to support the idea that the test or scale measures what it is purported to measure and “how well it does so”) and reliable (i.e., internally consistent or give consistent results over time, across raters, etc.). Therefore, a test should meet the criterion of standardization.

One of the main advantages of standardized testing is that the results can be empirically documented; therefore, the test scores can be shown to have a relative degree of validity and reliability, as well as results that are generalizable and replicable. A standardized test is a test that is administered and scored in a consistent, or “standard,” manner. Standardized tests are designed in such a way that the questions, conditions for administering, scoring procedures, and interpretations are consistent and are administered and scored in a predetermined, standard manner.

Psychological assessment is most often used in the psychiatric, medical, legal, educational, or psychological clinic settings. This type of clinical assessment can be thought of as a broad range of measurement techniques, all which involve having people provide scorable information about their psychological functioning. The types of assessments and the purposes for them differ among these settings.

In the psychiatric setting, the common needs for assessment are to determine risks, whether a person should be admitted or discharged, the location the patients should be held, and what therapy the patient should be receiving. Within this setting, psychologists need to be aware of the legal responsibilities that they can legally do in each situation.

Within a medical setting, psychological assessments are used to find a possible underlying psychological disorder, emotional factors that may be associated with medical complaints, an assessment for neuropsychological deficit, a psychological treatment for chronic pain, and the treatment of chemical dependency. There has been greater importance placed on the patient’s neuropsychological status as neuropsychologists are becoming more concerned with the functioning of the brain.

Psychological assessment also has a role in the legal setting. Psychologists might be asked to assess the reliability of a witness, the quality of the testimony a witness gives, the competency of an accused person, or determine what might have happened during a crime. They also may help support a plea of insanity or to discount a plea. Judges may use the psychologist’s report to change the sentence of a convicted person, and parole officers work with psychologists to create a program for the rehabilitation of a parolee. Problematic areas for psychologists include predicting how dangerous a person will be. There is currently no accurate measure for this prediction; however, there is often a need for this prediction to prevent dangerous people from returning to society.

Psychologists may also be called on to assess a variety of things within an education setting. They may be asked to assess the strengths and weaknesses of children who are having difficulty in the school systems (via intelligence testing), assess behavioral difficulties, assess a child’s responsiveness to an intervention, or help create an educational plan for a child. The assessment of children also allows for the psychologists to determine if the child will be willing to use the resources that may be provided. Due to rigorous efforts in developing norms, and developing reliability and validity measures, certain measures such as the Wechsler intelligence scales for both adults and children are seen as the strongest psychological instruments around.

In a psychological clinic setting, psychological assessment can be used to determine characteristics of the client that can be useful for developing a treatment plan. Within this setting, psychologists often are working with clients who may have medical or legal problems or sometimes with students who were referred by their school psychologist.

Some psychological assessments have been validated for use when administered via computer or the internet. However, caution must be applied to these test results as it is possible to fake in electronically mediated assessment. Many electronic assessments do not truly measure what is claimed, such as the Meyers-Briggs personality test. Although one of the most well-known personality assessments, it has been found both invalid and unreliable by many psychological researches and should be used with caution.^[1][2]

Types of Psychological Assessment

Psychological measures generally fall within one of several categories, including the following:

• Intelligence & achievement tests—These tests are designed to measure certain specific kinds of cognitive functioning (often referred to as IQ) in comparison to a norming group. These tests, such as the WISC-IV and the WAIS, attempt to measure such traits as general knowledge, verbal skill, memory, attention span, logical reasoning, and visual/spatial perception. Several tests have been shown to predict accurately certain kinds of performance, especially scholastic.
• Personality tests—Tests of personality aim to describe patterns of behavior, thoughts, and feelings. They generally fall within two categories: objective and projective. Objective measures, such as the MMPI, are based on restricted answers—such as yes/no, true/false, or a rating scale—which allow for the computation of scores that can be compared to a normative group. Projective tests, such as the Rorschach inkblot test, allow for open-ended answers, often based on ambiguous stimuli. Other commonly used personality assessment measures include the PAI and the NEO-PI-R.
• Neuropsychological tests—Neuropsychological tests consist of specifically designed tasks used to measure psychological functions known to be linked to a particular brain structure or pathway. They are typically used to assess impairment after an injury or illness known to affect neurocognitive functioning, or when used in research, to contrast neuropsychological abilities across experimental groups.
• Diagnostic Measurement Tools—Clinical psychologists are able to diagnose psychological disorders and related disorders found in the DSM-5 and ICD-10. Many assessment tests have been developed to complement the clinicians clinical observation and other assessment activities. Some of these include the SCID-5, the most widely used.
• Clinical observation—Clinical psychologists are also trained to gather data by observing behavior. The clinical interview is a vital part of the assessment, even when using other formalized tools, which can employ either a structured or unstructured format. Such assessment looks at certain areas, such as general appearance and behavior, mood and affects, perception, comprehension, orientation, insight, memory, and content of the communication. One psychiatric example of a formal interview is the mental status examination, which is often used in psychiatry as a screening tool for treatment or further testing.