psychopathology_neuro personality testing

Neuropsychological Tests

MEASURE brain functioning/ damage

Alternative for traditional cognitive measures

• Halstead-Reitan Battery

• Luria-Nebraska Battery

• Peabody Vocabulary

• Bender Visual Motor Gestalt test

• Rey-Osterrieth Complex Figure

Halstead-Reitan Battery

Measures brain damage while offering a comprehensive view of the patient’s individual functions

Provides a database for inferring nature, location and extent of structural changes in the brain

• Ten/10 tests • Better for localization of acute (vs. chronic) lesions• Ages 15 and older• Versions for younger individuals• Measures the ability of the nervous system and brain to process and

interpret information received through the senses (visual, auditory, analyze information, mental concepts, make judgments, motor output, attention, concentration and memory).

Screening and evaluation of neuropsychologically impaired individuals

Attempts to combine qualitative techniques of some tests with the quantitative techniques of others.

• Motor skills, language abilities, intellectual abilities,

nonverbal /auditory skills, and visual-spatial

skills.• 15 years and up

Luria-Nebraska Battery

Peabody Vocabulary

Verbal aspect of intelligence

Measures hearing or receptive vocabulary

• NO need to read/ write• Which of four pics BEST

relates to stimulus word

Bender-Gestalt Test

Measure of visual motor and visual perception skills

• Ages 4 and over• 10 minutes• 9 geometric designs• Reproduce designs on blank piece of paper

Rey-Osterrieth Complex Figure

Measures visuospatial abilities, memory, attention, planning and working /executive

functions.

• Reproduce a complicated line drawing, • Copy, 3 minute recall, • 30 minute delayed recall and a recognition trial• Test/ retest reliability

Achievement/ Educational Tests

Measures what the person has ACTUALLY acquired (vs. potential) or done with their potential

• Wide Range Achievement test (WRAT)

• Woodcock-Johnson

• Group tests

Woodcock - Johnson

Excellent evaluating learning disabilities!

Assesses general intellectual abilities, specific cognitive abilities, scholastic aptitude, oral

language, and achievement.

• Compares individual’s own cognitive abilities with achievement • 1.5 / 2 SD difference between cognitive and achievement =

POSSIBLE learning disabilities • Specific and accurate areas of diagnosis (i.e.separating speed vs.

ability)

Wide Range Achievement TestWRAT

Measures reading recognition, spelling, and arithmetic

computation. Helps determine learning ability/ disability.

• Level I (ages 5-0 to 11-11) and Level !! (12 – 64)• Help prescribe remedial programs • Assesses error patterns to plan instructional programs• Individual administration• Caution! Many problems esp. with reading

abilities

Group Tests

Wide range of abilities in educational/ vocational settings

Almost any purpose!

• Verbal, nonverbal or combination• Paper and pencil tests, booklet- pencil, computer

• Group tests in schools/ Kindergarten through 12 for ability (potential to learn) and achievement (learned)

• Group tests of Mental Abilities /intelligence • College entrance tests SAT, GRE• The Armed Services Vocational Aptitude Battery (military)

Personality Testing

Measures….

Stable patterns of behaviors that characterizes a person and his/her

interactions with surroundings

• Dealing with people• Coping with stress• Leader/follower• Control of environment

Activity

you have about 3 minutes to write down what the stimulus

might be/ what you see

Projectives/Unstructured

Responses……

1. In what ways the responses

vary?

2. Why do you think the responses vary?

The Projective Hypothesis

When people attempt to understand an ambiguous or vague stimulus, their

interpretation of that stimulus reflects their needs, feelings, experiences, prior

conditioning, thought processes and so forth.

Projectives Tests Types

1. Pictorial-type tests1. Rorschach, TAT

2. Nonpictorial- type tests1. Word association test, Rotter incomplete

sentence blank

3. Expressive-type tests1. Draw a person, House/Tree/Person, Kinetic

Family test

The Rorschach Inkblot Test

CONTROVERSIAL!!!!

“the most powerful psychometric instrument ever envisioned”

To

“bears a charming resemblance to a party game”

Developed by Swiss psychiatrist Hermann Rorschach in 1921

10 different cards / an ambiguous inkblot.

Describe what he or she sees in the image.

Recorded verbatim by the tester.

Two phases: RESPONSES, INQUIRY

Many different scoring systems (Exner, Rappaport)

d

Responses

1. It is a bat!

2. The body of a woman, in the middle

3. Ghosts! 4 of them

InquiryWHAT MAKES IT LOOK LIKEWHERE IS IT?

1. The whole thing, see the wings? And this middle is the body, it is black.

2. Here in the middle, see the skirt, legs,

3. These white things, like ghosts, they look like it!

ScoringLOCATION DETERMINANTSPECIAL SCORES

1. Wo FC’o A

2. Do Fo H

3. DdS o FC’ Ghost

Responses

1.Two crabs fighting

2.A bunch of different sea animals dancing in the water

InquiryWHAT MAKES IT LOOK LIKEWHERE IS IT?

1..here, see it? The little legs, and claws.. Blue crab. And they have their hands up, to fight

2. The whole thing, look at these creatures, like they are all dancing.

ScoringLOCATION DETERMINANTSPECIAL SCORES

1. Do MaC Pair A Ag

2. W+ Ma A, Ls

The Thematic Apperception TestTAT

A more scientifically based test

Based on Murray’s theory of needs

(Needs for achievement, affiliation, sex, dominance.. )1935

31 cards of ambiguous scenes:

– Men only/ women only/ or either gender

– usual administration: 10 – 20 cards

Instructions

Asked to tell a story• describing the scene, • including what is happening, • how characters are feeling, • and how the story will end.

Scoring

Based on needs, motivations and anxieties of main characters and end of story

InterpretingTHREE areas of focus

1. Content• Can reveal subject’s attitudes, fantasies, wishes, inner

conflicts and view of the outside world

2. The feeling of story

• the story structure usually reveals the subject’s feelings, assumptions about the world and underlying attitude of optimism and pessimism

3. Subject’s behaviors• Verbal remarks (I am not a good story teller)• Nonverbal reactions/ signs (blushing, fidgeting)

Common uses

• Employment in fields with high degree of stress (military leadership, religious ministry, education..)

• Psychotherapy TREATMENT plan (not a diagnostic tool)

• Forensic settings :– 24-year-old man in prison for a series of sexual

murders. Results indicated that his attitudes toward other people are not only outside normal limits but are similar to those of other persons found guilty of the same type of crime.

Cultural, gender and class issues

• Very important to take into account and not assume a response is “abnormal”

• I.E. gender/ Card 6G - woman seated turning toward a somewhat older man standing behind her smoking a pipe. – Males – typically do not react implying

aggressiveness– Females – most females regard it as an aggressive

picture, with unpleasant overtones of intrusiveness and danger

Drawings

• Draw a person

• House / Tree/ Person

• Kinetic family drawing

• Person in the rain

Drawings

Based on psychodynamic interpretation of the details of the drawing:

Size, shape, complexity of features, omissions and disproportions.

Low validity

Scoring/Interpretation Draw a person / House – Tree- Person

60 questions

Three assumptions

1. House = subject’s home life and relationship with family

2. Tree = Experiences

3. Person = Relationships with other people aside from family

In general: areas of conflict/concerns

Sentence Completion

Responses are considered a projection of their conscious and /or unconscious attitudes, personality characteristics,

motivations, and beliefs.

• Opportunity to provide information in private

Sentence completion task

1. I am _________2. I enjoy _______3. What annoys me __________4. It pains me to ___________5. Men ___________6. Dancing ___________7. Sports ______________

Objective tests

First objective/ structured test Woodworth Personal Data sheet, created to identify

military recruits who were at risk to break down in combat (during WWI).

Minnesota Multiphasic Personaltiy Inventory MMPI 1939

Designed to aid in the diagnosis or assessment of the major psychological

disorders

Captures aspects of human psychopathology that are meaningful

despite theoretical approach

MMPI-2

• 567 items• Abbreviated form 370 items (illness, time pressure)

• True/ False

• 1-2 hours• • MMPI-A

• Raw scores transformed into a standardized T-scores (Mean equals 50, standard deviation equals 10)

60.I do not read every editorial in the newspaper everyday61.I have not lived the right kind of life62.Parts of my body often have feeling like burning, tingling, crawling, or like “going to sleep”63.I have had no difficulty in starting or holding my bowel movement64.I sometimes keep on at a thing until others lose their patience with me65.I loved my father66.I see things or animals or people around me that others do not see67.I wish I could be as happy as others seem to be68.I hardly ever feel pain in the back of the neck69.I am very strongly attracted by members of my own sex70.I used to like drop-the-handkerchief71.I think a great many people exaggerate their misfortunes in order to gain the sympathy and help of others72.I am troubled by discomfort in the pit of my stomach every few days or oftener73.I am an important person74.I have often wished I were a girl.  (Or if you are a girl) I have never been sorry that I am a girl75.I get angry sometimes

Sample MMPI questions T/F

Uses

1. Clinical /Diagnostic

2. Forensic/ legal matters

3. Research

4. Employment

5. Treatment Program Effectiveness

MMPI-2

• VALIDITY scales

• CLINICAL scales

• CONTENT scales (substance abuse, anxiety, repression..)

Validity Scales

To detect inconsistencies in responses, over reporting or exaggerating, and under

reporting or downplaying the severity of symptoms.

Abbreviation

New in version

Description Assesses

CNS 1 "Cannot Say" Questions not answered

L 1 Lie Client "faking good"

F 1 Infrequency Client "faking bad" (in first half of test)

K 1 Defensiveness Denial/Evasiveness

Fb 2 Back F Client "faking bad" (in last half of test)

VRIN 2Variable Response Inconsistency

answering similar/opposite question pairs inconsistently

TRIN 2True Response Inconsistency

answering questions all true/all false

F-K 2 F minus Khonesty of test responses/not faking good or bad

S 2Superlative Self-Presentation

improving upon K scale, "appearing excessively good"

Fp 2 F-PsychopathologyFrequency of presentation in clinical setting

Fs 2 RFInfrequent Somatic Response

Overreporting of somatic symptoms

Clinical scales

Measures person’s perception and preoccupation with their health issues

umber

Abbreviation

Description What is measuredNo. of items

1 Hs Hypochondriasis

Concern with bodily symptoms 32

2 D Depression Depressive Symptoms 57

3 Hy HysteriaAwareness of problems and vulnerabilities

60

4 Pd Psychopathic Deviate

Conflict, struggle, anger, respect for society's rules

50

5 MFMasculinity/Femininity

Stereotypical masculine or feminine interests/behaviors

56

6 Pa Paranoia Level of trust, suspiciousness, sensitivity 40

7 Pt PsychastheniaWorry, Anxiety, tension, doubts, obsessiveness

48

8 Sc Schizophrenia Odd thinking and social alienation 78

9 Ma Hypomania Level of excitability 46

0 Si Social Introversion

People orientation 69

Content scales

Supplemental scales to assist interpretation of particular issues such

as anxiety and substance abuse

Abbreviation Description

Es Ego Strength Scale

OH Over-Controlled Hostility Scale

MAC MacAndrews Alcoholism Scale

MAC-R MacAndrews Alcoholism Scale Revised

Do Dominance Scale

APS Addictions Potential Scale

AAS Addictions Acknowledgement Scale

SOD Social Discomfort Scale

A Anxiety Scale

R Repression Scale

TPA Type A Scale

MDS Marital Distress Scale

Conclusion

Tests are tools to ADD to your clinical repertoire.

Tests should be used with caution! -Cultural differences, SES, history…

Tests should NEVER be used in isolation

Tests are used to obtain information that otherwise is difficult to “see”