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Psychological Testing
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INTENDED LEARNING OBJECTIVES (ILOs)
By the end of the course the student will be able to:
1. Describe mental and behavioral health assessment
2. Identify different neuropsychological tests
3. Explain indication and applications of psychological tests
3
Tuesday, March 4, 2025 Clinical Psychiatry- Humanity Psychology
Psychological Assessment
❑It includes a combination of clinical examinations and psychological tests that
provide information about how a patient is functioning.
❑Identify mental health problems
❑Differentiate between mental and physical health problems.
❑Diagnostic and treatment follow up.
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Psychological Assessment
❑A typical mental health assessment may include the following elements:
• Interview (History Taking):Asking questions about the patient's symptoms and concerns
• Physical exam: To distinguish between from a mental disorder and bodily illness.
• Lab tests: exclude organicity.
• Psychological Tests: if indicated.
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Psychological Testing
❑A psychological test is an objective and standardized measure of an individual's
mental and/or behavioral characteristics.
❑Assess psychological constructs, such as ability, cognitive and emotional
functioning, personality and neurological functioning.
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Psychological Testing
Effective care delivery relies on a comprehensive assessment being made.
✓ The use of validated assessment tools enhances assessment and can be incorporated into the
management of patient/client care in a variety of ways.
✓ They can be useful for providing evidence for clinical decisions.
✓ They are also useful where potential risk is suspected
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Psychological Testing
Effective care delivery relies on a comprehensive assessment being made.
✓ They are also useful where potential risk is suspected
✓ They can be used to measure the level of risk.
✓ Psychological tests are used in research
✓ The use of validated assessment tools is crucial to providing documentary quantifiable evidence
of patient/client state of health and determining the patient/client progress/difficulties with the
plan of care.
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Types of Psychological Testing
❑ Diagnostic tools:
Psychological assessment measures can support a qualified clinician in making a formal
diagnosis of a mental health problem and dig deeper into screening results.
It can include the use of semi-structured diagnostic interviews and validated questionnaires.
Items in self-report measures used for diagnosis often bear a close correspondence to criteria
specified in the diagnostic manuals (ICD and DSM).
E.g.: SCID I/MINI.
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Types of Psychological Testing
❑ Screening tools:
1. Identify the possible presence of certain problems (test potential disorders).
2. Usually given in a checklist or questionnaire format
The MMSE is effective as a screening tool for cognitive impairment with older, community dwelling,
hospitalized and institutionalized adults.
Assessment of an older adults cognitive function is best achieved when it is done routinely,
systematically and thoroughly.
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Types of Psychological Testing
❑ Screening tools:
MICHIGAN ALCOHOL SCREENING TEST (MAST) is a psychological tool designed to help
identify all people with alcohol dependency syndrome, if they respond truthfully.
Suicide risk: screening for suicide risk is an essential preventive measure (Colombia scale C-SSRS).
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Types of Psychological Testing
❑ Screening tools:
1. Identify the possible presence of certain problems (test potential disorders).
2. Usually given in a checklist or questionnaire format
The MMSE is effective as a screening tool for cognitive impairment with older, community dwelling,
hospitalized and institutionalized adults.
Assessment of an older adults cognitive function is best achieved when it is done routinely,
systematically and thoroughly.
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Mental Health Assessment formats
❑Checklist:
- It provide a method for assessing presence or absence of a skill, behavior, or knowledge in a
person and is typically formulated as “yes” or “no” questions.
- Used in conjunction with other assessment methods.
- The Child Behavior Checklist (CBCL): is used to assess children for various behavioral and
emotional problems. The preschool forms and profiles span ages 1.5 to 5 years. The parents,
child care providers, and teachers provide ratings on 99 problem items and descriptions of the
child’s strengths and problems
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Mental Health Assessment formats
❑Rating scale:
- It is similar to checklists except they assess the degree of accomplishment of skill, behavior, or
knowledge instead of just the presence or absence of it.
- Provide numerical data, determine the severity of symptoms
- Childhood Autism Rating Scale (CARS) is used for the detection and diagnosis of autism. The
CARS consists of 14 domains assessing behaviors associated with autism, with a 15th domain
rating general impressions of autism. Each domain is scored on a scale ranging from 1 to 4;higher
scores are associated with a higher level of impairment.
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Mental Health Assessment formats
Liverpool University Side Effect Rating Scale (LUNSERS) is a fully validated and
comprehensive self-rating scale for measuring the impact of side effects from neuroleptic
medication.
• The scale rates the severity of recognized neuroleptic side effect
• Users of the scale should read the article below to familiarize themselves with the test.
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Mental Health Assessment formats
❑Questionnaires/standardized tests:
1. Often go into greater detail about a specific illness and its severity.
E.g. global mental health assessment tool .
CAGE Questionnaire is a very brief, relatively non-confrontational questionnaire for detection of
alcoholism ,may be focused to delineate past or present.
Target population: Adults & adolescents over 16 years.
Additionally useful in the general medical population being examined in a primary care setting.
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Principles of psychological testing
❑ The diagnostic or predictive value of a psychological test depends on:
1. Ability degree of the test to be an indicator of a significant area of behavior.
2. Ability of the test to diagnose the present condition such as retardation or emotional
disorder, implies a prediction of what the individual will do in situations.
❑ Limitations:
• Prediction cannot assess individual’s future performance on a job
• projective tests may involve some level of subjective interpretation.
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Principles of psychological testing
❑ Consideration for proper psychological testing consists of the following:
• Standardization: All procedures and steps must be consistence under the same environment to achieve
the same testing performance
• Norms: Appropriate and accurate norms must be present in a quality test (age, grade, percentile rank,..).
• Reliability is the ability of a measure to obtain consistent results after multiple testing.
• Validity is the ability to discriminate between a person with a problem and one without such a problem.
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Principles of psychological testing
• Simplicity: should be simple with available resources.
• Economy: It should be administer in short time for the ease.
• Interesting /Objectivity
• Sensitivity is the accuracy of the test in identifying a problem.
• Specificity is the accuracy of the test in identifying individuals who do not have a problem.
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TESTS of Specific Disorders
❑ Three types of Psychological tests: Mental Ability , Personality and neuropsychological tests
❑ Both of these types of tests divided into sub-categories of testing.
❑ There is a clear-cut distinction between ability tests and personality tests.
❑ All three ability tests (Achievement, aptitude, intelligence) are highly interrelated- NO clear-
cut distinction.
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TESTS of Specific Disorders
❑Ability tests : Assessment in and for Education
❑ Aptitude:
• Potential for learning or acquiring a specific skill and talents (training, education or
experience , speed, mechanical reasoning, etc.)
❑ Achievement:
• Measure aspects of personality, including motives, interests, values, and attitudes
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Mental ability tests
❑ Intelligence:
• Refers to a person’s general potential to solve problems, adapt to changing
circumstances, think abstractly and profit from experience.
• Measure general mental abilities.
• Measure motives, interests, values, and attitudes
• Measure intellectual potential
• For example : Binet Intelligence Test , Wechsler Adult Intelligence Scale.
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Intelligence Quotient (IQ)
❑IQ is a general estimate of the functional capacities of a person
❑ 70% inherited, recent studies suggest most from mother.
❑ IQ is not an absolute score but a comparison among people.
❑Distribution mean: 100; standard deviation: 15.
❑Calculating an intelligence quotient by mental age method:
• Mental age (MA) = median test score for a given age
• Chronological age (CA) = actual age of the person taking the test
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Intelligence Quotient (IQ)
Range Label Distribution
Less than 69 Intellectual disability About 2.5% of the population
70 to 79 Borderline
80 to 89 Low average
90 to 109 Average About 50% of the population
110 to 119 High average
120 to 129 Superior
over 130 Very superior About 2.5% of the population
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Commonly Used (IQ) Tests
1. Wechsler Adult Intelligence Scale, Revised (WAIS-R) for age 17 and older.
2. Wechsler Intelligence Scale for Children, Revised (WISC-R) for age 6 to 17.
3. Wechsler Preschool and Primary Scale of Intelligence (WPPSI) for age 4 to 6.
4. Stanford-Binet Scale was the first formal IQ test (1905) and is used for children
aged 2 to 18. Today, it is most useful with children younger than 6, the impaired,
or the very bright
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Personality Tests
❑ Personality tests related to the overt and covert traits of the individual.
❑ Types of personality tests
1. Structured personality test is “self-report” variety requires the subject to choose
between 2 or more alternative responses.
2. Projective personality test.
Meaning of responses found by clinical correlation between collected cases of
responses and personal characteristics, psychopathologies.
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Examples of Personality Tests
1. Minnesota Multiphasic Personality Inventory (MMPI).
2. Thematic Apperception Test (TAT): Patients are asked to tell a story about what is
going on in the pictures.
3. Sentence Completion Test: Patient is asked to complete a set of sentence stems with
the first thing that comes to mind.
4. Projective drawings: Patient is given a sheet of paper and asked to draw a house, a
tree, a person, a family, or some other subject.
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Neuropsychologic Tests
❑ Luria Nebraska Battery: Tests level of impairment and functioning.
Subscales: motor, rhythm, tactile, visual–spatial, receptive, expressive speech, writing,
reading, arithmetic, amnestic, intellectual, right and left hemisphere function.
❑ Benton Visual Retention Test: Spatial construction, drawing task. 10 designs that the
patient copies as presented or from memory.
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Neuropsychologic Tests
❑ Wechsler Memory Scale: Assesses memory impairment.
Subcomponents: recall of current and past information, orientation, attention,
concentration, memory for story details, memory designs, and learning.
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Take Home Message
• Mental health professionals use a variety of instruments to assess mental health and
wellbeing.
• Common purposes for psychological testing include: screening for the presence or
absence of common mental health conditions; making a formal diagnosis of a mental
health condition; assessment of changes in symptom severity; and monitoring client
outcomes across the course of therapy.
• Screening: Brief psychological measures can be used to ‘screen’ individuals for a range
of mental health conditions.
• Screening tends are quick to administer but results are only indicative: if a positive
result is found on a screening test then the screening test can be followed up by a more
definitive test.
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Take Home Message
• Diagnosis: Psychological assessment measures can support a qualified clinician in
making a formal diagnosis of a mental health problem.
• Symptom & outcome monitoring: One strand of evidence-based practice requires that
therapists use outcome measures to monitor progress and guide the course of therapy.
Psychologists, CBT therapists, and other mental health professionals often ask their
clients to complete self-report measures regularly to assess changes in symptom
severity.
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References
❑ Kaplan medical book step 1 USMLE , lecture notes 2016
❑ Kaplan and Sadocks Comprehensive textbook of Psychiatry
– 10th edition
❑ Kaplan and Sadocks Synopsis of Psychiatry – 11th edition
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