Psychological evaluation

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Psychological evaluation is defined as a way of testing people about their behavior, personality, and capabilities to draw conclusions using combinations of techniques.[1] Over the years, it has developed from unethical methods of locking people up for tests to the many different strategies today. We currently see evaluation being used in several different settings for multiple purposes, such as education or legal situations. The purpose behind modern psychological evaluation is to try and pinpoint what is happening in someone's psychological life that may be inhibiting their ability to behave or feel in more appropriate or constructive way. A psychological evaluation may result in a diagnosis[dubious ] of a mental illness. It is the mental equivalent of physical examination. It is important to use psychological evaluation properly, because if guidelines aren't followed, violations of ethical codes can be made, resulting in harm to a client and invalid assessment results . There is also a risk of evaluation based upon unscientific principles, as found in pop psychology, or pseudopsychology.

History[edit]

Psychological evaluation has been around for roughly 200 years. It started in China, and many psychologists throughout Europe worked to develop methods of testing into the 1900s. The first tests focused on aptitude. Eventually scientists tried to gauge mental processes in patients with brain damage, then children with special needs.

Psychological evaluation has its roots in China in the 1800s. This primitive form of testing was used to determine people’s eligibility to hold public office. Those who wanted a position were locked in a room and wrote essays and poems for long periods of time. Those who passed moved onto the next round. This continued until 1-3 people were considered eligible to hold office. Early written exams also included material about civil law, military affairs, agriculture, revenue, and geography.[2] These methods were not popular amongst citizens and were therefore abolished in 1906.

Also in the 1800s, Hubert von Grashey developed a battery to determine the abilities of brain-damaged patients. This test was also not favorable, as it took over 100 hours to administer. However, this influenced Wilhelm Wundt, who had the first psychological laboratory in Germany. His tests were shorter, but used similar techniques. Wundt also measured mental processes and acknowledged the fact that there are individual differences between people.

Frances Galton established the first tests in London for measuring IQ. He tested thousands of people, examining their physical characteristics as a basis for his results and many of the records remain today.[2] James Cattell studied with him, and eventually worked on his own with brass instruments for evaluation. His studies led to his paper “Mental Tests and Measurements,” one of the most famous writings on psychological evaluation. He also coined the term “mental test” in this paper.

As the 1900s began, Alfred Binet was also studying evaluation. However, he was more interested in distinguishing children with special needs from their peers after he could not prove in his other research that magnets could cure hysteria. He did his research in France, with the help of Theodore Simon. They created a list of questions that were used to determine if children would receive regular instruction, or would participate in special education programs. Their battery was continually revised and developed, until 1911 when the Binet-Simon questionnaire was finalized for different age levels.

After Binet's death, intelligence testing was further studied by Charles Spearman. He theorized that intelligence was made up of several different subcategories, which were all interrelated. He combined all the factors together to form a general intelligence, which he abbreviated as "g".[3] This lead to William Stern's idea of an intelligence quotient. He believed that children of different ages should be compared to their peers to determine their mental age in relation to their chronological age. Lewis Terman combined the Binet-Simon questionnaire with the intelligence quotient and the result was the standard test we use today, with an average score of 100.[3]

As America grew larger throughout the early 1900’s, it saw a huge influx of immigrants looking for a new life. With the face of America changing, psychologists began to realize that evaluations that were heavily reliant upon verbal skills were not appropriate for people that didn't speak English, were illiterate, or had speech/hearing problems. In 1913, R.H. Sylvester standardized the first non-verbal psychological test. In this particular test, participants fit different shaped blocks into their respective slots on a Seguin form board.[2] From this test, Knox developed a series of non-verbal psychological tests that he used while working at the Ellis Island immigrant station in 1914. In his tests, were a simple wooden puzzle as well as digit-symbol substitution test where each participant saw digits paired up with a particular symbol, they were then shown the digits and had to write in the symbol that was associated with it.[2]

When the United States moved into WWI, Robert M. Yerkes convinced the government that they should be testing all of the recruits they were receiving into the Army. The results of the tests could be used to make sure that the “mentally incompetent” and “mentally exceptional” were assigned to appropriate jobs. Yerkes and his colleagues developed the Army Alpha and Army Beta tests to use on all new recruits.[2] These tests set a precedent for the development of psychological testing for the next several decades.

After seeing the success of the Army standardized tests, college administration quickly picked up on the idea of group testing to decide entrance into their institutions. The College Entrance Examination Board was created to test applicants to colleges across the nation. In 1925, they developed tests that were no longer essay tests that were very open to interpretation, but now were objective tests that were also the first to be scored by machine. These early tests evolved into modern day College Board tests, like the Scholastic Assessment Test, Graduate Record Examination, and the Law School Admissions Test.[2]

Formal and informal evaluation[edit]

Formal psychological evaluation consists of standardized batteries of tests and highly structured clinician-run interviews, while informal evaluation takes on a completely different tone. In informal evaluation, assessments are based on unstructured, free-flowing interviews or observations that allow both the patient and the clinician to guide the content. Both of these methods have their pros and cons. A highly unstructured interview and informal observations provide key findings about the patient that are both efficient and effective. A potential issue with an unstructured, informal approach is the clinician may overlook certain areas of functioning or not notice them at all.[4] Or they might focus too much on presenting complaints. The highly structured interview, although very precise, can cause the clinician to make the mistake of focusing a specific answer to a specific question without considering the response in terms of a broader scope or life context.[4] They may fail to recognize how the patient's answers all fit together, they lose the forest through the trees.

There are many ways that the issues associated with the interview process can be mitigated. The benefits to more formal standardized evaluation types such as batteries and tests are many. First, they measure a large number of characteristics simultaneously. These include personality, cognitive, and/or neuropsychological characteristics. Second, these tests provide empirically quantified information. The obvious benefit to this is that we can more precisely measure patient characteristics as compared to any kind of structured or unstructured interview. Third, all of these tests have a standardized way of being scored and being administered.[4] Each patient is presented a standardized stimulus that serves as a benchmark that can be used to determine their characteristics. These types of tests eliminate any possibility of bias and produce results that could be harmful to the patient and cause legal and ethical issues. Fourth, tests are normed. This means that patients can be assessed not only based on their comparison to a "normal" individual, but how they compare to the rest of their peers who may have the same psychological issues that they face. Normed tests allow the clinician to make a more individualized assessment of the patient. Fifth, standardized tests that we commonly use today are both valid and reliable.[4] We know what specific score mean, how reliable they are, and how the results will affect the patient.

Most clinicians agree that a balanced battery of tests is the most effective way of helping patients. Clinicians should not become victims of blind adherence to any one particular method.[5] A balanced battery of tests allows there to be a mix of formal testing processes that allow the clinician to start making their assessment, while conducting more informal, unstructured interviews with the same patient may help the clinician to make more individualized evaluations and help piece together what could potentially be a very complex, unique-to-the-individual kind of issue or problem .[5]

Modern uses[edit]

Psychological assessment is most often used in the psychiatric, medical, legal, educational, or psychological clinic settings. 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 emitted or discharged, the location the patients should be held, as well as what therapy the patient should be receiving.[6] The psychologists must often determine what information the ward administrator wants, specifically relating to the needs of the patient. Within this setting, the psychologists need to be aware of the legal responsibilities that what they can legally do in each situation.

Within a medical setting, psychological assessment is used to find a possible underlying psychological disorder, emotional factors that may be associated with medical complaints, assessment for neuropsychological deficit, 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.[6]

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 are currently no accurate measure for this prediction, however there is often a need for this prediction to prevent dangerous people from returning to society.[6]

Psychologists may also be called on to assess a variety of things within an education setting. They may be asked to assess strengths and weaknesses of children who are having difficulty in the school systems, assess behavioral difficulties, assess a child’s responsiveness to an intervention, or to 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.[6]

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, psycholgists often are working with clients who may have medical or legal problems or sometimes students who were referred to this setting from their school psychologist.[6]

Pseudopsychology (pop psychology) in assessment[edit]

Although there have been many great advancements in the field of psychological evaluation, some issues have also developed. One of the main problems in the field is pseudopsychology, also called pop psychology. Psychological evaluation is one of the biggest aspects in pop psychology. In a clinical setting, patients are not aware that they are not receiving correct psychological treatment, and that belief is one of the main foundations of pseudopsychology. It is largely based upon the testimonies of previous patients, the avoidance of peer review (a critical aspect of any science), and poorly set up tests, which can include confusing language or conditions that are left up to interpretation.[7] Not all of this is intentional, however. Some psychologists who have Ph. D.s are unaware of the fact that they’re using these methods. There are many biases that can contribute to incorrectly assessing a patient, such as a hindsight bias or a confirmatory bias. [7]

Pseudopsychology can also occur when people claim to be psychologists, but really lack qualifications.[8] A prime example of this is found in quizzes that can lead to a variety of false conclusions. These can be found in magazines, online, or just about anywhere accessible to the public. They usually consist of a small number of questions designed to tell the participant things about themselves. The problem is, they’re usually written by people who know nothing about psychological assessment, and have no research or evidence to back up any diagnosis made by the quizzes.[8] These types of things can tarnish the reputation for true psychological assessment.

Ethics[edit]

Concerns about privacy, cultural biases, tests that have not been validated, and inappropriate contexts have led groups such as the American Educational Research Association (AERA) and the American Psychological Association (APA) to publish guidelines for examiners in regards to assessment.[6]

Privacy is a concern when it comes to assessments. The American Psychological Association states that a client must give permission to release any of the information that may come from a psychologist.[9] The only exceptions to this are in the case of minors, when the clients are a danger to themselves or others, or if they are applying for a job the requires this information. Also, the issue of privacy occurs during the assessment itself. The client has the right to say as much or little as they would like, however they may feel the need to say more than they want or even may accidentally reveal information they would like to keep private.[6]

Guidelines have been put in place to ensure the psychologist giving the assessments maintain a professional relationship with the client since their relationship can impact the outcomes of the assessment. Friendly verbal reinforcement has been demonstrated to increase the results of the WISC-R scores by an average of 13 IQ points.[10] The examiners expectations may also influence the clients’ performance in the assessments.[6] The American Psychological Association also states that the psychologist may not exploit the relationship with the client or anyone they work with through financial arrangements or sexual relationships.[9]

The validity and reliability of the tests being used also can affect the outcomes of the assessments being used. When psychologists are choosing which assessments they are going to use, they should pick one that will be most effective for what they are looking at. Also, it is important for the psychologists are aware of the possibility of the client, either consciously or unconsciously, faking answers and consider use of tests that have validity scales within them.[6]

See also[edit]

Notes and references[edit]

  1. ^ Framingham, J. (2011). What is Psychological Assessment?. Psych Central. Retrieved on November 11, 2013, from http://psychcentral.com/lib/what-is-psychological-assessment/0005890
  2. ^ a b c d e f Gregory, R. J. (2010). Psychological testing: history, principles, and applications. (7th ed., pp. 1-29 inclusive). Boston, MA: Allyn & Bacon.
  3. ^ a b Fancher, R., & Rutherford, A. (2012). Pioneers of psychology. (4th ed., pp. 563-601 inclusive). New York, NY: W.W. Norton & Company, Inc.
  4. ^ a b c d Meyer, G., Finn, S., & Eyde, L. (2001). Psychological testing and psychological assessment. American Psychologist, 56(2), 128-165.
  5. ^ a b Fernandez-Ballesteros, R. (2003). Encyclopedia of psychological assessment. (Vol. 1, pp. 173-175). London: Sage Publications.
  6. ^ a b c d e f g h i Groth-Marnat, G. (2003). Handbook of Psychological Assessment. Hoboken, N.J.: John Wiley & Sons.
  7. ^ a b Lilienfeld, S., Lynn, S., & Lohr, J. (2003). Science and pseudoscience in clinical psychology. (1st ed., pp. 1-25 inclusive). New York, NY: The Guilford Press.
  8. ^ a b Burtt, Harold Ernest , (1948). Applied psychology. , (pp. 38-63). New York, NY, US: Prentice-Hall, Inc, x, 821 pp.
  9. ^ a b American Psychological Association. (2010). Ethical principles of psychologists and code of conduct. Retrieved from http://apa.org/ethics/code/index.aspx
  10. ^ Feldman, S. E., & Sullivan, D.S. (1971). Factors mediating the efforts of enhanced rapport on children’s performance. Journal of Consulting and Clinical Psychology, 36, 302.

Further reading[edit]