Psychological Testing in the Service of Disability Determination (2015) / Chapter Skim
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3 Overview of Psychological Testing
3 Overview of Psychological Testing
Pages 87-116
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From page 87... ...
. The clinical interview remains the foundation of many psychological and neuropsychological assessments.
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From page 88... ...
Any reference to a specific test is to provide an illustrative example, and should not be interpreted as an endorsement by the committee for use in any specific situation; such a determination is best left to a qualified assessor familiar with the specific circumstances surrounding the assessment. To respond to questions regarding the use of psychological tests for the assessment of the presence and severity of disability due to mental disorders, this chapter provides an introductory review of psychological testing.
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From page 89... ...
Because tests of maximal performance typically involve cognitive performance, they are often referred to as cognitive tests. Most intelligence and other ability tests would be considered cognitive tests; they can also be known as ability tests, but this would be a more limited category.
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From page 90... ...
Similarly, symptom validity tests do not measure non-cognitive status, but are used to examine whether a person is providing an accurate report of his or her actual symptom experience. Because cognitive tests frequently are performance based and non-cognitive measures generally involve self-report, performance validity tests and symptom validity tests are shown as being associated with these types of tests.
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From page 91... ...
Intelligence tests are so prevalent in many clinical psychology and neuropsychology situations that we also consider them as neuropsychological measures. Some abilities are measured using subtests from intelligence tests; for example, certain working memory tests would be a common example of an intelligence subtest that is used singly as well.
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From page 92... ...
Cognitive tests of various types can be considered as process or product tests. Take, for example, mathematics tests in school.
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From page 93... ...
Likewise, most if not all intelligence tests are norm-referenced, and most other ability tests are as well.
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Test Content As noted previously, the most important distinction among most psychological tests is whether they are assessing cognitive versus non-cognitive qualities. In clinical psychological and neuropsychological settings such as are the concern of this volume, the most common cognitive tests are intelligence tests, other clinical neuropsychological measures, and performance validity measures.
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From page 95... ...
A standard error of measurement is often presented to describe, within a level of confidence (e.g., 95 percent) , that a given range of test scores contains a person's true score, which acknowledges the presence of some degree of error in test scores and that obtained test scores are only estimates of true scores (Geisinger, 2013)
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From page 96... ...
Diagnostic validity: The degree to which psychological tests are truly aiding in the formulation of an appropriate diagnosis.
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From page 97... ...
Each of these forms of validity poses complex questions regarding the use of particular psychological measures with the SSA population. For example, ecological validity is especially critical in the use of psychological tests with SSA given that the focus of the assessment is on examining everyday levels of functioning.
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From page 98... ...
Stratified samples enable the test developer to identify particular demographic characteristics represented in the population and more closely approximate these features in proportion to the population. For example, intelligence test scores are often established based upon census-based norming with proportional representation of
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From page 99... ...
Tests administered to persons with disabilities often raise complex issues. Test users sometimes use psychological tests that were not developed or normed for individuals with disabilities.
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It must be established that the measure is operating appropriately in various cultural contexts. Test developers address issues of equivalence through procedures including • Expert panel reviews (i.e., professionals review item content and provide informed judgments regarding potential biases)
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From page 101... ...
. The premise of these IRT models is most easily understood in the context of cognitive tests, where there is a correct answer to questions.
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From page 102... ...
In some high-stakes admissions tests such as the GRE, MCAT, and GMAT, for example, forms are scored and equated by virtue of IRT methods, which can perform such operations more efficiently and accurately than can be done with classical statistics. TEST USER QUALIFICATIONS The test user is generally considered the person responsible for appropriate use of psychological tests, including selection, administration, interpretation, and use of results (AERA et al., 2014)
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and the APA's Guidelines for Test User Qualifications (Turner et al., 2001) , many publishers of psychological tests employ a tiered system of qualification levels (generally A, B, C)
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. SSA requires psychological testing be "individually administered by a qualified specialist … currently licensed or certified in the state to administer, score, and interpret psychological tests and have the training and experience to perform the test" (SSA, n.d.)
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From page 105... ...
In contrast, standardized psychological tests and measures, such as those discussed in the ensuing chapters, are structured and objectively scored. In the case of non-cognitive self-report measures, the respondent generally answers questions regarding typical behavior by choosing from a set of predetermined answers.
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From page 106... ...
Psychological testing may play a key role in understanding a client's functioning in each of these areas. Box 3-1 describes ways in which these four areas of core mental residual functional capacity are assessed ecologically.
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From page 107... ...
Interview distractibility Disturbance in mood Observations Processing speed Emotional lability Executive functioning Loss of measured intellectual Adaptive functioning ability from premorbid levels or overall impairment Schizophrenic, Screening Cognitive/intellectual Delusions or hallucinations paranoid, instruments ability Catatonic or other grossly and other Personality tests Language and disorganized behavior psychotic Interview communication Incoherence, loosening of disorders Observations Memory acquisition associations, illogical Cognitive tests Attention and thinking, or poverty distractibility of content of speech if Processing speed associated with one of the Executive functioning following: • Blunt affect • Flat affect • Inappropriate affect • Emotional withdrawal and/or isolation continued
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From page 108... ...
Affective Personality tests Memory acquisition Depressive syndrome (mood) Interview Attention and characterized by at least disorders Observations distractibility four of the following: Cognitive tests Processing speed • Anhedonia or pervasive Executive functioning loss of interest in almost all activities • Appetite disturbance with change in weight • Sleep disturbance • Psychomotor agitation or retardation • Decreased energy • Feelings of guilt or worthlessness • Difficulty concentrating or thinking • Thoughts of suicide • Hallucinations, delusions, or paranoid thinking Manic syndrome characterized by at least three of the following: • Hyperactivity • Pressure of speech • Flight of ideas • Inflated self-esteem • Decreased need for sleep • Easy distractibility • Involvement in activities that have a high probability of painful consequences that are not recognized • Hallucinations, delusions, or paranoid thinking Bipolar syndrome with a history of episodic periods manifested by the full symptomatic picture of both manic and depressive syndromes (and currently characterized by either or both syndromes)
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From page 109... ...
Intellectual Cognitive tests Cognitive/intellectual Mental incapacity evidenced disability ability by dependence on others disorders Language and for personal needs (e.g., communication toileting, eating, dressing, Memory acquisition or bathing) and inability Attention and to follow directions, such distractibility that the use of standardized Processing speed measures of intellectual Executive functioning functioning is precluded Adaptive functioning Anxiety- Personality tests Cognitive/intellectual Generalized persistent anxiety related Screening ability accompanied by three out of disorders instruments Language and four of the following signs Cognitive tests communication or symptoms: Memory acquisition • Motor tension Attention and • Autonomic hyperactivity distractibility • Apprehensive expectation Processing speed • Vigilance and scanning Executive functioning A persistent irrational fear of a specific object, activity, or situation that results in a compelling desire to avoid the dreaded object, activity, or situation Recurrent severe panic attacks manifested by a sudden unpredictable onset of intense apprehension, fear, terror, and sense of impending doom occurring on the average of at least once per week Recurrent obsessions or compulsions that are a source of marked distress Recurrent and intrusive recollections of a traumatic experience that are a source of marked distress continued
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Somatoform Personality tests Cognitive/intellectual A history of multiple physical disorders Cognitive tests ability symptoms of several years Language and duration, beginning before communication age 30, that have caused the Memory acquisition individual to take medicine Attention and frequently, see a physician distractibility often, and alter life patterns Processing speed significantly Executive functioning Persistent nonorganic disturbance of one of the following: • Vision • Speech • Hearing • Use of a limb • Movement and its control (e.g., coordination disturbance, psychogenic seizures, akinesia, dyskinesia) • Sensation (e.g., diminished or heightened)
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From page 111... ...
Personality Personality tests Deeply ingrained, maladaptive disorders patterns of behavior associated with one of the following: • Seclusiveness or autistic thinking • Pathologically inappropriate suspiciousness or hostility • Oddities of thought, perception, speech, and behavior • Persistent disturbances of mood or affect • Pathological dependence, passivity, or aggressivity • Intense and unstable interpersonal relationships and impulsive and damaging behavior Substance Interviews Memory acquisition Behavioral changes or physical addiction Screening Attention and changes associated with the disorders instruments distractibility regular use of substances Processing speed that affect the central Executive functioning nervous system Autistic Observations Cognitive/intellectual Qualitative deficits in disorder Screening ability reciprocal social interaction and other instruments Language and Qualitative deficits in pervasive Checklists communication verbal and nonverbal develop- Rating scales Memory acquisition communication and in mental Cognitive tests Attention and imaginative activity disorders distractibility Markedly restricted repertoire Processing speed of activities and interests Executive functioning Attention Observations Cognitive/intellectual Developmentally inappropriate deficit Screening ability degrees of inattention, hyperactiv- instruments Memory acquisition impulsiveness, and ity disorder Checklists Attention and hyperactivity (children) Rating scales distractibility Cognitive tests Processing speed Executive functioning continued
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From page 112... ...
Developmental Interviews with Cognitive/intellectual Deficit or lag in social and parents/ ability functioning emotional caregivers Language and Apathy, overexcitability, or disorders of Observations, communication fearfulness, demonstrated newborns scales of infant by an absent or grossly and infants development excessive response to one of the following: • Visual stimulation • Auditory stimulation • Tactile stimulation RELATED DIAGNOSTIC ENTITIES Traumatic Cognitive tests Cognitive/intellectual brain injury ability Language and communication Memory acquisition Attention and distractibility Processing speed Executive functioning Cognitive Cognitive tests Cognitive/intellectual dysfunction ability Language and communication Memory acquisition Attention and distractibility Processing speed Executive functioning
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From page 113... ...
Adapted from Form SSA-4734-F4-SUP: Mental Residual Functional Capacity Assessment.
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From page 114... ...
The next two chapters build on this overview, examining the types of psychological tests that may be useful in this process, including a review of selected individual tests that have been developed for measuring validity of presentation. Chapter 4 focuses on non-cognitive, self-report measures and symptom validity tests.
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From page 115... ...
2001. APA's guidelines for test user qualifications: An executive summary.
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