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”