THE USE AND ABUSE OF PSYCHOLOGICAL TESTING:PERSONALITY

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Clinical Psychology (PSY401)

LESSON 19

THE USE AND ABUSE OF PSYCHOLOGICAL TESTING

Ours has long been a test-oriented society. Whether the question concerns personnel selection,

intellectual assessment, or measuring the "real me," many people turn to tests. Some consult popular

magazines (and now the Internet!) for these tests, others consult skilled clinicians but the abiding

curiosity and the inflated set of expectations about tests seem constant. And quite often, such high

expectations lead to abuse.

Testing is big business. Psychological, educational, and personnel corporations sell many thousands of

tests each year. So many of our lives are touched in so many ways by assessment procedures that we

have become accustomed to them and hardly notice them. Admission to college, employment, and

discharge from military service, imprisonment, adoption, therapeutic planning, computer dating, and

special classes all may depend on test performance. Any enterprise that becomes so large and affects

such large numbers of people invites careful scrutiny.

Protection: The APA's (1992) ethical standards require that psychologists use only techniques or

procedures that lie within their competence. These ethical standards, the growth of state certification and

licensing boards, and the certification of professional competence offered by the American Board of

Professional Psychology all combine to increase the probability that the public's interests will be

protected.

In addition, the purchase of testing materials is generally restricted by the publisher to individuals or

institutions that can demonstrate their competence in administering, scoring, and interpreting tests. In

effect, then, the sale of tests is not open but is dependent upon the user's qualifications. However,

neither professional guidelines nor publishers' restrictions are totally successful. Tests still sometimes

find their way into the hands of unscrupulous individuals. Ethical standards ate hot always sufficient

either.

The marketers for each test bear some responsibility as well. Normative data and instructions for

administration and scoring should be included in every test manual. All in all, enough data should be

included to enable the user to evaluate the reliability and validity of the test.

The Question Of Privacy: Most people assume that they have the right to reveal as little or as much as

they like about their attitudes, feelings, fears, or aspirations. Of course, with subtle or indirect

assessment procedures, an examinee cannot always judge with complete certainty whether a given

response is desirable. But what ever the nature of a test, the individual has the right to a full explanation

of its purposes and of the use to which the results will be put.

The examinee must be given only tests relevant to the purposes of the evaluation. If an MMP1-2 or a

Rorschach is included in a personnel-selection battery, it is the psychologist's responsibility to explain

the relevance of the test to the individual. Informed consent to the entire assessment process should be

obtained, and individuals should be fully informed of their options. This applies even to those who have

initiated the contact (as by voluntarily seeking clinical services).

The Question Of Confidientiality: Issues of trust and confidentiality loom large in our society. The

proliferation of computer processing facilities and huge data banks makes it very easy for one

government agency to gain access to personal records that are in the tiles of another agency or a

company. Credit card agencies, the FBI, the CIA, the IRS, and other organizations create a climate in

which no one's records or past seem to be confidential or inviolable. Although information revealed to

psychiatrists and clinical psychologists is typically regarded as privileged, there are continuing assaults

on the right to withhold such information. For example, the Tarasoff decision of the California Supreme

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Court makes it clear that information provided by a patient in the course of therapy cannot remain

privileged if that information indicates that the patient may be dangerous. If the "sanctity" of the therapy

room is less than unassailable, it is certain that personnel records, school records, and other test

repositories are even more vulnerable. Clinical psychologists employed in industrial settings are also

unable to ensure absolutely the privacy of test results. Clinicians can become caught in the middle of

tugs of war between union and management over grievance claims. It sometimes happens also that when

people are treated under insurance or medical assistance programs, their diagnoses are entered into

computer records to which many companies may obtain access.

When an individual is tested, every effort should be made to explain the purposes of the testing, the use

to which the results will be put, and the people or institutions that will have access to the results. If the

individual gives informed consent, the testing can proceed. However, if it subsequently becomes

desirable to release the results to someone else, the individual's consent must be obtained. It is clear that

not all clients wish to have their mental health records released, and even when they sign consent forms,

they often seem to do so either out of a fear that they will be denied services or out of sheer obedience to

authority'.

The Question of Discrimination: Since the rise of the civil rights movement, most people have become

increasingly aware of the ways in which society has both knowingly and unknowingly discriminated

against minorities. Within psychology, attacks have recently centered on the ways in which tests

discriminate against minorities. For example, the original standardization of the Standford-Binet

contained no African American samples. Since then, many tests have been published whose attempts to

include racially unbiased samples have been questioned. It is often charged that most psychological tests

are really designed for white middle-class populations and that other groups are handicapped by being

tested with devices that are inappropriate for them.

Sometimes the minority group member's lack of exposure to tests and test situations may be a major

source of the problem. Such inexperience, inadequate motivation, and discomfort in the presence of an

examiner from another race all may affect test performance. Often, too, test materials are prepared or

embedded in a racially unfair context. For example, the TAT cards may all depict white characters, or

the items on an intelligence test may not be especially familiar to an African American child. The

problem here is the test items themselves, the manner in which they are presented, or the circumstances

surrounding a test may work to the disadvantage of the minority individual.

Test Bias: It is important to remember that significant differences between mean scores on a test for

different groups do not in and of themselves indicate test bias or discrimination. Rather, test bias or

discrimination is a validity issue. That is, if it can be demonstrated that the validity of a test (in

predicting criterion characteristics or performance, for example) varies significantly across groups, then

a case can be made that the test is "biased" for that purpose. In other words, a test is biased to the extent

that it predicts more accurately for one group than for another group.

An example can illustrate these considerations. Let us assume that one of the authors developed a

personality inventory measuring the trait "hostility." As part of the standardization project for this test,

the author discovered that men scored significantly higher than women on this test. Doe this indicate

that the test is biased? Not necessarily. The author found, in a series of validity studies, that the

relationship (correlation) between hostility inventory scores and the number of verbal fights over the

succeeding two months was quite similar for both men and women. In other words, the predictive

validity coefficients for the two groups were comparable; similar hostility scores "meant" the same thing

(predicted a comparable number of verbal fights) for men and women. On the other hand, it is quite

possible that the strength of the correlation between hostility scores and physical fights over the next

two months is significantly greater for men than for women. In this case, the use of the test to predict

physical aggression in women would be biased if these predictions were based on the known association

between hostility scores and physical fights found in men.

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Several general points should be clear. First, differences in mean scores do not necessarily indicate test

bias. In the previous example, there may be good reasons why men score higher on average than women

on a measure of hostility (for example, hormonal differences or other biological factors may lead to

higher levels of hostility for men). In fact, to find no difference in men scores might call into question

the validity of the test in this case. Second, the pronouncement of a test as "valid," although frequently

seen in the clinical psychology literature, is in-correct. Tests may be valid (and not biased) for some

purposes but not for others. Finally, one can "overcome" test bias by using different (and more

appropriate) prediction equations for the different groups. In other words, bias comes into play when the

clinical psychologist makes predictions based on empirical associations that are characteristic of another

group (such as men) but not of the group of interest (such as I women). The goal is to investigate the

possibility differential validity and, if found, to use the appropriate prediction equation for that group.

Computer Based Assessment: Computers have been used for years to score tests and to generate

psychological profiles. Now they are also used to administer and interpret responses to clinical in-

terviews, IQ Tests, self-report inventories, and even projective tests. The reasons given for using

computers include cutting costs, enhancing clients' attention and motivation, and standardizing

procedures across clinicians. Clearly computers have great potential, but they also contain the seeds of

definite problems. To begin with, there needs to be greater acceptance of computers by professionals.

Beyond that, more attention must be devoted to the feelings and reactions of clients upon whom these

procedures are imposed. Important issues of reliability and validity as well as proper feedback to clients,

have yet to be settled. Finally, the field needs better overall professional standards for such testing. It is

important to remember that computer systems can easily be misused, either by those who are poorly

trained or by those who endow computers with a sagacity that transcends the quality and utility of the

information programmed into them.

Numerous efforts have been made to computerize the scoring and interpretation of the MMPI in

particular .The approaches are mainly descriptive and most often useful for screening. But programs

exist to generate highly interpretive statements as well). However, not everyone believes that

computerized and conventional usages of the MMPI yield comparable results.

PERSONALITY

When we assume that people will display continuity in their behavior and emotional style over time, we

are making assumptions about the continuity of their personality. When the psychologists use the word

personality they are referring to the observation that people display a certain degree of consistency and

structure in the ways that they experience and interact with the world. There are two aspects of this

consistency: stability across different situations and consistency over time within similar circumstances

or situations. Personality theories are concerned with stable enduring characteristics of people, or what

they refer to as traits consistent ways of perceiving the self, the world, and other people; consistent

ways of experiencing and managing one's emotions; and consistent ways of behaving. These basic

consistencies in behavior, thoughts, and feelings may be due to genetic factors, or they may be learned,

ingrained patterns of behavior or they may be both.

ASSESSMENT OF PERSONALITY

According to Ozer and Reise (1994),

`personality assessment ,as a scientific endeavor, seeks to determine those characteristics that

constitute important individual differences in personality, to develop accurate measures of such

attributes and to explore fully the consequential meanings of these identified and measured

characteristics.'

Personality tests can be grouped according to the methods that they use to obtain data. The broadest

distinction is between what are termed objective personality tests and projective personality tests.

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Objective Personality Tests: - The objective approach to personality assessment is characterized by the

reliance on structured, standardized measurement Devices, which are typically of a self-report nature.

"Structured" reflects the tendency to use straight-forward test stimuli, such as direct questions regarding

the person's opinion of themselves, and unambiguous instructions regarding the completion of the test.

Many objective tests use a [true/false or yes/no response format; others pro-; vide a dimensional scale

(for example, 0 = strong \ disagree; 1 = disagree; 2 = neutral; 3 = agree; 4 = [strongly agree). Objective

tests have both advantages and disadvantages, discussed below.

Some Advantages

1. First of all, they are economical. After only brief instructions, large groups can be tested

simultaneously, or a single patient can complete an inventory alone. Even computer. Scoring

and interpretation of these tests are possible.

2. Second, scoring and administration are relatively simple and objective. This, in turn, tends to

make interpretation easier and seems to require less interpretive skill on the part of the clinician.

3. Often a simple score along a single dimension (such as adjustment-maladjustment) or on a

single trait (such as dependency or psychopathy) is possible.

4. A final attraction of self-report inventories, particularly for clinicians who are disenchanted with

the problems inherent in projective tests, is their apparent objectivity and reliability.

Some Disadvantages

1. The items of many inventories are often behavioral in nature. That is, the questions or

statements concern behaviors that may (or may not) characterize the respondent. For example,

although two individuals may endorse the same behavioral item ("I have trouble getting to

sleep"), they may do so "for entirely different reasons.

2. Some inventories contain a mixture of items dealing with behaviors, cognitions, and needs. Yet

inventories often provide single, overall score--which may reflect various combinations of

these behaviors, cognitions, and needs

3. Other difficulties involve the transparent meaning of some inventories' questions, which can

obviously facilitate faking on the part of some patients.

4. In addition, the forced-choice approach prevents individuals from qualifying or elaborating their

responses so that some additional information may be lost or distorted.

5. In other instances, the limited understanding or even the limited reading ability ' of some

individuals may lead them to misinterpret questions

Methods of the Test Construction for Objective Tests: Over the years, a variety of strategies for

constructing self-report inventories have been proposed.

Content Validation: The most straightforward approach to measurement is for clinicians to decide

what it is they wish to assess and then to simply ask the patient for that information.

Ensuring content validity, however, involves much more than simply deciding what you want to assess

and then making up some items that appear to do the job. Rather, more sophisticated content validation

methods involve 11) carefully defining ail relevant aspects of the variable you are attempting to

measure; (2) consulting experts before generating items; (3) using judges to assess each potential item's

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relevance to the variable of interest: and (4) using psychometric analyses to evaluate each item before

you include it in your measure

However several potential problems are inherent in the content validity approach to test construction.

First, can clinicians assume that every patient interprets a given item in exactly the same way? Second,

can patients accurately report their own behavior or emotions? Third, will patients be honest, or will

they attempt to place themselves in a good light (or even a bad light at times)? Fourth, can clinicians

assume that the "experts" can be counted on to define the essence of the concept they are trying to

measure? Most of these seem to be general problems for the majority of inventories, regardless of

whether they depend on content sampling to establish their validity.

Empirical Criterion Keying: In an attempt to help remedy the foregoing difficulties, the empirical

criterion keying approach was developed. In this approach, no assumptions are made as to whether a

patient is telling the truth or the response really corresponds to behavior or feelings. What is important is

that certain patients describe themselves in certain ways.

The important assumption inherent in this approach is that members of a particular diagnostic group will

tend to respond in the same way. Consequently, it is not necessary to select test items in a rational,

theoretical fashion. All that is required is to show on an empirical basis that the members of a given

diagnostic group respond to a given item in a similar fashion.

Factor Analysis: These days, the majority of test developers use a factor analytic (or internal con-

sistency) approach to test construction Here, the idea is to examine the inter-correlations among the

individual items from many existing personality inventories. Succeeding factor analyses will then

reduce or "purify" scales thought to reflect basic dimensions of personality. The exploratory factor

analytic approach is atheoretical. One begins by capturing a universe of items and then proceeds to

reduce them to basic elements--personality, adjustment, diagnostic affiliation, or whatever--hoping to

arrive at the core traits and dimensions of personality. Confirmatory factor analytic approaches are

more theory-driven, seeking to confirm a hypothesized factor structure (based on theoretical

predictions) for the test items.

The strength of the factor analytic approach to test construction is the emphasis on an empirical

demonstration that items purporting to measure a variable or dimension of personality are highly related

to one another. However, a limitation of this approach is that it does not in and of itself demonstrate that

these items are actually measuring the variable of interest; we only know that the items tend to be

measuring the same "thing."

Construct Validity Approach: This approach combines many aspects of the content validity, empirical

criterion keying, and factor analytic approaches (In this approach, scales are developed to measure

specific concepts from a given theory. In the case of personality assessment, the intent is to develop

measures anchored in a theory of personality. Validation is achieved when it can be said that a given

scale measures the theoretical construct in question. The selection of items is based on the extent to

which they reflect the theoretical construct under study. Item analysis, factor analysis, and other

procedures are used to ensure that a homogeneous scale is developed. Construct validity for the scale is

then determined by demonstrating, through a series of theory-based studies, that those who achieve

certain scores on the scale behave in nontest situations in a fashion that could be predicted from their

scale score. Because of its comprehensiveness, the construct validity approach to test construction is

both the most desirable and the most labor intensive. In fact, establishing the construct validity of a test

is a never-ending process, with empirical feedback used to refine both the theory and the personality

measure.

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Clinical Psychology (PSY401)

THE MMPI AND THE MMPI-2

The MMPI is a self-report inventory that is the most widely used and most thoroughly researched of the

objective personality assessment instruments. It was developed in 1937 by Starke Hathaway, a

psychologist, and J. Charnely McKinley, a psychiatrist. This test was recently updated and is called the

MMPI-2. This test consists of over 500 statements---such as "I sometimes tease animals", "I believe I

am being plotted against"----to which the subject must respond with "true", "false" or "cannot say".

The test may be used in card or booklet forms.

The MMPI gives score on 10 standard scales, each of which was derived empirically. The items for

each scale were selected for their ability to separate medical and psychiatric patients from normal

controls.

Clinical Scales: the clinical scales are often referred by number e.g. 8(sc). The other is:

HYPOCHONDRIA (Hs)

DEPRESSION (D)

HYSTERIA (Hy)

PSYCHOPATHIC DEVIANCE (Pd)

MASCULINITY-FEMININITY (Mf)

PARANOIA (Pa)

PSYCHASTHENIA (Pt)

SCHIZOPHRENIA (Sc)

HYPOMANIA (Ma)

10.

SOCIAL INTROVERSION (Si)

Validity Scales: To help detect malingering ("faking bad"), or other response sets or test-taking

attitudes, and carelessness or misunderstanding, the MMPI-2 has four validity scales

1. ? (CANNOT SAY) Scale: this is the number of items left unanswered.

2. F (INFREQUENCY) Scale: these 60 items were seldom answered in the scored direction by

the standardization group. A high F score may suggest deviant response sets, markedly aberrant

behavior.

3. (LIE) Scale: this includes 15 items whose endorsement places the respondent in a very positive

light. In reality, however, it is unlikely that the items would be truthfully so endorsed. E.g. "I

like everyone I meet".

4. K (DEFENSIVENESS) Scale: these 30 items suggest defensive in admitting certain problems

Interpretation: An accurate interpretation requires great experience with the test and some

understanding of the social, educational, and socioeconomic background from which the patient comes.

Recent evidence indicates that religion and race are both potential variables in MMPI responses.

Interpretation through Profile Analysis: interpretation has now shifted to an examination of patterns

or "profiles" of scores. For example, individuals who produce elevations on the first three clinical scales

(Hs, D, and Hy) tend to present with somatic complaints and depressive symptoms and often receive

somatoform, anxiety or depressive disorder diagnosis.

Interpretation through Content: For the MMPI-2, a variety of content scales have been developed as

well. E.g. certain items can help identify fears, health concerns, cynicism, and the type-A personality

and so on. Such scales enable the clinician to move beyond simple diagnostic labels to a more dynamic

level of interpretation.

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Clinical Psychology (PSY401)

MILLON CLINICAL MULTI-AXIAL INVENTORY (MCMI)

The MCMI is a 175 item, true-false, paper-pencil personality inventory that was developed by Theodore

Millon and his co-workers in the late 1970's. The original test allowed for scoring and interpretation on

11 scales, which represented personality disorders from the DSM. The test also contained a brief

validity scale and nine scales designed to assess reactive symptoms disorders, which the test authors

claimed were of a less enduring nature than the personality scales.

Examples of some scales are:

Avoidant personality

Dependent personality

Histrionic personality

Narcissistic personality

Hypo manic personality

Compulsive personality

Passive-aggressive personality

Antisocial personality

The MCMI was revised in 1987, the new version is the MCMI-II, item Content was reevaluated for the

MCMI-II and new validity scales were added. Normative data were enhanced by the addition of clinical

samples and the MCMI-II is compatible with the revised DSM (IV).

THE REVISED NEO-PERSONALITY INVENTORY

Description: The NEO-PI-R is a self-report measure of personality developed by Costa & McCrae in

1992, and is also known the five-factor Model (FFM). As operationalzed by the NEO-PI-R, the five

factors or Domain are neuroticism, extraversion, and openness to experience, agreeableness, and

conscientiousness. Each domain has six facets or subscales. The NEO-PI-R consists of 240 items (8

items for each of the 30 facet r 48 items for each of the 5 domains). Individuals rate each of the 240

Statements on a five-point scale.

DOMAINS AND FACETS OF PERSONALITY MEASURED BY THE NEO-PI-R

Domain

Facets

Neuroticism

Anxiety, Hostility, Depression, Self- Consciousness,

Impulsiveness, Vulnerability

Extra version

Warmth, Gregariousness, Assertiveness, Activity, Excitement

Seeking, Positive Emotions

Openness to Experience

Fantasy Aesthetics, Feelings, Actions, Ideas, Values

Agreeableness

Trust, Straightforwardness, Altruism, Compliance,

Modesty, Tender-Mindedness

Conscientiousness

Competence, Order, Dutifulness, Achievement Striving,

Self-Discipline, Deliberation

TYPE A- TYPE B BEHAVIOR

Two cardiologists, Meyer Friedman and Ray Rosenman, developed the Concept that a specific behavior

pattern, type A seta into motion the Pathophysiology necessary for the production of coronary artery

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disease They further hypothesized that the type A behavior pattern is a major Risk factor (along with

cholesterol, hypertension, smoking and a positive Family history) for the disease.

According to Friedman, the most important aspects of the Type A behavior patterns are excesses of time

urgency and competitive Hostility(psychomotor manifestations like rapid eye blinking, lip clicking

During speaking, tense posture, speech hurrying, sucking in of air during Speech etc). Person designated

as type B display obverse qualities of Behavior. They are relaxed, less aggressive, unhurried, and less

apt to strive vigorously to achieve a goal than are type A persons. Although one Might expect type A

person to be successful than type B. In fact, some Data indicate that type A are less successful than type

B persons, despite The ardent desire of type A persons to achieve.

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