A psychological assessment is a process of standardized testing and measurements that are performed to help a psychologist better understand an individual and arrive at a diagnosis and treatment plan. The primary purpose of this procedure is to gather information about a person to diagnose a mental disorder that a person may have. Having completed the assessment, a psychologist will be able to establish either a tentative or definitive diagnosis. When used professionally, psychological testing can guide the treatment or require further examination.
Psychological Assessment of Post-Traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) is a debilitating mental illness that develops in response to a catastrophic life event. Over the last decades, the knowledge of psychometric assessment of PTSD has greatly expanded, and new empirical evaluation instruments for measuring PTSD and trauma exposure have been developed (Maruish, 2018). Current relevant tests, structured interviews, and questionnaires have proven psychometric properties that help elucidate aspects of the mental condition. Two psychological assessment procedures that will be discussed in this section are the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and the PTSD Checklist for DSM-5 (PCL-5).
The CAPS-5 is a 30-item structured questionnaire that was developed by the staff of the US Department of Veteran Affairs National Center for PTSD. The given questionnaire corresponds to the DSM-5 diagnosis for PTSD. The CAPS-5 is considered to be the gold standard in PTSD assessment which is used to make current or lifetime diagnosis of PTSD and assess PTSD symptoms which occurred over the past 7 days (Weathers et al., 2018). It is worth noting that the interview was developed for clinicians and clinical researchers who have professional knowledge of PTSD.
The PCL-5 is a self-report measure of 20 DSM-5 PTSD symptoms which was developed by the staff of VA National Center for PTSD (Blevins, Weathers, Davis, Witte, & Domino, 2015). This is a widely used screening tool for making a provisional PTSD diagnosis and monitoring symptoms change during and after treatment. As have been mentioned before, the standard measure for PTSD is the CAPS-5, and the PCL-5 is considered to be an additional assessment procedure which cannot be used as a stand-alone tool. Unlike the CAPS-5, the PCL-5 does not require administration of the professional and can be completed by patients in 5-10 minutes before a session (Blevins et al., 2015). The results of the PCL-5 should be interpreted by a clinician or a researcher.
The CAPS-5 has excellent psychometric properties which allow for using its methodology for assessing PTSD with a wide variety of trauma-exposed samples. In the study, psychometric properties of the CAPS-5 were examined in two samples of veterans (Weathers et al., 2018). It has been found that the assessment procedure showed great inter-rater reliability, internal consistency, and strong agreement with PTSD diagnosis. Even though the CAPS-5 is generally considered to be a psychometrically sound measure of PTSD, more research should be performed to study how the questionnaire works with other trauma-exposed samples.
Speaking of its psychometric properties, the PCL-5 is a valid and reliable self-report measure for the assessment and quantifying symptoms of PTSD. The psychometric methodology used for the test validation included a comparison of psychological assessment results for a chosen sample with reassessment made by expert clinicians. According to the recent study conducted by Ibrahim, Ertl, Catani, Ismail, and Neuner (2018), the PCL-5 has shown high internal consistency and adequate convergent validity. In other words, when applied to a sample of people with PTSD, the selected psychological assessment tool showed the optimal balance of sensitivity and specificity.
The validity and diagnostic accuracy of the PCL-5 are high, and calibration of the cut-off scores of the test allows for using it in the context of diverse social and cultural backgrounds. In particular, the study on the PCL-5 showed a positive correlation between the selected types of traumatic events with PTSD symptoms (Ibrahim et al., 2018). Particular challenges that arise when assessing individuals from diverse environments include the significant difference in exposure and specific responses to trauma. Therefore, to enable the application of the PCL-5 to various backgrounds, a gold standard measure for diagnosing PTSD should be established.
Adults with Attention Deficit Hyperactivity Disorder
Adult Attention Deficit Hyperactivity Disorder is a relatively common yet rarely recognized condition. In adults, ADHD is assessed by a team of professionals with training and expertise in this condition. There is a variety of methods and tools used to assess and diagnose ADHD, and most of them rely on subjective data from a patient’s friends and relatives. Two psychological assessment procedures that will be discussed in this section are the Wechsler Individual Achievement Test and the Woodstock-Johnson III Tests of Cognitive Abilities.
The Wechsler Individual Achievement Test, Third Edition (WIAT-III) helps assess the academic strengths and weaknesses of adolescents and adults in a broad range of academic areas. The four basic scales include reading, oral language, writing, and mathematical skills. The WIAT-III consists of sixteen subtests which include spelling, essay composition, oral reading fluency, and reading comprehension. The test should be administered depending on the age of an individual. It is important to notice that the WIAT-III can be used in both clinical and research settings.
The Woodstock-Johnson III Tests of Cognitive Abilities (WJ-III-COG) is a series of intelligence tests that can be administered to individuals from the age of two up to the age of ninety. Like the WIAT-III, the WJ-III-COG measures the academic achievements and general intellectual ability of a participant. However, unlike the WIAT-III, the WJ-III-COG can also be used to identify discrepancies between one’s cognitive abilities and academic scores.
There are thirteen tests available in WJ-III series, the average time each test takes is approximately 45-55 minutes. Subtopics of the test include fluid reasoning, visual processing, short-term memory, and rapid picture naming. Like WIAT-III, the exam is usually offered in a paper-and-pencil format.
Psychometric properties of the WIAT-III allow one to say that the test shows highly relevant results as internal consistency reliabilities are over 80% and inter-correlations range between 0,46 and 0,93 (Breaux & Lichtenberger, 2016, p. 144). The empirical relationship of the WIAT-III with the WISC-IV provides valid scores of the discrepancy. Also, it has been proven that the WIAT-III subtest and composite scores possess adequate stability over time (Breaux & Lichtenberger, 2016). Possible challenges related to diverse cultural and social backgrounds include the necessity to interpret the obtained results of both the WIAT-III and the WJ-III-COG in combination with the evaluation of a participant’s environment and personality.
The WJ-III-COG is standardized with a large sample of participants aged 2 through 90. The approach of the test is mainly based on focusing only on a few broad cognitive abilities at a time. The WJ-III-COG has median reliability coefficients of 0,80 and median reliability scores for clustered items of 0,90 or higher (Flanagan & Harrison, 2012, p. 307). It should also be mentioned that the given assessment tool, like the WIAT-III, is supported by several sources of validity evidence, including reviews of content experts, researchers, and psychologists.
Psychometric methodologies used when validating the tests included estimation and comparison of statistical coefficients for results obtained from the use of the tests for a chosen sample and following clinicians’ reassessment. Like all assessment instruments, the WJ-III-COG has certain limitations that are associated with the fact that academic achievements can be assessed in different ways. Speaking of diverse cultural and social backgrounds, the test has several adaptations for use with various populations.
Diagnosing ADHD is a time-consuming process that often requires the use of several methodologies for testing. Speaking of other relevant approaches to the assessment of the constructs being evaluated by the WJ-III-COG and the WIAT-III, it should be mentioned that there is no quick test for ADHD in adults. Other assessment procedures include neuropsychological evaluation (which is the gold standard for ADHD), Quantified Behavior Test Plus for individuals older than 12, and Adult Executive Functioning Inventory.
Individuals with Intellectual Disabilities
A severe intellectual impairment which usually has its roots in childhood has a strong impact on all aspects of the life of an individual, including social and intellectual functioning. The use of an IQ assessment is a critical element of the standardized assessment of intellectual disability. Two psychological assessment procedures that will be discussed in this section are the Wechsler Adult Intelligence Scale and the Wechsler Abbreviated Scale of Intelligence.
The Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) is the most widely used measure of assessment of intelligence and cognitive abilities in adults. The test consists of 10 core subtests and 5 additional subtests.
Tasks presented in the test include vocabulary, information, block design, reasoning, and arithmetic. The WAIS-IV measures scores on four areas, such as the perceptual reasoning index, the verbal comprehension index, the working memory index, and the processing speed index. Psychometric properties of the WAIS-IV were investigated using the four- and five-factor models. It has been found that calculated internal consistency, inter-scorer reliability, and test-retest reliability are high which allows one to say that the test is reliable and provides an adequate fit to the normative sample.
The Wechsler Abbreviated Scale of Intelligence, Second Edition (WASI-II) is a shortened form of estimating intellectual abilities. Since the WASI-II has a small number of subtests (only 4), it is used when a participant has limited time for testing or has concentration problems. Unlike the WAIS-IV, the WASI-II does not fulfill the criterion of a “multidimensional hierarchical model of intelligence” (The British Psychological Society, 2015, p. 17). The psychometric methodology employed in the validation of the WASI-II included the test administration for a selected sample and reassessment of randomly chosen subjects by expert clinical psychologists.
The WASI-II has strong psychometric properties due to high correlation and stability coefficients and internal consistency of subtests (Maruish, 2018). Provided that the WASI-II and the WAIS-IV have been appropriately adapted, the tests can be used for diverse social and cultural backgrounds. However, the reliability of assessments may be lower due to expected lower rates of inter-scorer reliability and test-retest reliability.
Conclusion
The proliferation of psychological testing has raised considerable concerns about the appropriate utilization of test data. The real misuses of assessments and assessment results are a serious dilemma that measurement professionals face nowadays. Professional and ethical issues form a continuum for standards of professional conduct in psychological testing. Currently, the lack of access to codes of ethics and professional standards and their incomprehensibility are considered to be major challenges to adequate results interpretation. Problems that arise from misconduct include an adverse impact on participants, discouraging failure for individuals, and creating barriers.
References
Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The posttraumatic stress disorder checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28(6), 489-498. Web.
Breaux, K. C., & Lichtenberger, E. O. (2016). Essentials of KTEA-3 and WIAT-III assessment. A. S. Kaufam & N. L. Kaufman (Eds.). Oxford, England: John Wiley & Sons.
Flanagan, D. P., & Harrison, P. L. (2012). Contemporary intellectual assessment: Theories, tests, and issues (3rd ed.). New York, NY: Guilford Press.
Ibrahim, H., Ertl, V., Catani, C., Ismail, A. A., & Neuner, F. (2018). The validity of posttraumatic stress disorder checklist for DSM-5 (PCL-5) as screening instrument with Kurdish and Arab displaced populations living in the Kurdistan region of Iraq. BMC Psychiatry, 18(1). Web.
Maruish, M. E. (2018). Handbook of pediatric psychological screening and assessment in primary care. London, England: Taylor and Francis.
The British Psychological Society. (2015). Guidance on the assessment and diagnosis of intellectual disabilities in adulthood. Web.
Weathers, F. W., Bovin, M. J., Lee, D. J., Sloan, D. M., Schnurr, P. P., Kaloupek, D. G.,… Marx, B. P. (2018). The clinician-administered PTSD scale for DSM–5 (CAPS-5): Development and initial psychometric evaluation in military veterans. Psychological Assessment, 30(3), 383-395. Web.