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Psychological Diagnostic Test

Psychological Diagnostic Test



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Can a person sway the results of their Psychiatric diagnosis test? Say a person has a mental illness that is more serious that they want to accept, if they know enough about Psychology, can they gear their answers toward a different diagnosis that is more acceptable to them and society?

When looking into this question many articles are listed about lie detector tests. https://theness.com/neurologicablog/index.php/detecting-lies-in-the-brain/

Some articles deal with how an individual might be able to detect another person's deception and the kinds of deception exhibited. https://pro.psychcentral.com/exhausted-woman/2017/03/the-levels-of-deceptive-people/

other articles deal with self-deception and possible reasons why. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6353154/

https://www.frontiersin.org/articles/10.3389/fpsyg.2019.01718/full.

I would like to know if a professional evaluation of an patient can be manipulated to achieve the results that patient wants while being deceptive concerning the more accurate diagnosis. For example someone with a serious personality disorder being diagnosis with a more socially acceptable illness, such as ADHD or anxiety disorder because of the deceptive interaction of the patient during the evaluation? Is there a way for a professional to determine what is the true diagnosis vs the diagnosis the patient consciously wants to be evaluated as suffering from?

The reason's why this patient might want to be diagnosed with a inaccurate illness may be many, as of now I am not interested in that unless it affects my original question.


We provide a range of assessment services at the Psychological Services Center, and fees vary depending on the nature of the presenting problem and purpose of the assessment.

The fee for our most comprehensive assessment batteries is $350 and includes the following types of assessment:

  • Attention Deficit/Hyperactivity Disorder (ADHD) Testing
  • Psychoeducational Testing
  • Learning Disabilities (LD) Testing

The fee for our other assessment batteries is $250 and includes the following types of assessment:

  • Intellectual Abilities Testing
  • Personality Testing
  • Psychological Functioning/Diagnostic Testing

Please note that payment for the full assessment is expected at the end of your first appointment. If you are unable to pay in full, please discuss this with your clinician.


More than 30 million people worldwide use 123test every year. They use more than 140 different tests across five languages.

The findings of the personality test are reported in highly recognizable behaviour

TIP -> IQ tests via @123test.com practice for higher IQ scores #assessment

Book: Participate in an Assessment (p152) Website with a large number of [assessment] articles. See also aptitude tests … great site!

I learned so much so quickly from the career test, amazing!

The team roles test is a great tool for team building and understanding group dynamics in the workplace

The IQ test is simply great. Both the classic and culture fair test are valid and reliable


Projective Tests of Personality in Popular Psychology

In a projective test, the examiner presents unstructured, vague, or ambiguous stimuli (such as the inkblots of the Rorschach test) with the belief that responses to the test represent revelations about the unconscious mental processes of the respondent. As of the mid-1990s, five of the fifteen most frequently used psychological tests were projective techniques. This is somewhat surprising, given that the psychoanalytic approach in which the tests are based has been out of favor in the mainstream of American psychology for more than fifty years, yet the tests demand just such an approach in scoring and interpretation. The popularity of the tests is even more surprising given the lack of solid proof that they are even capable of providing any useful diagnostic information, along with a substantial body of evidence indicating that the tests lack reliability and validity—this is sometimes referred to as the “projective paradox.” Validity is the extent to which a test is actually measuring what it claims to measure, as well as its ability to predict behavior. Reliability simply refers to the extent to which a person taking the same test more than once will obtain the same results each time, as well as the extent to which the test will yield similar results regardless of who scores it.

Certainly the best-known projective test is the Rorschach test, introduced in the 1920s by the Swiss psychiatrist Hermann Rorschach, in which people are asked to describe what they see in a series of ten inkblots. It is far and away the most popular projective technique, even now given to many hundreds of thousands of people annually. It came under harsh attack as long ago as the 1950s, due to its lack of standardized procedures and norms—averaged results from a representative sample of the population, used as a reference point. Without them it is impossible to determine whether an individual’s results are “normal” or not. Standardization is important because apparently minor differences in how a test is given can strongly influence a person’s responses.

Since the 1970s Rorschach users have felt protected against such criticism by John Exner’s Comprehensive System, which provides detailed procedures for standardized administration of the test as well as norms for both children and adults. Unfortunately, the test continues to have major problems with reliability and validity, largely because of the continuing subjective nature of many of the scoring criteria. The person scoring the test rates the subject’s responses on more than 100 characteristics, including such things as whether the person described the whole blot or just parts, whether the response was typical or

The Rorschach test consists of symmetrical inkblots similar to the one shown here, which was produced by the author (the actual Rorschach stimuli may not be reproduced). Photo by author. unusual, whether the response was based on shape or color or both, whether the person focused on the dark portions or the white spaces, and many other details. As a result, two well-trained examiners may come up with strikingly different interpretations of a single person’s responses.

The result of this lack of reliability is a remarkable lack of validity. The Rorschach is quite poor as a diagnostic tool for most psychiatric conditions, with the possible exception of schizophrenia and other thought disturbances, and even then the evidence is mixed. Quite clearly false, however, are the claims by some Rorschach proponents that the method can reliably detect depression, anxiety disorders, sexual abuse in children, antisocial personality disorder, tendencies towards violence, impulsivity, and criminal behavior. Furthermore, the norms that exist for the test are unrepresentative of the U.S. population, and their use results in substantial overestimation of maladjustment. In one California study of blood donors, for example, one in six appeared to have schizophrenia, according to their Rorschach scores.

The test also is remarkably susceptible to faking, an important consideration for a test so frequently introduced as evidence in court. A 1980 study is typical: Rorschach responses of twenty-four people were submitted to a panel of experts for diagnosis. The profiles actually came from the following four groups: six actual mental patients with a diagnosis of paranoid schizophrenia, six “uninformed” fakers instructed to try to fake the responses of a paranoid schizophrenic, six “informed” fakers who listened to a detailed tape about schizophrenia first, and six normal control subjects who simply took the test under standard conditions. Each test taker was rated by six to nine judges. The informed fakers were diagnosed as psychotic 72 percent of the time, versus only 48 percent for the actual psychotics. The uninformed fakers were also diagnosed as psychotic almost half of the time, and even the normal controls were diagnosed 24 percent of the time.

The reliability and validity of other projective tests also raise serious doubts. The Thematic Apperception Test (TAT), almost as widely used as the Rorschach, has neither standardized administration procedures nor an established scoring procedure. In the TAT, respondents are shown a series of ambiguous scenes drawn on large cards. For each picture, the respondent must make up a story. One card takes the projective approach to an extreme: it is totally blank. Individual clinicians choose the number of cards to show, up to thirty-one, as well as which particular cards are used. Although many standardized scoring systems have been created for the TAT, a survey of North American psychologists practicing in juvenile and family courts found that only 3 percent used any of them. Research suggests that using them would not help in any case. The systems show poor reliability and are unable to differentiate normal individuals from people who are either psychotic or depressed. Furthermore, these scoring systems provide no norms.

A third projective approach in wide use, again mostly by the courts, asks the person to draw a picture. The most widely used drawing test is the rather self-explanatory Draw-a-Person test. Interpretation proceeds in what has been called a “clinical-intuitive” manner, based on “signs” (features of the body or clothing, for example), usually guided by rather tentative psychodynamically based hypotheses. Large eyes might indicate paranoia and long ties might suggest sexual aggression, for example. A house with no windows might indicate feeling trapped. A person whose genitalia, or hands, or knees, or other features, depending on the interpretive guide used, are prominently visible might indicate a history of sexual abuse or latent homosexuality. There is no evidence, however, supporting the validity of this approach. Clinicians, in other words, have no grounds for believing any particular signs indicate any particular problem, other than their own prejudices and those of whoever trained them. Furthermore, studies suggest that clinicians will often attribute mental illness to many normal individuals who simply don’t draw very well.

At this point, it is clear that projective tests fail to meet even the most basic standards of reliability and validity. In fact, a recent review of projective tests commissioned by the American Psychological Society (APS) concluded “that, as usually administered, the Rorschach, TAT and human figure drawings are useful only in very limited circumstances” (author emphasis). Given this, how shall we interpret the projective paradox? Why are they still among the most popular tests? Of the various possible explanations, two seem especially important here. As human beings, clinicians are as susceptible as anyone to confirmation bias, or the tendency to take into account evidence that supports one’s own beliefs and expectations while failing to consider evidence which fails to do so. A clinician who believes large eyes indicate paranoia, for example, will place great importance on the single client who drew large eyes and actually was paranoid, while remaining unmoved by (and possibly not even having noticed) the many large-eyed pictures drawn by clients who were not paranoid.

A second, more positive possibility to consider is the fact that many clinicians who use projective methods do not use them as tests or diagnostic tools at all, but rather as auxiliary tools in clinical interviews. They help the clinician to form initial, tentative hypotheses about the client, to be tested by closer examination with better tools. This use of the tests seems more appropriate, given the apparent uselessness of projectives where diagnosis is concerned. Unfortunately, surveys suggest that many clinicians, despite the clear evidence to the contrary, continue to believe in the diagnostic efficacy of projective tests.


Psychologists as Detectives

Psychologists conducting assessments are like detectives trying to solve a case. The assessment requires a gathering of information from multiple sources, from written tests, personal interviews, job history records, and reports and records from other physicians, therapists, and counselors.

The clinical psychologist compiles an entire “case history” or in-depth story of a person’s inner and outer life, a sort of journey into the intricacies of psyche and behaviors. Past and present life situations are also considered.

According to Wikipedia, 91% of clinical psychologists perform some type of assessment. But the complexity of the assessment depends on several factors, such as the clinical setting, the severity of the condition, and the age and ability of the particular client.

For example, an assessment done on a child struggling in school will be quite different from an assessment conducted with a suspected criminal. And an assessment given to a soldier in Afghanistan experiencing symptoms of trauma will differ dramatically from an individual seeking treatment for depression from a psychotherapist who uses a form of “talk therapy” to diagnose and treat clients.

A “full” assessment of the soldier probably isn’t likely given the conditions of war and fighting, yet military psychologists are trained to assess soldiers using other methods, such as observational or interview-type approaches, to determine an effective immediate intervention, or to determine if the soldier needs to be removed from the situation and admitted to a military facility for a more thorough assessment, and longer term therapy.

Likewise, psychotherapists in private settings have more flexibility in the type of assessment given to clients than psychotherapists working in a mental health facility or hospital, which often recommends standard, commonly used tools for tests and assessments.

Comprehensive Assessments

The strength of the psychological assessment process stems from its comprehensive, scientific methodology.

In an article for the American Psychological Association’s journal “Monitor,” writer Rebecca Clay interviewed Bruce L. Smith, Ph.D., an assessment advocacy coordinator for the Society for Personality Assessment. Smith said that psychological assessments go far beyond simple testing.

“Testing implies something like a blood test, where you just give a test and get a number,” explained Smith, also in private practice and a faculty member at the University of California, Berkeley. “Assessment is a much more complex enterprise where you integrate data points from various places to get a more comprehensive understanding.”

Grasping empirical frameworks, forming hypotheses and how to test them, and knowing robust research methodology and practice are imperative skills taught to clinical psychology students in graduate school. Psychologists must be able to select the best assessment tools available for certain client populations, and to become, in a sense, wise consumers of psychological research.

Additionally, a post-assessment must occur after a psychological intervention has been applied, assessing the impact on the client’s behavior and progress toward healing.


THE INTERNATIONAL CLASSIFICATION OF DISEASES

A second classification system, the International Classification of Diseases (ICD) , is also widely recognized. Published by the World Health Organization (WHO), the ICD was developed in Europe shortly after World War II and, like the DSM, has been revised several times. The categories of psychological disorders in both the DSM and ICD are similar, as are the criteria for specific disorders however, some differences exist. Although the ICD is used for clinical purposes, this tool is also used to examine the general health of populations and to monitor the prevalence of diseases and other health problems internationally (WHO, 2013). The ICD is in its 10th edition (ICD-10) however, efforts are now underway to develop a new edition (ICD-11) that, in conjunction with the changes in DSM-5, will help harmonize the two classification systems as much as possible (APA, 2013).

A study that compared the use of the two classification systems found that worldwide the ICD is more frequently used for clinical diagnosis, whereas the DSM is more valued for research (Mezzich, 2002). Most research findings concerning the etiology and treatment of psychological disorders are based on criteria set forth in the DSM (Oltmanns & Castonguay, 2013). The DSM also includes more explicit disorder criteria, along with an extensive and helpful explanatory text (Regier et al., 2012). The DSM is the classification system of choice among U.S. mental health professionals, and this chapter is based on the DSM paradigm.


Psychologist Bios

Dr. Joe Roszkowski, PsyD

Licensed Clinical Psychologist

Dr. Roszkowski is a licensed clinical psychologist who has been working in the human services field for 19 years. Dr. Roszkowski has provided psychological assessment and neuropsychological assessment in a variety of settings including hospitals, rehabilitative facilities, nursing homes, community mental health centers, residential programs, and schools. He is trained and experienced in providing assessments for pre-school age across the lifespan. Dr. Roszkowski has assisted a number of school districts in providing assessments for some of their most complex diagnostic cases and receives referrals from hospital-based programs in the area. He is a popular and respected referral source for a number of physicians, psychiatrists, schools, and counselors.

Dr. Mandi Thompson, PsyD

Licensed Clinical Psychologist

Dr. Thompson has a variety of experience with children, adolescents, and families by providing individual and family therapy, as well as comprehensive psychological assessment. Dr. Thompson has worked with diverse populations exhibiting various levels of functioning, including individuals with intense trauma histories and attachment issues, mood and behavioral disorders, and anxiety disorders. Dr. Thompson is the supervisor of the Psychological/Neuropsychological Testing program at Pathways and assists in the training, research, and administration of this program.

Dr. Jennifer Sansone, PsyD

Licensed Clinical Psychologist

Dr. Sansone is a licensed clinical psychologist with extensive experience working with children and adolescents. Dr. Sansone works with hospital-based programs in the area. She is also a referral source for adoption, foster-care, and the state of Illinois child welfare system. Dr. Sansone has extensive experience with complex diagnostic issues, academic testing, and neurocognitive assessment.

Dr. Luisa Toska, PsyD

Licensed Clinical Psychologist

Dr. Toska is a licensed clinical psychologist who has a variety of experiences with children, adolescents, families and adults by providing individual, group, and family therapy, as well as comprehensive psychological and psychosexual evaluations. Dr. Toska has written over 150 psychological reports for the juvenile court and supervised the Will County Health Department training program before joining Pathways full-time. Her reports have received high praise from school personnel in assisting students and guiding intervention.

Dr. Stacy Clark, PsyD

Doctor of Psychology

Dr. Clark completed her post-doctoral fellowship at Pathways and plays a significant role in test administration and assessment at Pathways. Dr. Clark has worked with diverse populations exhibiting various levels of functioning, including individuals with intense trauma histories and attachment issues, mood and behavioral disorders, substance use disorders, and anxiety disorders.

Dr. Jeanne Kestel, PsyD

Doctor of Psychology

Dr. Kestel has worked in a variety of environments, including health, forensic, and community mental health settings, where she provided therapy and behavioral support to children, adolescents, and adults. Dr. Kestel also has experience in working with couples and families, as well as with providing psychological assessments to all age ranges.

Pathways Psychology Services offers psychological testing & therapy to Naperville, Wheaton, Glen Ellyn, Aurora, Oswego, Geneva, Winfield, Carol Stream, West Chicago, Bartlett, Downers Grove, Plainfield, and surrounding IL communities.


List of psychological tests requiring sorting

High school placement test (HSPT) Open Edition / STS. Bensenville, IL : Scholastic Testing Service, 1982-1997.

Interpersonal style inventory (ISI) / Maurice Lorr and Richard P. Youniss. Los Angeles, CA : WPS, c.1985, 1986.

Jenkins activity survey / David C. Jenkins, Stephen J. Zyzanski, and Ray H. Rosenman. San Antonio, TX :Psychological Corp., c.1965-1979.

Kaufaman brief intelligence test (K-BIT) / Alan S. Kaufman and Nadeen L. Kaufman. Circle Pines, MN : American Guidance Service, 1990.

    (K-SEALS) / Alan S. Kaufman and Nadeen L. Kaufman. Circle Pines, MN : American Guidance Service, 1993.
    (KMMPI) / Joe Khatena and David Morse. Bensenville, IL : Scholastic Testing Service, c.1985, 1994.
    / Richard Gail & Mary Anne Hanner. Moline, IL : LinguiSystems, 1995.
    / Mark Barrett, et al. Moline, IL : LinguiSystems, 1992.
    (MSES) / Nancy E. Betz and Gail Hackett. Redwood City, CA : Mind Garden, 1993.
    (MAT) / Jack A. Naglieri. San Antonio, TX : Psychological Corp., 1989, 1985.
    (MDQ) / Rudolf H. Moos. Los Angles, CA : WPS, 1991.
  • Millon behavioral health inventory (MBHI) / Theodore Millon, et al. Minneapolis, MN : National Computer Systems Inc., 1976-1982. 3rd ed.
  • Minnesota importance questionnaire : A measure of vocational needs and values / James B. Rounds, Jr., et al. Minneapolis, MN : Vocational Psychological Research, University of MN. 1968-1981.
  • Minnesota job description questionnaire / Fred H. Borgen, et al. Minneapolis, MN. Vocational Psychological Research, University of MN. 1967-1980.
  • Minnesota satisfaction questionnaire (MSQ) / David J. Weiss, et al. Minneapolis, MN. : Vocational Psychological Research, University of MN. 1967-1977.
  • Minnesota satisfactoriness scales (MSS) / Dennis L. Gibson, et al. Minneapolis, MN. : Vocational Psychological Research, University of MN. 1970-1977.
    (MSGO) / R. W. Miskimins. Ft. Collins, Colo. : Rocky Mountain Behavioral Science Institute, 1979.
    (MVPT-R) / Ronald P. Colarusso and Donald D. Hammill. Novata, CA : Academic Therapy Publications, c.1996. Age 4-11.
    (MVPT-V) / Louisette Mercier, Rejean Hebert, Ronald Colarusso and Doanld Hammill. Novata, CA : Academic Therapy Publications, 1997. Age 55-90.
    (PCRI) / Anthony B. Gerard. Los Angeles, CA : WPS, 1994.
    (PEI) / Ken C. Winter. Los Angeles, CA : WPS, c.1989, 1994.
    - Adult (PEI-A) / Ken C. Winter. Los Angeles, CA : WPS, 1996.
    / Laurence Siegl and Lila C. Siegel. Oxford, OH : Miami University, 1966.
    (PSE> / J.K. Wing, J.E. Cooper and N. Sartorius. 9th ed. London : Cambridge University Press, 1973, c.1974.
    (OWLS) / Elizabeth Carrow-Woolfolk. Circle Pines, MN : American Guidance Service, c.1995, 1996.
    (QCI) / Annabelle Most Markoff. Novato, CA : Academic Therapy Publications, 1990. Primary grades.
     : Upper extension (ROWPVT) / Rick Brownell. Novato, CA : Academic Therapy Publications, 1987,
    (ROLI) / Annabelle M. Markoff. Novato, CA : Academic Therapy Publications, 1995.
    (RHRSD) / W. L. Warren. Los Angeles, CA : WPS, 1994.
    / Michael Schmidt. Los Angeles, CA : WPS, c.1996.
    / Glyndon D. Riley. Los Angeles, CA : WPS, 1971.
     : A measure of communication and interaction / Louis Rossetti. Moline, IL : LinguiSystems, 1990.
    (RISB) / Julian B. Rotter, Michael I. Lah and Janet E. Rafferty. San Antonio, TX " Psychological Corp., c.1950, 1992. 2nd ed.
    (SCALE) / Victor W. Doherty and Gail H. Roid. Los Angeles, CA : WPS, 1992.
    (SIPT) / A. Jean Ayres. Los Angeles, CA : WPS, c.1989, 1991.
    (S-AdhD-RS) / Gerald J. Spadafore and Sharon J. Sparafore. Novato, CA : Academic Therapy Pub., 1997.
    9th ed. / Psychological Corp. San Antonio, TX : Psychological Corp., c.1996.
    (SDMT) / Psychological Corp. San Antonio, TX : Psychological Corp., 1995. 4th ed.
    (SDRT) / Bjorn Karlsen and Eric F. Gardner. San Antonio, TX : Psychological Corp., 1995. Form J. 4th ed.
    , 7th ed. : intermediate 1/2/3/4. / Irving H. Balow, Roger C. Farr & Thomas P. Hogan. San Antonio, TX : Psychological Corp., 1993.
    - revised (TSCS-R) / Gale H. Roid & William H. Fitts. Los Angeles, CA : WPS, 1988-1991.
    (TSCS:2) second edition / William H. Fitts and W. L. Warren. Los Angeles, CA: WPS, 1996. Ages 7-90.
    (CTBS) / CTB/McGraw-Hill. Monterey, CA : CTB/McGraw Hill, c. 1997 5th ed.
    / Linda Zachman, et al. Moline, IL. : LinguiSystems, 1994.
    / Morrison F. Gardner. Burlingame, CA : Psychological and Educational Publications, 1995. Age 3-13.
    / Elisabeth H. Wiig and Wayne Secord. San Antonio, TX : Psychological Corp., 1991, 1992.
     : appraisal of visual performance and coordinate classroom activities / Regina G. Richard, Gary S. Oppenheim, and Gerald N. Getman. Novato, CA " Academic Therapy Publications, 1984.

*Wechsler memory scale - revised (WMS-R) / David Wechsler. San Antonio, TX : Psychological Corp., c.1987.


Types of Psychological Tests and Structured Interviews

Personality assessment is perhaps more an art form than a science. In an attempt to render it as objective and standardized as possible, generations of clinicians came up with psychological tests and structured interviews. These are administered under similar conditions and use identical stimuli to elicit information from respondents. Thus, any disparity in the responses of the subjects can and is attributed to the idiosyncrasies of their personalities.

Moreover, most tests restrict the repertory of permitted of answers. “True” or “false” are the only allowed reactions to the questions in the Minnesota Multiphasic Personality Inventory II (MMPI-2), for instance. Scoring or keying the results is also an automatic process wherein all “true” responses get one or more points on one or more scales and all “false” responses get none.

This limits the involvement of the diagnostician to the interpretation of the test results (the scale scores). Admittedly, interpretation is arguably more important than data gathering. Thus, inevitably biased human input cannot and is not avoided in the process of personality assessment and evaluation. But its pernicious effect is somewhat reined in by the systematic and impartial nature of the underlying instruments (tests).

Still, rather than rely on one questionnaire and its interpretation, most practitioners administer to the same subject a battery of tests and structured interviews. These often vary in important aspects: their response formats, stimuli, procedures of administration, and scoring methodology. Moreover, in order to establish a test’s reliability, many diagnosticians administer it repeatedly over time to the same client. If the interpreted results are more or less the same, the test is said to be reliable.

The outcomes of various tests must fit in with each other. Put together, they must provide a consistent and coherent picture. If one test yields readings that are constantly at odds with the conclusions of other questionnaires or interviews, it may not be valid. In other words, it may not be measuring what it claims to be measuring.

Thus, a test quantifying one’s grandiosity must conform to the scores of tests which measure reluctance to admit failings or propensity to present a socially desirable and inflated facade (“False Self”). If a grandiosity test is positively related to irrelevant, conceptually independent traits, such as intelligence or depression, it does not render it valid.

Most tests are either objective or projective. The psychologist George Kelly offered this tongue-in-cheek definition of both in a 1958 article titled “Man’s construction of his alternatives” (included in the book “The Assessment of Human Motives”, edited by G.Lindzey):

“When the subject is asked to guess what the examiner is thinking, we call it an objective test when the examiner tries to guess what the subject is thinking, we call it a projective device.”

The scoring of objective tests is computerized (no human input). Examples of such standardized instruments include the MMPI-II, the California Psychological Inventory (CPI), and the Millon Clinical Multiaxial Inventory II. Of course, a human finally gleans the meaning of the data gathered by these questionnaires. Interpretation ultimately depends on the knowledge, training, experience, skills, and natural gifts of the therapist or diagnostician.

Projective tests are far less structured and thus a lot more ambiguous. As L. K.Frank observed in a 1939 article titled “Projective methods for the study of personality”:

“(The patient’s responses to such tests are projections of his) way of seeing life, his meanings, signficances, patterns, and especially his feelings.”

In projective tests, the responses are not constrained and scoring is done exclusively by humans and involves judgment (and, thus, a modicum of bias). Clinicians rarely agree on the same interpretation and often use competing methods of scoring, yielding disparate results. The diagnostician’s personality comes into prominent play. The best known of these “tests” is the Rorschach set of inkblots.

II. MMPI-2 Test

The MMPI (Minnesota Multiphasic Personality Inventory), composed by Hathaway (a psychologist) and McKinley (a physician) is the outcome of decades of research into personality disorders. The revised version, the MMPI-2 was published in 1989 but was received cautiously. MMPI-2 changed the scoring method and some of the normative data. It was, therefore, hard to compare it to its much hallowed (and oft validated) predecessor.

The MMPI-2 is made of 567 binary (true or false) items (questions). Each item requires the subject to respond: “This is true (or false) as applied to me”. There are no “correct” answers. The test booklet allows the diagnostician to provide a rough assessment of the patient (the “basic scales”) based on the first 370 queries (though it is recommended to administer all of 567 of them).

Based on numerous studies, the items are arranged in scales. The responses are compared to answers provided by “control subjects”. The scales allow the diagnostician to identify traits and mental health problems based on these comparisons. In other words, there are no answers that are “typical to paranoid or narcissistic or antisocial patients”. There are only responses that deviate from an overall statistical pattern and conform to the reaction patterns of other patients with similar scores. The nature of the deviation determines the patient’s traits and tendencies – but not his or her diagnosis!

The interpreted outcomes of the MMPI-2 are phrased thus: “The test results place subject X in this group of patients who, statistically-speaking, reacted similarly. The test results also set subject X apart from these groups of people who, statistically-speaking, responded differently”. The test results would never say: “Subject X suffers from (this or that) mental health problem”.

There are three validity scales and ten clinical ones in the original MMPI-2, but other scholars derived hundreds of additional scales. For instance: to help in diagnosing personality disorders, most diagnosticians use either the MMPI-I with the Morey-Waugh-Blashfield scales in conjunction with the Wiggins content scales – or (more rarely) the MMPI-2 updated to include the Colligan-Morey-Offord scales.

The validity scales indicate whether the patient responded truthfully and accurately or was trying to manipulate the test. They pick up patterns. Some patients want to appear normal (or abnormal) and consistently choose what they believe are the “correct” answers. This kind of behavior triggers the validity scales. These are so sensitive that they can indicate whether the subject lost his or her place on the answer sheet and was responding randomly! The validity scales also alert the diagnostician to problems in reading comprehension and other inconsistencies in response patterns.

The clinical scales are dimensional (though not multiphasic as the test’s misleading name implies). They measure hypochondriasis, depression, hysteria, psychopathic deviation, masculinity-femininity, paranoia, psychasthenia, schizophrenia, hypomania, and social introversion. There are also scales for alcoholism, post-traumatic stress disorder, and personality disorders.

The interpretation of the MMPI-2 is now fully computerized. The computer is fed with the patients’ age, sex, educational level, and marital status and does the rest. Still, many scholars have criticized the scoring of the MMPI-2.

III. MCMI-III Test

The third edition of this popular test, the Millon Clinical Multiaxial Inventory (MCMI-III), has been published in 1996. With 175 items, it is much shorter and simpler to administer and to interpret than the MMPI-II. The MCMI-III diagnoses personality disorders and Axis I disorders but not other mental health problems. The inventory is based on Millon’s suggested multiaxial model in which long-term characteristics and traits interact with clinical symptoms.

The questions in the MCMI-III reflect the diagnostic criteria of the DSM. Millon himself gives this example (Millon and Davis, Personality Disorders in Modern Life, 2000, pp. 83-84):

“… (T)he first criterion from the DSM-IV dependent personality disorder reads ‘Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others,’ and its parallel MCMI-III item reads ‘People can easily change my ideas, even if I thought my mind was made up.'”

The MCMI-III consists of 24 clinical scales and 3 modifier scales. The modifier scales serve to identify Disclosure (a tendency to hide a pathology or to exaggerate it), Desirability (a bias towards socially desirable responses), and Debasement (endorsing only responses that are highly suggestive of pathology). Next, the Clinical Personality Patterns (scales) which represent mild to moderate pathologies of personality, are: Schizoid, Avoidant, Depressive, Dependent, Histrionic, Narcissistic, Antisocial, Aggressive (Sadistic), Compulsive, Negativistic, and Masochistic. Millon considers only the Schizotypal, Borderline, and Paranoid to be severe personality pathologies and dedicates the next three scales to them.

The last ten scales are dedicated to Axis I and other clinical syndromes: Anxiety Disorder, Somatoform Disorder, Bipolar Manic Disorder, Dysthymic Disorder, Alcohol Dependence, Drug Dependence, Posttraumatic Stress, Thought Disorder, Major Depression, and Delusional Disorder.

Scoring is easy and runs from 0 to 115 per each scale, with 85 and above signifying a pathology. The configuration of the results of all 24 scales provides serious and reliable insights into the tested subject.

Critics of the MCMI-III point to its oversimplification of complex cognitive and emotional processes, its over-reliance on a model of human psychology and behavior that is far from proven and not in the mainstream (Millon’s multiaxial model), and its susceptibility to bias in the interpretative phase.

IV. Rorschach Inkblot Test

The Swiss psychiatrist Hermann Rorschach developed a set of inkblots to test subjects in his clinical research. In a 1921 monograph (published in English in 1942 and 1951), Rorschach postulated that the blots evoke consistent and similar responses in groups patients. Only ten of the original inkblots are currently in diagnostic use. It was John Exner who systematized the administration and scoring of the test, combining the best of several systems in use at the time (e.g., Beck, Kloper, Rapaport, Singer).

The Rorschach inkblots are ambiguous forms, printed on 18X24 cm. cards, in both black and white and color. Their very ambiguity provokes free associations in the test subject. The diagnostician stimulates the formation of these flights of fantasy by asking questions such as “What is this? What might this be?”. S/he then proceed to record, verbatim, the patient’s responses as well as the inkblot’s spatial position and orientation. An example of such record would read: “Card V upside down, child sitting on a porch and crying, waiting for his mother to return.”

Having gone through the entire deck, the examiner than proceeds to read aloud the responses while asking the patient to explain, in each and every case, why s/he chose to interpret the card the way s/he did. “What in card V prompted you to think of an abandoned child?”. At this phase, the patient is allowed to add details and expand upon his or her original answer. Again, everything is noted and the subject is asked to explain what is the card or in his previous response gave birth to the added details.

Scoring the Rorschach test is a demanding task. Inevitably, due to its “literary” nature, there is no uniform, automated scoring system.

Methodologically, the scorer notes four items for each card:

  1. Location – Which parts of the inkblot were singled out or emphasized in the subject’s responses. Did the patient refer to the whole blot, a detail (if so, was it a common or an unusual detail), or the white space.
  2. Determinant – Does the blot resemble what the patient saw in it? Which parts of the blot correspond to the subject’s visual fantasy and narrative? Is it the blot’s form, movement, color, texture, dimensionality, shading, or symmetrical pairing?
  3. Content – Which of Exner’s 27 content categories was selected by the patient (human figure, animal detail, blood, fire, sex, X-ray, and so on)?
  4. Popularity – The patient’s responses are compared to the overall distribution of answers among people tested hitherto. Statistically, certain cards are linked to specific images and plots. For example: card I often provokes associations of bats or butterflies. The sixth most popular response to card IV is “animal skin or human figure dressed in fur” and so on.
  5. Organizational Activity – How coherent and organized is the patient’s narrative and how well does s/he link the various images together?
  6. Form Quality – How well does the patient’s “percept” fit with the blot? There are four grades from superior (+) through ordinary (0) and weak (w) to minus (-). Exner defined minus as:

“(T)he distorted, arbitrary, unrealistic use of form as related to the content offered, where an answer is imposed on the blot area with total, or near total, disregard for the structure of the area.”

The interpretation of the test relies on both the scores obtained and on what we know about mental health disorders. The test teaches the skilled diagnostician how the subject processes information and what is the structure and content of his internal world. These provide meaningful insights into the patient’s defenses, reality test, intelligence, fantasy life, and psychosexual make-up.

Still, the Rorschach test is highly subjective and depends inordinately on the skills and training of the diagnostician. It, therefore, cannot be used to reliably diagnose patients. It merely draws attention to the patients’ defenses and personal style.

V. TAT Diagnostic Test

The Thematic Appreciation Test (TAT) is similar to the Rorschach inkblot test. Subjects are shown pictures and asked to tell a story based on what they see. Both these projective assessment tools elicit important information about underlying psychological fears and needs. The TAT was developed in 1935 by Morgan and Murray. Ironically, it was initially used in a study of normal personalities done at Harvard Psychological Clinic.

The test comprises 31 cards. One card is blank and the other thirty include blurred but emotionally powerful (or even disturbing) photographs and drawings. Originally, Murray came up with only 20 cards which he divided to three groups: B (to be shown to Boys Only), G (Girls Only) and M-or-F (both sexes).

The cards expound on universal themes. Card 2, for instance, depicts a country scene. A man is toiling in the background, tilling the field a woman partly obscures him, carrying books an old woman stands idly by and watches them both. Card 3BM is dominated by a couch against which is propped a little boy, his head resting on his right arm, a revolver by his side, on the floor.

Card 6GF again features a sofa. A young woman occupies it. Her attention is riveted by a pipe-smoking older man who is talking to her. She is looking back at him over her shoulder, so we don’t have a clear view of her face. Another generic young woman appears in card 12F. But this time, she is juxtaposed against a mildly menacing, grimacing old woman, whose head is covered with a shawl. Men and boys seem to be permanently stressed and dysphoric in the TAT. Card 13MF, for instance, shows a young lad, his lowered head buried in his arm. A woman is bedridden across the room.

With the advent of objective tests, such as the MMPI and the MCMI, projective tests such as the TAT have lost their clout and luster. Today, the TAT is administered infrequently. Modern examiners use 20 cards or less and select them according to their “intuition” as to the patient’s problem areas. In other words, the diagnostician first decides what may be wrong with the patient and only then chooses which cards will be shown in the test! Administered this way, the TAT tends to become a self-fulfilling prophecy and of little diagnostic value.

The patient’s reactions (in the form of brief narratives) are recorded by the tester verbatim. Some examiners prompt the patient to describe the aftermath or outcomes of the stories, but this is a controversial practice.

The TAT is scored and interpreted simultaneously. Murray suggested to identify the hero of each narrative (the figure representing the patient) the inner states and needs of the patient, derived from his or her choices of activities or gratifications what Murray calls the “press”, the hero’s environment which imposes constraints on the hero’s needs and operations and the thema, or the motivations developed by the hero in response to all of the above.

Clearly, the TAT is open to almost any interpretative system which emphasizes inner states, motivations, and needs. Indeed, many schools of psychology have their own TAT exegetic schemes. Thus, the TAT may be teaching us more about psychology and psychologists than it does about their patients!

VI. Structured Interviews

The Structured Clinical Interview (SCID-II) was formulated in 1997 by First, Gibbon, Spitzer, Williams, and Benjamin. It closely follows the language of the DSM-IV Axis II Personality Disorders criteria. Consequently, there are 12 groups of questions corresponding to the 12 personality disorders. The scoring is equally simple: either the trait is absent, subthreshold, true, or there is “inadequate information to code”.

The feature that is unique to the SCID-II is that it can be administered to third parties (a spouse, an informant, a colleague) and still yield a strong diagnostic indication. The test incorporates probes (sort of “control” items) that help verify the presence of certain characteristics and behaviors. Another version of the SCID-II (comprising 119 questions) can also be self-administered. Most practitioners administer both the self-questionnaire and the standard test and use the former to screen for true answers in the latter.

The Structured Interview for Disorders of Personality (SIDP-IV) was composed by Pfohl, Blum and Zimmerman in 1997. Unlike the SCID-II, it also covers the self-defeating personality disorder from the DSM-III. The interview is conversational and the questions are divided into 10 topics such as Emotions or Interests and Activities. Succumbing to “industry” pressure, the authors also came up with a version of the SIDP-IV in which the questions are grouped by personality disorder. Subjects are encouraged to observe the “five year rule”:

“What you are like when you are your usual self … Behaviors. cognitions, and feelings that have predominated for most of the last five years are considered to be representative of your long-term personality functioning …”

The scoring is again simple. Items are either present, subthreshold, present, or strongly present.

VII. Disorder-specific Tests

There are dozens of psychological tests that are disorder-specific: they aim to diagnose specific personality disorders or relationship problems. Example: the Narcissistic Personality Inventory (NPI) which is used to diagnose the Narcissistic Personality Disorder (NPD).

The Borderline Personality Organization Scale (BPO), designed in 1985, sorts the subject’s responses into 30 relevant scales. These indicates the existence of identity diffusion, primitive defenses, and deficient reality testing.

Other much-used tests include the Personality Diagnostic Questionnaire-IV, the Coolidge Axis II Inventory, the Personality Assessment Inventory (1992), the excellent, literature-based, Dimensional assessment of Personality Pathology, and the comprehensive Schedule of Nonadaptive and Adaptive Personality and Wisconsin Personality Disorders Inventory.

Having established the existence of a personality disorder, most diagnosticians proceed to administer other tests intended to reveal how the patient functions in relationships, copes with intimacy, and responds to triggers and life stresses.

The Relationship Styles Questionnaire (RSQ) (1994) contains 30 self-reported items and identifies distinct attachment styles (secure, fearful, preoccupied, and dismissing). The Conflict Tactics Scale (CTS) (1979) is a standardized scale of the frequency and intensity of conflict resolution tactics and stratagems (both legitimate and abusive) used by the subject in various settings (usually in a couple).

The Multidimensional Anger Inventory (MAI) (1986) assesses the frequency of angry responses, their duration, magnitude, mode of expression, hostile outlook, and anger-provoking triggers.

Yet, even a complete battery of tests, administered by experienced professionals sometimes fails to identify abusers with personality disorders. Offenders are uncanny in their ability to deceive their evaluators.

APPENDIX: Common Problems with Psychological Laboratory Tests

Psychological laboratory tests suffer from a series of common philosophical, methodological, and design problems.


The Growing Need for Psychiatric Evaluation in the United States

Psychiatric evaluation is a valuable tool in identifying mental disorders. It can help with better diagnosis and also aid proper treatment.

Sadly, mental illnesses are more common than many people think. Below are some recent stats about the growing mental health problems in the United States.

According to the Centers for Disease Control and Prevention (CDC),

  • 20% of children have a current or past diagnosis of a debilitating mental disorder.
  • In any given year, mental illness affects 1 in 5 Americans.
  • Over half of Americans will have some types of mental disorder during their lifetimes.
  • Severe mental disorders affect about 4% of Americans (1 in 25). Examples of these disorders include schizophrenia, bipolar disorder, and major depression.

The Top Three Mental Disorders in the U.S.

The top three mental disorders among adults in the United States are:

Anxiety disorders, which affect 48 million people

Major depression, which affects 17.7 million people

Posttraumatic stress disorder (PTSD), which affects 9 million people​​​ 1

Between 2013 and 2016, the number of people diagnosed with major depression increased by about 33%. 4 Over 40% of people addicted to prescription painkillers have depression and anxiety. 5

Untreated depression is one of the major causes of suicide. About 1 in 5 people with untreated depression attempt suicide during their lifetimes. 6

Suicide ranks tenth in the list of leading causes of death in the United States. In 2017, suicide was responsible for 47,000 deaths. Most notably, among people aged 10 to 34 years, suicide was the second most common cause of death. 7


Online Mental Health Diagnosis - Mental Health Assessments for Legal, Education, Employment

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Online Mental Health Assessment UK

Mental Health Online Assessment ― How Is An Online Mental Health Diagnosis Carried Out?

Our online assessments of mental health comprise of an online clinical interview with an expert psychologist, analysis of your medical records, and a series of psychological tests online. Online Mental Health DIagnosis allows us to provide gold standard mental health diagnosis online, of conditions such as depression, ADHD, anxeity, phobias, Post-Traumatic Stress Disorder (PTSD), biolploar disorder, learning disability, and autism (ASD). We aim to provide the best online mental health assessment in the UK. Where necessary, we will carry out additional online interviews with people that know the person who is to be assessed very well. Each individual completes several online psychological tests as part of the online mental health diagnosis. Psychological evaluations online can be used to accurately diagnose a range of mental illnesses such as depression, anxiety, social anxiety, stress, bipolar disorder, personality disorder, and avoidant personality disorder. By providing mental health assessment online in the UK we aim to provide access to top psychologists for people who cannot attend our clinic in the UK for a traditional face-to-face assessment and prefer to have their psychological assessment online. Clients can opt to have an additional face-to-face assessment to supplement the online mental health assessment.

Online Mental Health Diagnosis for Legal Proceedings, Employment and Education

Online mental health diagnosis can be used as part of our medico-legal reports for court cases, occupatiional health assessments, and for applications for reasonable adjustments or special measures. Expert psychologist appiontments can be arranged quickly in the comfort of your own home or office. Online medicolegal assessments can be arranged at a time that is convenient to you.

Psychiatric Assessment Online ― What Happens in the Evaluation?

Online psychiatric evaluations are also offered by our expert psychiatrists. Both our psychologists and psychiatrists use secure online video conferencing and psychiatric evaluation online tests to complete the psychiatric evaluation online. Where the individual would rather have their online psychiatric assessment carried out by telephone rather than video conferencing, telephone mental health assessments are offered. Online psychiatric assessment is a highly responsive means of diagnosing mental health problems. The psychiatrist assessment online, also has the option of an individual face-to-face evaluation as the second stage of the mental health diagnosis, if this is necessary.

Free Mental Health Assessment Online – How to Decide If You Need An Online Psychological Assessment?

To prepare for the first stage of the online mental health diagnosis clients complete the relevant free psychological tests online. If the online psychology test indicates that you might have a mental health condition, you will need a full online psychological assessment. In this online mental health diagnosis the psychologist will use online psychology tests which only qualified and trained psychologists can use. Although free online tests for mental disorders are useful in signposting you to the possibility that you my have a recognised mental illness, only a full online mental health diagnosis carried out by a psychologist or psychiatrist will be acceptable for use in legal proceedings, education, or employment. Online tests to diagnose mental health form only part of an evidenced based diagnosis of mental illness. It is not recommended that you use the free online tests to self diagnose mental illness. The final diagnosis of any mental health condition should always be made by a psychologist or psychiatrist using their clinical judgement and evidence from a range of sources.

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How Do I Find Free Mental Health Diagnosis Tests Online?

Free online mental health tests can be found by clicking the links below. Please complete these tests to help you decide whether you need a full online mental health diagnostic assessment. Please remember that self diagnosis of a mental illness may not be accurate and is not a substitute for a proper online mental health assessment with a trained psychologist or psychiatrist.

Depression Test – How Is the Depression Test Used in the Online Mental Health Diagnosis?

In our online mental health diagnosis, we use a variety of depression tests. Our expert psychologists might use tests such as the Patient Health Questionnaire 9 (PHQ-9) to Monitor your progress from initial assessment through to the end of any Cognitive Behavioural Therapy or other psychological therapy that we may well provide following your online mental health diagnosis. Our expert psychologists may also use other tests of depression such as the Beck Depression Inventory. Additionally, our expert psychologists, may use more in-depth tests of depression and mental illness such as the Personality Assessment Inventory (PAI) or the Minnesota Multiphasic Personality Inventory (MMPI) so that we can obtain a more in-depth view of your depression, your likely response to therapy and any other psychiatric conditions in the clinical picture that might well be affecting you. Our expert psychologists use these standardise psychometric tests to understand both personality and psychopathology. They are useful in our medicolegal work when answering legal questions for solicitors and courts. They are also helpful when advising employers as part of personnel selection and occupational health. These psychological tests are useful in advising educational establishments about the necessary reasonable adjustments that they should make for students with mental health problems. Finally, we use these mental illness tests as part of the therapeutic procedure with our clients.

Bipolar Disorder Test

Bipolar disorder is a type of depression it is characterised by a manic phase and a depressive phase. During the manic phase the individual may have extreme happiness excitement or hopefulness. The individual often shows hostile behaviour and anger. They can be extremely restless and often have quite rapid speech. People with bipolar disorder often have poor judgement and concentration. Many individuals with bipolar disorder will report increased energy and a little need for sleep. Some people may start to set overambitious goals and engage in frequent sexual activity (as a result of a heightened sex drive). Individuals with bipolar disorder often have paranoia.

People with biopolar disorder in the manic phase are often sad and cry for long periods of time. They feel guilty and have little self-worth. They exhibit a lack of energy and are not interested in the normal day-to-day activities that they were interested in previously ― they show difficulty concentrating and have poor decision-making ability. In the manic phase individuals are often quite irritable and need either considerably more sleep or find it extremely hard to sleep. Their eating habits can change and they can either gain a significant amount of weight all lose a significant amount of weight. In the manic phase people often report suicidal thoughts and may attempt suicide.

Where Can I Find A Depression, Bipolar Disorder Anxiety or Stress Test?

Examples of depression, bipolar disorder, anxiety and stress test are given below. These tests can be completed as part of a screening assessment, before deciding whether to contact our expert psychologists for a more in-depth assessment.