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CHAPTER 11: CLINICAL ASSESSMENT – OBHECTIVE &PROJECTIVE PERSONALITY TESTS Clinical assessment involves assessing clients through one or more of the following methods: the clinical interview, the administration of informal assessment techniques and the administration of objective and projective tests OBJECTIVE PERSONALITY TESTS -

Paper-n-pencil tests to assess various aspects of personality Mostly uses multiple choice, true/false, and related types of format Each object test measure different aspects of the person Ex- MMPI measure psychopathology For personalities of people

Common tests: 1. MMP-2: assists in identifying psychopathology, takes skill to interpret. Developed by Hathaway and McKinley in 1942. Min requirements to administer test: grad-level course in psychological testing and psychopathology. Core scales include 3 of the 9 validity scales, 10 basic (clinical) scales and 15 content scales. Broad personality characteristics – ex. Emotional distress - content scales identify 15 specific traits: anxiety, fears, depression, anger, criticism…etc. The MMPI-2, for example, contains four validity scales designed to measure a person’s test-taking attitude and approach to the test: 

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Lie (L) – The Lie scale is intended to identify individuals who are deliberately trying to avoid answering the MMPI honestly and in a frank manner. This scale contains 15 questions designed to identify individual who are trying to make themselves look better person than they really are. F – The F scale (the “F” does not stand for anything) is intended to detect unusual or atypical ways of answering the test items, such as randomly filling out the test. These 60 items, which are scattered through the test, address things like peculiar experiences, strange thoughts, as well as unlikely or contradictory beliefs. Back F (Fb) – The Back F scale measures the same issues as the F scale, except only during the last half of the test. The scale has 40 items. If a person answers too many of the F and Fb scale items incorrectly, it will invalidate the entire test. K – The K scale is designed to identify psychopathology in people who otherwise would have profiles within the normal range. These 30 questions measure selfcontrol, and family and interpersonal relationships, and people who score highly on this scale are often seen as being defensive.

2. Million Clinical Multiaxial Inventory (MCMI): used to assess personality disorders (formerly Axis II) and clinical symptomology - second most used under the MMPI (for measuring psychopathology) - 175 true/false questions, written at 5 grade reading level & meant for 18 years + - 6 different scales 3. Personality Assessment Inventory: aid in making diagnosis, treatment planning and screening for psychopathology. Argued may be more effective than MMPI-2 - 18+, 344 items at 4th grade reading level

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- 4 point ordinal scale (true, somewhat true, not true) - normed using 3 samples….? - good validity and reliability? Beck Depression Inventory (BDI-II): quick and easy method to assess depression - aaron beck in 1961 - #1 assessment tool for counsellors - 10 mins, 21 questions scale from 0-3 - discriminant validity Beck Anxiety Inventort (BAI): assessment of anxiety - simple tool, for ages 17 to 80 - top 10 tool used by counsellors - self-report instrument that takes 5- 10 mins - 21 questions, 4 point likert-scale, rate 0-3 - good reliability and validity, Myers-Briggs Type Indicator (MBTI): popular method to assess normal personality; based on Jung’s psychological types -Jung’s factors include: extroversion or introversion, sensing or intuiting and thinking or feeling - Kathryn Briggs added fourth dimension: judging vs. perceiving - helps with career choosing, marriage counselling, better understanding of yourself and others - 93 items, uses IRT, 15-25 mins, 7th grade reading level and ages 14+ - different forms replaces different subtypes of the tests FORM M & Q 16PF: based on Cattell’s 16 bipolar personality traits - method to describe human behaviour, not measure pathology - 185 items, 45 mins, at a 5th grade level - provides results in 3 sections: 16 primary factors, 5 global factors, 3 validity scales - 5 global factors= extraversion, anxiety, tough-mindedness, independence and self-control - these are a result of factor analysis (statistical method of determining how individual items or factors correlate) - 3 validity scales: impression management (“social desirability” high score would indicate the person’s inability to admit to faults, low score=low self-esteem), infrequency (high score=comprehension problems) and acquiescence (high score= difficulty evaluating oneself) Big Five Personality Traits – NEO PI- 3: uses the Big Five model to assess personality differences - based on research rather than theory: O-C-E-A-N (openness, conscientiousness, extraversion, agreeableness & neuroticism - 30-40 mins, 5 point likert-scale ranging from strongly agree to strongly disagree - 2 versions, self report and for a rater -uses t-scores - reliability shows consistent from old and new NEO tests Conners 3: asses ADHD and other problematic behaviours - replaced CRS-R, discontinued end of 2012 - children 3- 18, forms that are completed by parents, teachers, and self-report (8+) - 4 point likert scale, 0-3 (never to often) up to 115 items for long one, 41-45 for short forms - help if child need special education or monitor treatment interventions

- content validity demonstrated, construct validity established through factor analysis - concurrent validity 10. Substance Abuse Subtle Screening Inventory (SASSI): a subtle instrument to screen for substance dependence - good tool for identifying people who have a high probability of a substance use related disorder -2 versions: SASSI-4 for adults 18+ and SASSI-A2 for ages 12-17 - 74 true/false questions, four point scale ranging from “never” to “repeatedly” - can have false positive and false negatives, it’s designed toward making false positives rather than false negatives - Can be useful in diagnosis, treatment planning and interpreting validity. - can suggest a use disorder with high accuracy, don’t have a disorder but SASSI-4 says they do, it’s a false positive - evidence of validity is suggested through criterion-related validity because the developers compared their instrument (SASSI-4) with another criterion (DSM-5) -9 subscales PROJECTIVE TESTS -

Responses to stimuli are used to interpret personality factors Testing often used is psychopathology and treatment planning Client respond in an open-ended manner to vague stimuli that results in a wide-range of responses that often limits norm-group comparisons Validity and reliability not as solid as most objective tests – battery of projective tests should not be used alone – paired with objective

Common projective tests: TAT, Rorschach Inkblot Test, Bender Visual-Motor Gestalt Test, House-TreePerson, Kinetic House-Tree-Person, Sentence Completion Series & Rotter Incomplete Sentence Bank Thematic Apperception Test (TAT): client creates a story based on cards with vague pictures; TAT is based on Murray’s need-press personality theory -

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Developed by Henry Murray 31 cards with vague pics (usually only 8-12 used during assessment) Asked to create a story that has a beginning, middle, end Allows access to the clients inner world and shows how the is affected by the clients needs and by environmental forces known as forces Tends to draw out from the clients issues related to more current life situations Based on Murray’s need-process personality theory: states that people are driven by their internal desires, such as attitudes, values, goals and so on (needs), or by external stimuli (press) from the environment No universally agreed upon scoring method – most clinicians use a qualitative process Controversy over reliability and validity 6th most frequently used test by clinical and counseling psychologists Cards may raise historical, cross-cultural bias CAT designed for children 3 – 10 only 10 cards

Rorschach Inkblot Test: clients are asked to identify what they see in 10 inkblots; the unconscious mind “projects” itself onto the image -

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Developed by Herman Rorschach in 1921 by splattering ink into pieces of paper and folding them in half to form a symmetrical image 10 cards, client is asked to describe what they see Became the most frequently used in clinical practice Difficulty providing adequate validity Scoring system used: Exner: examines location, determinants and content - location: portion to which the response occurred and how examinee’s responses are broken down into categories such as the whole blot (w), common details (d), unusual details (Dd), white space details (S). -Determinants: used to describe the manner of which the examinee understood or what he/she saw. Broken down (1) form (looks like a bat), (2) colour (it’s blood because it’s red), (3) shading (it looks like smoke because its grayish-white). -Content: based on 22 categories, such as whole human, human detail, animal, art, blood, clouds Once data recorded, complex series of calculations used to created numerical ratios, percentages and derivations with interpret results – very complex

Bender Gestalt II: assists in identifying in developmental, psychological or neurological deficits -

Published in 1938 by Lauretta Bender 5-10 minutes Measure individual’s developmental level and psychological functioning & assesses neurological deficits after a traumatic brain injury Asked to draw 9 figures, see how accurate the drawing is Predictive validity shown through kindergartener children scores is predictive of academic achievement a year later

House-Tree-Person & other drawing tests: quick, simple and effective projective tests -

Ask client to draw simple pictures – insight into the clients life – unconscious Some of the most popular & effective projective tests HTP- asks clients to draw a house, a tree and a person on 3 separate pieces of paper Draw-a-man, draw-a-woman tests, all meant to tap into client’s unconscious

Sentence completion tests: can reveal unconscious issues, but some question the validity and reliability -

Used since Galton and Jung “semi-projective” series of tests used to gather personality and psychodiagnostic information from adolescents and adults Address specific issues: marriage, family, work, aging Interpretive manual makes broad suggestions about how to interpret the responses – assess level of defensiveness for example No reliability, validity or norm data Weak in any psychometric data...