Psychometric assessment and its implications in mental health nursing....

1. Presented by
Premnath R
Govt . CON, Kottayam

2.  “ Psyche ” - mind
 “ Metron ” - to measure
 Chan dynasty - 1000 B C
 East India Company - 1832 A D
 British model of Chinese testing system -
1855 A D
 American Civil Service Commission – 1883 A D

3.  Two streams of thoughts
1. Measurement of individual differences
(Darwin, Galton, Cattell)
2. Psychophysical measurements (Herbart,
Weber, Fechner, Wundt)
 Experimental psychology and standardized
testing

4. Definition
Psychometrics is defined as the branch of
psychology dealing with measurable factors,
but also as the occult power of defining the
priorities of things by mere contact.
(Chambers Twentieth Century Dictionary)

5. Definition
‘A psychological test is any procedure on
the basis of which inferences are made
concerning a person's capacity, propensity or
liability to act, react, experience, or to
structure or order thought or behavior in
particular ways.’
(The British Psychological Society)

6. Definition
Psychological tests are written, visual, or
verbal evaluations administered to assess the
cognitive and emotional functioning of children
and adults.
American Psychological Association (APA)
A psychological test is an objective and
standardized measure of an individual's mental
and/or behavioral characteristics. A psychological
test is an instrument designed to measure
unobserved constructs, also known as latent
variables.
(Wikipedia)

7. Reliability.
Validity.
Norms
Uniform
Objective
Interpretable
Standardization
Objectivity

8. 1. Analysis of the situation
2. Tentative selection of test items
3. Development of standardized
procedures
4. Administration of test to a
representative group
5. Final selection of the test items
6. Evaluation of the final test-

9.  Depending upon time limit: Speed test and power
test.
 e.g. Kaufman Assessment battery for children
 Depending upon number of individuals: Group test
and Individual test
 Depending upon language: Verbal and Non- verbal
test.
 Depending upon method: Paper -pencil and
performance test .
 Computed assisted tests:

10. Depending upon what is measured:
Intelligence tests, Aptitude tests,
Achievement tests, Personality tests.
Occupational tests:
 Interest tests:
 Aptitude tests:
General Aptitude Test Battery (GATB),
Differential Aptitude Tests(DAT)

11. 1. STANFORD-BINET INTELLIGENCE SCALES:-
Devised in 1916 by Stanford psychologist Lewis
Terman.

12.  Consisting of questions and short tasks arranged
from easy to difficult, the Stanford- Binet scale
measures a wide variety of verbal and nonverbal
skills.
 Its fifteen tests are divided into
 verbal reasoning
 quantitative reasoning
 abstract/visual reasoning
 short-term memory

13. Over 140 Genius or Near-Genius/ Gifted
120 – 139 Very Superior
110 – 119 Superior
90 – 109 Average or Normal
80 – 89 Dull Normal
70 – 79 Borderline Deficiency/Mild
50 – 69 Moron /Moderate
20 – 49 Imbecile /Severe
Below 20 Idiot/ Profound

14. David "Wex" Wechsler (January 12, 1896 –
May 2, 1981)

15. Include both verbal and non- verbal tests
Verbal tests include,
 Vocabulary
 Information
 Comprehension
 Arithmetic
 Similarities
 Digit span

16. Performance tests include,
 Digit symbols
 Picture completion
 Block design
 Picture arrangement
 Object assembly(jigsaw)

17.  Information : A persons level of general
knowledge
Comprehension : How well you can
understand questions and grasp concepts.
 Arithmetic : A persons mathematical
abilities.
Similarities : Measures abstract thought.
 Digit Span : Measures attention span.
Vocabulary : How many word meanings you
know.

18.  Digit Symbol : Mental flexibility with random
symbols.
Picture Completion : Ability to notice
differences between two similar pictures.
 Block Design : Mentally construct printed
designs in your head.
Picture Arrangement : Arrange pictures in a
logical order.
Object Assembly : Place the correct part in
relationship to a whole.

19. TYPES
The Wechsler Preschool and Primary
Scales of Intelligence (WPPSI)
The Wechsler Intelligence Scale for
Children (WISC)
Wechsler Adult Intelligence Scale
(WAIS)

20. Testing Booklet
 Story Cards
 Puzzle Pieces
 Block Design

22. Incorporate ideas from cognitive
psychology and neuropsychology
It consists of 16 subtests ,some for older
and some for younger children (tests that
measure the school experiences more
directly such as naming pictures of well-known
places and objects).

23. The test fall into several categories:
Sequential processing, such as
remembering a series of digits or hand
movements;
Simultaneous processing, such as
arranging a series of related pictures in
the correct order;

24. The test consist of items at each age level
 vocabulary
 Language development
 compression
 sentence building
 similarities and differences
 analogies
 sentence repetition
 auditory perception
 social reasoning
 visual-motor co-ordination ability.

25.  It is useful to evaluate
 Basal age - the ability to pass all the test items at
the particular age.
 Terminal age - the inability to pass any of the items
on a particular age level.
 The Binet Kamat Test of Intelligence - the Hindi
version can be used for children well versed
with the Hindi language

26. Developed by John C Raven in 1936.
The test consists of 50 designs each of
which has a cut out segment . The
subject is shown the 6-8 cut out
alternative pieces and is asked to
indicate what to be put in the matrix.

27. Matrices are available in three different
forms for participants of different
ability.
Standard Progressive Matrices:
Colored Progressive Matrices:
Advanced Progressive Matrices:

30. Personality tests and inventories evaluate
the thoughts, emotions, attitudes, and
behavioral traits that comprise personality.
The results of these tests determine an
individual's personality strengths and
weaknesses, and may identify certain
disturbances in personality, or
psychopathology

31. 1. PERSONALITY INVENTORY
 Minnesota Multiphasic Personality Inventory
 Millon Clinical Multiaxial Inventory (MCMI )
 The California Psychological Inventory (CPI)
 Sixteen Personality Factor Questionnaire (or
16PF)
 The Eyesenck Personality Inventory

32. 2. PROJECTIVE TECHNIQUES
 Rorschach test:-
 Thematic Apperception Test (TAT)
 Sentence completion test
 Create drawings (Draw a person
test) or complete a story.
3. NEUROPSYCHOLOGICAL
ASSESSMENT
4. RATING SCALES

33. Developed in the late 1930’s by psychologist
Starke R. Hathaway and psychiatrist J.C.
McKinley at the University of Minnesota.
The most widely researched and clinically
used of all personality tests
Developed to identify emotional disorders
 This is one of the most frequently used
personality tests in mental health.

34.  The test is used by trained professionals to
assist in identifying personality structure
and psychopathology.
 consists of 567 statements that the test
taker has to mark as “true,” “false,” or
“cannot say.”
 Answers are scored according to how they
correspond with those given by persons
with various psychological disorders,
including depression, hysteria, paranoia,
psychopathic deviancy, and schizophrenia.

35.  The MMPI is copyrighted by the University of
Minnesota.
 It is appropriate for use with adults 18 and
over.
The current MMPI-2 has 567 items, all
true-or-false format, and usually takes
between 1 and 2 hours to complete
depending on reading level.

36.  The MMPI-2 is most commonly used by
mental health professionals to assess and
diagnose mental illness.
 The MMPI-2 has been utilized in other fields
outside of clinical psychology. The test is often
used in legal cases, including criminal defense
and custody disputes.

37.  It has been designed for adults (18 years and
older) who have a minimum of an eighth-grade
reading level.
 The MCMI is one of the few self-report tests
that focus on personality disorders along with
symptoms that are associated with these
disorders.

38.  The current version, the MCMI-III, is composed of
175 items that are scored to produce 28 scales
divided into following categories
 Modifying Indices,
 Clinical Personality Patterns,
 Severe Personality Pathology
 Clinical Syndromes
 Severe Syndromes

39. It assesses
 Traits (including dominance,
responsibility, self-acceptance)
 Socialization
 Traits relevant to academic achievement.
 Personality Research Form (PRF)
 The Neuroticism Extroversion Openness
Personality Inventory, Revised (NEO-PIR)

40.  Over several decades of research by
Raymond B. Cattell and his colleagues.
 Big Five secondary traits, which have
become popularized by other authors in
recent years.

41. THE EYESENCK PERSONALITY
INVENTORY
 Short questionnaire which can be completed in 10
to 20 minutes.
 It assesses two dimensions of personality:
Introversion versus Extroversion, and Neuroticism
versus Emotional stability.
 The EPI includes a subset of questions that
comprises a Social Desirability Scale (Lie Scale):

42.  Projective techniques involve asking subjects to
interpret or fill in visual stimuli, complete
sentences, or report what associations
particular words bring to mind.
 Because of the leeway provided by the tests,
subjects project their own personalities onto
the stimulus, often revealing personal conflicts,
motivations, coping styles, and other
characteristics.

43. Hermann Rorschach (8 November 1884 –
1 April 1922)

44.  Created in the 1920s by Swiss psychologist
Hermann Rorschach (1884-1922).
 It consists of a series of 10 cards, each
containing a complicated inkblot. Some are in
black and white, some in color.
 Subjects are asked to describe what they see
in each card.

45. Test scores are based on several parameters:
1) what part of the blot a person focuses on
2) what particular details determine the
response;
3) the content of the responses (what objects,
persons, or situations they involve);
4) the frequency with which a particular
response has been given by previous test takers

47.  Introduced at Harvard University in 1935 by Henry
Murray.
 Test takers look at a series of up to 20 pictures of
people in a variety of recognizable settings and
construct a story about what is happening in each
one. They are asked to describe not only what is
happening at the moment shown in the picture but
also what events led up to the present situation and
what the characters are thinking and feeling.

48.  Its adherents assert that the TAT taps a
subject's unconscious to reveal repressed
aspects of personality, motives and needs for
achievement, power and intimacy, and
problem-solving abilities.

49.  The subject is asked to tell as dramatic a story
as they can for each picture presented, including
the following:
? what has led up to the event shown
? what is happening at the moment
? what the characters are feeling and thinking
? what the outcome of the story was

52.  There are 31 picture cards in the standard form of
the TAT .
 Some of the cards show male figures, some
female, some both male and female figures, some
of ambiguous gender, some adults, some children,
and some show no human figures at all.
 One card is completely blank

53. USES OF TAT
 Individual assessments for employment in fields
requiring a high degree such as law
enforcement, military leadership positions.
 For diagnosis in order to match psychotherapy
best suited to patients personalities.
 Forensic purposes in evaluating the motivations
and general attitudes of persons accused of
violent crimes.
 Research into specific aspects of human
personality, most often needs for achievement,
fears of failure, hostility.

54. Specifically for children or adolescents.
Subjects are asked to complete sentences
with such open-ended beginnings as “I
wish . . .” or “My mother . . .”
Same sentence beginnings are shown to
different test takers.
There are no norms for comparing their
answers to those of previous subjects.

55. CREATE DRAWINGS
 (Draw a person test)
 complete a story.

56.  Luria- Nebraska battery
 Halsted- Reitan battery
 Michigan neuropsychological battery
 Shipley Institute of Living Scale
 NIMHANS neuropsychological battery.

57. Assessment of the neurological deficit
 Predicts the possible organic psychopathology
 Identification of intact neurological functioning
 help in the process of neuro-rehabilitation
(Cognitive retraining)
 Evaluation and comparison of various treatment
options and its perceived efficacy
 Progressive evaluation and formulation of
differential diagnosis
Developmental progression of the milestones
Tackling the mental developmental delay, and
taking necessary actions on time

58. Rating scales are instruments used to assess
the magnitude or severity of a
psychological construct or disorder.
Rating scales aid in research and clinical
practice such data are important for
evaluation, decision making, documentation
and/or analysis.

59.  For the assessment of general mental health:
1. Golberg general health questionnaire(GHQ)
2. Subjective wellbeing inventory (SWBI)
 For the assessment of anxiety :-
1. Hamilton anxiety rating scale (HARC),
2. Covi anxiety scale

60.  For the assessment of depression :-
1. Hamilton depression rating scale (HDRS),
2. Beck depression Inventory(BDI)
 For the assessment of mania :-
1. Young’s mania rating scale,
2. Bech- Rafaelson mania scale

61.  For the assessment of schizophrenia :-
1. Brief psychiatric rating scale,
2. Scale for assessment of positive symptoms
and scale for assessment of negative
symptoms.

62.  The Bayley Scales of Infant Development has been
standardized on Indian children
 The Pandey's Cognitive Development test for the pre-school
child is a standardized test,
1. Conceptual skills
2. Information
3. Comprehension
4. Visual Perception
5. Memory
6. Object vocabulary

63. Assist in diagnosis:-
 Assist in the formulation of psychopathology
and in the identification of areas of stress.
 Determine the nature of the deficits.
 Assess the severity of psychopathology and
response of treatment.
To assess general characteristics of the
individual.
Easy to get information and is more
scientifically consistent.
 Used for forensic evaluation, family court
issues, or criminal charges.
 Assess level of functioning or disability.

64.  Uncritical use
Faking
Attitudes toward testing
Effects of negative attitudes
Ethical issues
Test users
Test security
Test interpretation
Test publication
Privacy issues

65.  Should have knowledge about all the
psychological tests.
 Clarify the patient’s and relatives’ doubts
regarding the psychological tests they have to
undergo.
 Nurses should have good rapport with the
patients and family members.

66.  The nurse should reassure the patient about
the safety of the tests and the confidentiality
of the observations of the psychologist.
 The nurse observes the patient’s behavior and
the changes, which occur once the therapy is
commenced.
 The nurse observes, informs and records these
changes in patient’s chart.

67.  A nurse who is knowledgeable and skilled is an
empowered nurse who is able to function at par
with other team members and thus further
build up the nursing images in the public eye.
 The nurse can also interrupt the findings of
various tests and then plan the nursing care
accordingly.