Psychological tests

Psychological tests are written, visual, or verbal evaluations administered to assess the cognitive and emotional functioning of children and adults.

Psychological tests are used to assess a variety of mental abilities and attributes, including achievement and ability, personality, and neurological functioning.

For children, academic achievement, ability, and intelligence tests may be used as a tool in school placement, in determining the presence of a learning disability or a developmental delay, in identifying giftedness, or in trackingintellectual development. Intelligence testing may be used with adults to determine vocational ability (e.g., in career counseling) or to assess adult intellectual ability in the classroom.

Personality tests are administered for a wide variety of reasons, from diagnosing psychopathology (e.g., personality disorder, depressive disorder) to screening job candidates. They may be used in an educational or vocational setting to determine personality strengths and weaknesses, or in the legal systemto evaluate parolees.

Patients who have experienced a traumatic brain injury, brain damage, or organic neurological problems (for example, dementia) are administered neuropsychological tests to assess their level of functioning and identify areas of mental impairment. They may also be used to evaluate the progress of a patient who has undergone treatment or rehabilitation for a neurological injury or illness. In addition, certain neuropsychological measures may be used to screenchildren for developmental delays and/or learning disabilities.

Psychological testing requires a clinically trained examiner. All psychological tests should be administered, scored, and interpreted by a trained professional, preferably a psychologist or psychiatrist with expertise in the appropriate area.

Psychological tests are only one element of a psychological assessment. Theyshould never be used alone as the sole basis for a diagnosis. A detailed history of the test subject and a review of psychological, medical, educational,or other relevant records are required to lay the groundwork for interpretingthe results of any psychological measurement.

Cultural and language differences in the test subject may affect test performance and may result in inaccurate test results. The test administrator shouldbe informed before psychological testing begins if the test taker is not fluent in English and/or belongs to a minority culture. In addition, the subject's motivation and motives may also affect test results.

Psychological tests are formalized measures of mental functioning. Most are objective and quantifiable; however, certain projective tests may involve somelevel of subjective interpretation. Also known as inventories, measurements,questionnaires, and scales, psychological tests are administered in a variety of settings, including preschools, primary and secondary schools, collegesand universities, hospitals, outpatient healthcare settings, social agencies,prisons, and employment or human resource offices. They come in a variety offormats, including written, verbal, and computer administered.

Achievement and ability tests are designed to measure the level of an individual's intellectual functioning and cognitive ability. Most achievement and ability tests are standardized, meaning that norms were established during thedesign phase of the test by administering the test to a large representativesample of the test population. Achievement and ability tests follow a uniformtesting protocol, or procedure (i.e., test instructions, test conditions, and scoring procedures) and their scores can be interpreted in relation to established norms. Common achievement and ability tests include the Wechsler intelligence test (WISC-III and WAIS) and the Stanford-Binet intelligence scales.

Personality tests and inventories evaluate the thoughts, emotions, attitudes,and behavioral traits that comprise personality. The results of these testsdetermine an individual's personality strengths and weaknesses, and may identify certain disturbances in personality, or psychopathology. Tests such as the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Millon Clinical Multiaxial Inventory III (MCMI-III), are used to screen individuals for specific psychopathologies or emotional problems.

Another type of personality test is the projective personality assessment. Aprojective test asks a subject to interpret some ambiguous stimuli, such as aseries of inkblots. The subject's responses provide insight into his or herthought processes and personality traits. For example, the Rorschach InkblotTest and the Holtzman ink blot test (HIT) use a series of inkblots that the test subject is asked to identify. Another projective assessment, the ThematicApperception Test (TAT), asks the subject to tell a story about a series ofpictures. Some consider projective tests to be less reliable than objective personality tests. If the examiner is not well-trained in psychometric evaluation, subjective interpretations may affect the evaluation of these tests.

Many insurance plans cover all or a portion of diagnostic neuropsychologicalor psychological testing. As of 1997, Medicare reimbursed for psychological and neuropsychological testing. Billing time typically includes test administration, scoring and interpretation, and reporting.

Prior to the administration of any psychological test, the administrator should provide the test subject with information on the nature of the test and its intended use, complete standardized instructions for taking the test (including any time limits and penalties for incorrect responses), and informationon the confidentiality of the results. After these disclosures are made, informed consent should be obtained from the test subject before testing begins (except in cases of legally mandated testing, where consent is not required ofthe subject).

All psychological and neuropsychological assessments should be administered,scored, and interpreted by a trained professional. When interpreting test results for test subjects, the test administrator will review with subjects: what the test evaluates, its precision in evaluation, any margins of error involved in scoring, and what the individual scores mean in the context of overalltest norms and the background of the test subject.

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