Chapter 6: Psychological Assessment

WHAT IS PSYCHOLOGICAL ASSESSMENT?

Psychological assessment is the systematic process by which psychologists evaluate characteristics of people (Weiner, 2010). Characteristics may include personality traits, intelligence, neuropsychological functions, psychiatric symptoms or disorders, behaviors and their contingencies, attitudes and beliefs, learning disabilities, academic achievement, school readiness, adaptation to medical illness and disabilities, appropriateness for surgery or organ donation, adaptive and social functioning, coping skills, quality of life, fitness for duty, criminality, and competency to stand trial, among others. It may extend beyond individual characteristics to the assessment of parent–child or couple interactions, family functioning, or group and organizational factors.

Psychological assessment usually involves the integration of multiple sources of data for characterizing people, including interviews, behavioral observations, collateral reports, and historical documents. A key component of most psychological assessment is the use of reliable and valid psychological tests or measures to gather data. These tests often have norms by which psychologists can compare an individual's performance with those of others (e.g., age groups, psychiatric populations). Depending on the nature of the assessment, psychologists rely on one or more methods or tests to make their determinations. The use of multiple tests within a single assessment is called a "battery." A "common battery" refers to the use of the same core set of tests across individuals based on contemporary research and practice findings within an area of psychological assessment. Common batteries help standardize the assessment and measure change in testing performance over time. Psychologists often supplement common batteries with other measures to further refine and individualize the assessment process.

PSYCHOLOGICAL ASSESSMENT IN PSYCHIATRIC SETTINGS

Psychological assessment in psychiatric settings generally focuses on the determination of patients' psychiatric diagnoses, symptom expression and severity, personality functioning, and cognitive and neuropsychological functioning. Referral questions often center on differential diagnosis, the contribution of personality factors to psychiatric symptomatology, central nervous system dysfunctions, neurodevelopmental disorders, potential risk for suicide or homicide, primary defense mechanisms and coping styles, malingering, and identification of major therapeutic issues. The results of the assessment are used to directly answer referral questions and inform treatment recommendations. When repeated at follow-up time points, psychological assessment can play an important role in determining treatment effectiveness for a given patient.

The psychiatrist's ability to call upon and use psychological assessment on complex clinical cases in the course of practice has many diagnostic advantages, particularly in today's health care environment that emphasizes documentation, the use of psychometrically validated measures, and the demonstration of treatment effectiveness. In particular, psychological assessment can improve the reliability and validity of conclusions drawn solely from standard clinical interviews or observations. Further, psychological assessments may help psychiatrists make well-considered judgments about the appropriateness of psychosocial treatments, pharmacological treatments, or their combination. For example, a ...