Clinical Assessment of Patients with Behavioral Symptoms

د.وليد عزيز العميدي المرحله الثالثه
Clinical Assessment of Patients with Behavioral Symptoms
OVERVIEW OF PSYCHOLOGICAL TESTING
A- Types of tests
1. Psychological tests are used to assess intelligence, achievement, personality, and psychopathology.
2. These tests are classified by functional area evaluated.
B- Individual versus group testing
1. Tests administered to one individual at a time allow careful observation and evaluation of that particular person; a test battery looks at functioning of an individual in a number of different functional areas.
2. Tests given to a group of people simultaneously have the advantages of efficient administration, grading, and statistical analysis.
INTELLIGENCE TESTS
A- Intelligence and mental age
1. Intelligence is defined as the ability to understand abstract concepts; reason; assimilate, recall, analyze, and organize information; and meet the special needs of new situations.
2. Mental age (MA),as defined by Alfred Binet, reflects a person s level of intellectual functioning. Chronological age (CA)is the person s actual age in years.
B- Intelligence quotient (IQ(
1. IQ is the ratio of MA to CA multiplied by 100: MA/CA× 100= IQ.An IQof 100means that the person s mental and chronological ages are equivalent.
2. The highest CA used to determine IQ is 15 years.
3. IQ is determined to a large extent by genetics. However, poor nutritionand illness during development can negatively affect IQ.
4. The results of IQ tests are influenced by a person s cultural background and emotional response to testing situations.
5. IQ is relatively stable throughout life. In the absence of brain pathology, an individual s IQ is essentially the same in old age as in childhood.
C- Normal intelligence
1. As stated above, an IQ of 100 means that the MA and CA are approximately the same. Normal or average IQ is in the range of 90–109.
2. The standard deviation (see Chapter 26) in IQ scores is 15. A person with an IQ that is more than two standard deviations below the mean (IQ < 70) is usually considered mentally retarded (see Chapter 2). Classifications of mental retardation(the overlap or gap in categories is related to differences in testing instruments) are:
1. Mild (IQ 50–7(
2. Moderate (IQ 35–5)
3. Severe (IQ 20–4)
4. Profound (IQ < 20(
3. A score between 71and 84indicates borderlineintellectual functioning.
4. 4. A person with an IQmore than two standard deviations above the mean (IQ > 130) has superior intelligence.
D- Wechsler intelligence tests
1. The Wechsler Adult Intelligence Scale-Revised (WAIS-R) is the most commonly used IQ test.
2. The WAIS-R has 11 subtests: six verbal (general information, comprehension, arithmetic, similarities, digit span, and vocabulary) and five performance picture completion, block design, picture arrangement, object assembly, and digit symbol.
3. The Wechsler Intelligence Scale for Children-Revised (WISC-R)is used to test intelligence in children 6–16 1/2 years of age.
4. The Wechsler Preschool and Primary Scale of Intelligence (WPPSI)is used to test intelligence in children 4–6 1/2 years of age.
E- Related tests
1. The Vineland Social Maturity Scale is used to evaluate skills for daily living (e.g., dressing, using the telephone) in mentally retarded and other challenged people (e.g., those with impaired vision or hearing.
2. The Wisconsin Card Sorting Test(WCST) and Stroop Color Word Test assess executive function as well as the ability to reason abstractly, to solve problems, and to attend to a specific task while inhibiting interfering stimuli.
ACHIEVEMENT TESTS
A- Uses
1. Achievement tests evaluate how well an individual has mastered specific subject areas ,such as reading and mathematics.
2. These tests are used for evaluation and career counseling in schools and industry.
B- Specific achievement tests
1. Achievement tests include the Scholastic Aptitude Test (SAT), Medical College Admission Test (MCAT),and United States Medical Licensing Examination )USMLE(.
2. The Wide Range Achievement Test (WRAT),which is often used clinically, evaluates arithmetic, reading, and spelling skills.
3. Achievement tests often used by school systems include the California, Iowa, Stanford, and Peabody Achievement Tests.
PERSONALITY TESTS
a- Personality tests are used to evaluate psychopathology and personality characteristics and are categorized by whether information is gathered objectively or projectively.
b- An objective personality testis based on questions that are easily scoredand statistically analyzed; a projective personality test requires the subject to interpret the questions. Responses are assumed to be based on the subject s motivational state and defense mechanisms.
c- Commonly used personality tests are described in Table 8-1.