Description of Tests Commonly Used in Psychological Evaluations, Risk Assessments, and/or Custody Evaluations

Ever look at the list of tests used in a psychological evaluation, risk assessment, or custody evaluation and wonder what exactly these tests are supposed to test for? When thinking that a psychological evaluation of your client, or the other party, may be helpful to your case, ever wish you knew more about what tests might be given? While many if not most evaluations do not include a description of tests used, at Lepage Associates we think it is helpful for the readers to understand more about the tests used and thus we include a description of all tests used on every evaluation we do. Read on to find a description of some of the most common tests used in evaluations. You will find a sampling of some of the most common cognitive, self-report, and projective tests. (This is just a sample; other tests are available. We are always happy to chat with you on the phone to help determine what could be beneficial to your case.)

Cognitive tests are assessments of capabilities. Examples include IQ tests, achievement tests, and tests of executive functioning. In addition projective tests may provide information on a person’s cognitive processes.

Self-report tests are a useful adjunct to interviews alone. Such measures are widely recognized among clinicians and evaluators as a means to collect information that may not be openly admitted except through a self-report method, as people can sometimes be more hesitant to be open in a face-to-face interview format. Self-report measures are also an efficient and organized way to ask questions and elicit answers regarding one’s perception of their own psychological and interpersonal functioning. Validity scales in the more sophisticated self-report tests also serve to provide information on whether a person is trying to fake good or fake bad in testing.

Projective tests are  tests in which the test taker ‘projects’ his or her personality onto provided stimuli, and as such are a useful adjunct to interviewing and self-report tests. Designed to let a person respond to ambiguous stimuli, the person has to organize the situation, and must utilize their characteristic disposition, i.e., their personality, to respond. Projective tests are widely recognized among clinicians and evaluators as a means to learn information about a person’s personality patterns that may not be openly provided as direct information by the client.

The Wechsler Memory Scale, Fourth Edition (WMS-IV) is an individually administered battery designed to assess various memory and working memory abilities in individuals ages 16-90. In addition to the assessment of memory functioning, the WMS-IV contains a brief evaluation of cognitive status. The WMS-IV provides a detailed assessment of clinically-relevant aspects of memory functioning commonly reported in individuals with suspected memory deficits or diagnosed with a wide range of neurological, psychiatric, and developmental disorders.

The Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) is used to assess the general thinking and reasoning skills of persons aged 16 years and older. This test has five main scores:  Verbal Comprehension score, Perceptual Reasoning score, Working Memory score, Processing Speed score, and Full Scale score. The Verbal Comprehension score indicates the level of skill in understanding verbal information, thinking and reasoning with words, and expressing thoughts as words. The Perceptual Reasoning score indicates the level of skills in solving nonverbal problems, sometimes using eye-hand coordination, and working quickly and efficiently with visual information. The Working Memory score indicates the level of skill with attention, concentration, and mental reasoning. This skill is closely related to learning and achievement. The Processing Speed score is a measure of skill with speed of mental problem-solving, attention, and eye-hand coordination. This skill is important for reading, and being able to think quickly in general. The Full Scale score is derived from the combination of the Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed scores. The WAIS–IV Full Scale score is a measure of overall thinking and reasoning skills.

The Wechsler Intelligence Scale for Children (WISC-IV) is a self-report test which assesses the same constructs and dimensions as the WAIS-IV; however, it is normed for persons ages 6 to 16. The WISC-IV provides the same composite scores as the WAIS-IV (Verbal Comprehension, Perceptual Reasoning, Working Memory, Processing Speed, and a Full Scale IQ score), though the subtests are slightly different. The WISC-IV is generally utilized to get a nuanced understanding of a child’s cognitive abilities and can inform treatment plans. In the fall of 2014, an updated version, the WISC-V, will be released and considered the current test.

The Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV) is used to assess the general thinking and reasoning skills of persons aged 2 years, 6 months to 7 years, 7 months. This test has four main scores: Verbal Comprehension, Visual Spatial, Working Memory, and Full Scale score. The Verbal Comprehension score indicates the level of skill in verbal concept formation, verbal reasoning, and knowledge acquired from the environment. The Visual Spatial score indicates the level of skill in organizing visual information, part-whole relationships, attending to visual detail, and visual motor integration. The Working Memory score indicates the level of skill with attention, concentration, and mental reasoning. This skill is closely related to learning and achievement. The Full Scale score is derived from the combination of the other three scores. The WPPSI–IV Full Scale score is a measure of overall thinking and reasoning skills. In addition to these four scores, three ancillary indexes are provided. These include Verbal Acquisition, Nonverbal Index, and General Ability. These scores further analyze various skills while accounting for other areas of functioning to provide a more comprehensive picture.

The Adult AD/HD Self-Report Scale (ASRS-v1.1) is a Symptom Checklist consisting of the eighteen DSM criteria. Six of the eighteen questions were found to be the most predictive of symptoms consistent with AD/HD. These six questions are the basis for the ASRS v1.1 Screener and are also Part A of the Symptom Checklist. Part B of the Symptom Checklist contains the remaining twelve questions.

The Adaptive Behavior Assessment System (ABAS-II) is a caretaker report assessing numerous skills and behaviors contributing to an individual’s functioning across a variety of areas which impact day to day living. The assessment provides four composite scores: Conceptual Composite, Social Composite, Practical Composite, and General Adaptive Composite. The assessment measure is used to identify life and self-care skill deficits that may need to be addressed to improve overall functioning.

The MMSE-2 (Mini-Mental State Examination) is the most widely used cognitive status exam. The MMSE-2 is a brief assessment of cognitive impairment that can be used to track patients’ progress over time, to screen large populations for cognitive impairment, and to select patients for clinical trials research in dementia treatment.

The Psychiatric Diagnostic Screening Questionnaire (PDSQ) is a brief self-report instrument that screens for the DSM Axis I clinical disorders most commonly encountered among individuals 18 years of age and older (Major Depressive Disorder, Generalized Anxiety Disorder, Panic Disorder, Posttraumatic Stress Disorder, Alcohol Abuse/Dependence, Drug Abuse/Dependence, Psychosis, Bulimia/Binge-Eating Disorder, Somatization Disorder, Obsessive-Compulsive Disorder, Social Phobia, Hypochondriasis, and Agoraphobia). In addition it provides a Total Score which functions as a global indicator of psychopathology.

The Minnesota Multiphasic Personality Inventory, Second Edition (MMPI-2) is a written psychological assessment used to diagnose mental disorders; it is the most widely used and widely researched test of adult psychopathology. It is a self-report measure used to screen for clinical and psychosocial disorders. The questions asked on the MMPI-2 are designed to evaluate the thoughts, emotions, attitudes, and behavioral traits that comprise personality. The results of the test reflect an individual’s personality strengths and weaknesses, and can identify certain disturbances of personality (that is, psychopathologies). The validity scales of the MMPI-2 (the L-Scale, F-Scale, and K-Scale) assess the response set of the subject taking the inventory. In particular, these scales assess whether a subject put forth an inordinate effort to: (1) portray oneself in excessively socially desirable terms, (2) claim an unusual frequency of problems and distress, and/or (3) persistently deny any problems or distress.

The Minnesota Multiphasic Personality Inventory, Adolescent Version (MMPI-A) is a self-report test which is a version of the MMPI-2 designed to assess the functioning of adolescents aged 14-18. It includes the same clinical and validity scales as the MMPI-2, and provides the same robust information. The MMPI-A is one of the most commonly utilized assessments of adolescent personality functioning.

The Minnesota Multiphasic Personality Inventory-Second Edition-Restructured Format (MMPI-2-RF) is the most recent version of the MMPI-2 and much more brief than the MMPI-2. No new norms were collected for this shortened version of the MMPI-2.

The Millon Clinical Multiaxial Inventory, Third Edition (MCMI-III) is a standardized, self-report questionnaire used to diagnose mental disorders that assesses a wide range of information related to a person’s personality, emotional adjustment, interpersonal style, and attitude toward test taking. The MCMI-III is a nice complement to the MMPI-2, as a strength of the MCMI is that it is designed to evaluate personality disorders in addition to psychopathology. These are enduring and pervasive personality traits that underlie a person’s emotional, cognitive, and interpersonal difficulties. Thus rather than focus solely on the largely transitory symptoms that make up Axis I clinical syndromes, this test also concentrates on one’s more habitual and maladaptive methods of relating, behaving, thinking, and feeling. These personality characteristics likely reflect long-term or chronic traits that have persisted for several years prior to the present assessment. Validity subscales of the MCMI-III (Disclosure-X, Desirability–Y, and Debasement-Z) assess whether someone put forth an inordinate effort to: (1) portray oneself in excessively socially desirable terms, (2) claim an unusual frequency of problems and distress, and/or (3) persistently deny any problems or distress.

The Millon Adolescent Clinical Inventory (MACI) is the adolescent version of the MCMI-III and assesses the same domains as the MCMI-III. The MACI produces the same validity scales as the MCMI-III, enabling one to assess the responding style of the adolescent. The MACI is appropriate for ages 13-19, and requires a sixth grade reading level.

The Millon Pre-Adolescent Clinical Inventory (M-PACI) self-report tool is designed to identify psychological problems in children ages 9–12. The M-PACI assessment provides an integrated view that synthesizes the child’s emerging personality styles and clinical syndromes. It identifies emerging personality styles such as emotional instability, oppositional unruliness, and sensitive inhibitions. It addresses clinical problems such as AD/HD, depression, anxiety, conduct disorder, and reality distortions. It is based on up-to-date national norms with children in court settings, school psychology evaluations, residential treatment programs, and other settings.

The Behavior Assessment System for Children, Second Edition (BASC-2) is a self-report/other-report system used to evaluate the perceptions of others and self of the behavior of children and young adults aged ages 2-25 years. It was designed to facilitate the differential diagnosis and educational classification of a variety of emotional and behavioral disorders of children and to aid in the design of a treatment plan. It is a multi-method, multidimensional tool in that it can use parent, teacher, and/or individual descriptions of observable behavior in a variety of settings such as home and school. It also evaluates the child’s emotions, personality, and perception of self of children age eight and above. Finally, it provides important background information that is useful when making clinical diagnoses or educational classifications.

The Personality Assessment Inventory (PAI) is a self-administered, objective test of personality. It is a multi-scale inventory designed for the clinical assessment of adults, ages 18 years and older. The PAI provides information relevant to clinical diagnosis, treatment planning, and screening for psychopathology. The Clinical scales of the PAI provide information about critical diagnostic features of psychopathology. The treatment consideration scales provide indicators of potential complications in treatment. The Validity scales assess the potential influence of certain response tendencies on PAI test performance such as careless or random responding, confusion, reading difficulties, or unusual item interpretation by the respondent. The interpersonal scales assess the interpersonal style of the respondent.

The Symptom Checklist-90-Revised (SCL-90-R) is a brief self-report measure designed to provide an overview of a patient’s symptoms and their intensity at a specific point in time. It that screens for nine primary symptom dimensions (Somatization, Obsessive-Compulsive, Interpersonal Sensitivity, Depression, Anxiety, Hostility, Phobic Anxiety, Paranoid Ideation, and Psychoticism). There are also three global indices. The Global Severity Index (GSI) is designed to measure overall psychological distress and can be used as a summary of the test. The Positive Symptom Distress Index (PSDI) is designed to measure the intensity of symptoms, and the Positive Symptom Total (PST) reports the number of self-reported symptoms.

The Rotter Incomplete Sentences Blank (RISB) is a projective test where the client is given a series of incomplete sentences that he or she is supposed to finish. Assessment of the client is based on what he or she projects onto the sentences, and sentence quality can also provide information on thinking. The RISB is a semi-structured projective technique used as a measure and indication of psychological adjustment or maladjustment. Responses on this type of test typically reflect the individual’s wishes, desires, fears, and attitudes. For the purposes of the RISB, adjustment is defined as freedom from prolonged unhappy emotions, the ability to cope with frustration, the ability to initiate and maintain constructive activity, and the ability to initiate and maintain constructive activity. Maladjustment is the presence of prolonged unhappy emotions, inability to cope or difficulty coping with frustration, a lack of constructive activity or interference in initiating or maintaining such activity, or the inability to establish and maintain satisfying interpersonal relationships.

The Rorschach Test test is a projective test used to examine a person’s personality characteristics and emotional functioning. The examinee’s perceptions of inkblots are recorded and then analyzed using psychological interpretation and complex algorithms. The results describe how the examinee pays attention to surroundings, thinks about experiences, expresses feelings, manages stress, self-perception, and how the examinee relates to other people.

The Thematic Apperception Test (TAT) is a projective test in that its assessment of the client is based on what he or she projects onto ambiguous images to explore the underlying dynamics of personality, such as internal conflicts, dominant drives, interests, and motives; it is also used in a psychiatric context to assess disordered thinking. There are 31 pictures total in the TAT that depict a variety of social and interpersonal situations, but a standard administration often includes a series of 10 pictures, about which the subject is asked to tell a story about each picture to the examiner. Clients are given standard instructions to tell a story with a beginning, middle, and end, to include what the characters were thinking, feeling, and doing. The CAT is the child version of the TAT.

The Substance Abuse Subtle Screening Inventory, Third Edition (SASSI-3) is a brief self-report instrument that assesses one’s current substance use. It evaluates one’s reported usage, in addition to underlying factors which are typically associated with substance use and dependence.

The Buss-Perry Aggression Questionnaire is a 29-item self-report questionnaire where clients rank certain statements along a five-point continuum from “extremely uncharacteristic of me” to “extremely characteristic of me.” The questionnaire returns scores for four dimensions of aggression: Physical Aggression, Verbal Aggression, Anger, and Hostility.

The Parenting Stress Index (PSI) is a screening and diagnostic self-report instrument that identifies areas of stress in parent-child interactions as perceived by the parent for children ages birth to 12. It allows a clinician or researcher to examine the relationship of parenting stress as reported by the parent to child characteristics, parent characteristics, the quality of the child-parent interactions, and stressful life circumstances. As such it provides information on the course of the developing parent-child relationship.

The Stress Index for Parents of Adolescents (SIPA) is a screening and diagnostic self-report instrument that identifies areas of stress in parent-adolescent interactions as perceived by the parent, and is appropriate for parents of adolescents ages 11-19 years. It allows a clinician or researcher to examine the relationship of parenting stress as reported by the parent to adolescent characteristics, parent characteristics, the quality of the adolescent-parent interactions, and stressful life circumstances. As such it provides information on the course of the developing parent-child relationship.

The Parenting Alliance Measure (PAM) is a self-report assessment which measures the perceived strength of the bond or “alliance” between the parents of children ages 1 to 19 years. Responses on the twenty-item PAM questionnaire reflect one parent’s ability to willfully cooperate with the other parent in order to fully meet the needs of the child. Parenting alliance has been shown to be an accurate indicator of a couple’s success at raising a child, independent of their success as simply a couple. For instance, couples with strong parenting alliance often remain invested in the parenting of their children even after separation or divorce. The PAM total score reveals to what extent parents perceive themselves to be in a cooperative, communicative, and mutually respectful alliance for the care of their children; higher scores are equated with stronger degrees of perceived parenting alliance. Factors that can affect PAM scores include divorce or recent separation, as well as child adjustment issues (e.g. delinquent acts). In addition, specific mother factors (such as communication and perception of respect) and specific father factors (teamwork and level of respect for other parent) may also have an impact.

The Early Assessment Risk List for Boys (EARL-20B) for for Girls (EARL-21G) is a structured early assessment risk list for under age 12 thought to be at risk of engaging in future antisocial behavior. Research on the EARL-20B and 21G has found the tools to be reliable and a statistically significant predictor of future antisocial conduct, that is, a better predictor of future antisocial behavior than unstructured clinical opinion. As such, they can be used as a decision-enhancing tool for assessing risk for violence. Risk items included fall under three categories: Family, Child, and Responsivity. Family Items include: household circumstances, caregiver continuity, supports, stressors within the family, parenting style, and antisocial values and conduct of family members. Child Items include: developmental problems, onset of behavioral difficulties, abuse/neglct/trauma, attention and/or hyperactivity, likeability, peer socialization, academic performance, neighborhood, authority contact, antisocial attitudes, antisocial behavior, and coping abilities. Responsivity is related to family and child responsivity to treatment.

The Juvenile Adjudicative Competence Interview (JACI) is currently the only structured competence interview designed for use with juveniles. It provides a structured set of questions to help assess the youth’s Understanding, Appreciation, and Reasoning. The JACI provides interview questions for 12 content areas carefully selected in accordance with long-standing definitions of the abilities associated with the legal standard for competence to stand trial, using wording structured to be more understandable to juveniles. Areas include: nature and seriousness of the offense, nature and purpose of the juvenile court trial, possible pleas, guilt and punishment/penalties, role of the prosecutor, role of the juvenile defense lawyer, role of the probation officer, role of the juvenile court judge, assisting the defense attorney, plea bargains/ agreements, reasoning and decision making, and participating at juvenile court hearing.

The MacArthur Competence Assessment Tool – Criminal Adjudication (MacCat-CA) is a competence-to-proceed measure which provides simple judicially-based scenarios to the examinee and then asks his or her understanding of the scenario. If the examinee does not respond correctly, he/she is given the correct answers and then asked to convey understanding. An examinee’s competence is assessed within three distinct domains: Understanding, Reasoning, and Appreciation. The Understanding subscore assesses the examinee’s capacity for factual understanding of the legal system and the process of adjudication. The Reasoning subscore assesses one’s ability to weigh alternatives and make decisions regarding legal proceedings. The Appreciation subscore reflects one’s capacity to appreciate one’s specific legal situation and circumstances.

The Test of Memory Malingering (TOMM) is a visual recognition test designed to help psychologists and psychiatrists distinguish between malingered and true memory impairments. Research has found the TOMM to be sensitive to malingering and insensitive to a wide variety of neurological impairments, which makes it very reliable. The TOMM consists of two learning trials and an optional retention trial. Results are based on two cut off scores: 1) below chance and 2) criteria based on head injured and cognitively impaired clients.

The Trauma Symptom Checklist for Young Children (TSCYC) is a caretaker report assessing various behaviors consistent with exposure to trauma in children ages 3 to 12. When completing this assessment, the caretaker evaluates the child’s behavior over the previous month. In addition to looking at various clinical presentations, this measure can also assist in the diagnosis of posttraumatic stress disorder.

The Child Sexual Behavior Inventory (CSBI) is a questionnaire used to assess sexual behaviors in children ages 2 to 12 utilizing the report of the mother or primary female caregiver. It is used to evaluate children who have been sexually abused or who are suspected of having been sexually abused. This assessment measures various domains including boundary problems, exhibitionism, gender role behavior, self-stimulation, sexual anxiety, sexual interest, sexual intrusiveness, sexual knowledge, and voyeuristic behavior.

The Multiphasic Sex Inventory, Second Edition (MSI-II) is a self-report psychosexual assessment. It measures what an individual knows about his sexual problems and what he still does not recognize or cannot (or will not) acknowledge. The MSI-II scales range from an assessment of how well the client is learning to be honest and forthright with his treatment program to an assessment of whether he still blames others and situations to avoid taking responsibility for his past assaultive or deviant behaviors and interests. The test has been designed to assess the complete range of paraphilic disorders, from child molest to transvestism, as identified in the Diagnostic and Statistical Manual. To assess how well progress is occurring, the MSI-II subscales assess underlying features of paraphilia disorders which include “recurrent and intense” a) sexually arousing fantasies, b) sexual urges, or c) sexual behaviors (DSM). A client who is making good progress should be able to recognize and acknowledge his paraphilia features (a, b, c) so that the treatment strategies he learned can be employed to help control deviant fantasies and urges before they again become recurrent and intense.

 The Psychosexual Life History is a self-report measure designed for use with persons referred for psychological or forensic evaluation following allegations of sexual abuse. The client completes the measure first and it is then reviewed during a clinical interview with the evaluator. It includes areas of physical health status, mental health issues, family background data, childhood and adolescent developmental history, adolescent behavioral history, educational history, occupational history, substance abuse history, sexual history, marital-family history, adult legal history, treatment history, and a description of the alleged sexual impropriety.