Some of our colleagues think of psychological testing as an area that is restricted to psychologists or forensic evaluators. But psychological testing can provide valuable information about our patients and is an area in which all psychiatrists can become proficient.
For years, in fact, we have been using various forms of psychological tests, such as the Mini-Mental Status Examination and Beck Depression Inventory.
One of the challenges of assessing and treating mental illness involves the self-reported nature of psychiatric symptoms. Given this subjectivity--and the possibility of conscious and unconscious bias--patient reliability and credibility are reasonable concerns.
But psychological testing, also known as psychometrics, can provide objective information about patients in a variety of situations.
These include confirming diagnoses, screening for occult conditions, assessing the role of psychological factors in treatment, assisting in developing a prognosis, and helping to screen for elective, preoperative evaluations in clinical care.
Psychometrics can help confirm our diagnoses and screen for occult conditions. Distinguishing anxiety, depression, and bipolar disorder can be a challenging task.
Patients may be unable to provide a history that is clear enough to differentiate these disorders.
In addition, these conditions may be comorbid. Psychometric instruments, such as the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), can help with evaluating all of these conditions. Also, the tests can assist in detecting substance abuse, which is often comorbid with anxiety, depression, and bipolar disorder.
Psychometrics can provide information about psychological factors affecting treatment, such as personality disorders, authority issues, willingness to admit shortcomings and seek help, and treatment compliance.
Patient populations that could benefit from psychometrics include those suffering from infertility, chronic pain, cancer, and cardiac conditions, and patients considering elective surgery.
Psychometrics can provide surgeons with information about how their patients may fare in elective procedures like bariatric or plastic surgery. In bariatric surgery, compliance with postoperative care, including psychotherapy and diet, is crucial to the procedure's success. Having information about a patient's treatment compliance and authority issues can help the surgeon anticipate and deal accordingly with those concerns.
Like any other assessment method, psychometrics does have limitations.
For example, psychometrics requires training for the proper administration, scoring, and interpretation of tests. Variations in test protocols and testing circumstances could compromise test results.
Test results may change when test subjects receive coaching or take a test repeatedly.
Likewise, using psychometric instruments for conditions outside the scope of their design can provide unreliable results. …