The relationship between assessment and psychotherapy

The many arguments, pro and con, about the usefulness and roles of diagnosis in general, and a psychological test battery in particular, can be settled only with reference to particular tests, a particular tester, particular patients, with reference to particular questions, in a particular context. Psychologists need to establish the usefulness of tests in cost-effective ways and demonstrate how tests provide a means of studying the mind. It follows that all psychotherapists should be able to use the tests, as all physiologists should be able to use a microscope. The rule of thumb that therapists should not give tests to their patients is unnecessary, though it is preferable that the tests be given early in the relationship, and that patients have the opportunity to explore their reactions to the procedure. To maximize the usefulness of tests given by someone who is not the patient's therapist, the test report should be designed as a means of persuasion toward therapeutic action more than a passive report of findings. An outline for test report writing is suggested. Finally, the use of tests helps elucidate the many factors that contribute to change through psychotherapy.     

Comment on Bohannon (2011): "Five-repetition sit-to-stand test: usefulness for older patients in a home-care setting"

Bohannon (2011) found that the five-repetition sit-to-stand test had limited usefulness for older patients in a home-care setting because most of the patients were not able to perform the test. However, the five-repetition sit-to-stand test can be modified in several ways, if assessment of lower limbs' performance is required by functional testing. Depending on the cohort and on parameters of interest, functional tests and objective biomechanical measures can be used.     

On the aims of medicine: Comments on ‘philosophy of medicine as the source for medical ethics’

Health defined as the psychophysiological capacity to act or respond appropriately in a wide variety of situations, is enhanced by many means other than preventing and treating disease and injury. Therefore no choice of a particular medical intervention is likely to maximize health for all people with (or at risk for) a given disease. As a result, if medical practitioners are to be fully competent in the sense of knowing not only how to perform procedures but when and when not to do so, they must be able to support patients (and those who know and care about them) in weighing all of the many factors which bear upon the decision as to which, if any, medical interventions are likely to improve the person's health.     

A general framework for using latent class analysis to test hierarchical and nonhierarchical learning models

Several articles in the past fifteen years have suggested various models for analyzing dichotomous test or questionnaire items which were constructed to reflect an assumed underlying structure. This paper shows that many models are special cases of latent class analysis. A currently available computer program for latent class analysis allows parameter estimates and goodness-of-fit tests not only for the models suggested by previous authors, but also for many models which they could not test with the more specialized computer programs they developed. Several examples are given of the variety of models which may be generated and tested. In addition, a general framework for conceptualizing all such models is given. This framework should be useful for generating models and for comparing various models.     

An exact and optimal standardized person test for assessing consistency with the rasch model

The Rasch model predicts that an individual's ability level is invariant over subtests of the total test, and thus, all subtests measure the same latent trait. A person test of this invariance hypothesis is discussed that is uniformly most powerful and standardized in the sense that the conditional distribution of the test statistic, given a particular level of ability, does not depend on the absolute value of the examinee's ability parameter. The test can be routinely performed by applying a computer program designed by and obtainable from the author. Finally, a suboptimal test is derived that is extremely easy to use, and an overall group test of the invariance hypothesis discussed. All tests considered do not rely on asymptotic approximations; hence, they may be applied when the test is of only moderate length and the group of examinees is small.     

Effects of feedback and test practice on recollection and retrieval monitoring: comparing first graders,third graders,and adults*

We tested the effects of repeated testing and feedback on recollection accuracy in first graders, third graders, and adults. All participants studied a list of words and pictures, and then took three recollection tests, with each test probing different words and pictures from the earlier study phase. On the first and third tests no feedback was given, whereas on the second test, some subjects received item-level feedback throughout the recollection test. Recollection confusion scores declined across successive tests in all age groups. However, explicit feedback did not improve recollection accuracy or reduce recollection confusions in any age group. We also found that all age groups were able to use picture recollections in a disqualifying monitoring strategy without task experience or feedback. As a whole, these findings suggest that children and adults can use some aspects of retrieval monitoring without feedback or practice, whereas other aspects of retrieval monitoring can benefit from test practice in children and adults. We discuss the potential roles of metacognitive learning and unintended social feedback on these test practice effects.     

PERFORMANCE ON MEASUREMENT AND PSEUDOMEASUREMENT TASKS BY FIVE- TO SEVEN-YEAR-OLD CHILDREN

Subjects trained by a non-verbal reinforcement method to select the longer one of a pair of sticks were given two genuine measurement (G) and two pseudomeasurement (P) tests. The first P-test involved the use of two measuring sticks, clearly different in length, and the second test addition or subtraction of a piece of the measuring stick between measurements. A single factor seemed to generate much of the performance in all four tests, suggesting that, since the P-tasks had to be solved by means of non-transitive inferences, the G-tasks were solved in the same way. It is concluded that non-verbal reinforcement methods may not yield a valid diagnosis of transitivity.     

Reactions to and Desire for Prognostic Testing in Choroidal Melanoma Patients

To determine if choroidal melanoma patients want cytogenetic prognostic information. Ninety-nine choroidal melanoma patients completed a questionnaire regarding their opinions about receiving prognostic information. The perceived usefulness of prognostic information was evaluated in patients who had undergone cytogenetic testing. Depressive symptoms, quality of life, and interest in supportive counseling during test receipt were assessed. Ninety-seven percent of respondents reported that they would have wanted prognostic information at the time of their treatment and 98% of respondents reported that supportive counseling should be offered when prognostic information is given. Patients who had received a more favorable prognostic result were more likely to endorse the usefulness of cytogenetic testing than were patients who had received a less favorable prognostic result. Psychological status did not vary significantly as a function of cytogenetic test result. Prognostic information was important to patients with choroidal melanoma, even in the absence of prophylactic measures which might improve prognosis.     

Analyzing runs of an event occurring in a series with other kinds of events

A method for analyzing runs of an event occurring in a series with other kinds of events is presented. The first step of the analysis is to determine whether the event of interest occurs in longer runs than would be expected by chance. For this purpose, a cumulative frequency histogram, consisting of the relative proportions of runs as a function of length, is compared with a theoretically derived frequency histogram by means of the Kolmogorov-Smirnov test. The theoretical histogram is the outcome of a Bernoulli process; it represents the distribution of run lengths that would be expected by chance for a given base-rate probability of occurrence of the event of interest. Iteratively applied Z tests are proposed as a post hoc procedure for use when the Kolmogorov-Smirnov test reveals that the histogram of runs is not comparable to the theoretical histogram. The results reveal how the two histograms differ. Performing the same analysis on the class of all other events reveals whether runs occur in proximity. When they do, the frequency histogram for the event should be recalculated, allowing for brief intervening runs of other events, and tested with the appropriate theoretical distribution.     

Statistical criteria for parallel tests: A comparison of accuracy and power

Parallel tests are needed so that alternate forms can be applied to different groups or on different occasions, but also in the context of split-half reliability estimation for a given test. Statistically, parallelism holds beyond reasonable doubt when the null hypotheses of equality of observed means and variances across the two forms (or halves) are not rejected. Several statistical tests have been proposed for this purpose, but their performance has never been compared. This study assessed the relative performance (type I error rate and power) of the Student–Pitman–Morgan, Bradley–Blackwood, and Wilks tests of equality of means and variances in the typical conditions surrounding studies of parallelism—namely, integer-valued and bounded test scores with distributions that may not be bivariate normal. The results advise against the use of the Wilks test and support the use of the Bradley–Blackwood test because of its simplicity and its minimally better performance in comparison with the more cumbersome Student–Pitman–Morgan test.     

Further evaluating the conditional decision rule for comparing two independent means

Many books on statistical methods advocate a ‘conditional decision rule’ when comparing two independent group means. This rule states that the decision as to whether to use a ‘pooled variance’ test that assumes equality of variance or a ‘separate variance’ Welch t test that does not should be based on the outcome of a variance equality test. In this paper, we empirically examine the Type I error rate of the conditional decision rule using four variance equality tests and compare this error rate to the unconditional use of either of the t tests (i.e. irrespective of the outcome of a variance homogeneity test) as well as several resampling‐based alternatives when sampling from 49 distributions varying in skewness and kurtosis. Several unconditional tests including the separate variance test performed as well as or better than the conditional decision rule across situations. These results extend and generalize the findings of previous researchers who have argued that the conditional decision rule should be abandoned.     

SOME COMMENTS ON CULTURE FAIR TESTS1

An attempt has been made in this paper to show that culture fair tests have some problems associated with them. These tests should be examined and reviewed closely before being used and should not be regarded as the answer to testing the culturally disadvantaged. The following points were made in this paper: Culture fair tests measure different psychological functions. Culture fair tests today measure such functions as spatial visualization, abstract reasoning, perceptual speed, etc. Culture fair tests vary considerably in format. Some are pencil and paper tests, some are performance tests. Some use verbal instructions, others do not. There are many test parameters along which culture fair tests now vary. Some evidence suggests that culture fair tests possibly increase the differential between the culturally disadvantaged and the more advantaged population. Use of these tests may not be in the best interests of minority groups. It is not yet definite about the kind of items on which culturally disadvantaged people perform poorer. Some evidence suggests that they do better on verbal items and worst on perceptual items, which is in contrast to the assumption of most proponents of culture-fair tests. The validity of culture fair tests has not been shown to be better than more traditional tests. In contrast, some research even indicates that they do not show relationships as high. What is to be done, if anything, about the test differentials between the culturally disadvantaged and the majority population? Some individuals (Lorge, 1964; Coffman, 1964) agree that the elimination of group differences on tests is futile and argue that the real task at hand is a realistic attempt to study the behavioral significance of test differences. In essence, this is an all out attempt to collect validation information. Does a particular score for a black have the same behavioral implications of a higher (or lower) test score for a white? Are there criterion differences that are related to test differences? Do differential validities exist for various subgroups? Are the standard errors of estimates different for different groups? This approach is essentially what has been pursued by individuals investigating the “moderating” effects of subgrouping by race and/or socio-economic factors. The investigation of test differences within and between subgroups is called for. In my opinion, attempting to mask test differentials by using culture fair tests may in actuality have a reverse effect than what was intended. Test differentials may actually increase, making it more difficult for culturally disadvantaged individuals to be selected into schools, jobs, etc. Clearly, the construction of culture fair tests is not the only answer to testing the disadvantaged.     

Operant techniques used in stuttering therapy: A review

This article reviews research concerning the use of operant conditioning in stuttering therapy, and discusses the clinical implications of this literature. In order to be considered for this review, a report had to treat the findings of research specifically designed to use operant conditioning in the manipulation of speech disfluency. This body of experimental literature clearly indicates that operant management techniques can effectively reduce stuttering with punishment of disfluencies producing more notable results than reinforcement of fluent responses. Operant conditioning is an effective means of modifying stuttering behavior and should be more visible in terms of procedures used by speech therapists.     

Latent class regression analysis for describing cognitive developmental phenomena: An application to transitive reasoning

The aim of cognitive developmental research is to explain latent cognitive processes or structures by means of manifest variables such as age, cognitive behaviour, and environmental influences. In this paper the usefulness of the latent class regression model is discussed for studying cognitive developmental phenomena. Using this model, the relationships between latent and manifest variables can be explained by means of empirical data without the need of strong a priori assumptions made by a cognitive developmental theory. In the latent class regression model a number of classes are distinguished which may be characterized by particular cognitive behaviour. Environmental influences on cognitive behaviour may vary for different (developmental) classes. An application is given of the latent class regression model to transitive reasoning data. The results showed that a Five-Class model best fitted the data and that the latent classes differ with respect to age, strategy use (cognitive behaviour) and the influence of task characteristics (environmental influences) on the strategy use. The flexibility of the model in terms of mixed measurement levels and treatment of different cognitive variables offers a broad application to several cognitive developmental phenomena.     

Keeping an eye on the truth? Pupil size changes associated with recognition memory

During recognition memory tests participants' pupils dilate more when they view old items compared to novel items. We sought to replicate this "pupil old/new effect" and to determine its relationship to participants' responses. We compared changes in pupil size during recognition when participants were given standard recognition memory instructions, instructions to feign amnesia, and instructions to report all items as new. Participants' pupils dilated more to old items compared to new items under all three instruction conditions. This finding suggests that the increase in pupil size that occurs when participants encounter previously studied items is not under conscious control. Given that pupil size can be reliably and simply measured, the pupil old/new effect may have potential in clinical settings as a means for determining whether patients are feigning memory loss.     

Keeping an eye on the truth? Pupil size changes associated with recognition memory

During recognition memory tests participants' pupils dilate more when they view old items compared to novel items. We sought to replicate this “pupil old/new effect” and to determine its relationship to participants' responses. We compared changes in pupil size during recognition when participants were given standard recognition memory instructions, instructions to feign amnesia, and instructions to report all items as new. Participants' pupils dilated more to old items compared to new items under all three instruction conditions. This finding suggests that the increase in pupil size that occurs when participants encounter previously studied items is not under conscious control. Given that pupil size can be reliably and simply measured, the pupil old/new effect may have potential in clinical settings as a means for determining whether patients are feigning memory loss.