Assessment of intellectually disabled sexual offenders: The current position

Treatment relies on appropriate assessment, guided by the ‘What Works’ approach. As such, the assessment of sexual offenders with intellectual disabilities has three primary purposes: addressing the risk, needs, and responsivity principles. The aim of this paper is to examine different assessment methods for this population. Existing risk assessment protocols are discussed, as well as specific dynamic risk assessment tools for sexual offenders with an intellectual disability. The paper also investigates use of existing, adapted and new psychological tests to assess treatment needs. Assessment of responsivity specific to this population is discussed in terms of intellectual and adaptive functioning, as well as comprehension. Suggestions are made for moving towards a comprehensive assessment strategy for this population.     

Analogue observational methods in the assessment of social functioning in adults

This article provides a clinically oriented overview of analogue observational methods used in the assessment of problematic social functioning, specifically skill deficits and social anxiety. This article emphasizes role-play assessment methods, the predominant method used in clinical settings. An examination of the psychometric characteristics of analogue assessment methods is presented, followed by a review of procedural and structural considerations that may impact the quality of assessment data. Of special concern are the potential impacts of instructional variables, structured versus ideographic role-played situations, confederate characteristics and behavior, molar and molecular levels of assessment, self-ratings versus clinician ratings of functioning, and physical attractiveness. Finally, published and empirically evaluated analogue observation tests are critically reviewed with an emphasis on features that may impact their utility in clinical practice.     

Schizotypal and hypomanic traits,creativity, and psychological health

There are both theoretical and empirical linkages between the functioning of creative and eminent individuals and a variety of forms of psychopa‐thology, in particular schizophrenia and bipolar affective disorder. Thought disorder is conceptually and empirically related to creative Divergent Thinking; schizophrenics and their relatives sometimes show evidence of highly creative adaptations; and psychiatric symptoms, notably manic and impulsive behaviors, are observed in creative and eminent individuals. Recent work has studied both psychopathological and creative functioning as continua rather than as categories or classes. The present study is unique in its use of a population that is both nonclinical and noneminent and examines the relationship between pencil and paper measures of psychotic‐like experiences, creativity, and psychological health. Results indicate that unusual perceptual experiences and beliefs, Hypomanic traits, and Impulsive Nonconformity are associated with creative attitudes and activities. Deficits in experiencing pleasure are negatively correlated with creativity scores. These findings point to the importance of affective, motivational, and behavioral factors in creative functioning especially hypomania and impulsiv‐ity. Subclinical “positive”; symptoms are associated with higher levels of measured creativity; deficit symptoms are associated with lower levels. This research suggests that creativity tests should be included in the assessment of psychological health and personal resourcefulness.     

Relational and psychological mediators of change in low‐income couples' perceived health

Experimental tests of the association between relationship functioning and physical health are limited. Although associations are hypothesized to be partially mediated through improved psychological functioning, tests are mostly limited to lab‐based studies. The present study evaluated relational and psychological mediators of change in perceived health in a sample of 742 low‐income couples (1,484 individuals) who participated in a randomized controlled trial of two online relationship education programs and a waitlist control group. Results partially supported the Strengths and Strains Model of Relationships and Physical Health. Relationship functioning and some psychological functioning were mediators of change in perceived health. Future research is needed to understand how relationship functioning improved perceived health through mediators other than psychological functioning tested here.     

The Role of Racial Identity in Perceived Racism and Psychological Stress Among Black American Adults: Exploring Traditional and Alternative Approaches

This investigation tested whether racial identity status attitudes moderated the relationship between perceived racism and psychological functioning in a sample of 340 Black American adults. The study utilized 2 approaches to racial identity assessment: the standard group‐means approach, plus a profile analysis of individual racial identity statuses. Results based on the group‐means approach indicated that racial identity did not moderate the relationship between racism and psychological functioning. Findings based on the profile analysis, however, indicated that individuals whose profile type was identified as internalization‐dominant exhibited the lowest levels of general life stress, the lowest levels of psychological distress, and the highest levels of psychological well‐being. Implications for ongoing research are discussed.     

What standardized tests ignore when assessing individuals with neurodevelopmental disorders / Lo que ignoran los tests estandarizados en la evaluación de personas con trastornos del neurodesarrollo

Abstract

In this article we critique the use of traditional standardized tests for the cognitive assessment of children with neurodevelopmental disorders. Limitations stem from the lack of integrating (a) results from research into the psychological functioning of these populations, and (b) the main arguments underlying models of human development. We identify four secondary issues in this discussion: (1) these instruments cannot be used with children who have particularly low cognitive functioning; (2) little or no variance in the scores obtained by individuals with neurodevelopmental disorders, because all are at floor, prevent adequate interpretations; (3) measurements do not provide information useful for the design of intervention strategies; and (4) different cognitive and/or neural processes may underlie behavioural scores ‘in the normal range’. Rethinking traditional assessment methods in favour of technologically-mediated games yields new cognitive assessment possibilities.     

Mothers' and Fathers' Psychological Symptoms and Marital Functioning: Examination of Direct and Interactive Links with Child Adjustment

A community sample of 51 mother-father dyads with a school-age child rated marital functioning, parental psychological symptoms, and children's adjustment problems. Parents with more psychological symptoms reported lower marital satisfaction levels. Mothers' and fathers' marital functioning and symptomatology individually related to children's adjustment in the expected directions. In addition, interaction tests revealed that, for mothers but not fathers, the combination of poorer marital functioning and higher levels of psychological symptoms amplified the negative effects on children's adjustment problems. These findings support the hypothesis that parental psychopathology and marital adjustment together affect children's functioning in an interactive way, underscoring the need to consider multiple family influences in studies of child development.     

Assumptions underlying psychological testing

Tests purporting to reflect the learning aptitudes of school children differ much more than generally is recognized. However, error in assesing such learning aptitude inheres much more in the users of the tests than in the tests themselves. Assumptions fundamental to such assessment, or even testing, are considered. It is particularly important that the assessor, or tester, constantly be sensitive to the nature of the relationship between the psychological demands of test items or tests and the learning demands confronting the child. Even tests that generally are grossly or crudely used often can yield psychoeducationally meaninful information if their results are differentially perceived in terms of the light they throw on the psychological operations fundamental to learning, “process,” as contrasted with that thrown on the results of the functioning of such operations, “product.”     

Assumptions underlying psychological testing

Tests purporting to reflect the learning aptitudes of school children differ much more than generally is recognized. However, error in assesing such learning aptitude inheres much more in the users of the tests than in the tests themselves. Assumptions fundamental to such assessment, or even testing, are considered. It is particularly important that the assessor, or tester, constantly be sensitive to the nature of the relationship between the psychological demands of test items or tests and the learning demands confronting the child. Even tests that generally are grossly or crudely used often can yield psychoeducationally meaninful information if their results are differentially perceived in terms of the light they throw on the psychological operations fundamental to learning, “process,” as contrasted with that thrown on the results of the functioning of such operations, “product.”     

Optimism as an Indicator of Psychological Health: Using Psychological Assessment Wisely

Healthy aspects of psychological functioning are often overlooked in traditional psychological assessment. When this happens, the client may become discouraged with his or her testing results, or perhaps worse, may feel that the assessor was not interested in obtaining a complete picture of who he or she is. Assessing healthy aspects of psychological functioning can be problematic, however; adding new instruments that only speak to one aspect of psychological functioning is not practical. A system is proposed in which one aspect of healthy psychological functioning--optimism--can be assessed using a standard projective test. Use of this scale can aid the assessor in conceptualizing the client's functioning and can also be a helpful tool to draw on in the course of treatment.     

Optimism as an indicator of psychological health: using psychological assessment wisely.

Healthy aspects of psychological functioning are often overlooked in traditional psychological assessment. When this happens, the client may become discouraged with his or her testing results, or perhaps worse, may feel that the assessor was not interested in obtaining a complete picture of who he or she is. Assessing healthy aspects of psychological functioning can be problematic, however; adding new instruments that only speak to one aspect of psychological functioning is not practical. A system is proposed in which one aspect of healthy psychological functioning--optimism--can be assessed using a standard projective test. Use of this scale can aid the assessor in conceptualizing the client's functioning and can also be a helpful tool to draw on in the course of treatment.     

Extending Psychometric Norms for Pre-Cardiac Transplantation Evaluations: The Florida Cohort, 1990–1996

Multidisciplinary pre-cardiac transplantation evaluations determine an individual's ability to benefit from potential transplantation. Psychologists are routinely consulted to perform psychological evaluations and testing to examine the candidate's current functioning and to forecast future functioning in the event of transplantation. The establishment of appropriate norms for psychological tests is an ethical imperative to provide high quality psychological consultations that maximize the utility of information gathered. The purpose of this paper is to present pre-cardiac transplant norms for a battery of psychological tests in a large population of consecutive transplant candidates. Together with other recently published norms on alternative test batteries, these norms allow the transplant psychologist to select from a range of psychological tests that span multiple domains of critical importance including the affective, behavioral, coping, cognitive, and health related quality of life domains. These norms appear to set a standard of practice for the use of psychological tests by a consulting transplantation psychologist.     

The Suicide (SPI) and Violence Potential Indices (VPI) from the Personality Assessment Inventory: A Preliminary Exploration of Validity in an Outpatient Psychiatric Sample

Assessing risk of harm to self and others is an important component of psychological assessment, although methods for risk assessment vary considerably. The Personality Assessment Inventory (PAI) is frequently administered to evaluate general psychological functioning, as well as to provide information about suicide and violence risk. The purpose of this study was to evaluate the construct validity of the PAI Suicide (SPI) and Violence Potential (VPI) indices in a sample of 158 psychiatric outpatients referred for psychological and neuropsychological assessment within a large northeastern academic medical center between 2007 and 2011. Results generally supported the convergent and divergent validity of both SPI and VPI when evaluating groups with and without a history of suicide and violence risk, and effect sizes were moderate to large even after controlling for other covariates. SPI and VPI scores were also found to vary significantly across different psychiatric groups in ways that would be expected. Finally, we explored the relationship between SPI and VPI, and executive functioning impairment??a neuropsychological variable found to be associated with impulsive self and other-harming behaviors. Consistent with prior research, SPI and VPI were found to be significantly elevated in groups demonstrating executive dysfunction. The implications of these findings and specifically the utility of using SPI and VPI in the assessment of risk are discussed.     

Followup of psychoanalysis five to ten years after termination: I. Stability of change

Seven out of 17 patients interviewed in a long-term followup of psychoanalysis showed either improvement in psychological functioning or a retention of psychological gains they had made during the course of psychoanalysis. Six patients deteriorated in their psychological functioning, but their gains were restored with subsequent treatment. Four patients deteriorated in psychological functioning without restoration, whether or not treatment was reentered. Neither analysts' assessments at the time of termination nor patients' assessments of themselves or assessments based on psychological tests one year after termination predicted which patients would improve or retain psychological change. No causal generalizations about factors related to psychological change can be made from these data. Different factors in interaction are suggested to account for the stability and instability of psychological change.     

Testpsychologische Ansätze der Beschwerdenvalidierung

The presence of cognitive impairment has been documented for a large number of diseases, conditions and mental disorders. Due to their impact on functioning in professional life and in everyday activities, there appears to be an increasing demand of qualified neuropsychological examinations in civil forensic contexts. While neuropsychological testing is the method of choice for determining the presence and the profile of cognitive impairment, it is easy to underperform in such tests. The authenticity of test results has to be thoroughly checked using modern approaches of symptom validity assessment. Without adequate validity checks, forensic psychological examinations are incomplete.     

Positive Psychological Functioning and the Biology of Health

Most research considers both psychological and physical health with a disease perspective by focusing on poor psychological functioning or disease outcomes. However, identifying attributes that support adaptive functioning may inform approaches to achieving health beyond what we learn from studying risk factors that accelerate deterioration. Recent evidence suggests that positive psychological functioning contributes to attaining optimal physical health. We evaluate the current state of knowledge on the relationship between positive psychological functioning and physical health, defining health beyond solely the absence of disease. We further consider when positive psychological functioning begins to exert effects on health, whether it has direct effects on biological processes or serves primarily to buffer the effects of stress, and whether it is associated with health outcomes and biological processes beyond those that reflect the absence of deterioration and disease. We propose some key directions for future research including the assessment of positive psychological functioning, positive biological functioning, and optimal health, the value of multi‐system measures, and the potential of “omics” to provide novel insights into biological mechanisms underlying associations between positive psychological functioning and physical health.     

A survey of psychological test use patterns among forensic psychologists

Clinical psychologists are frequently called on to testify in court regarding mental health issues in civil or criminal cases. One of the legal criteria by which admissibility of testimony is determined includes whether the testimony is based on methods that have gained "general acceptance" in their field. In this study, we sought to evaluate the psychological tests used in forensic assessments by members of the American Psychology-Law Society Division of the American Psychological Association, and by diplomates in the American Board of Forensic Psychology. We present test results from this survey, based on 152 respondents, for forensic evaluations conducted with adults using multiscale inventories, single-scale tests, unstructured personality tests, cognitive and/or intellectual tests, neuropsychological tests, risk assessment and psychopathy instruments, sex offender risk assessment instruments, competency or sanity-related instruments, and instruments used to evaluate malingering. In addition, we provide findings for psychological testing involving child-related forensic issues.     

Don't hide your happiness! Positive emotion dissociation, social connectedness, and psychological functioning

It is now clear that positive emotion leads to enhanced psychological functioning. What is less clear, however, is just why this is so. Drawing on a social-functional perspective, we argue that positive emotional behavior that accurately signals to others the individual's internal state will enhance social connectedness. Positive emotional behavior that does not accurately signal a person's experience--such as a smile that is not felt--may impede social connectedness and, in turn, psychological functioning. This perspective suggests that (a) the degree to which experience and behavior are dissociated during positive emotional episodes, over and above level of positive behavior, should predict worse psychological functioning and (b) the effect of dissociation should be mediated by social connectedness. To test these hypotheses, we conducted a short-term prospective longitudinal study, with a baseline assessment of depressive symptoms and well-being at Time 1. Six months later, at Time 2, we used a novel within-individual laboratory paradigm to measure the degree to which positive emotional behavior was dissociated from (vs. coherent with) a participant's positive emotional experience. We also assessed level of positive behavior and experience. Then, another 6 months later, we assessed social connectedness as a mediator and depressive symptoms and well-being as outcomes at Time 3. Even when controlling for baseline functioning and for level of positive emotion behavior and experience, we found that greater positive experience-behavior dissociation at Time 2 predicted higher levels of depressive symptoms and lower levels of well-being at Time 3. As predicted, these associations were mediated by social connectedness.     

Homeostatic interactions: a longitudinal study of biological, psychosocial and family variables in children with cystic fibrosis

A two-Year longitudinal study of thirty-five children used data gathered from pulmonary function tests, clinical measurements and standardized tests of depression, self-esteem and family environment to illustrate homeostatic interactions among biological and psychosocial adaptation to cystic fibrosis. Despite physical deterioration over the course of the study, children with cystic fibrosis reported lower depression and higher self-esteem than population norms, and improvements in psychological functioning. Decline in biological indicators of health was associated with increases on an index based on Family Environmental Scales (FES), subscales of cohesion, expressiveness and organization, and maintenance of high self-esteem and low depression. Presence of additional major life stressors was associated with deterioration in pulmonary function, higher levels of depression and poorer scores on the FES. These findings suggest that homeostatic interactions between children's health status and family functioning may moderate the physical and psychological sequelae of cystic fibrosis.     

Implications of recent research in neurobiology for psychological assessment

In this article, I highlight 3 major findings from current research in attachment, neurobiology, psychopathology, and psychotherapy: (a) attachment failures and early trauma are related to many forms of psychopathology, (b) one of the major sequelae of developmental trauma is disorganization of the right hemisphere, and (c) psychological interventions that promote emotional experience, awareness, and expression are more effective than those that rely solely on cognitive restructuring. I then suggest implications of these findings for the practice of psychological assessment: (a) the relationship between client and assessor is more important than has been acknowledged generally, (b) performance-based personality tests are very useful in part because they tap right-hemisphere and subcortical brain functioning and provide information that clients cannot directly report, and (c) when psychological assessments provide clients with powerful emotional experiences, therapeutic change is often the result. I illustrate these points with excerpts from the Therapeutic Assessment of a 27-year-old man with compulsive sexual behavior.