Clinical Personality Assessment: History, Evolution, Contemporary Models, and Practical Applications
Abstract and Keywords
This book provides a comprehensive view of the field of personality assessment from its historical roots to the major, methodological issues defining the field and that have led to numerous approaches and applications, and to the broad range of assessment techniques available today. One can find throughout history an awareness of the importance of evaluating personality and character using observation and other means of acquiring information on which to make such decisions. The modern era for personality assessment began in late-nineteenth-century England with the work of Sir Francis Galton. The first self-report personality inventory used to obtain personality information was developed by Robert Woodworth during World War I. Numerous personality inventories were developed in the years that followed, including the Minnesota Multiphasic Personality Inventory (MMPI). Paralleling the work on personality inventories was the development of projective assessment instruments such as the Thematic Apperception Test. These instruments came to be the most widely used assessment instruments during the expansion of applied psychology after World War II and are still the predominant tests in use today.
People have likely been making personality assessment decisions and personality appraisals since the beginning of human interactions. As an adaptive human activity, effective personality appraisal has clear survival value for our species (Buss, 1984). If our cave-dwelling ancestors happened to choose a hunting partner with the “wrong” personality and motivations, the outcome could be tragic. Or if groups from antiquity failed to evaluate whether potential leaders possessed essential personal qualities, their own survival could be threatened. Personality assessments in antiquity were probably based on diverse, if not particularly valid or reliable, sources of information. Early writings, for example, mention such factors as dreams, signs from the gods, oracular speculation, spies, traitors, direct observation, pedigree, physiognomic characteristics, and the interview as important sources of information about people. Even “tests” were employed to evaluate personality characteristics. Hathaway (1965) described an early personality screening situation from the Old Testament: For example, Gideon had collected too (p. 6) large an army, and now the Lord saw that the Israelites would give Him scant credit if so many men overran the Midianites camped in the valley. The Lord suggested two screening items for Gideon. The first of these items had face validity: Gideon proclaimed that all who were afraid could go home. More than two of every three did so. The second was subtle: Those who fought the Midianites were the few who drank from their cupped hands instead of stooping to drink. Altogether it was a battle decided by psychological devices, and 300 men literally scared the demoralized Midianites into headlong flight (p. 457).
Highlights in History
Efforts to appraise personality characteristics were evident in antiquity. DuBois (1970) pointed out that for over 3,000 years an elaborate system of competitive examinations was used for selecting government personnel in China. Some of these tests used were designed to assess the personal characteristics of applicants. This system of examinations was described in the year 2200 BC, when the emperor of China examined government officials every 3 years to determine their fitness for office (DuBois, 1970). In 1115 BC, candidates for government positions were examined for their proficiency in the “six arts”: music, archery, horsemanship, writing, arithmetic, and the rites and ceremonies of public and private life (DuBois, 1970). Examinees were required to write for hours at a time and for a period of several days in succession. For a picture of the early testing booths, see Ben-Porath and Butcher 1991.
One can find throughout history an awareness of the importance of evaluating personality and character as using observation and other means of acquiring information on which to make such personality-based judgments. However, interest in obtaining further understanding and for evaluating underlying personality and personal qualities began to take more objective focus in the nineteenth century. Some scholars came to believe that human physical characteristics such as bumps on the head or the shape of the eyes were associated with underlying personality or character and that one could understand people by careful observation of their physical features. This phenomenon, known as phrenology, was held by a number of prominent physicians. Phrenology appealed to intellectuals who followed a biological determinism that gave promise to individuals improving themselves in life by being able to read and understand characteristics of other people from their appearance. Boring (1950) pointed out that the modern character of phrenology (as well as its name) was initially founded by Johan Spurzheim (1776–1832), a Viennese physician who studied with Franz Joseph Gall (1758–1828) in 1800 and was soon employed as his assistant. Gall, also a Viennese physician and lecturer, had been involved in the investigation of his theory that powerful memory as a characteristic in humans was reflective of having very prominent eyes and that other bodily characteristics, such as head size, were indicative of special talents for painting or music. Gall and Spurzheim were very popular speakers among upper-class intellectuals and scientists in Europe in the 1820s and influenced British physican George Combe (1788–1858), who was the most prolific British phrenologist of the nineteenth century.
During the brief period that Spurzheim and Gall worked together, Gall had hoped to have Spurzheim as his successor and included him as a co-author in a number of publications. However, they had a disagreement that prompted Spurzheim to start his own career, writing extensively about the physiognomical system. Spurzheim was highly successful in his effort to popularize phrenology throughout Europe, particularly in France and England. After leaving the tutorship of Professor Gall, he continued to expand his views and established a new and more complete topography of the skull, filling in blanks that Gall felt had not been empirically established. He also revised the terminology for the faculties used in phrenology. Once he completed the system to his satisfaction, Spurzheim set about spreading the word on phrenology in other countries. Providing lectures in Europe he influenced others such as John C. Warren (1778–1856), a professor of medicine at Harvard (also known for performing the first surgery under ether in the United States). Warren had begun the study of Gall's ideas on phrenology in 1808, but during a trip to France he studied Spurzheim's views on phrenology in 1821. When he returned to Boston, he developed a series of lectures on phrenology at Harvard and later incorporated these ideas into presentations for a broader audience at the Massachusetts Medical Society.
The most prominent promoter of phrenology in the United States during the 1820s was Charles Caldwell (1772–1853), who had also attended Spurzheim's lectures in Paris. He toured throughout the United States lecturing on phrenology and founded a number of societies that promoted phrenology. In 1832, Spurzheim traveled to the (p. 7) United States to spread his views on the science of phrenology. After a lengthy series of lectures, he became ill and died with severe fever. The most notable phrenologists in the United States were the Fowler brothers who lectured and performed in public during the 1840s. Orson Squire Fowler (1809–1889) and his younger brother Lorenzo Fowler (1811–1896) wrote extensively and promoted phrenology during this period. The brothers operated a publishing house, mail-order business, and museum of human and animal skulls. They zealously promoted phrenology as a practical tool for self-improvement.
Although the phrenology movement was popular for a time, it was not widely accepted in the broader scientific community and was a short-lived phenomenon. The popularity of the movement does, however, show that the scientific community at the time was open to and interested in scientifically assessing underlying personality attributes.
Twentieth-Century Developments in Personality Assessment
One of the greatest steps in introducing personality assessment in the modern era began in the late nineteenth-century England with the work of Sir Francis Galton (1822–1911), a half-cousin and contemporary of Charles Darwin and a prolific explorer and researcher. Galton (1879, 1884) conducted a number of experiments on mental processes and devised explicit experimental procedures for measuring psychological attributes. He also proposed that human character could be studied by observation and experimentation and pointed out that such observations could be standardized and readily compared by the use of developmental norms. Sir Francis Galton initially suggested that questionnaires could be used for measuring mental traits although he did not develop a specific questionnaire for this purpose himself. The first formal use of a structured rating scale for studying human character was published by Heymans and Wiersma 1906. They constructed a 90-item rating scale and asked 3,000 physicians to rate people with whom they were well acquainted using the scale. The manual of mental and physical tests published by Whipple (1910) addressed primarily physical, motor, sensory, and perceptual tests.
The first self-report personality inventory used to obtain personality information was developed by Robert Woodworth (1879, 1920) as a means of detecting psychiatric problems for the U.S. Army in World War I. The Woodworth Personal Data Sheet included 116 items such as:
Have you ever seen a vision?
Do you make friends easily?
Do you feel tired most of the time?
The scoring on the scale was the total number of extreme item responses (based on a rational determination of adjustment problems). In addition, he included a number of “starred items” or particularly problematic behaviors (today we refer to them as critical items) which were thought to indicate particularly serious problems that require special attention. During the war, Woodworth developed the items and conducted research on a sample of draftees and returning soldiers with “shell shock” comparing the results with college students (Woodworth, 1919). The Personal Data Sheet was not, however, completed in time to be used to select out draftees who were maladjusted during the war and was published after the war was over. A few years later, Woodworth and Matthews 1924 also published a 75-item version of the inventory for children and adolescents that included some of the same items as the adult version but with additional content they thought more relevant for young people, such as:
Are you troubled with dreams about your play?
Do you find school a hard place to get along in?
Is such an idea as that you are an adopted child difficult for you to shake off?
Do you like to be tickled?
These personality inventories set the stage for broader development of psychological measures to address personality functioning (see Table 1.1). In the years that followed, a large number of personality inventories were developed to assess a variety of characteristics or temperaments. Some of those efforts persisted into the 1920s and 1930s with the development of inventories designed to measure trait-like features such as introversion, extraversion, and neuroticism, but none was used extensively in clinical settings. One exception was the Bernreuter Personality Inventory published by Robert Bernreuter (1931). This personality scale differed from the Woodworth Personal Data Sheet in that it provided scores for a number of personality characteristics, including an appraisal of neurotic tendencies, ascendance-submission, and introversion-extraversion. The Bernreuter Personality Inventory came to be widely used for counseling, clinical and personnel applications and influenced the development of other inventories that followed, such as the MMPI, that are in use today. (p. 8)
Table 1.1. Highlights in the History of Personality Assessment.
Year Personality Test
Personal Data Sheet
1921 The Rorschach Inkblot Test
1924 Woodworth & Matthews Personal Data Sheet (children and adolescent)
Woodworth & Matthews (1924)
1933 The Bernreuter Personality Inventory
1938 Thematic Apperception Test
1940 Minnesota Multiphasic Personality Inventory
Hathaway & McKinley (1940)
1956 The California Psychological Inventory
1957 The Sixteen Personality Factors Questionnaire
Cattell & Stice (1957)
1977 The Millon Clinical Multiaxial Inventory
1985 The NEO Personality Inventory
Costa & McCrae (1985)
1989 The Minnesota Multiphasic Personality Inventory (MMPI-2)
Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer (1989)
1991 Personality Assessment Inventory
1992 Minnesota Multiphasic Personality Inventory-Adolescent Form (MMPI-A)
Butcher, Williams, Graham, Tellegen, et al. (1992)
Development of the Three Major Clinical Personality Assessment Instruments of the Twentieth Century: Rorschach, TAT, and MMPI
The most significant event in the history of projective psychological assessment occurred during the early years of the twentieth century when the Swiss psychiatrist Herman Rorschach published his monograph Psychodiagnostik, which detailed the development of the “Rorschach inkblot technique.” During this period, inkblots were commonly used in Europe at the time as stimuli for imagination in the popular parlor game known as Klecksographie or blotto, in which people made up responses to various inkblot designs. Although Rorschach had experimented with various types and forms of inkblots in 1911 he did not pursue these efforts until his work in 1921 that detailed the interpretation of responses to the inkblots to assess mental health symptoms and personality. This was the only work that Rorschach published on the test because he died of acute appendicitis the following year.
Subsequent developments and refinements of the Rorschach inkblot technique occurred several years later in the United States when Beck (1938), Klopfer and Tallman (1938), and Hertz (1938) began to use the Rorschach blots to understand personality and emotional characteristics of patients in a movement that was to see the publication of thousands of articles and recruitment of countless advocates who began to use the 10 blots in clinical settings—a movement that continues today. Beck, Klopfer, and Hertz also developed separate interpretation systems for the inkblots in the 1940s. The most widely used contemporary Rorschach interpretive system was published by John Exner 1983.
An important theoretical article defining this approach to personality assessment was published by L. K. Frank 1939. This article detailing the use of ambiguous stimuli like the Rorschach inkblots to assess personality provided an important theoretical explanation that came to be known as the projective method in assessment. In Frank's view, the use of ambiguous stimuli allowed people to “project” their internal meanings and feelings from their unconscious personality in their responses. This process of projection allowed an interpreter to gain a better understanding of the client's thinking. Frank's theoretical interpretation of the projective process by the projective method was influential as projective tests such as the Rorschach and TAT expanded in use during the 1940s.
The Thematic Apperception Test, or TAT, was developed in 1935 by Henry Murray and Christiana Morgan and described in Murray's early works (1938, 1943). The TAT is a projective measure comprised of a series of pictures to which a client is asked to make up a story describing the events going on in the picture. The test allows the clinician to evaluate the client's thought patterns, attitudes, beliefs, observational capacity, and emotional (p. 9) responses to test stimuli that are ambiguous and unstructured. The TAT pictures consist of scenes that portray human figures in a variety of activities and situations. The subject is asked to tell the examiner a story about each card to include the following elements: the event shown in the picture; what has led up to it; what the characters in the picture are feeling and thinking; and the outcome of the event. The TAT has been administered to individuals in a variety of settings such as clinical assessment, personnel screening, and research in personality. It has been shown to be an effective means of eliciting information about a person's view of the others and his or her attitudes toward the self and expectations of relationships with peers, parents, or other authority figures.
In addition to the development of these specific projective measures to assess personality characteristics, the field of personality assessment was advanced substantially by theoretical views of personality developed during this period. Several psychologists made substantial contributions to theoretical perspectives in personality assessment during the early twentieth century. The theoretical views as to the focus of personality research, that is, nomothetic versus idiographic perspectives, can also be traced back to early twentieth-century research, when studies of traits and temperament were beginning to emerge in sufficient numbers to warrant their being reviewed by Thurstone in 1916 and Allport and Allport in 1921. For example, Allport (1937) pointed out that the movement to define the “psychology of personality” gained considerable momentum after 1920 and prompted extensive but conflicting theories and inconsistent research. Allport can be credited with bringing the issue into sharper focus by clarifying the roughly 50 definitions or descriptions of personality and providing a model for personality assessment. Shortly after Allport's classic work on personality was released, Henry Murray (1938) published another classic work Explorations in Personality, in which he emphasized the use of case studies that described the unique integration of various characteristics within individuals. Both Murray and Allport distinguished between idiographic and nomothetic approaches to the study of people and, in their own way, each argued for an integration of the two. They advocated an approach that would not simply judge a person against others but would contrast a person's unique features with those found in others. Allport and Murray stimulated thinking about the objectives of the psychological study of people and, in effect, created a challenge for those interested in testing or assessment. The idea of assessing personality and psychopathology began to be of greater interest to psychologists, although they often used the two terms interchangeably. And, early on, most attempts to use tests to understand people actually did not include much personality testing, focusing instead on issues of intelligence, aptitude, achievement, and vocational interests.
One of the most significant achievements in personality assessment occurred with the development of the Minnesota Multiphasic Personality Inventory (MMPI) in the late 1930s. The research underlying the MMPI was initiated by Hathaway and McKinley, who were critical of the way in which personality inventories had been developed up to that time using rational scale development strategies, that is, by simply guessing as to what items would measure the variable in question. They approached the task with an empirically based method. Initially, they developed a large set of items without determining in advance which items were measuring the clinical problem areas they were interested in studying. They next defined a set of clinical problem areas such as depression, somatization, and schizophrenia by grouping together homogeneous problem cases. They then constructed their scales by determining which items actually empirically differentiated the specific clinical group (such as depressed patients) from a known sample of non-patients or “normals.” The first article on the MMPI was published in 1940 introducing a novel approach to clinical personality assessment (Hathaway & McKinley, 1940). The test was published in 1943 by the University of Minnesota. In the 1940s and 1950s, numerous applications of the test were established, including medical assessment and personnel selection, as it became the most widely used personality instrument in psychology with well over 19,000 articles and books published on the MMPI and its successors MMPI-2 and MMPI-A. The MMPI went through a major revision during the 1980s. The first public discussion of the need for an MMPI revision was addressed by a panel of MMPI experts at the Fifth MMPI Symposium on Recent Developments in the Use of the MMPI at Minneapolis in 1969, and a book detailing the need for revising the MMPI was published in 1972 (Butcher, 1972). In 1982, the MMPI revision and data collection began after many years of discussion: The MMPI-2 Revision Committee was comprised of James Butcher, John Graham, and W. Grant Dahlstom. Auke Tellegen (p. 10) joined the committee a few years later at the data analysis stage. The MMPI-2 was published in 1989 and the MMPI-A (for adolescents) in 1992 (Butcher, Williams, Graham, & Ben-Porath, 1992).
Expansion of Personality Assessment During and Following World War II
The entry of the United States into World War II in 1941 brought with it an important need for psychological services in both the clinical service area and personnel selection. The military services implemented several programs in which tests like the MMPI were used in personnel selection for positions such as pilots and special services personnel (Altus, 1945; Blair, 1950; Fulkerson, Freud, & Raynor, 1958; Jennings, 1949; Melton, 1955).
Other wartime assessment efforts in the selection of special forces included those of the Office of Strategic Services or OSS, a predecessor to the present Central Intelligence Agency, which performed extensive psychological evaluations on persons who were to be assigned to secret overseas missions during the war. Henry Murray created and supervised the selection process in which over 5,000 candidates were evaluated. The psychologists involved in the program used over a hundred different psychological tests and specially designed procedures to perform the evaluations. The extensive assessment project was described, after their work was declassified when the war ended, in the OSS staff history description provided in the Office of Strategic Services Assessment Staff (1948). See also the article by Handler 2001.
Expansion of Personality Inventory Development in the Later Part of the Twentieth Century
After World War II, developments in personality assessment continued at a high rate. Most notably, shortly after the war, Cattell began working on the factor analysis of personality and published the Sixteen Personality Factors (16-PF) based upon a number of factor analyses he conducted on a large item pool of adjectives he used to construct trait names. Cattell's 16-PF included a set of 15 personality trait scales and one scale to assess intelligence which were designed to assess the full range of normal personality functioning (Cattell & Stice, 1957). This personality inventory has gained wide acceptance and use in both personnel and research applications.
In 1948, Harrison Gough, who had studied with Hathaway at Minnesota, began work on a set of personality trait scales that would assess personality characteristics in nonclinical populations. The California Psychological Inventory or CPI, published in 1956 (Gough, 1956), contained 489 items (over 200 items of which were from the original MMPI). He included an additional group of items to address personality traits that were not addressed by MMPI items. The personality scales for the CPI were grouped into four categories: (1) Poise, (2) Socialization, (3) Achievement Potential, and (4) Intelligence and Interest Modes. The CPI scales were designed to assess a broad range of personality attributes found in “normal” populations and became a standard measure for assessing personality in personnel selection and in conducting psychological research (see discussion by Megargee in Chapter 17).
In 1977, Theodore Millon developed the Millon Clinical Multiaxial Inventory (MCMI) (see Millon, 1977) to assess personality problems among clients in psychotherapy. Millon based his test development strategy upon his theory of psychopathology (a strategy that is very different from the strict empirical method followed by Hathaway and McKinley with the MMPI). Item development followed a rational strategy and his comparison samples were patients in psychotherapy rather than a “normal” population. The MCMI largely addresses Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis II dimensions of personality rather than symptom disorders on AXIS I of DSM that are addressed by the MMPI.
The NEO Personality Inventory (NEO PI) was developed by Paul Costa and Robert McCrae to assess personality dimension that had been described as the “Big Five” or Five Factor Model of personality. The NEO was published in 1985 as a measure of the major personality dimensions in normal personality to assess: openness, agreeableness, neuroticism, extraversion, and conscientiousness (Costa & McCrae, 1985).
The Personality Assessment Inventory (PAI) was developed by Leslie Morey in 1991. This instrument, similar to the MMPI, was designed to address the major clinical syndromes, such as depression (Morey, 1991). The PAI contains item content and scales that are similar to the MMPI and devised to be used in the clinical assessment in a range of settings analogous to the applications of the MMPI.
Computer-Based Personality Assessment
No treatment of the history of personality assessment would be complete without mention of the (p. 11) beginnings of computer-based personality assessment (see discussion in Chapter 10). The automated interpretation of personality measures has revolutionized psychological testing. The first psychological test to be used in a computerized assessment program was the MMPI in 1962. A group of mental health professionals (Rome et al., 1962) at the Mayo Clinic in Rochester, Minnesota, developed the first computer interpretation program to provide personality and symptom information on all patients being evaluated at Mayo. Most personality tests today, even projective tests like the Rorschach, are interpreted by a computer. The contemporary computer interpretation option provides fast, reliable, and effective psychological results for clinical settings and for research (see discussion by Butcher, Perry, and Dean in Chapter 10).
Contemporary Approaches and Directions in Personality Assessment
The science and practice of personality assessment have expanded substantially over the past two decades both in terms of developing effective measures and in the extent of annual research on testing (Butcher, 2006; Weiner & Greene, 2008). The sheer number of research articles and journals (and that number increases by about 300 per year) devoted to personality assessment methods makes the task of keeping updated difficult in more than a few techniques. In fact, many researchers and practitioners tend to narrow their focus and rely exclusively on relatively few techniques in their assessment. Many reasons can be found for the increased rate of research publication and clinical application of personality assessment methods. First, personality assessment devices are often used as criterion measures for psychological research into abnormal behavior and psychological processes. Second, clinical assessment, the activity that accounts for the greatest use of personality tests today, appears to be becoming a more respected and engaging task for clinical practitioners today with diverse applications such as medical screening for bariatric surgery as well as traditional mental health assessment. A third reason for the increased interest in personality assessment can be seen in the broadened acceptance of psychological assessment in forensic settings. Psychological tests are more frequently requested and admitted as evidence in court today than were even a decade ago (Pope, Butcher, & Seelen, 2006). A fourth reason is that psychological assessment in industrial applications, both for conducting fitness-for-duty evaluations and for personnel screening, has expanded greatly in recent years (Butcher, Ones, & Cullen, 2006).
The rapid growth in the field of personality assessment and broad range of techniques available guided us in developing the Oxford Handbook of Personality and Clinical Assessment. New areas of research have emerged in recent years requiring consideration. In developing this volume, we wanted to bring together in a single volume of personality and clinical assessment the important and diverse perspectives on personality assessment to illustrate the broad range of views and methods of study that are prominent in the field today. The task of developing this comprehensive handbook in personality and clinical assessment was made somewhat easier by beginning with a substantial core of topic areas and contributors from an earlier work. We began this volume with a number of contributors/chapters that have been at the core of the Oxford University Press's Handbook of Clinical Assessment published in 1995 and revised in 2002. Several of these chapters have been expanded and updated and serve as a valuable core to the present handbook. In addition, a number of additional topic areas were included in order to make this volume more comprehensive and focused on the contemporary assessment scene. In choosing additional contributors for this expanded handbook, we considered it important to provide comprehensive chapters dealing with crucial issues in the field and to focus on general theoretical perspectives as well as specific assessment techniques. We wanted to illustrate a number of varied and more recent personality assessment approaches. And finally, as is evident throughout this volume, we considered it important to try to maintain a pragmatic focus to the field of personality assessment with practical case examples and to pay attention to issues of diversity with chapters that address diverse populations. Contributors of chapters with an applied focus have been encouraged to present their ideas within a practical framework and provide case examples to illustrate the assessment process.
Human personality is infinitely varied and highly complex. The need to gain a thorough understanding of personality has prompted psychologists to approach the task of assessment through highly diverging avenues. Personality theorists have viewed personality from very different angles and have assayed different “chunks” of what we know as personality in their efforts to understand these complex human characteristics. Differing theories of personality and varying conceptions of how (p. 12) personality is structured have led to rather different assumptions about what data are important in understanding personality. For example, psychodynamic theorists have viewed personality as a complex and intricate system of drives and forces that cannot be understood without extensive personal historical information. The means of understanding the connections between personal history and personality can come from many sources, such as through the individual's response to intentionally ambiguous stimulus material such as the Rorschach inkblots or their response to a highly structured sentence acknowledging a clinical symptom. Other perspectives in personality have been oriented more toward “surface” behaviors. For example, a learning- or behavioral-based viewpoint may not involve such historic assumptions as the psychodynamic view but may rely more on overt, observable behaviors. Most researchers and practitioners are familiar with the “standard” sources of personality information that have been developed to appraise personality today—personality inventories, projective methods, and the clinical interview.
Goals of the Handbook
Our goal in this volume is to provide a broad-based and comprehensive view of the field of personality assessment from its historical roots to the major sources of theoretical stimuli, and the methodological issues defining the field that have led to numerous approaches and applications. This volume will serve as an introductory textbook in psychological assessment for graduate students in clinical and counseling psychology as well as a comprehensive “refresher course” for active professionals in the field. At the offset, we provide an introduction to the major sources of personality-based thought—both genetic and cultural sources of information. We next turn to presenting a framework for personality assessment and examine the methodological and conceptual factors and the psychometric considerations defining the field. We have included a number of chapters that address broad methodological issues and strategies for developing personality assessment appproaches. We also include several chapters that examine the meanings of personality assessment results. In addition, we include a number of topics that deal with issues that can impact findings or require particular attention in understanding to find meaningful results. We have tried to incorporate a broad range of personality assessment procedures and instruments to give the reader a picture of the depth of personality assessment field today. We also address factors related to a number of specific populations that require special attention in conducting personality assessments. We examine traditional clinical personality assessment approaches and include new and expanding avenues of assessment such as behavior genetics, and functional magnetic resonance imagery (fMRI). Finally, we examine several problem areas in clinical personality assessment that require special attention because they present problems or issues that are somewhat different from mental health settings where much of the interpretive lore for clinical personality tests has evolved.
Psychological assessments are undertaken in many different settings and for many different purposes. The same psychological tests might be employed to evaluate clients in forensic settings, for example, to assist the court in determining custody of minor children in family disputes as in mental health settings to determine the nature and extent of psychological problems in pretreatment planning.
In this book, contributions were invited to provide the reader with illustrations of a number of different applications. Authors and topics were selected both to cover as many problem areas as practical. Space limitations, of course, prevent a full exploration of all the areas that might touch on assessment. It is hoped that the topics chosen will illustrate both the diversity and the effectiveness of the assessment techniques involved. In all cases, chapters were invited that would address problem-oriented assessment, and they were written by noted psychologists with substantial expertise in the assessment area in question.
Genetic and Cultural Perspectives
We begin this volume by providing two chapters that orient the readers to major sources of variance in the development of personality and important considerations for developing personality measures to assure relevance for practical assessment. A great deal of personality-based genetic research has unveiled the liklihood that many personality traits—those enduring personality characteristics—are likely to be in part inherited qualities. In Chapter 2, Susan South, Robert Krueger, and Kristian Markon focus on the genetic factors pertinent to understanding and assessing personality in the light of extensive behavior genetics research today. South, Krueger, and Markon provide a background in behavioral genetics and detail the important influences on personality assessment emanating from this rapidly growing research domain. Their chapter “Behavior genetic perspectives on clinical personality assessment” discusses how twin studies work to (p. 13) provide information on the genetics of personality and summarize the contributions to date for understanding personality. They describe current models for analyzing twin data and give a perspective on fruitful current directions in twin research and the implications of behavior genetics for assessment and classification theory.
However, genetic inheritance is not the whole story in personality development. The culture and family in which a person develops plays a crucial role in personality formulation, The perspective provided by Fanny Cheung addresses this second important source of variance in understanding personality and developing effective personality measures that is referred to as the cultural perspective in personality assessment. In Chapter 3, Professor Cheung points out that everyone grows up in a unique family and social environment that influences the ways they behave and view the world. She provides a rationale for understanding the well-established social and cultural forces that can form personality functioning along highly different lines. She describes the cultural factors that can impact the process of psychological assessment that need to be taken into consideration in developing or adapting psychological assessment procedures across different social or cultural boundaries. She describes the steps necessary in adapting a personality measure that crosses cultural borders. Describing, for example, adapting personality scales such as the MMPI-2 in China, she provides a perspective on the development of a personality measure specifically for Chinese populations in an effort to reduce the impact of cultural variables in personality.
Methodological and Conceptual Factors and Psychometric Considerations
Personality test results do not always mean what we think they mean at first glance. Under some conditions, test scores may not impart the information that we expect. For example, a given score on a particular scale might not reflect the same level of the measured characteristic in two different samples because the base rates for the characteristic in the two groups are different. Or, the scale might not assess the attributes in question because the test is vulnerable to measurement distortion because individuals in the particular setting may tend to dissimulate: claim extreme problems when they do not have them or deny problems when they do. Several contributors were invited to address the important question of what test scores mean or what test interpretation reflects. We initially focus attention on discussion of a number of methodological issues and perspectives in the development of personality assessment measures. Professors Fritz Drasgow, Oleksandr Chernyshenko, and Stephen Stark have made substantial contributions to our understanding of modern test theory and applications. In Chapter 4, they provide a solid perspective on test theory and contemporary personality testing. They address a number of important related topics including a discussion of classical test theory and its pertinence for contemporary personality assessment and describe how personality constructs can be translated into measurable personality scales as well as the strategies for developing personality assessment measures (criterion-related or empirical validation, mean difference approach, factor analysis, and item response theory). They also illustrate how these methods perform in scale development. Their chapter provides an insightful perspective on test construction and test evaluation strategies in psychological assessment today. In the subsequent chapter, Chapter 5, Gregory Smith and Tamika Zapolski provide a viewpoint on the importance of demonstrating construct validity for measures of personality. In the past, Dr. Smith has contributed substantially to a contemporary understanding of this important area of thought and has generated a revival of thinking about the importance of construct validity in personality assessment. In this chapter, he and Zapolski provide an extensive description and analysis of construct validity by examining the historical basis and theoretical facets of the concept and the relationships between construct validity and other identified approaches (e.g., content validity). They detail how the construct validity model operates and provides clear illustrations of how this important validational effort can be approached and describes how researchers can incorporate material on the various means of assuring construct validity.
Having agreed upon standards by which personality test procedures can be developed and evaluated is important to a scientific field in order to assure high quality of measurement. The chapter by Kurt Geisinger and Janet Carlson (Chapter 6) addresses the importance of standards and norms in interpreting psychological test scores. This chapter describes the importance of maintaining instrument integrity in a sound research context and describes issues that can occur when traditional and well-established standards are set aside or ignored in favor of other goals. Geisinger and Carlson provide an important perspective on standards and standardization in personality measurement development. (p. 14) They discuss test standardization issues and focus upon the importance of test administration factors in assessment. The authors also highlight the importance of considering differences that can emerge and accomodations that might be required in the testing of minority clients and those with disabilities. Over time, psychological assessment procedures that have been established as standards in the field for measuring aspects of personality begin to show their age or become targeted for some reason for change. After a personality inventory has become a widely used one over a number of years, its limitations may begin to be recognized and efforts to modify or surpass the existing scales with new or modified measures emerge. Are there important factors that need to be considered if standard measurement instruments or tests become altered? In Chapter 7, entitled “Changing or replacing an established standard: Issues, goals, and problem,” Michelle Ranson, David Nichols, Steven Rouse, and Jennifer Harrington address these factors and discuss the issues involved in developing test revisions or modifications of instruments that have become widely used standards. They consider several factors: ethical standards, when should a measure be revised, goals for the revised measure, pragmatic concerns for widely used procedures, challenges for self-report inventories, challenges for free-response measures. They also provide a case study, viz. the MMPI by describing the MMPI-2 restandardization project and some recent changes being developed for the instrument to highlight the importance of assuring continuity to the applied psychological assessment base.
An important issue in personality assessment and prediction of behavior involves the accuracy of the assessment procedure. It is important for practitioners to consider the relative frequency of phenomena (base rates) in particular settings in order to interpret psychological test scores appropriately. One factor that influences the power of an instrument to predict behavior is the base rate of the occurrence of the phenomenon in the population. Stephen Finn, in Chapter 8, “Incorporating base rate information in daily clinical decision making,” addresses this important issue. Base rates are defined for specified populations and are restricted to them. Thus, a base rate is the a priori chance or prior odds that a member of a specified population will have a certain characteristic, if we know nothing else about this person other than that he or she is a member of the population we are examining. Base rates have important implications for a wide variety of issues in clinical practice. Although rarely acknowledged, base rates affect the prediction of behaviors (e.g., suicide), the interpretation of test data (e.g., MMPI-2 scores), and the making of diagnostic decisions.
Predicting phenomena with low base rates is difficult. In general, it is easier to increase predictive accuracy when the events to be predicted are moderately likely to occur (i.e., occur with a probability close to 50%) than when the events are unlikely to occur. Much improvement in clinical decision making can be accomplished if each of us remembered to think about base rates every time we made a clinical hypothesis. The chapter by Finn provides clear strategies for incorporating base rate information in the prediction process.
Personality assessment has been substantially advanced by theoretical conceptualization of the variables that comprise personality. The view that personality is comprised of definable factors such as personality traits (see the classical work of Allport) has made developing personality-based measures an easier task. Allan Harkness in Chapter 9, “Theory and measurement of personality traits,” provides a contemporary perspective on the importance of traits in personality assessment. Harkness discusses individual differences in traits and describes the “traits versus states” debate in the search for explanatory concepts in personality assessment. He examines factors that create, develop, and maintain traits and he explores the causal source of personality variance. As an illustration, he describes the development of the MMPI-2 PSY-5 Scales and illustrates their use for assessing personality dimensions.
Computer-based test interpretation of psychological tests has a long history dating back to 1962 when psychologists at the Mayo Clinical developed the first MMPI interpretation program. In contemporary assessment psychology today, many instruments provide computer-derived reports. The extent of this medium of interpretation will be explored in Chapter 10, “Computer-based interpretation of personality scales,” by James Butcher, Julia Perry, and Brooke Dean. The authors describe the issues involved in providing computer-based personality tests and discuss the professional guidelines for offering computer testing services presented. Research on the adequacy of widely used computer testing resources will be summarized.
Personality Assessment Procedures and Instruments
We next turn to an exploration of a number of personality assessment procedures and instruments that are widely used in contemporary (p. 15) personality assessment. We begin with a discussion of behavioral observation by Martin Leichtman in Chapter 11 who introduces the reader to topics such as the rationale and nature of the behavioral observation process and important facets for developing the standardized interview. He provides an insightful perspective on understanding behavioral observations and the personality inference process and means of incorporating descriptions from different sources of data. Throughout the process he underscores the value of subjectivity in the integration of “behavioral observations” in psychological reports and to maintaining the consumer rights and the importance of developing “humane” psychological reports. The clinical interview is the oldest and most widely used assessment procedure for obtaining assessment information in use today. The contribution by Robert Craig, in Chapter 12, provides an important overview of the use of this assessment strategy describing both the values and limitations of this approach. The widespread use and demonstrated effectiveness of behavioral therapy in contemporary clinical psychology is prefaced upon having a clear assessment of the problems in question. Sound behavioral assessment is a key ingredient to therapeutic success. Stephen Haynes, Dawn Yoshioka, Karen Kloezeman, and Iruma Bello in Chapter 13 provide an excellent introduction and exploration of behavioral assessment strategies in clinical assessment.
One of the oldest and still most widely used personality assessment instrument around the world today is the MMPI (MMPI-2 and MMPI-A). Chapter 14, by Andrew Cox, Nathan Weed, and James Butcher, addresses the history, interpretation, and clinical issues to provide an introductory overview of the use of the MMPI-2 in clinical assessment. The chapter includes exhibits illustrating historical developments and summarizing MMPI-2 measures and contain, up-to-date references and resources for readers interested in a more thorough treatment. The traditional MMPI-2 clinical, content, and supplemental scales are described and strategies for interpretation are provided. Some newer measures, such as the PSY-5 and Restructured Clinical scales, are also described. Clinical issues in the use of the MMPI-2 such as using the MMPI-2 with minority populations and international settings are described. In addition, some procedures that have produced less effective results, such as MMPI short forms, are noted.
No handbook on personality assessment would be complete without a section describing the utility of the Rorschach Inkblot Test. Weiner and Meyer provide a contemporary perspective on a major approach in clinical assessment that has a tradition dating to the early twentieth century (see Weiner & Greene, 2008)—the projective method. This chapter (Chapter 15), “Personality assessment with the Rorschach,” is contributed by two of the most prominent Rorschach experts in the psychological assessment field—Irving Weiner and Gregory Meyer. This approach holds the view that clients disclose intimate and powerful descriptions of themselves through their interpretations of ambiguous stimuli, inkblots. The use of the Rorschach in personality assessment has had a strong following in both research and clinical application; the Rorschach method is one of the most widely researched and applied assessment strategies (Butcher & Rouse, 1996) and has been one of the most intriguing and widely researched personality assessment procedures in the field since the early twentieth century. The authors deal with important topics: “Is Rorschach assessment psychometrically sound?,” “Does Rorschach assessment serve useful purposes?,” “Is Rorschach assessment being widely taught, studied, and practiced?,” “Can Rorschach assessment be applied cross-culturally?”
Two instruments that were designed to address personality characteristics in a broad range of normal populations are the NEO PI and the CPI. The view that personality can be summarized as five major dimensions or traits has been widely explored in contemporary personality assessment. Paul Costa and Robert McCrae, in Chapter 16, provide an introduction, theoretical basis, and interpretive strategies for the most widely used five-factor model instrument—the NEO PI. One of the most widely used measures in personality assessment is the CPI published by Harrison Gough (1956). This instrument is described in Chapter 17 by Edwin Megargee who had studied with Gough and later wrote a widely used textbook on the test. Megargee shares his updated perspective on the CPI in contemporary psychology and provides some key interpretive strategies for the measure.
One of the most difficult and evolving areas in the personality assessment field involves assessing personality disorders. Thomas Widiger and Sara Boyd, in Chapter 18, bring this important research and clinical area into clear focus by both presenting a theoretical perspective on the diagnosis of personality disorder and surveying the assessment instruments that make this task easier. They describe semistructured interviews based upon DSM-IV Personality Disorder Interviews as well as surveying (p. 16) a number of self-report inventories such as the PAI, MCMI-III, MMPI-2, and Hare Checklist. They provide a solid perspective on the issues to that need to be considered in the assessment of personality disorders including gender, culture, and ethnicity.
New psychophysiologic approaches to personality have emerged in recent years to assess personality factors or problems. Research on magnetic brain imaging has been increasing at a very rapid pace over the past 10 years. There have been numerous studies published on using fMRI to explore and identify brain processes underlying mental disorders, such as schizophrenia, and to improve the evaluation of these conditions. We have included in this handbook a chapter that addresses the emerging fMRI assessment field, entitled “Functional imaging in clinical assessment? The rise of neurodiagnostic imaging with the fMRI” (Chapter 19), by Professors Angus MacDonald, III, and Jessica Hurdelbrink. The chapter includes a description of the use of fMRI in assessing psychiatric disorders and provides an up-to-date survey of the important findings in the area. A great deal of research effort is being devoted to the psychobiology of abnormal behavior today. MacDonald and Hurdelbrink address a new, but rapidly expanding, area of assessment research and its potential in providing unique information in understanding clinical problems.
By its very nature the field of personality assessment is concerned with individual differences and is enveloped in human diversity. To understand the behavior and personality of individuals, it is imperative that many “status” variables be given careful consideration. Background factors such as age, gender, and ethnicity are important, since personality is in many respects influenced by the environment or groups to which a person belongs. People may share certain characteristics of groups with which they are affiliated. In the assessment of individuals it is important to consider influences that may come from belonging to a group that has been treated differently by our social institutions than others have. Being a member of an ethnic minority group in the United States places a person at considerable risk for discrimination and diminished opportunity. Those who are cast in less dominant societal roles by fact of birth may be at risk for developing problems or adjustment difficulties that are not shared by the majority classes. To fully explore the potential problems associated with being a minority group member in contemporary society, several contributors were asked to provide different perspectives on issues involved in the psychological assessment of minority clients. We begin our discussion in Chapter 20 with an article entitled “Clinical personality assessment with Asian Americans.” Sumie Okazaki, Mimi Okazaki, and Stanley Sue contribute an informative discussion of possible factors involved in the assessment of ethnic Asian minorities that need to be considered in cross-ethnic psychological evaluations. Their work with Asian-American clients has made a substantial contribution to clinical as well as to cross-cultural psychology. In this article they provide information on the demographics of the population and a description of the recent literature on research with Asian-American populations. They describe the problem of the imposed-etic perspective in studies involving Asian-American populations. They also describe studies with overseas Asian populations and provide a critique of imposed-etic studies and provide a discussion of the alternate approach—the indigenous or emic perspective. They conclude with a framework and guidelines for conducting assessments with Asian-Americans. Professor Bernadette Gray-Little, in her chapter entitled “The assessment of psychopathology in racial and ethnic minorities” (Chapter 21), addresses factors to consider in conducting psychological evaluations on African-American clients. She describes the factors that are important in the clinical interview pertinent to understanding bias and social distance that can impact an evaluation. She examines racial and ethnic variations that can occur in symptoms of distress and addresses potential factors to consider in employing psychological tests such as the MMPI-2, the MCMI, the Rorschach Inkblot Test, the TAT, and other projective instruments.
This handbook also addresses several populations requiring the assessment psychologist to consider population-specific factors in dealing effectively with potential differences in personality assessment. Women may experience situations or activities differently because of the roles in which they may have been cast and in their lack of access to equal opportunities in society. In Chapter 22, “Issues in clinical assessment with women,” Judith Worell and Damon Robinson provide valuable insights into understanding specific factors in assessment of women. They include factors related to the purposes of the assessment that is being undertaken and deals with issues related to possible gender bias in the measurement, for example, factors such as sex of (p. 17) clinician, psychiatric diagnosis with women, specific diagnosis and criteria, and clinical decisions. They provide a framework on contextual assessment for women and importance of screening for sexual and physical abuse. They also describe some barriers to screening as well as the need for assessing strength and well-being.
There are other important individual difference variables that require careful consideration in personality evaluation. The chapter entitled “Use of the MMPI-2 in Neuropsychological Evaluations” (Chapter 23) by Dr Carlton Gass provides information that will assist psychologists and neuropsychologists in their work with individuals who have known, suspected, or questionable brain damage. Gass describes the distinctive aspects of the MMPI-2 in neuropsychological settings and how this instrument can contribute to significant understanding of behavior and symptoms presented by neuropsychological patients. He describes special interpretive issues in neuropsychological settings including issues in diagnosing brain dysfunction, localizing brain lesions, and diagnosing neuropsychological deficits while controlling for neurological symptom reporting. He provides insights into procedures for incorporating MMPI-2 results in neuropsychological reports and factors to attend to in addressing the referral question.
Factors occurring in another subgroup of the population—couples undergoing emotional distress—require special considerations. In Chapter 24, Professors Douglas Snyder, Richard Heyman, and Stephen N. Haynes bring the pertinent issues related to marital problems into focus in their chapter entitled “Assessing couples.” They begin with a discussion of important issues involved in conceptualizing couple relationship distress and explore the paramaters of couple distress. Next they focus upon the prevalence and comorbid conditions in couple distress and examine the etiological considerations and describe the implications for assessment. The authors devote a substantial portion of their discussion to assessment for issues involved in case conceptualization and treatment planning from a behavioral perspective. They also include appropriate considerations of cultural differences in couple distress. Finally they discuss effective assessment strategies and specific techniques for evaluating couple distress and the importance of monitoring progress in therapy and evaluating treatment outcome. In Chapter 25, Edward Cumella and Jennifer Lafferty provide an overview of adolescent assessment based upon the most widely used adolescent test, the MMPI-A. This chapter, “Assessing adolescents with the MMPI-A” provides an overview of special issues in the clinical assessment of adolescents and a historical introduction of the use of the MMPI in assessment of adolescents, and discusses the revision of the original instrument and publication of the MMPI for adolescents, the MMPI-A. The chapter focuses upon the use of the MMPI-A for assessing adolescents. A case example of an adolescent client will be provided and the MMPI-A performance highlighted. The use of the MMPI-A in providing test feedback to adolescents is described.
Specific Settings and Problems
In this section, we examine psychological assessment in a number of problem areas and explore their operation in different settings. In Chapter 26, Ronald Stolberg and Bruce Bongar discuss the problems and issues involved in assessment of suicide risk—an important and sometimes urgent task for a practitioner to address. They describe the recent empirical evidence on risk assessment practices and explore how risk factors are assessed through a number of psychological tests such as the Rorschach Inkblot Technique, the MMPI-2, the 16-PF, the MCMI, the MCMI-II, the TAT, the Bender Gestalt, the Beck Depression Inventory (BDI), and the Beck Hopelessness Scale (BHS). They discuss issues involved in the assessment of suicidal ideation, intent, and behavior and describe in depth assessing suicide through structured interviews and a psychological battery and discuss the limitations of theoretical orientation and DSM-IV and diagnostic formulation.
One of the most frequent psychological adjustment problems in society today involves the use and misuse of alcohol and drugs. In many instances, persons who are being seen in mental health or medical settings for problems other than substance abuse also have a hidden problem with addictive substances. Consequently, psychologists frequently find themselves involved in the determination of potential substance abuse in addition to whatever other problems clients are reporting. Because of the importance of substance abuse assessment problems in many settings, Joseph Banken and Roger Greene (Chapter 27) in “Use of self-report measures in assessing alcohol and drug abuse” address objective assessment strategies for detecting and appraising alcohol and drug problems. Banken and Greene describe the overall considerations important to conducting an effective substance abuse evaluation and (p. 18) the process of screening for substance abuse. They discuss several traditional personality scales that have been widely used to identify alcohol or drug problems such as the MacAndrew Alcoholism Scale (MAC-R) and the Addiction Admission and Addiction Potential Scales (MMPI-2), scales b and t on the MCMI/ MCMI-II. In addition, they describe additional screening scales such as the Alcohol Use Inventory (AUI). The authors also provide a discussion on the timing of psychological assessment and the role of objective psychological tests traditionally used in alcohol or drug treatment programs.
Edwin I. Megargee, in Chapter 28, entitled “Understanding and assessing aggression and violence,” discusses the issues pertinent to defining and understanding these problems in society. Dr. Megargee discusses the factors leading to aggressive behavior and violence and provides an overview of contemporary methods being used to assess and predict aggressive behavior and violence. He describes the types of assessments and deals with referral questions and assessment contexts such as not guilty by reason of insanity defense, treatment planning, and needs assessments. He details useful information on assessment tools and techniques that are effective for retrospective and prospective predictions. In his chapter, he provides an overview of violent crimes—assault and murder, domestic violence, forcible rape and sexual battery, kidnapping and hostage taking, arson, bombing, and terrorism—and describes the types of violent offenders delineated in the literature. He also highlights a conceptual framework for the analysis of aggression and violence including his “algebra of aggression” for predicting violence. He describes some personal factors that decrease the likelihood of aggression and discusses situational factors influencing the likelihood of aggression. In a related chapter (Chapter 29), “Assessing antisocial and psychopathic personalities,” Carl Gacono and Reid Meloy provide a comprehensive treatment on the assessment of antisocial personality disorder. They begin with a discussion of forensic assessment and issues, and then provide a thorough overview of our knowledge of the personality disorder and a discussion of the relevant research findings on the use of the Psychopathy Checklist-Revised, the Rorschach, and the MMPI-2. They also include an overview of various measures of cognition and intelligence and their relevance to understanding antisocial personality.
The next chapter in the handbook provides an example of personality assessment in a nonclinical context, personnel selection. Chapter 30, “Clinical personality assessment in the employment context,” by Butcher, Gucker, and Hellervik provides an overview of the use of personality measurement techniques in employment applications. Major goals of the chapter include the following areas of emphasis. First a rationale for the inclusion of clinical personality assessment measures in personnel decisions such as employment screening, fitness for duty evaluations, and reliability screenings for making recommendations for promotion to responsible positions or for the issuance of security clearances for sensitive applications will be provided. The history of personnel assessment is highlighted. A number of contemporary issues pertaining to clinical personnel screening will be presented. Next, a historical summary of the use of the most widely used personality measure, the MMPI-2, will be presented along with a strategy for the interpreting instruments used in employment settings. The chapter will include several practical examples of clinically based assessments in employment settings. The target audience for the article is professionals who are using personality assessment measures in these industrial-organizational (I-O) settings or are considering a career as an assessment practitioner in business/industrial settings. The strategy of interpreting psychological measures in personnel selection is illustrated with a case example. The article includes descriptive information on the most widely used measure (the MMPI-2) and contains up-to-date references and resources that interested readers wishing more thorough information can follow up on.
We next turn to a guide for the care and effective documentation of psychological test results. Regardless of one&s basic approach to personality assessment, careful accumulation and analysis of information are important considerations in any psychological assessment. In this regard, the discussion by Irving Weiner (Chapter 31) provides the practitioner with important background information and a clear rationale for employing meticulous safeguards in conducting personality evaluations in order to avoid potential legal or ethical problems. Weiner, who has made substantial contributions to the field of personality assessment, provides a valuable overview of the issues and guidelines for practitioners in his chapter entitled “Anticipating ethical and legal challenges in personality assessment.” In this chapter, he discusses topics such as accepting a referral, selecting the test battery for conducting the psychological evaluation, how to prepare and present a report, and factors important to managing case records in an assessment practice.
No treatment of clinical assessment would be complete without a chapter on the validity of (p. 19) psychological tests. This volume includes an important discussion about malingering on psychological tests by David Berry and his colleagues that highlights the importance of incorporating validity scales in any personality assessment evaluation in order to assure the credibility of the assessment. In Chapter 32, entitled “Assessment of feigned psychological symptoms,” Berry and his colleagues provide an up-to-date summary and overview of research related to the credibility of the client's responses in a personality assessment. They discuss important topics such as the criteria for malingering, methodological issues in the research on malingering, the problem of base rates, and issues related to coaching to appear in particular ways on psychological tests. The authors provide a substantial research literature supporting their suggested strategy for clinical practice and assessment of malingering. They describe malingering indices on multiscale inventories and provide examples of malingering assessment using instruments such as the MMPI-2, the MCMI-III, the NEO PI-R, and the PAI as well as specific malingering measures such as the Structured Inventory of Malingered Symptomatology (SIMS), the Structured Inventory of Reported Symptoms (SIRS), and the M Test.
One of the most essential clinical tasks that practitioners are asked to perform in many clinical settings is that of conducting pretreatment planning evaluations—an activity that is often given less attention than it deserves in contemporary clinical practice. In their chapter (Chapter 33), entitled “Assessment of clients in pretreatment planning,” Mark Harwood and Larry Beutler explore a number of key issues concerning this major goal of psychological assessment and provide important new insights into personality assessment in pretreatment planning. Harwood and Beutler describe a problem-solving approach in pretreatment planning that is both practical and effective. In their chapter, they focus upon important considerations in treatment planning such as subjective distress and arousal. They describe the patient's predisposition, diagnostic problems, and state variables that are important to their symptomatic picture. They also highlight the need to understand the patient expectations about treatment and the impact of the particular treatment variables inherent in the setting. An important consideration for treatment success includes factors such as important relationship variables and their impact on treatment strategies. Following this, in Chapter 34, entitled “Assessment of treatment resistance via questionnaire,” Julia Perry provides further thought about assessing personality factors in treatment planning. She focuses attention upon the concept of “resistance” and examines how resistance to undertaking psychological treatment can be assessed by objective personality measures. She describes the utility of the MMPI-2 and the Butcher Treatment Planning Inventory (BTPI).
Raymond Ownby in Chapter 35, devoted to writing clinical reports, involves the importance of viewing, summarizing, and communicating the conclusions about a patient's problem areas and personality functioning. The chapter addresses the important area of client description and developing case material in clinical reports. Issues pertinent to the practitioner's responsibility in presenting patient material are addressed and safeguards for protecting clients are described. The chapter addresses the important features of a client's interview, behavior, history, and psychological test data to be included in a forensic assessment report. He describes and provides an outline for the most pertinent case features to be included in a report and provides a case example and keys to important resources and guidelines for practitioners to follow in developing forensic reports. The related Chapter 36, “How to use computer-based reports” by James Butcher, discusses how the task of report writing and communicating personality test information can be enhanced by use of computer technology. Many practitioners use one or more computer-derived personality test interpretation programs in developing their personality assessment study of clients (see Atlis, Hahn, and Butcher (2006) for an extensive introduction to computer-based assessments). In this chapter, the clinical use of computerized exports is illustrated and cautions concerning their use provided. The value of using computer-based psychological test interpretations in developing clinical conclusions is addressed. The types of computer scorings and interpretation services are described. Several new approaches to computer-based testing are described, including computer adaptive results and Internet-based test applications. The clinical use of a computerized MMPI-2 report is illustrated and the task of providing test feedback to clients is described.
When an editor invites authors to contribute chapters to a compendium such as this, it is somewhat analogous to working a complex puzzle. Each of the component parts must mesh together to form an integrated picture. At the beginning of this project the contributions appearing here were sought to (p. 20) fill an important niche in the overall plan. The vastness of the field of personality assessment today does not permit all noted authorities and all perspectives to be equally represented. Some selectivity was required given the limitations of space. The reader will, of course, be the final judge as to how the many parts blend into an integral picture. As for me, I believe that the final pieces matched the initial plan quite well. A primary goal of this volume was to provide a practical and comprehensive overview of the field of personality assessment. I believe that the contributions included here provide the reader with a substantial compendium of assessment resources with diverse and interesting elements. I hope that clinicians and clinicians-in-training who are new to the field of personality assessment will be tantalized by the views and strategies presented here and will travel these paths further when this book is set aside.
Perpetuation of valuable scholarly resources for a scientific discipline is an important goal of this volume to help maintain valuable standards while at the same time incorporating new developments in the field. Following the general plan of the Oxford Handbook Series, this volume ends with a chapter, “Personality assessment: Overview and future directions” (Chapter 37), by the volume editor. An overview of the status of personality assessment as described in the contributions to this handbook will be provided and the significant contributions to future development will be summarized. Some lingering challenges to the field of personality assessment will be highlighted. Discussion is provided to highlight significant assessment trends and projections about new directions for research.
Index of Assessment Procedures
A great variety of personality assessment instruments and procedures are discussed in this volume. Because it is unlikely that readers are familiar with all of them, contributors were asked to provide a brief description of the tests they discuss in their chapter. These assessment procedures have been summarized and are described in an appendix.
Allport, G. W. (1937). Personality: A psychological interpretation. New York: Holt, Rinehart & Winston.Find this resource:
Allport, F. H., & Allport, G. W. (1921). Personality traits: Their classification and measurement. The Journal of Abnormal Psychology and Social Psychology, 16, 6–40.Find this resource:
Altus, W. D. (1945). The adjustment of army illiterates. Psychological Bulletin, 42, 461–476.Find this resource:
Atlis, M. M., Hahn, J., & Butcher, J. N. (2006). Computer-based assessment with the MMPI-2. In J. N. Butcher (Ed.), MMPI-2: The practioner's handbook (pp. 445–476). Washington, DC: American Psychological Association.Find this resource:
Beck, S. J. (1938). Personality structure in schizophrenia: A Rorschach investigation in 81 patients and 64 controls. Nervous and Mental Disorders Monograph Series, 63, ix–88.Find this resource:
Ben-Porath, Y. S., & Butcher, J. N. (1991). The historical development of personality assessment. In C. E. Walker (Ed.), Clinical psychology: Historical and research roots (pp. 121–156). New York: Plenum Publishing Corporation.Find this resource:
Bernreuter, R. G. (1931). The personality inventory. Palo Alto, CA: Consulting Psychologists Press.Find this resource:
Bernreuter, R. G. (1933). The theory and construction of the personality inventory. Journal of Social Psychology, 4, 387–405.Find this resource:
Blair, W. R. N. (1950). A comparative study of disciplinary offenders and non-offenders in the Canadian Army, 1948. Canadian Journal of Psychology, 4, 49–62.Find this resource:
Boring, E. G. (1950). A history of experimental psychology (2nd ed.). New York: Appleton-Century-Crofts.Find this resource:
Buss, D. M. (1984). Toward a psychology of person-environment (PE) correlation: The role of spouse selection. Journal of Personality and Social Psychology, 47, 361–377.Find this resource:
Butcher, J. N. (Ed.). (1972). Objective personality assessment: Changing perspectives. New York: Academic Press.Find this resource:
Butcher, J. N. (2006). Assessment in clinical psychology: A perspective on the past, present challenges, and future prospects. Clinical Psychology: Research and Practice, 13(3), 205–209.Find this resource:
Butcher, J. N., Dahlstrom, W. G., Graham, J. R., Tellegen, A. M., & Kaemmer, B. (1989). Minnesota Multiphasic Personality Inventory-2 (MMPI-2): Manual for administration and scoring. Minneapolis, MN: University of Minnesota Press.Find this resource:
Butcher, J. N., Ones, D. S., & Cullen, M. (2006). Personnel screening with the MMPI-2. In J. N. Butcher (Ed.), MMPI-2: The practioner's handbook (pp. 381–406). Washington, DC: American Psychological Association.Find this resource:
Butcher, J. N., & Rouse, S. V. (1996). Personality: Individual differences and clinical assessment. Annual Review of Psychology, 47, 87–111.Find this resource:
Butcher, J. N., Williams, C. L., Graham, J. R., Archer, R., Tellegen, A., Ben-Porath, Y. S., et al. (1992). MMPI-A manual for administration, scoring, and interpretation. Minneapolis, MN: University of Minnesota Press.Find this resource:
Butcher, J. N., Williams, C. L., Graham, J. R., Tellegen, A., Ben-Porath, Y. S., Archer, R. P., et al. (1992). Manual for administration, scoring, and interpretation of the Minnesota Multiphasic Personality Inventory for Adolescents: MMPI-A. Minneapolis, MN: University of Minnesota Press.Find this resource:
Cattell, R. B., & Stice, G. E. (1957). The sixteen personality factors questionnaire. Champaign, IL: Institute for Personality and Ability Testing.Find this resource:
Costa, P. T., Jr., & McCrae, R. E. (1985). The NEO Personality Inventory manual. Odessa, FL: Psychological Assessment Services.Find this resource:
DuBois, P. L. (1970). A history of psychological testing. Boston: Allyn & Bacon.Find this resource:
Exner, J. E., Jr. (1983). The Exner report for the Rorschach Comprehensive System. Minneapolis, MN: National Computer Systems.Find this resource:
Frank, L. K. (1939). Projective methods for the study of personality. Journal of Psychology, 8, 543–557.Find this resource:
Fulkerson, S. C., Freud, S. L., & Raynor, G. H. (1958). The use of the MMPI in the psychological evaluation of pilots. Journal of Aviation Medicine, 29, 122–129.Find this resource:
(p. 21) Galton, F. (1879). Psychometric experiments. Brain, 2, 179–185.Find this resource:
Galton, F. (1884). Measurement of character. Fortnightly Review, 42, 179–185.Find this resource:
Gough, H. G. (1956). California Psychological Inventory. Palo Alto, CA: Consulting Psychologists Press.Find this resource:
Handler, L. (2001). Assessment of men: Personality assessment goes to war by the Office of Strategic Services assessment staff. Journal of Personality Assessment, 76, 558–578.Find this resource:
Hathaway, S. R. (1965). Personality inventories. In B. B. Wolman (Ed.). Handbook of clinical psychology (pp. 451–476). New York: McGraw-Hill.Find this resource:
Hathaway, S. R., & McKinley, J. C. (1940). A multiphasic personality schedule (Minnesota): I. Construction of the schedule. Journal of Psychology, 10, 249–254.Find this resource:
Hertz, M. R. (1938). Scoring the Rorschach test with specific reference to “normal detail” category. American Journal of Orthopsychiatry, 8, 100–121.Find this resource:
Heymans, G., & Wiersma, E. (1906). Beitrage zur spezillen psychologie auf grund einer massenunterschung. Zeitschrift Fur Psychologie, 43, 81–127.Find this resource:
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