Overview and Future Directions Chapter
Abstract and Keywords
Personality assessment emerged during the early twentieth century largely through two avenues: development of personality questionnaires for assessing characteristics considered pertinent to screening draftees in the military in World War I, and early experiments with inkblot perception. It broadened into other areas of applied and research psychology including clinical, forensic, and personnel applications as psychologists' professional roles expanded during the twentieth century. An increasing variety of personality inventories and behavioral assessment strategies are now available for use in clinical assessment, including the Minnesota Multiphasic Personality Inventory (MMPI) and the Millon Clinical Multiaxial Inventory. This book has explored personality-assessment techniques and instruments and highlighted current challenges for personality assessment, while also discussing its potential to contribute further to understanding of personality and adjustment by various approaches. It has also suggested new directions for personality assessment and described the international expansion or globalization of Western-based personality-assessment methodology. Moreover, the book has noted an increasingly broadened and effective cross-cultural collaborative environment for the study of personality and psychopathology with the growing development of personality psychology worldwide.
Keywords: personality assessment, personality questionnaires, psychology, psychopathology, personality, personality inventories, behavioral assessment, clinical assessment, MMPI, Millon Clinical Multiaxial
A look backward in time at the development of personality assessment over the past 100 years gives one an interesting perspective on the diverse methodology and effective applications that occurred in the field. As described in Chapter 1, personality assessment emerged in the early twentieth century and expanded substantially until the close of century. Researchers and practitioners in applied psychology incorporated early personality assessment strategies originated by Herman Rorschach (1921) and Robert Woodworth (1920) to develop instruments to evaluate personality. The 1930s and 1940s witnessed a strong merger between applied psychology and personality assessment as new effective instruments and techniques became available. Two distinct tracks in personality assessment evolved during this period—the diverse development of personality questionnaires (Cattell & Stice, 1957; Meehl, 1945) and the use of ambiguous visual stimuli such as inkblots and pictures as a mode for eliciting “projective” responses from which personality characteristics are inferred (Exner, 1983; Lerner, 2007; Rapaport, Gill, & Schafer, 1945; Schafer, 1948).
As noted in Chapter 1, assessment psychology proceeded for years without a comprehensive underlying theoretical basis and instrument development and acceptance was sporadic at best. In the 1930s, Gordon Allport and Henry Murray provided a needed perspective and theoretical rationale for many types of personality assessments, particularly instruments that were “projective” in nature. The empirical approach by Hathaway and McKinley 1940, though without a theoretical “flag” until Meehl's thoughtful “empiricist manifesto” in 1945, (p. 708) provided a strong empirical rationale and justification for instruments like the Minnesota Multiphasic Personality Inventory (MMPI). These “trait-oriented” approaches to understanding personality characteristics provided the theoretical grounding for a functional perspective needed in personality assessment. After the 1940s, personality assessment psychology continued to be central in personnel screening but also merged extensively with clinical and counseling psychology and became oriented toward assessing personality and mental health problems. Later, forensic psychology, with assessment as a primary vehicle, came to address varied problems ranging from correctional assessment to family custody evaluations, and assessing litigants in personal injury cases.
Past Challenges to Personality Assessment
Personality assessment methodology and evolving techniques have not been without critics. Some of the problems will be noted in order to give the reader a view on past difficulties that assessment psychologists have faced during the evolution of the field. A number of psychologists raised concerns about personality assessment methods or tests (e.g., Ellis, 1946; Ellis & Conrad, 1948). Some criticism has been directed at the theoretical bases of assessment by questioning the existence of “traits” (Mischel, 1968). Some criticism of testing has come from outside of psychology, for example, criticisms that the use of personality inventories was an “invasion of privacy” (Ervin, 1965) or Annie Paul's general critique of “the cult of personality” (Paul, 2004). Other critics have more directly raised questions about specific instruments. For example, Jackson and Messick (1969) questioned aspects of self-report questionnaires in tests like the MMPI by viewing client's responses to the items as largely driven by response sets. Others have taken different strategies in their critiques, for example, Helmes and Reddon (1993) provided a number of blanket criticisms of the MMPI psychometrics including such factors as a perceived lack of a consistent measurement model, heterogeneous scale content, and suspect diagnostic criteria, item overlap among scales, lack of cross-validation of the scoring keys, inadequacy of measures of response styles, and suspect norms. Other critics viewed the original MMPI as outdated and incomplete and provided criticisms that would eventually lead to revising the instrument (Butcher, 1972). Other instruments have also been criticized; for example, there has been a substantial controversy surrounding the Rorschach Inkblot technique as well as the Exner Comprehensive System and its norms for interpreting the test (Garb, 1999; Lilienfeld, Wood, & Garb, 2000).
In spite of these criticisms, personality assessment has continued to contribute to understanding of personality characteristics and problems of clients in numerous settings. In many ways, responses to these criticisms have actually improved interpretation strategies or strengthened the use of the instruments like the Rorschach (see Chapter 15). For example, a recent issue of the Journal of Personality Assessment provided a series of articles reporting an extensive normative base for the Rorschach Comprehensive System from many countries (see Shaffer, Erdberg, & Meyer, 2007). In addition, the criticisms of the possibility of response sets affecting MMPI assessment prompted further research and development of validity scales (such as VRIN, TRIN, S scales) that provide valuable pictures of the client's approach to the assessment. In another example, Mischel's (1968) critique of personality assessment and trait conceptualizations was influential although the viewpoint received considerable opposition and continued development. Trait theorists have actively pursued the trait approach to personality and the past 20 years have witnessed an extensive development of trait-oriented research, specifically what has been described as the “Big Five” model from which a number of personality measures have evolved (see Chapters 9 and 16).
Broader developments in the field have also impacted assessment development of trait constructs in personality. During the 1970s, psychological assessment in mental health settings came to be viewed by some as less important in clinical settings because of the widespread popularity of behavioral therapy. There was a sharp reduction in the use of traditional assessment techniques in the clinical setting as shown by the dip in the total amount of research in psychological assessment across test instruments compared with the 1960s (Butcher, Atlis, & Hahn, 2003). Even some clinical and counseling training programs deemphasized personality assessment and focused upon providing behavioral treatment without training in traditional assessment methods. During this period some assessment psychologists began to move into settings other than mental health, particularly into medical, forensic, and personnel applications (Butcher, Ones, & Cullen, 2006).
The clinical practice of psychological assessment (particularly objective assessment methods) made a comeback with studies being conducted on more (p. 709) varied topics and broader clinical application in the 1980s. In the 1990s, assessment research regained some of its earlier emphasis. For example, one review during this period found that there were about 250 articles published a year on the MMPI-2 and about 50 articles a year on the Rorschach, the two most widely used assessment instruments (Butcher & Rouse, 1996).
Personality assessment practice in mental health settings encountered further difficulties during the late 1990s as the managed care system began to assert control over the types and amounts of funding available for mental health services (see Butcher, 1997; Harwood et al., 1997). Psychological assessment was, in some contexts, relegated a minor role in the provision of mental health psychological services because payment was often not provided for the evaluation. Piotrowski (1999) reviewed findings from several surveys conducted in the 1990s pointing out that managed care has constrained both practice and training in clinical psychology. Managed care adversely affected testing and assessment practices and resulted in psychologists performing less testing and restricted their pool of assessment instruments to brief, symptom-focused testing measures and away from the more difficult to interpret measures such as projective instruments. Reimbursement for psychological assessment in clinical settings has, however, been improving in recent years with mental health services being more consistently provided for psychological assessment (see American Psychological Association Practice Directorate, 2006). The extent to which this practice will result in broader assessment use in mental health settings awaits further development.
Developments in Assessment: The Current Scene
The field of personality assessment is one that is rich in variety and extensive in application. One of our primary goals in the development of this handbook on personality assessment was to provide a comprehensive and detailed examination of the rich array of personality assessment approaches that are available today and the methodological issues that can impact instrument development. As anticipated, the contributors to this volume have provided a very substantial picture of the history, current status, and illustrative applications in personality assessment. The reader can obtain a valuable perspective on contemporary issues and an appreciation of the growing methodological strategies and test applications that have evolved. Both the traditional and newer approaches to personality assessment are showcased in this book.
Broad Acceptance of Personality Assessment Strategies in Applied Psychology
The varied content of this handbook attests to the extent to which personality assessment has become an integral part of contemporary psychology. Assessment techniques are widely used in clinical activities such as assessment of potential suicide (Chapter 26), assessment of head injury patients (Chapter 23), evaluation of criminal offenders (Chapter 28; psychopathic personality in Chapter 29), assessment of marital couples in distress (Chapter 24), evaluations for therapy (Chapters 33 and 34), and personnel screening (Chapter 30), to mention only a few applications. Psychologists in many settings rely upon personality assessments to assist them in their decisions about people.
Evidence of Validity and Utility of Available Assessment Methods
Assessment-oriented psychologists can be reassured that the psychological assessment procedures available today validly address clinical problems in mental health settings as effectively as many trusted medical procedures. The validity and utility of psychological tests were highlighted in a study that underscored the value of psychological assessment in clinical settings (Meyer et al., 2001). These authors compared the accuracy of psychological tests with that of medical tests (such as X-rays or CT scans) for symptomatic evaluation. They found that psychological tests were as valid and reliable as most medical tests used in medical practice today (Meyer et al., 2001).
Classic Approaches to Assessment
Any comprehensive assessment volume, in order to be thorough and to reflect reality of our time, needs to incorporate the “old standards” as well as highlighting new methods. Several chapters in the handbook have been devoted to providing an updated overview of contemporary uses in the techniques that are widely used in assessment settings: clinical observation (see Chapter 11 on behavioral observations), behavioral assessment (as viewed in Chapter 13) and procedures for conducting interview (as described in Chapter 12) were reviewed. Two instruments that have been on the table for 70 or more years, the MMPI/MMPI-2 (Chapter 14 and the Rorschach as viewed in Chapter 15), were summarized and current developments in techniques described.
(p. 710) An Increasing Variety of Personality Inventories and Behavioral Assessment Strategies Are Available for Use in Clinical Assessment
Most of these newer personality inventories follow somewhat different theoretical viewpoints and test construction strategies than was used with the MMPI and, consequently, address different aspects of personality. For example, the Millon Clinical Multiaxial Inventory (and revised versions such as the MCMI-II and MCMI-III) (Millon, 1977) were developed from Millon's general theory of personality and standardized on patients undergoing mental health care. He did not use a general normative population as was used in the development of instruments such as the MMPI. The MCMI and the revised versions, the MCMI-II and MCMI-III inventories (Millon, 1996), are intended to evaluate patients undergoing psychotherapy and follow the Diagnostic and Statistical Manual (DSM) criteria. The use of psychotherapy patients as the reference sample is both a strength and a limitation for some applications. That is, comparing a protocol with patients gives the practitioner a perspective on his or her client's problems that is not provided with other tests. However, use of a patient reference group (instead of “normals”) weakens use in settings such as personnel selection or forensic evaluations in which reference samples need to be drawn from the normal population to be informative.
Another instrument, the NEO PI (Costa & McCrae, 1992), was developed as a measure of “normal range” personality characteristics but is sometimes used in clinical assessment. The authors constructed the NEO PI based upon the five-factor theory of personality (see Digman, 1990) in order to appraise the five major trait domains underlying this theoretical approach. Some inventories address highly specialized assessment tasks such as the Psychopathy Checklist (PCL) by Hare (2002) as a means for typifying psychopathic personalities. In applying psychological tests with clients, it is important for the practitioner to review the test manual for the instrument to ascertain proper administration, scoring, and interpretation guidelines to ensure that a test is properly used.
In addition to psychological tests, there are a number of formal behavioral assessment methods and rating scales that have evolved over the last half of the twentieth century to provide valuable information in clinical evaluations (see discussions by Gold fried & Kent, 1972; in Chapter 13; and by Haynes & O'Brien, 2000). These instruments are usually completed by the clinician or an observer rather than the client and address different aspects of the patient's behavior than those addressed by traditional assessment methods, such as self-report. There is also a range of interview formats that are used both for research and clinical applications (see Chapter 12).
Assessment has Been Successfully Integrated into Psychological Treatment
In the past 20 years, a clinical treatment approach has evolved that has taken the strengths of psychological assessment methods and incorporated assessment data into psychotherapy as a behavioral change strategy through providing test feedback to the client (Butcher, 1990). This approach, referred to as “therapeutic assessment” (Finn & Tonsager, 1992), has been shown to effectively provide clients with personality information based on their test results early in treatment—a tactic that leads to improved self-esteem and reduced symptoms. A recent survey by Smith, Wiggins, and Gorske (2007) reported the results of a survey from 719 psychologist members of the International Neuropsychological Society, the National Academy of Neuropsychology, and the Society for Personality Assessment who regularly conducted assessments as part of their professional activities. They found that the majority of respondents (71%) frequently provided in-person assessment feedback to their clients and/or their clients' families. Moreover, they reported that most respondents (72%) indicated that clients found this information to be helpful and positive in the clinical process.
The Wide Availability of Electronic Computers Enhance Personality Assessment Today
Computer scoring and test interpretation make psychological testing results more readily available and cost-effective for incorporating into psychological assessment. Moreover, computer interpretation provides the practitioner with an objective framework for a clinical evaluation (Atlis, Hahn, & Butcher, 2006; Chapter 10). A number of resources are available that demonstrate the utility of computer-based assessment in clinical evaluations (see Butcher et al., 1998, 2000; Butcher & Cheung, 2006).
Methodological Developments in Personality Assessment
Psychologists developing personality assessment instruments today, or those interested in evaluating (p. 711) existing instruments for their use, are blessed with a plethora of psychometric strategies, methods for approaching the scale construction task or evaluating psychometric utility, and software incorporating the programs necessary for statistical analyses of test data. For example, procedures are available for assessing item characteristics such as alpha coefficients (Streiner, 2003; item reponse theory or IRT [Weiss & Suhdolnik, 1985]). Scale construction strategies such as factor analysis (J öreskog, 2007) that are valuable for developing scales or refining measures have been explored. Several strategies are now widely used in evaluating the effectiveness and validity of psychological measures such as meta-analysis (Hunter & Schmidt, 1990) and reliability generalization (Rouse, 2007; Vacha-Haase, Henson, & Caruso, 2002). This book includes several methodological papers that address issues in validity (Chapters 4 and 5) and includes several chapters that provide guidelines for assuring that personality tests operate according to high professional standards (Chapters 6 and 7).
New Technologies in Personality Evaluation
New technological developments hold promise for expanding information in personality and psychological symptom assessment. Chapter 19 provides an overview of new developments in the use of neuroimaging for predicting clinical states, with particular attention to clinical assessment. The authors describe the underpinnings of the blood oxygenation level-dependent responses that are used in functional magnetic resonance imaging (fMRI). They provide background for understanding the development and use of models based on brain data to examine latent states, such as deception, and latent traits, such as the diagnosis of schizophrenia. Although neuroimaging is not, at present, a practical tool for clinical assessment, Chapter 19 concludes that it likely will provide an important avenue to pursue, for example, the study of depression and anxiety.
The Need for Objective Evaluations of A Client's Personality Characteristics in Applied Settings
The use of personality measures in nonmental health settings has increased the role that assessment psychologists play in contemporary psychology. Assessment-oriented forensic psychologists often contribute to the evaluation of clients, for example, to aid in determining a parent's suitability in parenting for custody of minor children, or to assess a client who alleges to be psychologically injured as a result of an accident in personal injury claims, or to assist in the evaluation of criminal offenders, for example, in the sentencing phase of a trial (see Megargee, 2006; Pope, Butcher, & Seelen, 2006) or to assesss dangerousness (see Chapter 28).
Personality tests have continued to contribute to assessing suitability in some personnel selection settings for positions, such as airline pilots, police personnel, and nuclear power plant employees, in which emotional stability is an important concern to safe job performance (Butcher et al., 2006; Chapter 30).
Attending to Cultural and Racial Factors in Personality Assessment
This handbook includes several chapters that focus attention on the importance of tailoring or adapting personality assessment methods and strategies to a multicultural society. The importance of continued vigilance for assuring nonbiased assessment is highlighted in Chapter 21. The author has pointed out that “Detecting and mitigating racial bias in assessment is a profoundly complex challenge” and provided a perspective on several conceptual issues central to assessing U.S. minority groups besides reviewing efforts to address ethnic and racial sensitivity in frequently used adult assessment instruments. She has pointed out that the MMPI-2 is a prime example of progress in this area, for example, in use with African-Americans, to the point that earlier controversy in its use has abated. In addition, she noted that recent research with the Rorschach also holds out the likelihood that it is equally applicable to very closely matched groups of African-Americans and Whites. However, in spite of such changes, serious concerns remain. For example, the MMPI-2 appears to show excess pathology in Asian-Americans (particularly those who are in the process of acculturating to a new culture) and reminds the reader that we have not reached the point of universal applicability of the major instruments used to assess psychopathology. Similarly, Chapter 20 points out that although there is ongoing research on the relationship between race-related measures and psychopathology, there is no consistent effort to develop and validate a clinical assessment measure that can tap into this critical aspect of many Asian-Americans' experience. The authors have noted that although a set of variables that are as complex, dynamic, and historically situated as racial discrimination affect Asian-American individuals, further efforts need to address these variables. Clinical personality assessment with (p. 712) Asian-Americans is a field that continues to face many challenging problems that require attention. The authors call for continued programmatic research on clinical personality instruments with Asian-American populations to ensure that the most effective procedures be used. Recent developments in test interpretation with Hispanic clients (see Butcher, Cabiya, Lucio, & Garrido, 2007; Garrido & Velasquez, 2006; Geisinger, 1992) show both a broad research base and effective interpretive guidelines in applying the MMPI-2 with Latino clients.
With respect to another demographic variable that requires careful consideration in assessment, Chapter 22 provides an important perspective on the historical and current approaches to gender in the assessment process, and provides suggestions for effective information collection strategies that acknowledge the influence of gender-related variables on women's psychological health and well-being. They discuss several concerns and available research associated with gender bias in assessment, and examine the evidence for the influence of bias in the diagnostic process.
International Developments in Assessment Research and Applications
The use of well-established and demonstrated equivalent assessment instruments can serve as an effective vehicle for gaining a broader understanding of personality factors in other cultures. Opportunities now exist for psychologists to broaden our knowledge of psychopathology through gaining a more global perspective of mental health problems. Psychological test adaptations in cultures that are different from the country of origin are not novel. In fact, two of the most widely used assessment techniques, the Rorschach and Binet Intelligence Scale, were initially cross-cultural adaptations from other countries to the United States. Several important differences in today's test adaptation are addressed.
Cross-cultural personality assessment research is more viable today than ever before (see research on cross-cultural comparisons of personality dimensions by Cheung, Cheung, Zhang, Leong, & Yeh, 2008). The capability of collecting comparable data describing similar clinical patterns in different countries can contribute to our general understanding of personality and adds cumulative information to the field of personality. An illustration of the gains to be made in the field of personality can be seen in using the large number of well-developed translations of the MMPI-2 that are presently available—over 33 (Butcher, 1996). These adapted versions of the test enable research on clinical problem areas across many countries and can serve as a basis for cross-national psychopathology research (Butcher, 2006). A number of studies have shown highly similar clinical patterns on the available translations of MMPI clinical measures (Manos, 1985; Savacir & Erol, 1990). Clinical research on the MMPI-2 has been expanding greatly in other countries, for example, in Europe (Butcher, Derksen, Sloore, & Sirigatti, 2003), and in China (Cheung, 2004; Cheung, Cheung, & Zhang, 2004). Three recent MMPI-2 research projects have been conducted by teams of psychologists in several countries in order to assess the effectiveness of computer-based assessment across cultures (Butcher et al., 1998, 2000; Butcher & Cheung, 2006).
With the growth in applied psychology in other countries there is an increasing number of trained personality researchers who have both the interest in and expertise for conducting collaborative international personality assessment research. International research programs to study personality processes are much more efficiently developed today. International research collaboration on personality projects is more efficient with the rapid communication that is available through the high-speed Internet (Butcher, 2006). And most researchers have ready access to the extensive body of published research that can be a great advantage to collaborating researchers today; finally, the use of email to transport data and communicate findings or problems makes the collaborative process more time-efficient.
Current Challenges Facing Contemporary Personality Assessment Psychologists
There are a number of continuing challenges that can result in diminished effectiveness in assessment psychology today if they are not resolved and improved; six problem areas that can impact future test applications or procedures will be described here.
Diminished Assessment Training in Professional Programs
As noted earlier, one challenge facing psychological assessment today is the reduced emphasis upon training graduate students in assessment (Merenda, 2007). There has been a noticeable reduction of assessment training in many graduate programs, particularly with respect to projective techniques. Graduate students from some training programs often find it difficult to obtain placements in desired (p. 713) internship programs or find that their lack of assessment skills disadvantages them in being accepted in their placement of choice. Clemence and Handler (2001) pointed out that major discrepancies exist between what is being taught in graduate school and what experiences are expected by internship programs.
Fortunately, some of the professional associations are committed to providing continuing education training in areas of clinical practice, for example, the American Psychological Association, the Society for Personality Assessment, and some state psychological associations. Their programs aim to update and “refresh” professionals but this is generally insufficient for providing the basic graduate education in assessment methods and techniques.
The challenge: In order for the field to continue to have highly qualified researchers and practitioners, it is necessary for educational institutions to provide objective, balanced educational experiences in assessment research methodology and applied assessment techniques.
Lag in Development of New Assessment Procedures
Greene (2006) recently noted, “It also behoves us as specialists in assessment to realize that if it were 1940 and we were discussing state of the art in assessment, we would be talking about the MMPI, Rorschach, and TAT. … The fact that in 2005 we still are using the same techniques is mind-boggling. There are few fields in which the advances have been so limited” (p. 254). In a similar vein, over 35 years ago, Hathaway (1972), in an evaluation of the progress of personality assessment methods entitled “Where have we gone wrong? The mystery of missing progress,” noted that the field of personality assessment has made little progress toward developing newer personality tests.
The hopeful view that the computer revolution held promise for providing more realistic visual environments such as enhanced “lifelike” test stimuli and more advanced and effective computer-based administrative formats has not materialized. It simply takes too much developmental work and costly validation effort in order for an instrument to gain trust and acceptance for clinical decisions. Moreover, the use of modern technologies in processing test results, such as Internet applications of psychological tests, has encountered a number of problems that require resolution (see discussion by Atlis et al., 2006) for this media to be effective and professionally acceptable. For example, the potential lack of test item security makes test publishers reluctant to expose successful and well-established tests to the perils of poor security of the web. Thus, psychological assessment relies substantially on traditional instruments and new innovations are not in sight.
The challenge: Over the past 60 years, new personality assessment approaches have not moved substantially beyond what the earlier assessment test developers produced. Technology exists to provide “lifelike” interpersonal situations that could be used effectively as stimuli but will the next generation find approaches that move the field further or in a different direction?
Practitioners Often Use Psychological Tests in the Applications for Which They Are Not Intended or Are Not Psychometrically Appropriate
Psychological tests have limits that need to be understood before they are applied with clients. Any psychological test will have limitations, depending upon factors such as restriction of the stimuli, specific nature of the test structure, the reference populations used to develop the norms, the research validation, and so forth. Or, a procedure that was developed for assessing a specific problem area might fall short or be irrelevant for assessing another. As noted earlier, the MCMI instruments were developed for assessing clients in psychotherapy and have items and reference groups designed for that population. Yet, the test is applied in settings such as forensic or personnel when results can only be puzzling given the test goals and norms.
The challenge: Psychological tests need to be clearly described to assure that tests are appropriately used and their limitations clearly understood. Practitioners need to be more cognizant of test limitations and not ask the test to perform tasks for which there are insufficient supportive data.
Abbreviating or Shortening Well-Established Instruments Can Have Undesirable Side Effects
Less is not more. In 1975, Hathaway pointed out, “If you choose to for any reason to administer only part of the test, you should be aware of how this would affect the interpretations and the consequences which you would subsequently find through your interpretation. I, for one, would never administer only part of the test. I suspect the increment of new information would fall short.” The MMPI/MMPI-2 were devised to assess a broad range of characteristics for use in general personality (p. 714) assessment settings and have a substantial research base in support of their varied applications. It takes only an hour and a half (with an MMPI-2) to obtain an extensive review of a client's symptoms, attitudes, test-taking behaviors, etc., that typically provides valuable information in giving a perspective on a client's problems. In the majority of settings this is not an overbearing commitment of time.
The abbreviation of established tests in order to provide a seemingly more “user-friendly” option can result in misleading interpretations or results. That is, a shortened test may require less testing time but can result in lowered validity and reliability or even a completely different set of results for the shortened measure than the practitioner was expecting based on the reputation of the original instrument. The clearest examples of this problem were found in the popular strategy for developing MMPI short forms during the 1970s and 1980s when there were several attempts made such as the Mini-Mult (Kincannon, 1968), the Faschingbauer (FAM; Faschingbauer, 1974), and the MMPI 168 (Overall & Gomez-Mont, 1974) (see discussion in Chapter 14). These short forms, however, did not completely capture the meanings of the full MMPI scale scores (see reviews by Butcher & Hostetler, 1990; Dahlstrom, 1980), and, for the most part, disappeared from the assessment scene. Two efforts to develop shortened MMPI-2 forms were published. For example, Dahlstrom and Archer (2000) published a shortened form of the MMPI-2 that comprised simply the first 180 items in the booklet. This abbreviated form resulted in similar problems as the earlier efforts (Gass & Luis, 2001). The other recent shortened version by McGrath, Terranova, Pogge, and Kravic (2003), the MMPI-297, proved more successful than the Dahlstrom and Archer version; however, it still produced T-scores that are substantially different (discrepancies of T 〉 5) from those derived from the full form of the MMPI-2, and its convergent validity is also weaker across a number of settings (McGrath et al., 2003).
Recently, there has been an effort to promote a shortened version of the MMPI-2 referred to as the MMPI-2-RF that takes a very different approach to abbreviating the test than past efforts. This 338-item, extremely altered version includes as its core the Restructured Clinical or RC Scales (Tellegen et al., 2003) in lieu of the traditional and well-established Clinical Scales. In addition, there are a number of other short measures that have not been previously published and the inclusion of one scale, the Lees-Haley Fake Bad Scale (FBS), has been at the center of a great controversy recently (see discussion below) as a result of bias. This RF approach to assessment uses the traditional name and reputation (MMPI) to provide a completely new instrument in its place. The test user needs to be aware that the RC Scales bear little psychometric resemblance to the traditional clinical scales (see Butcher, Hamilton, Rouse, & Cumella, 2006; Butcher & Williams, 2009; Nichols, 2006; Rouse, Greene, Butcher, Nichols, & Williams, 2008) and thus cannot effectively replace their functioning although the implication in the name, MMPI-2-RF, is that it does just that (see also the discussion in Chapter 23).
The challenge: Abbreviated versions of standard tests are typically not substitutes for the original form but are different tests and are often not equivalent to the original. Clear differentiation of new versions from the original needs to be carefully made to avoid confusion and test misuse.
Erosion of Standards for Assessment Instruments
It is important for the profession to guard against the dissemination of assessment instruments that do not perform psychometrically as promised or that perform in a biased manner and unfairly disadvantage clients. Professional vigilance to maintain quality assurance in assessment techniques is required, especially in “high stakes” evaluations such as personal injury forensic or work compensation cases.
Geisinger (2005) provided cautionary recommendations for psychologists using psychological tests in evaluations that can impact whether a client will or will not receive benefits based on a psychologist's test-based recommendations. See also Chapters 6 and 7 which discuss the importance of maintaining high standards in personality assessment instruments; new or modified assessment procedures need to meet high standards in order to assess personality variables with accuracy and reliability, and to be consistent with the expectations of qualified and ethical test users. Both chapters provide illustrations of problem situations that can occur in the field.
When high standards are ignored in the construction of instruments, the field of personality assessment is diminished, and clients, instead of being helped, can suffer consequences from an unfair evaluation (see Armstrong, 2008). The distribution of flawed assessment devices under the guise of “high standards” has recently occurred in changes made in the use of the MMPI-2. A scale that was developed several years ago from the MMPI-2 item pool (p. 715) (the FBS by Lees-Haley, English, & Glenn, 1991)— even with a documented proclivity to discriminate against women and against some persons with somatic problems (Butcher, Arbisi, Atlis, & McNulty, 2003)—was included in an MMPI-2 scoring program and made available across all settings. This formal, broad dissemination of the FBS was implemented even though the scale developer (see Lees-Haley & Fox, 2004) actually indicated that the FBS was designed for personal injury litigation only and not for broad clinical settings. This scale was included on the test scoring service by the test distributor in 2007 (see the rationale provided by Ben-Porath & Tellegen, 2007). The scale has not been shown to effectively detect malingering in any setting yet it has now become a widely disseminated “standard” option that could potentially result in patients with somatic symptoms being ignored or denied services if the practitioner uses this measure routinely or without careful attention to the limitations of the scale.
A recent review and analysis of the performance of the FBS in both forensic and clinical settings was conducted by Butcher, Gass, Cumella, Kally, and Williams (2008). The study further details the psychometric weakness of the FBS, the highly variable interpretive strategies used to interpret it, and the bias that occurs in using this scale to assess people. Butcher et al. also demonstrated the potentially damaging consequences of using the FBS in general mental health settings. They reported the high misclassification rate as “faking” in a sample of women eating disorder inpatients—a group with extremely unlikely malingering attitudes in taking the test. Using Lees-Haley's original cut off scores, 62% of the inpatient women with severe mental health problems (1,275 out of the sample of 2,054) would be classified as malingering; using the more conservative cutoff score suggested by Ben-Porath and Tellegen 2007, 11% of the women (235) were considered to be faking their symptoms.
The continued use of this scale for assessing litigants in personal injury cases is problematic in that many people with genuine physical or psychological symptoms would be characterized in a derogatory fashion (i.e., faking their symptoms).
The FBS has faired poorly in court cases in which their adequacy for admission into evidence has been challenged. Judges in four recent Frye hearings have not allowed the FBS into testimony (Davidson v. Strawberry Petroleum et al., 2007; Vandergracht v. Progressive Express et al., 2005; Williams v. CSX Transportation, Inc., 2007; Stith v State Farm Insurance, 2008) because it is baised against women and people with physical symptoms, thereby prohibiting the defense experts from testifying in court that the FBS showed the plaintiff had been malingering.
It is likely that damaging results could be obtained as the FBS is used in broader assessment contexts such as medical assessments and outpatient and inpatient mental health evaluations, because as both Butcher, Arbisi et al. (2003) and Butcher, Gass et al. (2008) have shown, a high percentage of mental health clients are characterized as “faking” using the generally recommended cutoff scores suggested by Ben-Porath and Tellegen 2007. Thus, people with genuine problems could be denied services or payment for medical services.
The challenge: There is a need to eliminate test bias in “high stakes” measures. If this is not possible for a particular measure, then such instruments need to be avoided in assessing clients in applications where potentially damaging consequences can occur.
The Challenge of Increasing Diversity in the Client Population of the United States
The United States is a multicultural society with the largest minority population of Spanish-speaking immigrants increasing at a fast rate. Practitioners need to be vigilant about possible cultural factors that can affect psychological assessment. Research needs to provide useful assessment for multicultural mental health services because of the increasing diversity in U.S. populations and the importance of assuring valid and reliable adaptations of existing psychological measures. The need to provide culturally sensitive psychological assessment instruments has been an increasing concern of psychologists (Garrido & Velasquez, 2006; Hall, Bansal, & Lopez, 1999; Hays, 2001) and progress has been made with some instruments, such as the MMPI-2 (Butcher et al., 2007) for providing appropriate interpretive strategies. The MMPI-2, for example, has been shown to result in comparable findings between Hispanic and Anglo populations (Hall et al., 1999); however, further evaluation is needed for all clinical procedures that are used in clinical assessment of diverse client populations (e.g., some scale differences on scale L might occur) if the goal of fair and effective multicultural assessment is to be attained.
The challenge: Demonstrating and assuring that personality assessment measures are appropriate when used with clients from diverse backgrounds.
As the field of personality assessment ends its first century with a strong record of success that is (p. 716) reflected in the range of contributions featured in this book, we anticipate the evolution in the next 100 years with several questions: Will there be novel, improved, and more effective approaches to carry the field forward? Or, will there be a persistence of past successes with further refinements made to old standards? Will the new technological advances we highlight here be followed by further broadening of personality assessment methodology? Will contemporary society continue to rely upon available personality assessment instruments as it currently does? Will personality assessment keep pace with society's advances and expectations?
Whatever avenues are pursued, it is likely that the demands of current applications and the general acceptance of well-established techniques will continue to encourage development in applied settings. Along with the successes come the challenges: Can we meet these expectations?
Given the challenges that personality assessment psychologists are facing today, as described above, we may wonder about the best strategies to take with regard to the question that where do we go from here. In my view, we can be very optimistic about the future pathways that personality assessment will follow. As we saw in this handbook, we have a very rich history and substantially contemporary database from which to proceed over the coming years. Some well-traveled paths will likely continue in use while other avenues will emerge as exploration proceeds. As the chapters here attest, we are well equipped methodologically to assure a fruitful passage. Perhaps the most effective approach to progress in personality assessment would be to confront the challenges we currently face, as described in this book, through further research while maintaining the strengths of past successes. With problems ameliorated, we can advance into the next generation of personality assessment technology with confidence.
It is my view that the challenges we have noted in various places in this book can be overcome and that sounder steps can be taken to insure that the future of personality assessment will be successful. I hope the accomplishments and the visions our personality assessment forebearers held will be maintained and the hopes they had for the future of the field will be fulfilled.
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