When conducting psychological assessments, there are several points to keep in mind:

Order of Tests

It is possible that without attention and care, you can administer tests in such a way as to allow one test to impact results of another, or you can conduct the assessment in a way to limit the findings. Consider:

  • tests that interfere with each other (e.g., part one of a verbal memory test, followed by a vocabulary or spelling test, then part two of the verbal memory test)
  • tests that require attention and concentration (e.g., administering a 90 minute IQ test, and then a 60 minute Rorschach right after)
  • timing of the assessment (e.g., completing all testing in one appointment vs. two, or testing in the afternoon after a full day of school for children, or testing in the evening after a full day of work for an adult)
  • adhering to a battery approach without regard for test findings (e.g., a reading test shows only a fourth grade reading level, but you still administer a test that requires a sixth grade reading level)
Psychological assessment requires some careful thought for each client, the needs and issues they face, and the referral source.

Apparent Contradictions

Keep in mind that contradictory findings are bound to occur. One way to explain this would be to consider that there are no contradictory results; there are only contradictory interpretations. Another way would be to remember that none of the tests we use are perfect, or immune to any administration, measurement, or estimation errors. If you measured the same object with five different rulers, each of which you crafted yourself, you would get small differences in the final measurements that were partly the result of differences in the rulers (could you make five rulers that were exactly alike?), and partly the result of differences in your measurement method (could you do something in exactly the same way five times in a row?).

However, keep in mind that you can not simply throw out the interpretations you don't like or don't agree with, simply arguing they must be wrong and that happens sometimes. You have to explain the results you have, explore which interpretations are most likely true, and draw a sound conclusion. To do this, try asking yourself the following questions:

  • Could they both be true? For example, consider a high score on the Hypervigilance Index of the Rorschach with a normal score on Scale 6 of the MMPI2. You might think the first clearly points to paranoia, but the second does not. It is possible to be apprehensive, distant and reserved, and concerned with details without being paranoid and prone to feeling mistreated and persecuted.
  • Is one open to another interpretation? A high Scale 8 on the MMPI2 may make you think "Schizophrenic thought processes." However, the low score on the BIZ scale may cause you to think this is a contradiction. Scale 8 taps Schizophrenic thought processes, but also distraction and concentration problems, social withdrawal, and feelings of distress in the environment. It is possible to have these aspects of Schizophrenic thoughts without the bizarre thoughts generally seen. Thus, the two scales do not contradict each other, but instead refine your interpretation.
  • Is one based on more reliable scales or data? For example, a 13 codetype on the MMPI2 indicate some somaticizing or real health issues. Somaticizing can be seen in more An and Xy contents on the Rorschach. When you get a 13 codetype but no An and Xy contents, it is OK to remember that the Rorschach is not so sensitive to somatization.
  • Could conflicting data indicate a conflict in the client? For example, an MMPI2 with a low Scale 2 and 5 and a Rorschach with elevated DEPI and T=2 may not be inconsistent. The stereotypic male (low 5) might deny depression (low 2) as it seems weak or unmasculine to him, but show a high need for affection (T=2) and a sense of being overwhelmed on the Rorschach (DEPI elevated).
  • Is the client under-reporting or over-reporting? A client might not consistently report symptoms for a number of reasons:
    • impression management, or conscious attempts to present a better picture of oneself on a test, either by denying problems or by endorsing personality traits they wish they had
    • lack of awareness, or failure to report a problem because they are not aware of it; antisocial personalities do not endorse relationship problems often because they do not perceive or understand that others think their callousness and poor empathy is a bad thing
    • discomfort, or difficulty admitting to a problem on a test
    • a "plea for help" effort to exaggerate existing symptoms in order to receive services
    • an over-reactive or overly dramatic style that commonly leads to exaggeration
    • keep in mind that faking efforts may be blunt (e.g., denying or endorsing many problems) or more subtle (e.g. endorsing or denying specific problems)
  • Is it possible the client is malingering? Malingering might be detectable by:
    • highly atypical, inconsistent, or very detailed symptoms
    • admitting to every symptom you ask about (such as "glove anesthesia" or a numbness in the hands that starts at the wrist and covers the entire hand - as if the client were wearing a glove - however, the nerves of the hand are laid out such that this is extremely unlikely)
    • inconsistencies between client/other/records reports
    • referral by an attorney or obvious benefit of being diagnosed
    • discrepancy between results of testing and client report/behaviors
    • lack of cooperation from client
    • antisocial characteristics