Diagnosis: using tests in practice

1. Diagnosis: using tests in practice

2. Test misuse and ethical issues

3. Example of misuse • Lack of inormed consent • Lack of procedure description • Test anxiety and stress • Errors in standarization and administration • Dehumanization/respect

4. Test misuse. Griggs v. Duke Power Co. •  Supreme Court of the United States on December 14, 1970 • Company's employment requirements not related with ability to perform the job • Discriminating black • Court: employer must show that hiring procedures are job related

5. Qualifications for Users of Psychological Tests LICENSE, DEGREE or TRAINING ≠ EXPERTISE LICENSE, DEGREE or TRAINING ≠ OBJECTIVITY Case of George C. Denkowskiforensic psychologists. He provided testimony of at least fourteen inmates currently on death row, including two who have exhausted all appeals, and four other inmates who have already been executed.

6. Sources for Ethical Decisions • APA: Ethical Principles of Psychologists and Code of Conduct • Local code, e.g. Polish Psychological Association Ethical Code. • Rights of test takers?

7. Test misuse Test misuse can occur at every step of the testing process, • starting with the inappropriateselection of instruments • for the purposes to which they areapplied • for the individuals to whom they are administered. • Errors in administration • Errors in scoring • Errors in the interpretation or reporting

8. Rights of Test-Takers (APA) • Be treated with courtesy, respect, regardless of age, disability, ethnicity, gender, national origin, religion, sexual orientation or other personal characteristics. • Be tested with measures that meet professional standards and that are appropriate. • Receive a brief explanation prior to testing about the purpose(s) for testing, the kind(s) of tests to be used. • Individual’s freedom to decline, and freedom to withdraw, is respected. • Have test administered and your test results interpreted by trained individuals who follow professional codes of ethics.

9. Ethical issues in psych testing • Competence of psychologist • Informed Consent • Theright to Results • Confidentiality • Test security • Divided Loyalties • Invasion of privacy • Labeling • Dehumanization

10. 1. Competence • Test giversshould: • select test after review of tests available • haveknowledge of test materials & manual • recognize boundaries of competence • not using test for purposes not recommended by developers • knowledge of ethicalcodes, e.g.: • provide test-takers, or their parents, with information about their rights • explain results in language test-taker can understand

11. Theoretical Issues Is your test reliable? Reliability – upper limit on validity. Is your test valid for particular purpose? Are you measuring a stable characteristic of the person being tested? Will it still be true next year? If the test result says that person does not have the characteristic you’re looking for, does that mean they could never acquire that characteristic?

12. 2. Informed Consent Consent requires “affirmative permission before actions can be taken”.

13. Informed Consent • Elements of Informed Consent Agreements • Must be presented in a clear and understandable manner • Reason for the test administration. • Tests and evaluations procedures to be used. • How assessment scores will be used. • Who will have access to the results. • Present rights of test taker e.g. to refuse.

14. Informed Consent If underage is tested written informed consent must be obtained from the parents, guardian.

15. Informed consent - exceptions When it is acceptable to test without getting consent? When it is necessary to test without getting consent?

16. Informed consent - exceptions Acceptable, e.g., psychology students during a course. Necessary e.g., when mandated by law.

17. Research: debriefing • Restate purpose of the research. • Explain how the results will be used (usuallyemphasize that the interest is in the group findings). • Reiterate that findings will be treated confidentially. • Answer all of the respondents questions fully.

18. 3. Knowledge of Results Must fully disclose test results in understandable language Avoid using theoretical constructs e.g. crystallized intelligence, ego strenght etc. Do not use technical terms, e.g. your neuroticism is 6 sten.

19. 4. Confidentiality Test results are confidential information Release of results should only be made to another qualified professional after client’s consent

20. 5. Test Security Test materials must be kept secure Test items are not revealed except in training programs and when mandated by law, to protect test integrity Test items are private property

21. 6. Divided loyalties Who is the client? The person being tested, or the institution you work for? What if these parties have conflicting interests? Examples? How do you maintain test security but also explain an adverse decision?

22. 7. Invasion of Privacy • When tested people may feel their privacy is invaded. • The clinician is always ultimately responsible; this includes scoring and interpretation done by a computer • Informed consent – informing the client about both the nature of the information being collected and the purposes for the which results will be used • Relevance – is the information gathered through assessment relevant to the counseling? Counselor should be able to clearly state purpose and benefits of appraisal process

23. 8. Labeling • Once diagnosed, the desease can be labeled. • E.g. psychiatric labels can be damaging. • Public has little understanding of e.g. schizophrenia. • When diagnosing, use least stigmatizing label consistent with accurate representation • It does not mean that counselors should always use less or nonstigmatizing diagnostic codes; a less stigmatizing code that is inaccurate could prevent the client from receiving appropriate treatment.

24. 8. Labeling • Problem: a psych. desease is perceived as medical. • Ergo: ill person cannot do anything about it. • It is not true for psychological disorders. • A person can take responsibility to get better.

25. 9. Dehumanization • Some forms of testing remove any human element from decision-making process • Seen as becoming more prevalent with the increase in computer-testing

26. 9. Dehumanization Does computerized testing and analysis of test results create a danger of minimizing human uniqueness? Humans are very complex – which allows us to be individuals, different from each other But testing and interpretation generalize

27. Diagnosis and assessment

28. Testing vs. decision making • Providing opinions e.g. educational or forensic setting • Providing base for decision e.g.. selection process, therapy in clinical setting In majority of cases test user (diagnostician) is not making formal decisions However! in many cases opinion or diagnosis is key point in someone's else decision WRONG DIAGNOSIS → WRONG DECISION

29. Responsibilities of Test Takers • The responsibility to read and/or listen to their rights and responsibilities. • The responsibility to ask questions prior to testing about • why the test is being given, • how it will be given, • what they will be asked to do, • what will be done with the results.

30. Test selection First question test user needs to ask is? To Use or Not to Use? (Urbina 2004) Cost-benefit analysis: • What kind of information is needed? • How will this information be used? • What and how many of the information is available from other sources? • What other tools might be used? • What are the advantages of using tests instead of, or in addition to, other sources of information? • What are the costs (time, effort, money…) of using tests instead of, or in addition to, other sources of information?

31. Test selection Reasons for not using tests • The purpose is unknown or unclear • Lack of expertise with the test documentation and procedures, lack of training with the test. • Lack of control over the test results. • The information is already available, or can be gathered more efficiently otherwise. • The test taker is not willing / able to cooperate. • The test taker is likely to be harmed someway due to the testing process. • The environmental setting and conditions for the testing are inadequate. • The test format / materials are inappropriate for test taker (e.g. age, sex, cultural or linguistic background, disability…) • The norms are outdated, inadequate, or inapplicable. • The reliability or validity of test scores is inadequate or unknown. Urbina,2004

32. Two main advantages (reasons) • Efficiency. • Objectivity.

33. Evaluating a test • Normative sample • Reliability • Determine the potential sources of error. • Evaluate the reliability data available (including sample!) • Evaluate the data on reliability in light of all the other attributes of the test (normative and validity data, cost and time constraints…) • Keeping all other things equal, select the one is most reliable for the purpose and population. • Validity • Validation strategies in relation to test score interpretation • Aspects of construct validity and related sources of evidence

34. Considerations in relation to test takers Test medium (e.g. computer administrated vs pen and pencil) • advantages or disadvantages for examinees, depending on their familiarity with the medium, sensory acuity in the auditory and visual modes, motor skills, and so forth (Even when a test includes some practice items) Test format (e.g. free response vs selected-response items, group vs individual testing) • Different type of items are prone to influence of other types of intervening variables Language of test items • Level of vocabulary, reading skills, and writing skills can influence test performance

35. Administration • Be prepared: Reading the manual! • Do everything by the book (manual) • Preparing the Testing Environment • Necessary materials • Space, light, air • No distractors • No other people (if the procedure does not require them) • Special needs

36. Wechsler Intelligence Scale for Children

37. Test user and test taker • Establishing Rapport (the harmonious relationship that should exist between test takers and examiners) • Friendly and proffesional

38. Test taker • Explanation of the purpose of the test and the testing procedures considerations • Test anxiety • Test-taking skills • Test-Taker Dissimulation

39. Scoring Clear instructions Sources of errors • Mistakes (in case of objective procedures) • Poor training (in case of open ended) • Errors in transformations

40. Interpretation • actual behavior samples (responses to test items) • aggregation of these samples into one score • available evidence concerning the reliability of the obtained scores • comparison of scores frame of reference • evaluation of scores in light of the quality of validation data available • specific context and situation in which the testing takes place • observationduringtesting

41. Communicating Test Results Reporting Two main factors • the purpose for which the testing was undertaken and • the party on whose behalf the testing was undertaken MAIN RULE: provide the information derived from test scores, including its limitations, in language that the recipient can understand.

42. Excercise • Definition of the construct • Reliability – how it was used • Info about SEM • Validity – how was assessed • Norms • Administration of the test – how?