WAIS-III Assessment. Psychological tests - Assignment Example

Provide a qualitative for Emma’s Full Scale IQ Score (0.5 marks). Should the Full Scale IQ be interpreted as a meaningful representation of Emma’s overall performance?  Emma's full scale IQ score is 104. This is the score for the verbal plus the performance. This means that she has average intelligence, as average intelligence is marked by scores between 90-109. The score may or may not be meaningful as an analysis of her overall performance. According to Kaufman & Lichtenberger (1999), the importance of the Full Scale IQ results are lessened if there is a large difference between Verbal and Performance IQ scores or among the index scores. Moreover, other factors, such as anxiety, fatigue and cultural background might also affect the interpretability of the Full Scale IQ score. In this case, Emma is suffering from depression and anxiety, and she also has been described by her mother as being fatigued. Moreover, she presented with dark circles under her eyes, looking very tired and pale. These are all physical signs of fatigue. Because of this, this score may not be an accurate representation of Emma's actual full scale IQ. 2. For each of the four WAIS-III indices (i.e., VCI, POI, WMI, PSI), list 4 key abilities shared by its subtests (4 marks). The VCI (Verbal Comprehension Index) consists of vocabulary, similarities and information abilities. The WMI (Working Memory Index) consists of arithmetic, digit span and letter-number sequencing abilities. The two together comprise the verbal IQ score, and comprehension shared by both. The POI (perceptual organization index) consists of picture completion, block design and matrix reasoning. The PSI (processing speed index) consists of digit symbol-coding and symbol search. The two together measure the performance IQ, and picture arrangement is shared by both (Kaufman & Lichtenberger, 1999). The key abilities shared by the subtests include comprehension, memory, perception and processing (Flanagan et al., 2000). Crystallized intelligence (intelligence that is reliant upon school-acquired knowledge), fluid intelligence (intelligence that measures one's ability to solve novel problems), visual scanning and immediate recall of stimuli are also abilities measured by these four tests (Kaufman & Lichtenberger, 1999). 3 List 2 key non-cognitive factors that can influence performance on each of the four WAIS- III indices (2 marks). Bilingualism and learning disabilities may lead to higher performance scores than verbal scores, which means that these factors depress verbal scores. Depression, multiple sclerosis, and alcoholism will all depress performance scores, which would lead to a large discrepancy between verbal and performance scores (Kaufman & Lictenberger, 1999). 4. List the key abilities (and influences affecting performance) shared by the subtests that have been identified as Emma’s ‘strengths’ (2 marks). Vocabulary, similarities, information & matrix reasoning are all designated Emma's strengths. Vocabulary, similarities and information all measure verbal comprehension and matrix reasoning measures perceptional organization (Tulsky et al., 2003). According to Frank (1983), one's logical ability will affect similarities scores, while the amount of knowledge will affect the information and vocabulary scores (Frank, 1983). 5. List the key abilities (and influences affecting performance) shared by the subtests that have been identified as Emma’s ‘weaknesses’ (2 marks). Her weaknesses are in the areas of arithmetic and digit span. Arithmetic and digit span both measure working memory, so her working memory is a weakness (Tulsky et al., 2003). According to Frank (1983), a lack of mental alertness may depress arithmetic scores, and attention deficit may affect digit span scores (Frank, 1983). 6. Provide a brief description (max. 100 words) of Emma’s emotional state based on the DASS scores (2 marks). Emma is suffering from a combination of anxiety and depression. According to Imam, the depression scale measures symptoms of worthlessness and low mood. The anxiety scale measures symptoms related to anxiety, including panic attacks, physical arousal and fear. The stress scale measures stress, which includes symptoms of tension, irritability and the tendency to overreact to stressful events (Imam; Cohen & Swerdlik, 2010). Lovibund & Lovibund (1994) state depression and anxiety are often comorbids of one another (Lovibund & Lovibund, 1994). Emma is experiencing many symptoms of physical arousal, fear and low mood, so she scores very high on the anxiety and depression scale. She scores less high on the stress scale, because of her answers regarding the trivalities of people interrupting her and getting impatient about small things. 7. Provide a brief summary (max. 500 words) of what the WAIS-III and the DASS suggest about Emma’s general cognitive ability and emotional state (i.e . What does one factor says to another, how one impacts another) (7 marks). The first thing to look at is whether there is a discrepancy between the verbal and the performance scores. Since depression is one factor that could depress performance scores, to where there would be a large discrepancy between verbal and performance scores, this would suggest, if this is the case, that Emma’s depression is interfering with her performance abilities. In Emma’s case, her scores on the verbal comprehension index are substantially higher than her scores on the working memory index. Both of these are a part of her scores for her verbal intelligence quotient, but one is much higher than the other. This suggests that her verbal intelligence scores are much better, overall, than her performance scores. The reason for this statement is that, according to Kaufman & Lichtenberger (1999), the verbal comprehension index is considered to be a “purer” measure of verbal intelligence. Therefore, even though the overall performance and verbal scales are not appreciably different from one another - she scored, overall, a 66 on her verbal scale and a 59 on her performance scale – there is more of a discrepancy between the scores than meets the eye. Since she scores so much higher on the more pure of the verbal intelligence scales, and this is the scale which is considered to be a more pure measure of verbal intelligence than the other, of which she scored considerably lower than any of the other scores, this suggests that her verbal intelligence quotient is considerably higher than her performance intelligence quotient. She appears to have problems with the working memory index, and this is not surprising, considering that this test involves memory, and depression will affect one’s memory, due to impaired concentration (Kaufman & Lichtenberger, 1999). Another factor to look at is what are good measures of g, which his general ability. General ability is, according to Walsh & Betz (2001), “the sum of all the simple, component parts of sensory functioning” (Walsh & Betz, 2001, p. 146). According to Kaufman & Lictenberger (1999), vocabulary, similarities and information are all excellent measures of g. Emma scored very high on all of these measures. Matrix reasoning is another excellent measure of general ability, which is another aspect that Emma scored very strongly on. On the other hand, digit span, which was one of Emma’s weaknesses, is a poor predictor of general ability, and is, in fact, the poorest predictor of general ability. Emma also has a weakness in arithmetic, and this has a fair correlation with general ability, but it could simply be that she is not very good with numbers. Kaufman & Lichtenberger (1999) also state that verbal IQ is more reliable than performance IQ and is more stable. In reviewing the WAIS scores, in correlation with her very high scores regarding depression and anxiety, what can be surmised is that her mental state is depressing the parts of the test which are most affected by depression. This would include memory, hence her low score on the working memory index, and performance intelligence quotient questions. Kaufman & Lichtenberger (1999) states that performance intelligence quotient is less stable than verbal IQ, which would suggest that it would be more likely to be affected by mental states, such as depression and anxiety. Depression is specifically cited as a factor in depressing performance scores by Kaufman & Lichtenberger (1999). This suggests that her performance IQ is depressed by her mental state. Moreover, since her strengths lie with the parts of the test which are most associated with general ability, what can be surmised, on the whole, is that Emma is considerably more intelligent than her full scale score would suggest. 7. List 5 key factors/influences in Emma’s current and past situation that needs to be taken into consideration in the interpretation of WAIS-III and DASS results – (look at the background history and identified key things and group them to either DASS or WAIS III) (2.5 marks). WAIS - Emma appears to be fatigued – her mother says that she is, and she appears that way, physically. Emma is depressed and anxious, so this will affect her WAIS scores. Emma has trouble sleeping, so, if she is sleep-deprived, this might affect her concentration. She also has headaches, so, if she is in pain, this could affect her scores. DASS – husband is non-attentive; she is living in a new town, and has made few friends. 7. List 5 additional information (both test and non-test) that you would obtain to enhance your interpretation of Emma’s test scores. Provide a brief statement explaining each of your choices – (identified and rationale why her background is useful) (5 marks). I would want to know if she was suffering from a headache at the time that she took her WAIS test, and if she did not get any sleep the night before. Since she indicates that she has been suffering from both headaches and lack of sleep, it would be reasonable to find out if these are occurring at the time that she took her test. Both of these factors would affect her cognitive functioning abilities (Maquet, 2001). Moreover, she appears to be malnourished – she is described as having a “very slender frame.” I would try to find out if she has been eating properly, or if she has eaten recently. If she hasn’t eaten recently, then she may be suffering from hypoglycemia, which would affect her cognitive functioning (Dye et al., 2000). I would also try to find out if she had a bad experience with spiders and snakes, which would help explain her fear of them, which would mean that the fear is not necessarily unreasonable. Also curious is her incident with the school counselor – she did not see the counselor after 10 sessions, because her depression did not last long. I would be curious as to whether Emma stopped seeing the counselor because she told him “what he wanted to hear,” in order to get out of seeing him anymore, of if she really, sincerely felt better, which is why she stopped seeing him. This would provide some kind of continuity – Emma has always had depression, and this was unabated, therefore it would be treated as more of a long-term, chronic problem than if it were something that was intermittent. 10. List the most important best practice/ethical considerations that need to be kept in mind during the psychological assessment of Emma - (reference from general conduct guideline, code of ethnic and text) (5 marks). Informed consent is a consideration, which means that, if Emma is to be provided with psychological services, she must be fully informed about the nature of these services (Australian Psychological Society). If the practitioner has any concern that Emma does not understand the risk and the benefits of the psychological services, because there is some evidence that she might be cognitively impaired, due the results of her IQ test and the fact that she is severely depressed and anxious, the practitioner should look showing a videotape about the services that should be rendered. According to Wirshing et al. (2005), there is an on-going issue with informed consent, in that psychiatric patients do not always understand the risks and benefits. For that matter, only 60% of medical patients understand risks and benefits of procedures or research. Wirshing et al. (2005) designed a teaching video which was effective in demonstrating to the patients the risks and benefits of the services that they were to receive (Wirshing et al., 2005). Also, if information must be collected from a third party regarding Emma, Emma must be fully informed and must give her consent to do so. Agrawal & Johnson (2007) state that a good way of securing this information, to preserve privacy, would be to develop a secure, interoperable electronic health records system (Agrawal & Johnson, 2007). Providing services within the bounds of competence is another consideration (Australian Psychological Society). 11. List the most important best practice/ethical considerations that need to be kept in mind when providing feedback to Emma regarding her psychological test results – (reference from general conduct guideline, code of ethnic and text) (5 marks). Confidentiality is one of the most important considerations, which means that her results are for her eyes only, unless she gives a written waiver to the contrary. According to Wynaden & Orb (2005), confidentiality is essential because it is at the core of a patient's dignity and right to privacy. Wynaden & Orb (2005) state that patients tell the providers information that is supposed to be private and the patient must depend upon this to be true. To do otherwise would be a breach of trust (Wynaden & Orb, 2005). Privacy is another consideration, which means that only information which is pertinent to the feedback will be obtained, as far as Emma’s psychological history goes. Full access is another ethical consideration, which means that Emma has the right to full access of her assessment and records (Australian Psychological Society). According to Ross & Chen-Tan (2003), providing full access to medical record are beneficial to patients, because it increases a patient's knowledge and empowerment, and it helps with adherence to protocols. On the negative side, it can also cause anxiety, and this was seen in a substantial portion of psychiatric patients. However, on the whole, allowing patient access to medical records is a net positive. 12. Provide a brief description (max 300 words) of your key recommendations for Emma on the basis of the assessment- (explains and link earlier answer / explain to client how and why and states the benefit of it) (6 marks). My recommendation to Emma would be that she should seek professional help for her psychological issues before she decides to give up on her studies at University. She took the WAIS because she was failing in school, and she wanted to find out if she has the intelligence necessary to pass her courses. The WAIS indicates that she is quite intelligent, but her depression and anxiety are standing in the way of using this intelligence. She should also get a full physical to rule out any clinical depression or indications of bi-polar disorder. She indicates both that she has low moods and also has nervous energy and agitation. According to the DSM-IV, this could be signs of bi-polar disorder (American Psychiatric Association, 2000). If she does have bi-polar disorder, than she could seek proper treatment with the proper medication. For that matter, she should be screened for a personality disorder, because it seems that she has had some degree of anxiety for most of her life. In other words, there should be further screening for any kind of underlying clinical issues which might indicate the way to go with treatment – perhaps there is a certain treatment that is recommended for a certain personality disorder, or drug therapy might be appropriate, in which case she needs to see a psychiatrist for this. A full physical should also be recommended, to find out if there is an underlying disease which is causing her to lose so much weight. Beyond this, I would ask that her husband accompany her to therapy, if therapy is appropriate, because her marital problems are at the heart of her unhappiness. Couples therapy might alleviate this, as it might help her overcome her marital problems. Cognitive behavioral therapy may also be recommended, as she has social issues, and issues with meeting other people. This could help her overcome these social anxiety issues. Bibliography American Psychiatric Association (2000). DSM-IV TR. Washington, D.C.: American Psychiatric Association. Australian Psychological Society. Code of ethics. Available at: http://www.psychology.org.au/Assets/Files/NewCode160807WEB.pdf Cohen, R. J., & Swerdlik, M. E. (2010). Psychological testing and assessment: An introduction to tests and measurement. (7th ed.). Boston, MA: McGraw-Hill. Dye, L., Lluch, A. & Blundell, J. (2000) Macronutrients and mental performance. Nutrition, 16(10), 1021-1034. Flanagan, D., McGrew, K. & Ortiz, S. (2000) The Wechsler Intelligence Scales and Gf-Gc Theory. Sydney: Allyn and Bacon. Frank, G. (1983) The Wechsler Enterprise. Sydney: Pergamon Press. Imam, S. Depression anxiety stress scales. Available at: http://bsris.swu.ac.th/iprc/4th/24.pdf Kaufman, A. & Lichtenberger, E. (1999) Essentials of WAIS-III Assessment. Brisbane: John Wiley & Sons. Lovibond, P. & Lovibond, S. (1995) The structure of negative emotional states. BRT 33(3), 335-343. Maquet, P. (2001) The role of sleeping in learning and memory. Science, 294, 1048-1052. Ross, S. & Chen-Tan, L. (2003) The effects of allowing patients access to medical records: A review. Journal of the American Medical Informatics Association, 10(2), 129-140. Tulsky, D., Saklofske, D., Heaton, R., Bornstein, R. & Ledbetter, M. (2003) Clinical Interpretation of the WAIS-III and WMS-III. Sydney: Academic Press. Walsh, B. & Betz, N. (2001) Tests and Assessment: Fourth Edition. Sydney: Prentice-Hall of Australia. Wirshing, D., Sergi, M. & Mintz, J. (2005) A videotape intervention to enhance the informed consent process for medical and psychiatric research. American Journal of Psychiatry, 162, 182-188. Wynaden, D. & Orb, A. (2005) Impact of patient confidentiality on carers of people who have a mental disorder. International Journal of Mental Health Nursing, 14, 166-171.   Read More