Psychological Testing

First of all, have any of you had any of this done? What kind and were you satisfied with the results? Did you feel it was worth doing?

And now my personal question...

So I had psychological testing done over 3 years ago, going on 4. But in that time my diagnosis has changed significantly and I have been on over a dozen meds. My current therapist suggested that I write down a list of all the meds to give to my new med prescriber. I did, but sort of half carelessly left it in my pocket and my dad saw it. He was a little concerned about all the meds I have been on and thinks that I need a new evaluation to see what I actually need.

I just dont know if this makes sense. I do not think it is a bad idea myself, because I have had way too many diagnoses floated at me, especially recently by my new providers, and even more new meds suggested. But I just do not know how frequently its reasonable to get psychological tests done.

I looked online and I could not find much information about the frequency of having these tests done. Are they mostly a one time thing?

Anyways. For those who have had these tests done, how many times have you gone through the process?

@Under*Over

Short answer: Yes, psychological tests can be done frequently.

For the longer explanation, read below:

Psychological testing can be done by many different providers, depending on what your referral is. A psychiatrist may have different psychologist tests than a psychologist, LCSW, LPC, or other counselor with a different title. Additionally, even if you went to another psychiatrist after seeing the first, their psychological tests may differ; the same could be said if you went to a therapist, who may have different psychological tests, even if they hold the same titles and/or have the same modalities.

When people apply for disability regarding mental illness, they are getting psychological tests throughout their life, repeatedly. When people are involved in an accident, there are different psychological tests for that as well, most often while in the emergency room. There are many different psychological test for many different reasons, or even for the same reasons.

You can always ask to have a second opinion by a psychiatrist, psychologist, or other mental health professional in a different institution than where you're currently receiving treatment and/or getting evaluated.

I've had many psychological tests done throughout my lifetime - too many to count, actually. I'm 45. Initially, the psychological tests I had from my early adulthood (18 to about 21) were testing for fitness for certain jobs. Later in life, I sought out treatment, which involved psychological tests for whatever my presenting symptoms were. When my functioning was so disabled that I could no longer work, I got psychologically tested for disability. Some of the psychological tests are required every 3 years (sometimes sooner, sometimes later) for disability, whereas others only take an initial test. For psychiatric treatment (for medications, not for talk therapy), you can request a second opinion, or you can stick with your current psychiatrist and ask for a re-examination. For talk therapy with a psychologist, licensed clinical social worker, licensed counselor, marriage and family therapist, other licensed counselor, or psychiatrists who offer talk therapy, you can ask for evaluations from them as well, which can serve as a second or third or umpteenth opinion.

Every test will be different, even if they are testing for the same thing. You may even get different answers. Psychology is not an exact science, but they try to make it as precise as possible with their given psychometric properties and research evaluations on those tests. Whatever diagnoses you receive, if receiving multiple different opinions, you can discuss the results with your various treatment team(s) and see what you find matches best with your symptoms. But make sure that your own biases don't get in the way, that is, if you receive a diagnosis that you feel you don't agree with because of the stigma versus feeling that you don't agree with the diagnosis because it doesn't seem like that represents you (sometimes your symptoms could be situational, as opposed to dispositional, whereby situational means that you're having adjustment problems with a lot of stressors in your life, so your symptoms are related to those adjustment problems at a particular time in your life, as opposed to being relatively stable symptoms across your life, which is dispositional). They may use more proper psychological lingo to describe what I'm trying to describe off the top of my head.

It's up to you whether or not you want a second opinion, a talk therapist to evaluate you, or a re-examination by your current psychiatrist. If your medications aren't working for a particular diagnosis, that is one thing. If your diagnosis and its treatments aren't seeming right, then a new psychological test might be needed to figure out exactly what is going on.

Hope this helps. Sorry it is so long.

I had it done when I was thirty. The clinicians was awesome and really understood me. I love her dearly for all the help and validation she gave me during the evaluation and after. We still even message occasionally on FB.
Now... fast forward 12 years... I have been through 2 different T’s since her and on T3. I adopted, raised and sent a child out into the world... my experiences of life are different. T3 and I have discovered a lot about my childhood that I never thought about because frankly I never thought it was important. The woman who did the eval did take a thorough history by all standards. T just accidentally stumbled onto things no one else ever would think of. So... the diagnosis (autism spectrum disorder) that brought me SO much relief and healing 12 years ago may, actually, be totally inaccurate! I believe parts of the eval are still valid and accurate but not the diagnosis. T and I are exploring that and what I believe the true concern is. So, IMO it was totally worth it even if 12 years later it proved to be wrong and I would absolutely consider doing another if I had someone as competent at the first woman.

I have had it done twice: once in my early 20's and once in my 40's.

The most recent was done at the request of my pdoc to help confirm diagnosis. He wanted to be sure he was treating me correctly based on the diagnosis he had made.

I had it done when I was in college - I was hoping to differentiate learning disabilities from depression from ADHD. No LDs diagnosed, just confirmation of depression/anxiety/adhd, and a recommendation for disability accommodations to help my performance in school.

Side note: It is very important to keep records of meds/treatments you've tried. This helps your providers, current and future, give you the best possible treatment. I keep 2 spreadsheets relating to medications I've tried. One is just a list - the med, the max dose, the dates I took it, who prescribed it, and my general impression of it. The other is timeline showing which meds I took simultaneously at any given time, as well as other things like ECT or hospitalizations. This has been very beneficial as I have been on complicated cocktails, which isn't as easy to see in list form. You can make such files password protected if privacy is a concern. (If anyone wants help/advice on how to create such files, feel free to PM me.)

I've had evaluations but the tests your talking I haven't had testing since I was a teen. As for all your medication have you gotten the test to see how you metabolize your medication?

Honestly I've cycled through tons of diagnosis and medication with certain providers. I have 2 dx p doc has bp down/ t has SzA down. I've been labeled with almost everything under the sun. I would make a list of symptoms that bother you from most to least and start over with meds. I've been on over 6 psych meds at a time now I'm on 1 with prn but I had to start over.

Yeah, like 15 or so years ago. I don't remember much except he actually did the rorschach inkblot test as part of it, which I thought was kind of outdated. Oh, and my IQ was assessed the same year but by a different person. I know those results. The only thing I remember coming from the other tests specifically is that I'm pretty doom and gloom and filled with foreboding.

A lot of self testing. I work in mental health and have access to many professional psych tests, so I tested myself. There was a period in the past when I could be diagnosed with at least 5-6 disorders, but most were actually just symptoms caused by an addiction issue and disappeared completely when I got sober. This is something that professionals should keep in mind more than they often do, that sometimes diagnosing can be misleading if they do not consider the interactions between issues and how one can mimic the symptoms of another... and in that case treatment can be quite ineffective if it does not target the mail culprit.

@Xynesthesia2

Interviewer bias can also factor into the equation.

But yes, some of the psychometrics fail to look at etiologies, differential diagnoses, historical accounts (not just today's psychosocial history), substance-use, interactions with substances, interactions with medications, interactions with pain management or physiological issues (including aging), etc.

Then there's the influence of insurance coverage.

I did one test in college to try to get disability accommodations. Oh, and I think I did one back when I was 14 when I first told my parents about the depression. The tests revealed that I was severely depressed, which honestly is no big surprise. They keep asking me if I have "up" times to rule out bipolar, but for me it is all low and lower.

I think taking another shot at psychological testing could be beneficial.

Definitely about the interviewer bias and also self-testing is not the most accurate method. I've done so many psych tests that I can often see how the tests work behind the questions, and that can make answers biased, especially if I am avoiding something. Not with actual tests, but I also had a T who was extremely prone to projections to the point of sometimes even making up things about me that I never said or experienced.

Physical conditions can sometimes really distort psych assessments, I always like to see when psych professionals inquire about physical health of a client and sometimes want the client to have a physical before they would provide treatment for certain psychological disorders. Not very many Ts do this unfortunately, in my experience... psychiatrists more often do but they also often prescribe medications too easily, without thorough evaluation.

I forgot to answer what kinds of tests - all sorts of psychiatric screening, diagnostic tests and personality tests. I liked some of the personality tests a lot and learned from them important patterns about myself, but those are exactly the kinds of tests that became very predictable after a while of doing many and I don't find them all that useful now because I've worked so much on myself. Answering many questions considering the original state before all the conscious work and self-awareness is no longer truthful, but responding with the more developed views and behaviors does not lead to an accurate picture of my personality structure either. Very insightful when I was younger though.

@Xynesthesia2

It's hard for me to participate in surveys because I was a research assistant for a clinical psychology lab, where I coded answers to a battery of tests disseminated among youth and families. I also had taken a psychometrics course as an undergrad, so that showed me how tests were designed, pilot tested, and checked statistically. The test makers (psychometrics) often include their own biases when designing such tests, as opposed to first doing focus groups or PAR (participatory action research), so as to remove bias. Still, there remains bias all around.

Who's to say that outliers can't also be "normal" in their own right - an existential position, a cultural position, a diversity issue? Oftentimes, culture plays a role in behavior, personality, and emotions. We need more tests for that, too. Those issues are often not accounted for in psychological testing.

I love the points you made though. It helps to know that some professionals understand these things, as well as the limitations to cross-sectional research.

This is why I never liked very much pre-designed tests in academic assessments either. Much prefer more unstructured, free essay types where I can express my answer in my own way, without having to follow and guess someone else's thinking.

One thing my second T did before we started therapy was asking me to email a summary of "my story". He did not give any more specific instructions or help to interpret it. I took it to write a summary of myself that brings out what kind of person I am, some of my background, preferences, values, interests and of course issues I wanted help with. I know he liked what I wrote very much but not sure what exactly he got out of it clinically to have a picture of me. I know such a thing would be very informative for me, you can read not only what the words directly say but many things about someone's thinking, emotional style and personality as well.

I’ve had two official tests by psychologists. One when I applied for ssdi and the other this year when I was defending myself against my sister for trying to get guardianship over me.