Psychological Testing, Psychopathology, and Culture
by Aaron Beatty
“Psychological testing has stayed fairly constant [at Riggs] for the last 69 years,” says Riggs Fellow Jeremy Ridenour, PsyD. He explains, “The instruments have stayed the same, more or less, and . . . we’ve had a similar patient base.” It was the arrival in the late 1940s of world class psychologists including Roy Shafer, PhD, and David Rapaport, PhD, who, according to Dr. Ridenour, “were the vanguard of clinical psychology and psychological testing at the time” that formed the approach to psychological testing that endures at Riggs.
In spite of the constancy, Dr. Ridenour was noticing “characteristic moves we [Riggs psychologists] made in our interpretations of the test data,” related to psychological testing results, based on his experience as a participant in the weekly Riggs psychological testing seminar. This observation piqued his interest and led him to wonder about the change in psychological testing reports over time. He says, “If the data are the same, the people [patients] are the same and the instruments are the same, what would account for differences in the narratives of the report?” To answer this question, Dr. Ridenour has spent the last year working on an exhaustive analysis (with the help of research interns) of the psychological testing reports at Riggs dating back to 1947.
Dr. Ridenour notes that at Riggs, the unique approach to psychological testing, which includes primarily projective tests, “provides an opportunity to look past what we can observe and try to understand some of the more implicit personality traits; it provides the psychologist a perspective that cuts across the way people are trying to present themselves.” This perspective is captured in the psychological testing report.
By looking at the reports over time, Dr. Ridenour is trying to understand how psychological testing has evolved at Riggs – “what we have lost, what we have gained, what were some of the implicit assumptions that were built into how psychologists were reading the data.” In addition, he wonders more broadly “if it [testing narratives] might reveal the way theories go in and out of fashion, what it reveals about psychology, about psychoanalysis and the ways in which cultural and historical forces shape our understanding of psychopathology.”
One of the trends he identified over the last 20 years in the psychological testing reports at Riggs has to do with the centrality of identity and affect. Patients were often described as having a poorly-defined identity and significant troubles managing and understanding their emotions. Research studies have demonstrated that patients who struggle to understand their emotions also suffer from identity diffusion and have trouble defining who they are (Neacsiu et al., 2015). He views those struggling with psychopathology as “at the forefront of encountering social demands and not being able to live up to them – every diagnosis in the DSM is based on poor adaptive and social functioning.’” He continues by saying, “The struggle of patients reflects something larger about what’s going on socioculturally. My interpretation is that right now people are given a lot of authority to define themselves. In this generation, traditional categories and markers of identity (e.g., sexuality, gender and religion) are being questioned, revised and renegotiated. For instance, for young adults in the United States the fastest growing religious identity is the “nones”, individuals who opt not to align themselves with either a religion (e.g., Christianity, Islam, etc.) or atheism/agnosticism. There is a proliferation of freedom for individuals to define or not define themselves and our patients might be demonstrating the difficulty with that kind of openness. In other words, if a person cannot make sense of her emotional experiences then it can be very challenging to understand and consolidate a sturdy sense of identity in an increasingly open society.
Regarding the patients who come to Riggs for treatment, Dr. Ridenour comments, “I think a lot of our patients have tried to make adaptations to their identity that have been unsuccessful – they are coming here to re-fashion and redefine themselves and re-think questions such as: ‘What are my ideals?’; ‘What do I want in the world?’; ‘How can I relate to others?’; and ‘How can I move forward with a firmer sense of who I am without losing myself?’”
Dr. Ridenour presented these findings recently at the 2016 Society for Personality Assessment Conference in Chicago, IL.
Reference: Neacsiu, A. D., Herr, N. R., Fang, C. M., Rodriguez, M. A., & Rosenthal, M. Z. (2015). Identity disturbance and problems with emotion regulation are related constructs across diagnoses. Journal of clinical psychology, 71(4), 346-361.