Psychiatric Mental Health Nursing by Videbeck

8 ASSESSMENT 167

needs in ways that are clear to health team mem-
bers in other disciplines as well as families and care-
givers. For example, a multidisciplinary treatment
plan or critical pathway may be the vehicle for plan-
ning care in some agencies. A plan of care that is use-
ful to the client’s family for home care may be neces-
sary. The nurse must describe and document goals
and interventions that many others, not just profes-
sional nurses, can understand. The descriptions must
contain no jargon or terms that are unclear to the
client, family, or other providers of care.

Psychological Tests

Psychological tests are another source of data for
the nurse to use in planning care for the client. Two
basic types of tests are intelligence tests and person-
ality tests. Intelligence testsare designed to evaluate
the client’s cognitive abilities and intellectual func-
tioning. Personality testsreflect the client’s person-
ality in areas such as self-concept, impulse control,
reality testing, and major defenses (Adams & Culbert-
son, 2000). Personality tests may be objective (con-
structed of true-false or multiple-choice questions).
Table 8-1 describes selected objective personality
tests. The nurse compares the client’s answers with
standard answers or criteria and obtains a score or
scores.
Other personality tests, called projective tests,
are unstructured and are usually conducted by the
interview method. The stimuli for these tests, such
as pictures or Rorschach’s inkblots, are standard,
but clients may respond with answers that are very
different. The evaluator analyzes the client’s re-
sponses and gives a narrative result of the testing.
Table 8-2 lists commonly used projective personal-
ity tests.
Both intelligence tests and personality tests are
frequently criticized as being culturally biased. It is
important to consider the client’s culture and envi-
ronment when evaluating the importance of scores or
projections from any of these tests; they can provide
useful information about the client in some circum-
stances but may not be suitable for all clients.

Psychiatric Diagnoses

Medical diagnoses of psychiatric illness are found in
the Diagnostic and Statistical Manual of Mental Dis-
orders, Text Revision,fourth edition (DSM-IV-TR).
This taxonomy is universally used by psychiatrists
and some therapists in the diagnosis of psychiatric ill-
nesses. The DSM-IV-TR classifies mental disorders
into categories. It describes each disorder and provides
diagnostic criteria to distinguish one from another

Table 8-1

OBJECTIVEMEASURES OFPERSONALITY

Test Description

Minnesota Multiphasic

Personality

Inventory (MMPI)

MMPI-2

Milton Clinical

Multiaxial

Inventory (MCMI)

and MCMI-II

(revised version)

Psychological

Screening

Inventory (PSI)

Beck Depression

Inventory (BDI)

Tennessee

Self-Concept

Scale (TSCS)

566 multiple-choice items;

provides scores on

10 clinical scales such as

hypochondriasis, depres-

sion, hysteria, paranoia;

4 special scales such as

anxiety and alcoholism;

3 validity scales to evalu-

ate the truth and accuracy

of responses

Revised version of MMPI

with 567 multiple-choice

items; provides scores

on same areas as MMPI

175 true-false items; pro-

vides scores on various

personality traits and

personality disorders

103 true-false items; used

to screen for the need for

psychological help

21 items rated on scale of

0–3 to indicate level of

depression

100 true-false items;

provides information on

14 scales related to self-

concept

Adams, R. L., & Culbertson, J. L. (2000). Personality assessment: Adults

and children. In B. J. Sadock & V. A. Sadock (Eds.). Comprehensive text-

book of psychiatry,Vol. 1 (7th ed.), 702–722. Philadelphia: Lippincott

Williams & Wilkins.

Table 8-2

PROJECTIVEMEASURES OFPERSONALITY

Test Description

Rorschach test

Thematic

Apperception

Test (TAT)

Sentence

completion

test

10 stimulus cards of ink blots;

client describes perceptions of

ink blots; narrative interpretation

discusses areas such as coping

styles, interpersonal attitudes,

characteristics of ideation

20 stimulus cards with pictures;

client tells a story about the

picture; narrative interpretation

discusses themes about mood

state, conflict, quality of inter-

personal relationships

Client completes a sentence from

beginnings such as, “I often

wish,” “Most people,” “When I

was young.”

Adams, R. L., & Culbertson, J. L. (2000). Personality assessment: Adults

and children. In B. J. Sadock & V. A. Sadock (Eds.). Comprehensive text-

book of psychiatry,Vol. 1 (7th ed.), 702–722. Philadelphia: Lippincott

Williams & Wilkins.