Let me start with a definition of a medical device that is set by the FDA, that regulates such:
"...an instrument, apparatus, implement, machine, contrivance, implant, invitro reagent,
......which is intended for use in the diagnosis of disease or other conditions, or in the cure,
mitigation, treatment of prevention of disease, in man or other animals."
Then basically it should be under the regulations of the FDA. At least that is my opinion.
- First let us consider testing for learning disabilities(this could be diagnosis or other conditions).
- Mental disorders or mental illness(this is diagnosis,an instrument, implement, mitigation in man).
- Treatment and prevention(I would say they are used this way)
Who does regulate it if the FDA does not? Another government agency? No the regulation of these tests are done on a voluntary basis by the American Psychological Association. Let me see a self regulated industry. Does anybody else see how this could lead to corruption? Or at least ethical issues? With no oversight by any one outside the profession a perspective can certainly be skewed. This is something a psychologist tries to avoid.
Before I go to far I want to list some information you can check out that has made me become so vehemently against these tests....or at least to a list of questions around them that need to be addressed. I can't remember all the books I read but I found one that has a lot of good information. Also, some comes from my personal knowledge due to my profession. So feel free to check these out. Let me restate this in a more reasonable way. These tests must be regulated to offer protection to those that may suffer harm from improper use of: test data that is unproven or on verifiable, and long term studies must be done to see what ill effects have happened because of wrong conclusion drawn from these tests. Drug companies have to answer for quite a bit. They have to do post marketing studies to see what the drugs do to people long term.
- A book by the name of The Cult of Personality : How Personality Tests Are Leading Us To Miseducate by Annie Murphy Paul. One can read a few pages free on Online Shopping for Electronics, Apparel, Computers, Books, DVDs & more. The introduction part will provide enough basic information for him/her to get an idea about some of the issues with these tests.
- Here is a website where one can see a psychologist's view of the famous inkblot test. Which is that it is basically worthless. You even get to see the inkblots. Here it is Page on Deltabravo
- Here is a website to an article by a law professor, I think. You can be certain when you go there. It talks about how the tests are normed and that they are accurate. He does admit that the math involved is very complicated. My problem deals with the groups they are normed against. Also, the people that make the test verify the data and do not submit it to anybody else. Drug companies must submit their data to the FDA before a drug can be brought to market to make sure it is safe. I recommend just glancing over this site. Page on Momnd
- This one is amazing. It deals with the development of the MMPI. It talks about how great this test is. It says the MMPI is normed against people in a hospital and friends or relatives that visited the hospital. It fails to mention, as Paul clarifies in her book, that the hospital is a mental hospital. The common theory out today, almost taken as gospel, is that mental illness has a very high genetic component. Variations on specific areas of the DNA are associated with a higher incidence of bipolar, schizophrenia and autism. Thus these run in families according to current theory(check The U.S. Government's Official Web Portal search genetic connection of all). Here is the kicker. Everyone says the MMPI is so accurate. This lists what I have read in other sources. Want to guess how accurate? WELL THE ACCURACY OF THE MMPI IS RATED AT 60%. That is about as good as a coin toss. Here is the site.http://www.psychualberta.ca/~chrisw.L10MMPI/L10MMPI.pdf
Before I start on more negative comments I want to state a few positive. Psychologists are not bad. I am not knocking them. They help a number of people work through a lot of problems and they save lives every year. The most effective course of treatment for depression has been identified as treatment with drugs and psychotherapy. I am just pointing out some issues that I feel need to be addressed. I asked the American Psychological Association about this and received no reply. I talked with a publisher of one of these tests and all they could say was I needed to talk to the person that administered the test.
- Why would the American Psychological Association not want a separate agency to regulate them? It would show the tests are verified by an independent source.
- How can the publishers of these test get out of any liability? And just state all the problems rest on the person that gave the test? Let me use the MMPI as an example. If it is almost a toss up at being right say drug treatment is started based on it or someone is deemed and unfit parent? Assume later it is found out the test finding were wrong, wouldn't you want some way to fight back at the test? I know I would. Can a drug company just day talk to the doctor that gave you the drug? Of course not.
- Now let us go back basic things that the tests makers, providers and publishers should have to do. A person should be given clear instructions about the test, how it is given, what it is for, the success/failure rate, what can influence it, if they can decline to answer some questions and how that will effect the outcome, if it is given to a child how it can effect that child's mental health for the rest of his/her life, what trauma can be inflicted........?
- Drug companies have to hand out inserts on specific drugs, most pharmacies give information on drugs the first time you get if not every time, patients have to read something before surgery(by the way there are long term studies on things implanted in you) and every one knows about hippa. Shouldn't these tests come with information leaflets? After all they are used in court everyday to help determine custody and more.
I will say just a little more about the tests before I get a little more personal, which will explain why I am so knowledgeable about this. Plus you may come to understand why it is so important if you don't agree with me already.
I already explained how the MMPI development sprung from the bed of a mental institution. Well the birth of the inkblot test has problems too in my opinion. If you looked at the link I posted it showed that almost each inkblot could have a sexual connotation. I don't know if this is from the original makers but it would not be a surprise. They were after all by a doctor and an assistant-mistress. What kind of morale's were being projected? Was their sexually relationship spilling over into the professional one? Were they nympho's? So again when these people norm these things remember the influence of the people giving the test, the history of the test and so forth.
Now I would like to share a little bit of my personal experience with the tests and some neuropsychologists. I have concerns about these tests and for our military men coming back from war with brain injuries.
Those of you that believe in God remember this. Proverbs 29:11-A fool uttereth all his mind: but a wise man keepeth it in till afterwards. This is not lying. It is being wise. The only time one must tell the whole truth and nothing but is in court. Everybody is entitle to his/her privacy.
At 18 years of age, just before starting college classwork, I had to take the MMPI. The thought was keep certain people out of this type of job. You see they don't want just anybody behind the counter of a pharmacy. The practice of giving this test has been dropped at the school I attended because of lack of reliability. At least that is what I was told by someone that is still on board there as an employee.
How is an 18 year old girl to answer: Are you happy with your sex life? I answered yes. The thought of someone asking me this and it being a requirement was unsettling to me. The guys giving the test said any girls that say no to that question can see them after the test.
Next were questions about when one is in the bathroom. How many of you have been taught this is not polite to talk about? Would it not be weird for a test to ask such stuff? And the test was so long. Some people may get tired and just not pay that much attention at the end and mark anything. Or some may be so stunned, traumatized or shocked their answers mean nothing. This test may have kept some from becoming what they had dreamed of all their life. Okay now it is thirty years later and I don't believe anybody has followed up any of those taking the test to see if it screened those people correctly.Remember the test is very accurate at 60%. I am sure it has dashed some one's career hopes or dreams. Does that sound worth giving the test? Here we have so much hippa that is hard to practice in the health care field. But this test can almost perform a personal privacy rape and not one person says a thing. Do some girls wonder if they are normal and make a swing toward sexual experimentation upon reflection of this test?
I recall a friend that was going to be a teacher taking one of these test. I think it was the MMPI but can't say that with complete recall. The test was not kind to her. She had to pass an interview with the complete Education faculty in order to stay in the teaching program. Today she is fine teacher of quite a few years. I think what she was really suffering was a lack of maturity at the time and too much freedom.
I now come to what has happened to me in the last three and half years. I had a wreck that resulted in me having a mild traumatic brain injury that was most likely made out to be worse than it was. I was originally treated only for two fractures but finally after pushing the hospital staff enough they treated another fracture. This left two other fractures and a rotator cuff to be dealt with by other physicians. There may have been one other fracture but the doctor that I trust said if it wasn't bothering me he saw no reason to x-ray it. It made sense to me. I also had to deal with vestibular dysfunction of central origin and tingling painful headaches. After being told my memories were false and I was not wearing my seat belt I still had a lot to deal with.......I know I need to close this soon....Let me try to be brief.
- In hospital ROSS Informational Processing tests says I'm okay. Further testing the next day with WJIII test of Cognitive abilities given when I was high on IV Morphine, Sublimaze and oral Lortab. I voiced my my desire to not participate in test that I learned later was being given by a graduate speech therapist student under another therapist, not present, that had been licensed less than one year. I was never told this could have a bearing on my career or if I had a husband that was a bad father, could have obtained custody at that time. My main goal was to get out of hospital and into a rehab one.
- At rehab hospital did fine except with speech therapist. In the hospital did okay with neuropsych it was later that I has issues with her advice. Again the speech therapist did not tell me her testing had a bearing on my career. An issue of flexibility came up. I really didn't pay much attention to her because my focus was on getting physically well. The test that showed I had flexibility issues is stupid. I filled in blank boxes on the basis of info given. She said what if I had to do it another way. I said is this correct. She said that is not the issue. I am like what then. How can you find a flaw in the logic if I was correct? How does this determine someone is inflexible? I can see how it might if I were working with stupid people that would not might argue my information was wrong. Then the discussion went to the fact that I was paid to be inflexible. I told her if I didn't think a drug order was filled correctly I would not let it go out the window. She was fit to be tied. She also went on to say how she had shown me to adapt to my problems by taking notes. I said you did nothing. I have always done better with a pen in my hand by writing things down.
- The speech therapist that I had during home health was also a pain with their testing. I was asked what a sun shinning, lemonade and a school bus might remind me of. I said my son coming home from school and having a refreshment on a nice day. Well I should have said yellow. What do kerosene, gasoline and oil have in common? I said they are all combustible fuels. Wrong she wanted the answer liquids. I was given some tasks to do...she could not do she said because she had read the directions recently. Well if she needs help she should not be giving the test or evaluating a person doing the tasks.
- Without going in to a long story I was vindicated in being proven right about having 2 more fractures but still felt out of sorts. I asked for counseling thing it was the mild brain injury. This neuropsychologist tried to help. Bear in mind they are considered the experts on how the brain injury has affected a person both emotionally and in fine motor function. She said I was bipolar and was before the accident. I was pretty moody. I was in pain and having bad headaches. What I had was missed by my very good PCP, neurologist and optometrist trained inn treating brain injured. It took some time but a vestibular test revealed dysfunction which could cause one to be tired, dizzy and complicate headaches. I would think it could contribute to my anger and short fuse. My research had shown that vestibular research could help. Yet, every time I asked her if the brain injury could have anything to do with my issues the answer was a big fat no. My neurologist put me on something for the headaches which helps but the therapy helped a great deal also.
- I could go one with more but I will leave you with this. If neuropsych's are the primary providers treating our military when they return, how many are getting the wrong treatment? It has been stated that those with brain injury often end up with a drug problem. Could it be that given the right test and treatment they might not end up that way? How many are put on mental health drugs that just need this therapy and some medication for real headaches?