It is widely accepted that patients should participate fully in their treatment. They should know the nature of their diagnosis and what treatment options are available to them.
There are at least two exceptions to this.
First if their functional status has been impaired to such an extent that they can neither understand or make use of such information.
Secondly when test results are manipulated. Patients may exaggerate the severity of their condition or minimise its severity. In the first case it maybe to enhance their eligibility for a pension for example or to increase the level of compensation they are awarded and in the second case it may be to retain a role, perhaps at work.
Many psychometric tests that rate the severity of symptoms are presented in such a way that it is easy for the patient to see how to manipulate the results. Each symptom is presented with a range of possible severities or frequencies of occurrence. Insurance companies, the Courts etc are sceptical about the authenticity of results.
As a trained scientist it worries me greatly that we should place any credence in such results. A particular issue that is of concern to me is the realisation that members of the American armed forces who can be shown to have acquired a physical or “mental” disability during active service are entitled to free healthcare for life. A person who for what ever reason wants to establish that he or she has acquired a mental disability might seek the support of a lawyer who could easily train the person how to manipulate the results.
Under these circumstances the patient and his or her advisers should not be given results until the cycle of assessment and monitoring are complete.
Expert witnesses are expected to give valid, reliable and credible evidence as for example in the case of genetic finger printing. Psychology infrequently provides evidence of that order of certainty but surely we can up our game from antediluvian psychometrics.
David J Mulhall
psychological test results article