ABSTRACT
There is an Indian parable of six blind men who encounter different parts of a large elephant and are asked to describe what it is they are feeling. The man who grasps the trunk reports that he’s holding a snake; the next man, who is holding one of the large tusks, insists that it is a spear; another man, grasping one of the animal’s large legs, says that it is a tree. The point of the parable is that incomplete evidence results in incomplete conclusions and a narrow perspective of the entire beast.As applied psychology becomes increasingly specialized, psychologists also run the risk of drawing incomplete conclusions about patients and their functioning. Understanding something as complex as human phenomenology through only one narrow lens guarantees that our perceptions and conclusions will be similarly narrow. I argue, as have others (Meyer, 2002; Ready, Stieman, & Paulsen, 2001; Wilson, 1993), that we can and should have both breadth and depth as our goal in all clinical activities, including psychological assessment.In this chapter, I discuss the current division between neuropsychology and personality assessment. I examine differences in training, test usage, and scientific literature that give rise to somewhat different (and perhaps incomplete) perspectives of our patients. I then discuss the neuropsychological challenges posed by traditional personality assessment and behavioral measurement of children and adolescents and the types of “lessons” that personality assessors can learn from neuropsychology. Similarly, I explore ways in which neuropsychology practice can inform the assessment of child and adolescent personality and behavior. Last, I present a case example and provide some recommendations for clinicians who wish to move toward integrating neuropsychological and personality assessment in practice. Throughout, I argue that the meaning of a given personality or neuropsychological test score should be seen as contingent upon the full array of patient functioning.
The separation between neuropsychology and personality assessment begins early in training. Neuropsychologists receive extensive specialized training in cognitive neuroscience, neuropsychological assessment, and psychometrics, in addition to generalist training in clinical psychology (Hannay et al., 1998). The ultimate goal of neuropsychological training is a board certification that would attest to the clinician’s expertise in the field. Those who conduct personality assessments, on the other hand, are not required to engage in a specified course of training, but do need to be well versed in their particular tools and instruments as well as the complexity of human personality, psychopathology, and interpersonal dynamics. Although the Society for Personality Assessment has outlined some training guidelines and board certification in assessment is available through the American Board of Assessment Psychology, these are not as tied to clinical training experience as is seen in neuropsychology. This does not imply, however, a lack of rigor in personality assessment training; my point here is merely that the foci, guidelines, and certification processes of clinical psychologists who identify themselves as personality assessors versus neuropsychologists are different and may result in different perspectives about patient functioning.In addition to training experiences, there are substantial differences in the types of tests used in neuropsychology and personality assessment. For example, Rabin, Barr, and Burton (2005) conducted a survey of the membership of the National Academy of Neuropsychology, International Neuropsychological Society, and APA’s Division 40 (Clinical Neuropsychology) to determine what measures are most commonly given by neuropsychologists. In this survey, respondents were asked to rate their top three assessment measures. A similar survey was conducted by Camara, Nathan, and Puente (2000), who surveyed both neuropsychologists and clinical psychologists in APA. The results of both surveys are displayed in Table 3.1. The question asked by the two surveys was slightly different (i.e., “top three” in Rabin et al. [2005] versus “most common” in Camara et al. [2000]), but it seems that neuropsychologists appear quite unlikely to use traditional measures of personality and psychopathology (e.g., the Rorschach was listed as 34th) and that most assessment by clinical psychologists is focused on either personality or cognitive functioning.
