Personality Assessment Paradigms and Methods

A Collaborative Reassessment of Madeline G

Christopher J. Hopwood, Mark H. Waugh, Christopher J. Hopwood, Mark H. Waugh

• Publisher: Routledge
• Year: 2019
• ISBN:
  9781351388115
• Edition: 1
• Topic: Psychologie
• Subtopic: Klinische Psychologie

This book is an update of Paradigms of Personality Assessment by Jerry Wiggins (2003, Guilford), a landmark volume in the personality assessment literature. The first half of Wiggins (2003) described five major paradigms: psychodynamic (as exemplified by the Rorschach and TAT), narrative (interview data), interpersonal (circumplex instruments), multivariate (five-factor instruments), and empirical (MMPI). In the second half of the book, expert representatives of each paradigm interpreted test data from the same patient, Madeline.

In this follow-up, personality experts describe innovations in each of the major paradigms articulated by Wiggins since the time of his book, including the advancement of therapeutic assessment, validation of the Rorschach Performance Assessment System, development of a multimethod battery for integrated interpersonal assessment, publication of the Restructured Form of the MMPI-2, and integration of multivariate Five-Factor Model instruments with personality disorder diagnosis. These innovations are highlighted in a reassessment of Madeline 17 years later.

This book, which provides a rich demonstration of trans-paradigmatic multimethod assessment by leading scholars in the personality assessment field in the context of one of the most interesting and thorough case studies in the history of clinical assessment, will be a useful resource for students, researchers, and practicing clinicians.

Chapter 1
Madeline G. and Five Assessment Paradigms Two Decades On

Christopher J. Hopwood and Mark H. Waugh

It can be overwhelming to learn a new clinical assessment method or psychotherapeutic technique. Competent clinical practice entails digesting a large body of validity evidence as well as the nuances of successful delivery. Even the most skilled clinicians meet help-seeking clients in the clinic with anxious anticipation, privately wondering how effective they will be. Our clients are living, breathing people whose personalities and life problems are “messy.” They typically do not fit neatly into the boxes and categories of DSMs or offer perfect matches to manualized protocols and procedures. How do we integrate our client’s experience, our experience of the client, the deluge of clinical data, and the many perspectives on personality and psychopathology that may pertain to determine how we can be helpful?

It is natural to want help from someone who knows what to do. We regularly seek consultation—recall in our minds the lessons we have learned—from teachers, supervisors, workshops, scientific articles, case reports, and technical manuals. But sometimes it would be better to observe a master of the craft in action. We want to ask this master to explain the what, why, and when of their technique. The goal of this book, a sequel to Paradigms of Personality Assessment (Wiggins, 2003), is to give the reader the opportunity to have this experience with master personality assessors.

In the first half of Paradigms of Personality Assessment, Wiggins described the historical roots, assumptions, and methods associated with five major paradigms of personality assessment: personological, psycho-dynamic, interpersonal, multivariate, and empirical. In the second half, representative experts of the five paradigms independently interpreted assessment data from the same person, Madeline G. Trobst and Wiggins (2003) concluded the book with an integrative formulation that incorporated insights from each paradigm. The goals of this book are twofold. First, experts from five major personality assessment paradigms provide updates about progress in their paradigm since Wiggins (2003). Second, these experts describe how to interpret data from their preferred instruments, collected from Madeline G. nearly two decades later, in order to describe what she is like now, how she has changed, and how we might answer questions she has about herself.

The remainder of this chapter is divided into four parts. We first discuss what Wiggins (2003) meant by the term paradigms and how we understand the five paradigms reviewed in this text. In the next section, we discuss some of the major trends in personality assessment during the two decades since Wiggins initiated the Paradigms of Personality Assessment project. We then describe Madeline G. in 1999/2000 and briefly introduce her in 2017. We conclude by outlining the plan for the rest of this book.

Paradigms

The term paradigms is borrowed from Kuhn (1962/2012) to refer to the idea that there are different ways of thinking about a field of inquiry or common issue—in this case, how to measure and conceptualize a person’s personality. This kind of situation is common in the sciences (e.g., the transition from Newtonian physics to Einstein’s general theory of relativity). Paradigms also occur in neighboring areas of psychology (e.g., different schools of psychotherapy or the person-situation debate). Wiggins focused on five paradigms and associated exemplar tests and methods: persono-logical (narrative assessment), psychodynamic (Rorschach, storytelling tasks, and other performance-based measures), interpersonal (interpersonal circumplex [IPC] instruments), multivariate (factor-analytically derived trait questionnaires) and empirical (Minnesota Multiphasic Personality Inventory [MMPI]). Wiggins elaborated how the paradigms give different answers to three questions: “‘What is personality?’, ‘How do we measure it?’, and ‘What should we measure?’” (Wiggins, 2003, p. 1). The personological tradition emphasizes the individual’s life story, which is measured by culling the themes and patterns of personal narratives for meaning. The psychodynamic perspective is most sensitive to implicit and unconscious dynamics as assessed through relatively indirect approaches such as inkblot tasks or storytelling techniques. Interpersonal theorists understand personality in terms of how people relate to proximal and internal others, the dynamics of which are structured around agency and communion and measured using multi-informant and observer methods. The multivariate paradigm asserts that factor analyses of items that reflect the variation with which people describe one another reveals the structure of personality, generally in the form of a hierarchical Five-Factor Model (FFM). The empirical paradigm interprets personality via the MMPI, a measure of hypothetical diagnostic constructs whose meaning is inferred by a broad network of observed correlates.

Wiggins (2003) also elaborated the ways in which personality assessment paradigms differ from scientific paradigms as defined by Kuhn. For instance, unlike Kuhnian paradigms that are fundamentally incommensurable owing to their different vocabulary, concepts, and acceptable methods, personality assessment paradigms can be integrated, as Trobst and Wiggins (2003) artfully showed in their conclusion to Paradigms of Personality Assessment. Kuhn (1963) himself suggested the professions such as law and medicine (and assessment psychology) do not display pure paradigm dynamics since they are shaped by societal needs as well as the so-called truth-value of their disciplines. Wiggins (2003) thus concluded that the paradigms might be better understood as “communities” with important historical, theoretical, and methodological differences. The use of the term “community” highlights a critical difference between personality assessment paradigms: the social networks that drive and define each paradigm. We think about different people when we consider the person-ological (e.g., Henry Murray, Dan McAdams), psychodynamic (Sigmund Freud, Sidney Blatt), interpersonal (Harry Stack Sullivan, Lorna Smith Benjamin), multivariate (Raymond Cattell, Lewis Goldberg), and empirical (Paul Meehl, Grant Dahlstrom) personality assessment paradigms. Wiggins devoted much of his initial chapters to describing each paradigm in terms of associated historical figures and tracing their imprint on the paradigms. We gather that it was not difficult for him to select individuals to represent each paradigm. It was likewise not difficult to think of people to represent the paradigms for the present book. At the same time, we can also think about people, like Wiggins, who are better known for putting different paradigms together.

Isaiah Berlin (1953/2013), borrowing from the ancient Greek Archilochus and the Medieval scholar Erasmus, labeled these two kinds of people as hedgehogs and foxes. Hedgehogs develop deep expertise in one area, hoping to identify a single, coherent solution to complicated problems. Foxes, in contrast, accept that they will never get it all at once and tend to explore various tracks and hop around in different areas. Hedgehogs seek to develop expertise in one approach, whereas foxes see multiple paths to accomplish the same goals, are attuned to the advantages and disadvantages of different approaches, and are interested in how different strategies can be integrated with one another. Foxes and hedgehogs both promote progress but do so in different ways; in turn, they are susceptible to different kinds of problems. Foxes can become unmoored and may be inclined to issues that are too distal or abstract to solve focal problems, or they may experience a kind of frustration about never having solid answers to their questions. Hedgehogs, burrowing down deep, can develop blind spots and miss opportunities for insights that may be known from other perspectives or experience a deep despair upon realizing that they will never actually grasp the full picture with their singular, dedicated approach.

How do we, as individuals, encounter the multi-paradigmatic world of personality assessment? Is it better to be a fox or a hedgehog? We are with Wiggins (2003) in proposing that we can have it both ways. The field is healthier to the extent that at least some of us act like hedgehogs at least some of the time. Hedgehogs take principled ideological stances that faithfully represent a certain perspective in the clash of ideas and that serves a deeper understanding. This is more consistent with the standard Kuhnian model. But we also need enough foxes to counter a situation in which paradigms develop into “invisible colleges” that tacitly influence the field, which is based more on historical and political factors than validity or utility (Blashfield, 1984). Fortunately, this binary choice of fox or hedgehog is not the only option. The same person can be both a fox and a hedgehog, albeit generally not at the same time. Wiggins (2003) argued that Henry Murray was both a hedgehog and a fox, and both of the authors of this chapter identify ourselves that way. A book also can be both. This volume has the dual aims to promote the unique value of individual personality assessment paradigms (“hedgehog” Chapters 2–6) and demonstrate how those paradigms can be fruitfully integrated (“fox” Chapters 1, 7, and 8).

Personality Assessment

Although Meehl (1978) warned us that progress in psychology would be slow, a lot has actually happened in personality science and assessment in the nearly two decades since Wiggins initiated his project. In fact, whereas the influence of personality assessment had been waning in some ways for decades at the end of the 20th century, during the beginning of the 21st we are witnessing a re-emergence of personality in clinical psychology. Several factors are responsible for this trend, including new evidence regarding personality stability and change, the ascendance of dimensional models of psychopathology in research and diagnosis, the rising popularity of Therapeutic Assessment (TA; Finn & Tonsager, 1997), major updates to some of the most widely used personality tests, and the Open Science movement.

Personality Stability and Change

When Paradigms of Personality Assessment was written, there were active debates about whether clinical psychologists should even be using a term like personality in clinical assessment. Views ranged from the perspective that personality basically never changes to the opinion that any stability observed in personality depended entirely on certain patterns of environmental consistency. Shortly thereafter, Brent Roberts and colleagues published two influential meta-analyses (2000, 2007) showing that individual differences in personality remain relatively stable across the lifespan but that there are normative changes in personality as people age that are consistent with psychological maturation. In other words, if you are more neurotic than your sister today, you probably will be more neurotic than she is tomorrow, but both of you probably will become less neurotic as you age. More recent research, again by Roberts and colleagues (2017), showed that psychotherapy can intensify these changes in the direction of maturity.

This work has important implications for clinical personality assessment. First, we can predict a great deal of consistency in the personality of a person, such as Madeline G., assessed two decades on. Second, we can predict that any changes will most likely be in the direction of greater adaptation and well-being. Third, we can predict that this might particularly be so to the degree that Madeline engaged in interventions such as psychotherapy. These were our general predictions before learning more about Madeline’s current life situation, which we describe in more detail below and revisit in the concluding chapter.

Dimensional Models

Personality assessors emphasize the difference between assessment and diagnosis (Meyer et al., 2001). Diagnosis involves determining what disorder an individual “has.” Diagnosis is usually an important part of an assessment, but assessment also includes understanding people beyond their diagnoses, including the textures and nuances of their histories, life contexts, and close relationships. Diagnosis is sometimes conflated with assessment, such as when the clinician presumes that the disorder explains the person’s functional difficulties. Formal diagnosis has typically been emphasized in biological psychiatry, as a branch of medicine, and manualized approaches to psychiatric treatment, whereas assessment has traditionally been emphasized in clinical and counseling psychology and more traditional psychotherapy approaches. Thus, an unfortunate side effect of this difference in focus is the reinforcement of ongoing schisms between science and practice.

One of the more exciting innovations of the 21st century is that psychiatric diagnosis is becoming more dimensional and thus more similar to personality assessment qua assessment. This innovation has taken various forms (e.g., Harkness et al., 2014). Dimensional schemes for personality disorder diagnosis have been presented as alternatives or replacements to the traditional categorical model in both the Diagnostic and Statistical Model for Mental Disorders (Skodol, 2012) and the International Classification of Diseases (Tyrer, Crawford, & Mulder, 2011). The Hierarchical Taxonomy of Psychopathology (HiTOP; Kotov et al., 2017) consortium has come to embody a powerful movement toward dimensionalizing other forms of psychopathology as well. The National Institutes of Mental Health Research Domain Criteria compels researchers to conceptualize psychopathology as continua rather than categories in research applications. Thus, psychiatric diagnosis increasingly resembles a multidimensional profile of scores that would be familiar to personality assessors. A major focus of this book is to conceptualize one person, Madeline G., after an interval of just less than 20 years, using several such multidimensional profiles that reflect the riches of five major paradigms of personality assessment.

Therapeutic Assessment

Another area in which traditional personality assessment has exerted its influence in the beginning of the 21st century has to do with how an assessment is conducted. There has been a long and interesting history of using assessment to go beyond the task of description or diagnosis and for the clinicians to relate to, or “get in the shoes of”, their clients (e.g., Fischer, 1985/1994; Handler, 2006) that received a shot of energy from Finn’s (2007) formalization of Therapeutic Assessment (TA) as a semi-manualized model of this approach. TA blends assessment and psychotherapy, with the idea that therapy is more effective when based on powerful personality assessment technology, and personality assessment achieves its full potential when it helps people understand themselves. In TA, assessment tools are regarded as ‘empathy magnifiers’ that help clients, mental health professionals, and important others understand clients’ ‘dilemmas of change.’ Although TA has theoretical origins in humanistic and phenomenological psychology, as a set of techniques it is congenial with all paradigms and tests (and in some ways is similar to motivational enhancement, which comes from a more behavioral/human-istic tradition). As an attitude toward mental health, TA is in keeping with current standards of collaborative care (Berry & Dunham, 2013). TA has had such an impact on personality assessment that not including it in this project would have been a major omission. We accordingly replaced the personological-narrative approach from Wiggins (2003) with a TA, conducted by Stephen E. Finn. This had several implications for other aspects of this project, as we describe in detail below.

Test Updates

Paradigms generally stay alive to the degree they can evolve and adapt. The four paradigms in this book that are generally associated with specific measures have each witnessed dramatic within-paradigm evolution during the last two decades. The most direct way to evolve in the area of personality assessment is to revise an instrument. Test revisions often involve more than new data, norms, and scores; they also can reconceptualize aspects of the instrument and its constructs. In two cases, there were major revisions to the central representative instrumentation. Within the psychodynamic paradigm,¹ the Rorschach Performance Assessment System (Meyer, Viglione, Mihura, Erard, & Erdberg, 2011) is an evidence-based approach to using the Rorschach Inkblot Task that solves several issues in earlier models of administration and focuses on scores with established empirical evidence. The Social Cognition and Object Relations (SCORS) approach to the Thematic Apperception Test (Murray, 1943; Morgan, 2002), which provides quantitative estimates of the respondent’s social cognition, has gained considerable popularity in a relatively short time (Stein & Slavin-Mulford, 2018). Within the empirical paradigm, the MMP...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• List of Contributors
• Preface
• 1 Madeline G. and Five Assessment Paradigms Two Decades On
• 2 Therapeutic Assessment of Madeline G.
• 3 A Psychodynamic Perspective on Madeline G.
• 4 A Contemporary Interpersonal Reassessment of Madeline G.
• 5 Madeline G. and the Five-Factor Model
• 6 The Empirical Paradigm and Madeline G.
• 7 Communicating the Assessment Findings to Madeline G.
• 8 Past, Present, and Future in Personality Assessment
• References
• Index