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#1
Old 07-02-2018, 02:52 PM
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How reliable is testing for proving people crazy (or not)

One of Sheldon Cooper's memes is "I'm not crazy. My mother had me tested."

Can tests really prove if a person is crazy or not? What types of mental illness can be proven with a test? What type of test? How objective would it be?

The mind boggles.
#2
Old 07-02-2018, 03:15 PM
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I believe a well written and interpreted psych and questionnaire evaluation is pretty effective. I've heard around 80% effective at diagnostics but I'm not sure what that is based on.

Newer tests based on genetics and blood samples are becoming more effective too.
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Last edited by Wesley Clark; 07-02-2018 at 03:17 PM.
#3
Old 07-02-2018, 03:34 PM
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There is the question of what constitutes ‘crazy’.

Is any mental illness crazy? Is someone with clinical depression crazy? Because if so, there are some fairly robust diagnostic tools for that.

So, I guess you would have to narrow down what you think crazy is to get a reasonable answer.
#4
Old 07-02-2018, 03:34 PM
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Insanity is a legal term. A shrink can say somebody is legally insane- they do not know right from wrong.

Speaking as somebody whose been on Tofranil, Trilafon, and Prozac just to name a few, who has been in therapy for decades now, and was a psych major in college before life kicked me in the groin, there is no one test for 'crazy'. There are all kinds of test that taken as a whole show something not normal.

Note that whether the patient is attempting to be deceptive and how good they are at being deceptive are big factors. I still remember one year when the battery of psych tests came up, I decided it would be fun to get them to think I was a powder keg of rage. The terrified therapist had a long talk with my parents. My parents had a short chat with me 'You take those tests again! And you answer honestly this time!' The therapist was much relieved by the second set of results. *Off the top of mi hed, most sociopaths are very good at pretending to have morals, empathy and be normal.

* Yes this actually happened.
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#5
Old 07-02-2018, 03:44 PM
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Quote:
Originally Posted by Annie-Xmas View Post
One of Sheldon Cooper's memes is "I'm not crazy. My mother had me tested."
She never took him to that specialist in Dallas though.

On top of testing to determine mental issues there are also clinicians who specialize in detecting faking mental illness. This comes up in criminal trials and often looking for malingerers seeking disability compensation.
#6
Old 07-02-2018, 11:38 PM
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As someone who used to administer some of those tests; prove? No. But in more cases than not they helped the clinicians set a base for further evaluation and/or treatment. A lot depended not just on the disease but also the setting. Test someone in an office and you may get one result and test that person in a more stressful setting (say in detention somewhere) and you may get a different result. As much as any score, what I was trained to do was observe and report on aspects of the patient during the testing. I was/am a behaviorist (Skinnerian) so that part was fairly easy for me; not so much so for some out of other disciplines. I am told the newer tests are "better" but having last done one around 1990 I can't say how or how much.
#7
Old 07-03-2018, 05:17 AM
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They're just words. But people really do take their kids to doctors to find out if there is anything wrong with them. And doctors really do report back to the parents.

I don't have any trouble calling this "testing" and "crazy", so my mind doesn't boggle.

The form of the "test" is normally that you talk with them. If you've met crazy people before, just talking to someone can tell you if they're crazy or not. If you want more fine-grained or comparable information, structured interview and standard questions, written or oral.

And, as mentioned by others, it doesn't prove anything. That's why we have court cases. But again, it's just a word, and I'm not boggled by it.

Sorry.
#8
Old 07-03-2018, 07:53 AM
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But haven't the courts pretty well set the precedent that if a shrink says somebody is insane, that by itself constitutes legally insane? I had a lawyer once tell me that if a child says he was sexually abused, and the shrink testifies that he believes him, the only remaining defense is to prove that the shrink is medically incompetent. Analogous to the medical malpractice defense, that a doctor only needs to show that medically accepted procedures were followed and all procedures were carried out by licensed practitioners..

Last edited by jtur88; 07-03-2018 at 07:58 AM.
#9
Old 07-03-2018, 08:13 AM
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This can't be answered without knowing why the testing is wanted. Off the top of my head: To determine educational needs. To decide if hospitalisation is necessary/essential (are they a danger to themselves or others). Eligibility for unemployment benefits. Mitigation of criminal charges. To obtain a diagnosis in order to treat someone.
#10
Old 07-03-2018, 08:15 AM
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Any one-time test provides limited insight into the individual's performance over time. My non-medical opinion is that a valid diagnosis and assessment of severity would have to be based - in large part - on repeated contacts over time, as well as information from objective third parties.

I am extremely dubious of mental health "professionals" who profess to be able to diagnose and assess severity of mental/emotional illness based on a single session. The willingness of so many to do so bolsters my suspicion that a good portion of the profession has an interest in expansively categorizing as treatable pathology behavior and personality which is within the range of normal.
#11
Old 07-03-2018, 08:20 AM
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Quote:
Originally Posted by jtur88 View Post
But haven't the courts pretty well set the precedent that if a shrink says somebody is insane, that by itself constitutes legally insane? I had a lawyer once tell me that if a child says he was sexually abused, and the shrink testifies that he believes him, the only remaining defense is to prove that the shrink is medically incompetent. Analogous to the medical malpractice defense, that a doctor only needs to show that medically accepted procedures were followed and all procedures were carried out by licensed practitioners..
Cases end up with dueling experts all the time. Then it becomes the job of the judge or jury to make the decision. Experts provide evidence, they don't make the decisions.
#12
Old 07-03-2018, 08:34 AM
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Quote:
Originally Posted by jtur88 View Post
But haven't the courts pretty well set the precedent that if a shrink says somebody is insane, that by itself constitutes legally insane? I had a lawyer once tell me that if a child says he was sexually abused, and the shrink testifies that he believes him, the only remaining defense is to prove that the shrink is medically incompetent. Analogous to the medical malpractice defense, that a doctor only needs to show that medically accepted procedures were followed and all procedures were carried out by licensed practitioners..
Yeah, right. Tell that to the victims of the Day Care Sex Abuse Hysteria of the 1980's. Not the supposed "abused" children, but the innocent parties who would accused, tried, convicted and went to prison.

Last edited by Annie-Xmas; 07-03-2018 at 08:36 AM.
#13
Old 07-03-2018, 11:45 AM
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Originally Posted by Annie-Xmas View Post
Yeah, right. Tell that to the victims of the Day Care Sex Abuse Hysteria of the 1980's. Not the supposed "abused" children, but the innocent parties who would accused, tried, convicted and went to prison.
That one always rattled me. The evidence demonstrating the claims were impossible was ignored and several adults obviously committed perjury. At least in that one the prosecutor got nailed for misconduct in the end.
#14
Old 07-03-2018, 05:47 PM
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There are many ways to be crazy. It's like asking "Is there a test to see if you're sick".

Some conditions, in some people, are easy to diagnose. But often there are several potentially overlapping conditions that are difficult to tell apart, and in the big picture, misdiagnosis is certainly a common issue.

Another issue, one that "Sheldon Cooper" obliquely referred to: when it comes to mental conditions that affect children, many parents desperately want there to be a test. Not just any test, but an itemized test with a numerical scale attached, where the final scores and sub-scores have reassuringly clear meanings.

So, using an example I know too well, there's an industry of illegitimate "ADHD testing". In fact the one and only test for that condition is the patient having a face-to-face discussion with a psychiatrist or psychologist (and probably a couple of questionnaires for parents and teachers to fill out) - but the invalid-and-useless other "tests" are big business because they give some parents the feeling of being more knowledgeable or certain or in control - when in fact they're none of the above.

I'm not so familiar with other conditions, but I expect the fact that some tests exist only to line the pockets of the test makers would not be limited to one little situation.

Last edited by DavidwithanR; 07-03-2018 at 05:47 PM.
#15
Old 07-03-2018, 06:09 PM
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Quote:
Originally Posted by TriPolar View Post
This comes up in criminal trials and often looking for malingerers seeking disability compensation.
Well they either suck at their jobs or there are not enough to be very effective.

Quote:
Originally Posted by DavidwithanR View Post
There are many ways to be crazy. It's like asking "Is there a test to see if you're sick"..
I wouldn't say it's "like" asking that question about there being a test to see if you're sick,, I'd say it's another way of asking the same question. Perhaps a better comparative question would be "Is there a test to see if you're happy". Both questions are asking about very nebulous, ill-defined concepts in which subjective interpretation trumps any objective truth.
#16
Old 07-03-2018, 07:01 PM
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Quote:
Originally Posted by Annie-Xmas View Post
Can tests really prove if a person is crazy or not?
No. Sanity is not like oil, you can't stick a dipstick in someone's ear and test their sanity levels. It is mostly diagnosed through self-reporting, which is subject both to patients lying and doctors being imperfect humans with biases.

As for how objective it is, let me put it this way. I have received six separate mental health diagnosis over the decades, two from panels with multiple psychiatrists on them. No two have been the same, and some have been wildly different. (No, I'm not planning on sharing the details.) I don't believe that shrinks routinely diagnose mental health problems by throwing darts at a dartboard, but it sure can feel like that when you are navigating the system.
#17
Old 07-03-2018, 09:42 PM
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Quote:
Originally Posted by Crazy Canuck View Post
No. Sanity is not like oil, you can't stick a dipstick in someone's ear and test their sanity levels. It is mostly diagnosed through self-reporting, which is subject both to patients lying and doctors being imperfect humans with biases.

As for how objective it is, let me put it this way. I have received six separate mental health diagnosis over the decades, two from panels with multiple psychiatrists on them. No two have been the same, and some have been wildly different. (No, I'm not planning on sharing the details.) I don't believe that shrinks routinely diagnose mental health problems by throwing darts at a dartboard, but it sure can feel like that when you are navigating the system.
Part of the issue is that mental health professionals are limited by what the person they are evaluating is describing them. From my personal experience from struggling with a lifetime of anxiety and depression, my exact diagnosis has changed over the years (Post Traumatic Stress Disorder(PTSD), Social Anxiety Disorder, General Anxiety Disorder, Panic Disorder, Major Depression with Anxious Features among others). They don't really "test" for mental disorders; they basically have checklist which they check off if the patient displays symptoms and if they have 6 out of 10 symptoms you are considered to have that disorder. It's also possible for a person to have multiple disorders concurrently(referred to by psychiatrists as comorbidity). My exact diagnosis has changed over the years due to how open I'm able to be with the person evaluating me. I definitely have an anxiety disorder; which one I'm not exactly sure.

I definitely have some degree of PTSD as well. PTSD is probably under- and misdiagnosed as other anxiety disorders because unless you are really comfortable with the person doing your evaluation it can be very difficult to disclose the trauma and abuse which caused you problems.

Another thing to keep in mind is that psychiatrists use a book known as the Diagnostic and Statistical Manual of Mental Disorders to help diagnose mental conditions. The DSM (as the book is known informally) is on its fifth edition-The DSM V. Each new edition has changed some conditions around and changed diagnostic criteria. So people using different editions of the book might diagnose someone with a different conditions do to the changes.
#18
Old 07-04-2018, 08:13 PM
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Depends mostly on whether the crazy person wants to be cooperative or not.
#19
Old 07-04-2018, 08:44 PM
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It also depends a great deal on exactly what moved Mary Cooper to have Sheldon tested. OCD-like behavior? It's hard to see how that didn't raise a few flags-- on the other hand, that tends to get more and more prominent with age, so it's unlikely that Mary would have noticed it in a young Sheldon.

It's more likely it was for something that bothered Mary a great deal, but didn't bother Sheldon at all, like his lack of friends. The fact that he was clearly a lot brighter than most kids his age, along with the fact that a lack of friends didn't bother him would probably lead a child psychologist to say "Give him time; there's nothing wrong with him. He just hasn't found the right peer group." And in that case, the psychologist would probably be right. You really can't force children into friendships. The referral to the specialist in Houston probably had to do with the beginnings of OCD, depending on just how old Sheldon was. If he was very little, maybe it was for IQ testing.

My mother had me tested for "hyperactivity" (that's what they called it then) once, and it was negative. She had trouble believing the results. However, if she'd had me tested for depression when I was 11, she probably would have been told that I was. I doubt she would have believed that either.
#20
Old 07-05-2018, 04:50 AM
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Quote:
Originally Posted by Velocity View Post
Depends mostly on whether the crazy person wants to be cooperative or not.
??? what exactly did you have in mind ???
#21
Old 07-05-2018, 09:34 AM
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IME "crazy" usually refers to some manner of schizophrenia or psychosis. Most people can understand depression, and even mania to some extent, and so don't really regard those conditions as worthy of ostracism. But the real attention-grabbers are the people who have howling debates with walls or fire hydrants (or nobody at all, as they just shamble down the street expounding to the air about the work they did for the government involving scalar weapons and newts back in the 1920s), or will bend your ear for hours as they develop impossibly complex pictures of the world as they see it.

With Sheldon being tested, I'd always assumed his adults looked at him and wondered whether he was (schizophrenic) or simply waaaYYY smarter than any of them and was legit knowledgeable about stuff beyond their ken; and that the test in question was an I.Q. test. He scored highly, and as a result "crazy" was ruled out.
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#22
Old 07-06-2018, 08:30 AM
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I know from personal experience that all it takes is someone saying they think you are suicidal to have so-called experts forcing you to take anti-depressants which (guess what?) can make you suicidal. No tests, just give you drugs before they even let you have food or even soap. No wonder so many drug abuses are think and dirty.

And you now what they think the cure for "situational depression" is? You guessed it--Stay in the same situation and do drugs.
#23
Old 07-06-2018, 01:30 PM
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Quote:
Originally Posted by DocCathode View Post
Insanity is a legal term. A shrink can say somebody is legally insane- they do not know right from wrong.

Speaking as somebody whose been on Tofranil, Trilafon, and Prozac just to name a few, who has been in therapy for decades now, and was a psych major in college before life kicked me in the groin, there is no one test for 'crazy'. There are all kinds of test that taken as a whole show something not normal.

Note that whether the patient is attempting to be deceptive and how good they are at being deceptive are big factors. I still remember one year when the battery of psych tests came up, I decided it would be fun to get them to think I was a powder keg of rage. The terrified therapist had a long talk with my parents. My parents had a short chat with me 'You take those tests again! And you answer honestly this time!' The therapist was much relieved by the second set of results. *Off the top of mi hed, most sociopaths are very good at pretending to have morals, empathy and be normal.

* Yes this actually happened.
I've suspected you can pretty much get them to diagnose and label you with whatever mental illness you want. My dear friend wasn't being deceptive with any of her sessions though, she has had some problems with depression that came on late in her life, along with certain anxieties. No doctor or medicine they prescribed her ever helped either. I pointed out Cecil's column to her about many studies show that drugs treating for depression are a placebo, but might be of some help for those considered clinically depressed. She's off of meds now. But no label the doctor gave her seem to fit. She eventually self diagnosed herself that she had borderline personality disorder. She ran it by her psychiatrist, and he concurred.
#24
Old 07-07-2018, 08:19 AM
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Odd that, after being labelled with "situational depressions" and being told to stay in the same situation, get on disability and take medication, I've been working, supporting myself and not doing drugs for the past 4 1/2 years.
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