I wreck brains for a living, AMA

What would be a reason for someone to be tested?

eg. Is it a mandated test? Similar to an IQ test? Job screening?

Typically, I see people with neurocognitive deficits, like dementia, Alzheimer's, MS, ADHD, etc. However, I also see people who are being tested for autism, IQ testing for schools/aptitude and other miscellaneous cognitives concerns. The work is specialized and deeply diagnostic, so I only work with one patient a day for 4-6 hours at a time!

I want to be tested. How do I do one of these tests?

Well, you can always learn more about neuropsychology testing online, but in general if you're a person with no functional impairments I'd say steer clear ;) testing is a rigorous process!

What about moderately bad OCD?

I'm no expert, but on a neurocognitive level I don't believe someone would necessarily need to see a neuropsychologist just for OCD. My guess is they'd be more likely to see a therapist to manage anxiety, intrusive thoughts, all that stuff. If there were neurocognitive deficits present as well, then they'd see us.

More than a few times there have been patients in being tested for memory problems and in actuality they end up diagnosed with depression or anxiety. Our process looks for deficits that result from neurological problems.

So I found this: Typically, a psychometrician has an advanced graduate degree from a university, usually either from an Educational Measurement program or from a Quantitative Psychology program. However, there is no certification or licensure process that a person has to complete in order to become a psychometrician. Instead, a person working in any area of testing may simply choose to call himself or herself a psychometrician. Is this true?

While true, most psychometricians I've met have a neuroscience or psychology background. Advanced degrees are typical and all of my coworkers have Master's or Ph.D. I have a B.S. in Neuroscience and compounded with my background in clinical research, hospitals and assisted living, I was a good fit for my workplace.

There's extensive training that goes into administering the tests and it'd be very atypical IMO to hire someone who didn't have a good grasp of scientific rigor and data collection.

Just checking in. I'm a firmware tester but psychometrician sounds cooler and I now am one.

Welcome, colleague!

How can I push my mind to the limit?

On a serious note, engage your brain! Read books, solve puzzles, learn another language... Nurture your mind with knowledge and engagement. On a less serious note, probably mysterious experimental drugs judging from some recent movies on this topic.

There has been movies other than Limitless (and maybe Lucy)? Though there is a whole sub, r/nootropics that does explore such of these compounds. Basically, it sort of sounds like keep on learning and don't just go through the day to day.

How are the tests given and scored? Verbally, via computer or via written exam? Are the answers yes/no, multiple choice, or up to the subjective assessment of the person giving the test? Do you do any measurement of bio-signals (such as brain waves or looking at what areas of the brain are active during the tests)?

Yes, I was referencing those movies haha. I didn't really care for either and not just for brain reasons.

The tests are scored all three ways! Some tests have immediate feedback, some are scored pen and paper, some are scored with a few different computer programs. In the end a comprehensive statistics report and cognitive impairment profile sheet are generated that condense all of the info into a nice few pages. Then the mounds of raw data sit under that.

No measurement of biosignals in this line of work, but I'm also a research assistant at a university and study neurolinguistics. In that research, biosignals are measured while subjects do these same types of tests.

Verified.

Edit: removed until OP starts answering.

and can we assume OP will reply today?

It's the test. In silence, how soon do respondents take to lose their minds? Game, set, match, I could be a psychologist.

;)

Are the kind of test you give available to anyone who would want to take the test to see where they are at and what they could improve on, or are these usually used only by referral?

Also I see that you have said you mentally tax them over the course of a few hours, have there been any patients that have just blown you away in either a good or a bad way? And if so, would you feel up to talking about them?

Where I work, it's typically by referral. Some people come without a referral, but it's usually to follow up on suspicions of a cognitive disorder like dementia or to better diagnose memory deficits. People typically don't come in sans referral unless they have reason to believe their cognition is suffering or there is a mental issue, usually not just to see where they are. The testing is expensive and takes up most of the day.

And then there's many people that are referred who should be seeing a therapist instead!

I commented on the patient thing and I can't get too detailed, but there have been folks that were notably good or bad. The worst is when there's a noncompliant elderly person or a faker. I've seen some genius kids come through and very well educated adults too. Protip for anyone reading... The fakers never win. So don't fake!

And if they're usually only by referral, how do I go about asking my doctor for such a referral?

You could seek out a neurologist or psychologist, or even see if there's a neuropsychology practice that will do it without a referral. I don't think you'd have trouble being seen if you have a need for it.

Is there any real validity to the IQ score?

Most certainly, but not in the ones you can take online. I give IQ tests every day of the week and there are a few different versions, depending on need and the patient's general cognitive level (i.e. healthy person vs dementia patient, adult vs child).

While I appreciate the general confirmation, I think as an INTP you can understand my wanting of a more detailed and fact based explanation... Please.

Hm, I'm not sure exactly what info you're looking for, but there's a lot of good cognitive science stuff online to read about IQ testing. You could look into the WAIS test too which is the typical long version test we give. The test given is based on time constraints, need, and capacity to perform. An elderly patient with dementia is not typically going to get the long IQ test and only kids will get the kid IQ test, which measures different things than the adult.

I cut brains for a living. Any thoughts about Creutzfeldt-Jakob disease? Specifically - do you feel that CJD may have been around before the uprising of mad cow, and could it have been previously misdiagnosed as other neurological diseases?

Interesting! I can't really offer an opinion, but I know part of diagnosing CJD is ruling out dementia, so someone like that might just show up in a neuropsych practice!

What are some examples of questions you would ask?

On cognitive abilities, the tests where I ask questions generally measure verbal or executive functioning abilities. So the questions might simply be asking definitions of vocabulary, asking questions that prompt abstracted answers or even what I asked them to read 10 minutes ago, haha!

Hi there, thanks for doing this AMA.

1. How subjective do you think these tests can still br despite all the efforts to make it objective?
2. Can you give an overview of how these tests are conducted and what type of intelligence it claims to measure?

Very good questions. There is some degree of subjectivity that goes into testing, as when you are testing you are not simply a robot spitting out data -- you need rapport with patients and you need to carefully observe behaviors as they test. How patients go about performing the tests is almost always as important as the actual results. So, that is, if you're a poor observer and unfriendly, the results will not be optimal!

On the overview, typically patients arrive in the morning and do paperwork, just like you would at any medical facility. The doctor (neuropsychologist) will do a clinical interview and then draw up a preliminary test battery which typically evolves throughout the day. The patient gets turned over to me and I administer all the tests, giving feedback throughout the day to the doctor.

All types of cognitive abilities are measured, not just IQ. Patients are tested on attention, memory, executive functioning and so on. These tests are to diagnose cognitive and neurobehavioral deficits and results usually then go to a neurologist or other practitioner.

Have you ever had someone administer the same hours long examination to you? If so, what was it like? If not, why not?

Not in it's entirety, but part of my training was doing all the tests as if I was the patient. People seem comforted when I tell them that. It's stressful and tiring, no doubt about it!

What kind of cognitive abilities do you measure?

How much does a person's cognitive ability really differ based on sleep, nervousness, mood and other such variable factors?

How much can a person improve their scores in your tests through exercise?

Is there any kind of cognitive ability which you would like to be able to measure, but for which there is not yet any scale available?

Good questions! We measure things like attention, memory, verbal abilities, perception, reasoning, executive functions and many others. We also evaluate neurobehavioral issues and do personality inventories.

Mood, anxiety, sleep... These are all very relevant to testing. If someone is not feeling their best or their anxiety is dominating them, they will not perform at their best and the results will not be reliable.

People ask me about improving IQ a lot and I'm not sure on that. It'd be better for a true cognitive scientist to weigh in, but from my layman perspective I do believe some improvements can be made if a person were to work at it. The IQ tests have verbal, perception and reasoning components, all of which can be improved through study, and everything is weighted in regards to age and education. So I would believe there is flexibility to improve.

are there any surprising results you have found in correlation to age? ie. have there been children who have absolutely smashed the test?

I have seen something like that, yes. A very bright kid with autism scored quite high on an IQ test. I also saw a very educated man who had Alzheimer's score perfect on verbal reasoning tests and speak multiple languages, but couldn't remember how he got here or where he lived.

how often do you say #rekt?

Not often enough

Have you done any tests regarding the effects of dehydration on the brain?

I have not, but I work in a medical practice and the tests are all diagnostics, no research. I don't think we can bill for dehydrating brains on purpose ;)

I've read your comments about "pushing your brain", and I'm sure you've seen plenty of evidence of mental abilities increasing over time... But in your opinion, do you think that the idea of intelligence is something that is learned or something you're born with?

i.e. Are some of us born smarter than others or are the "smarter" people just given more opportunities?

I think that's a very relevant question for many fields, but I'm no cognitive scientist. That's a great topic to learn about though! I think I'll look into it.

Thanks for your answer! I'm in artificial intelligence myself, so the idea of what intelligence is and how we can define or create it comes up a lot, along with how it happens in humans. I just wanted to know your opinion! :) It's been really interesting reading this AMA so thank you for doing this and for your answers to everyone.

It's an interesting topic I wish I knew more about. A friend of mine is doing AI in his comp sci graduate work, it's fascinating stuff. I had a minor fling with neural networks.

[deleted]

It was a cheeky comment, don't take it too seriously! I'm no doctor either way though.

We don't do anything relating to life expectancy. Everything we do is assessing neurocognitive and neurobehavioral data.

West kind of education is necessary to work as a tester?

I don't believe there are hard cutoff requirements, but most (I think all) testers I know have advanced degrees typically in psychology or neuroscience. I have a B.S. in neuroscience, and I was hired because of my education combined with a lot of clinical background. The guy before me had a bachelor's in something cognitive and now he has a Ph.D. So I would imagine the barriers for entry are having a relevant education, having a background of human service and a strong grasp on scientific methods and statistics. When I'm not with patients I'm knee deep in z-scores.

How exactly does the process work? Is it purely an interogative process, or is there surgery involved as well?

No surgery, it's all verbal and written stuff at a desk in an office.

How far has the field come along in your career? Where can one go for a better understanding of the field?

I couldn't give a great answer to how far it's come along as i only knew the job existed with this year! I had taken a neuropsychology course at university and got a good understanding of the field, but we were told you only saw these people as Ph.D's who worked in conjunction with surgeons and things like that. Not entirely true! I was quite pleased to learn of the opportunity to enter the field at this level and intend to pursue my graduate studies in this field.

I would simply research neuropsychology and psychometrics online. You can learn a good bit about the tests from reading academic papers too, as they're used for other neuroscience-related fields too. Learning about the WAIS and WASI tests from PsychCorp is a good look into IQ testing. Some others to learn about are the Stroop test, 2s & 7s.

What are some examples of the toughest questions you ask to people?

One of the tougher things is a test of abstract verbal abilities where I name two things and the patient must answer what makes the items alike. It's a measure of executive functioning in their ability to abstract an idea and the answers are graded on how well they meet this long list of criteria. I'd say that one really irritates people!

What sort of people are you testing, and for what reason?

I answered this in another comment more fully, but basically people with neurocognitive or neurobehavioral deficits.

How does creativity work? Is there a way to increase it?

Well, I can't offer a neuroscience perspective, but as a musician, I recommend digesting any creative work you can, especially if it's outside of your comfort zone. Read, go see art, see bands in different genres!

Do you find yourself testing people you meet outside of work in everyday conversation?

Not testing, but the job has honed my observational skills ;)

How does that affect your close relationships? When I was working on my MSW, I found difficult to relax and enjoy TV. I instinctively labeled their behaviors and motivations and did armchair diagnosis from the DSMIV.

Ruined entertainment for a while.

I don't think about that stuff too much. My work is more medically-oriented than say a therapist or clinical psychologist, so I don't analyze people really in a way related to my job. But I do have a more keen sense of elements involved in cognition now, so I notice things like speech errors and random stuff now. I see a lot of psych issues on the job too, so needless to say when you deal with that a lot, you see it in the real world more too.

In what situation this kind of tests is needed ?
Could this tests unveiled psychological issues ?

Yes, absolutely. I see people fairly regularly who have more pressing psychological needs than anything cognitive. These people are usually referred to a therapist.

What is the age of your youngest patient?

The youngest I've seen was around 13-14. We don't take many young patients. I've only seen about three this year in the practice.

How accurate are IQ tests? Can IQ test have differing results?

I'm not sure what you mean by differing results, but if the tests are administered correctly then the results will be accurate

Differing as in if i got an IQ score of 120 using your test. And then I do a completely different IQ test in another country and my IQ score is 130. Does that happen and if so how accurate can they be?

It's tough to say. There is an estimated margin on scores of just a few points, but there's also confounding elements like if you are familiar with the test. Typically people are not retested less than 6 months from their original test date. But hypothetically, if you perform optimally then your score should be accurate.

Do you like the your job and is the most difficult aspect of it ?

I do like it a lot. Every day is different and a new challenge. The hardest part is subjective I think. Some people have a hard time maintaining a "clinical attitude," i.e. trying to connect with patients but remain objective and observational. For me, it's not making errors on my reports!

what types of questions are generally asked to measure cognitive abilities? also, how do you mean you 'wreck brains'?

I answered your first question in another comment. I "wreck brains" because I exhaust peoples mental abilities over the course of a few hours. Have you seen people after they take an extensive exam like GRE and such? It's like that.

How accurate is the MMPI? How do the deception scales work?

I can't weigh in on the MMPI as the neurobehavioral/personality inventories we use are different, but I'm aware there is some controversy regarding the different versions.

Strangest fact you learned about intelligence?

Hm... I would say what is most fascinating to me is the different range of abilities I see in dementia patients. In some recent neuroscience research, this idea of a "cognitive reserve" has been proposed where certain people can retain cognitive abilities longer than others after dementia. The research I've read deals with bilinguals, but it's a very interesting idea to me!

Why would someone go see you?

I've answered this in more detail elsewhere, but people who suffer from neurocognitive deficits resulting from mental illness, traumatic brain injuries or otherwise and need their mental faculties assessed come to us. So one day might be a dementia patient, next is someone who had a concussion from a motor vehicle accident, someone with a learning disorder, someone who's prescreening for Alzheimer's, multiple sclerosis patients... the list goes on!

Where could I find one of those tests online (for free)?

As a precaution, anything you find online wouldn't really be valid as the testing setting and administration are key to validity. But if you're just looking for laughs, check out the Stroop test, which measures response inhibition and cognitive flexibility.

As someone with Asperger's Syndrome and Dyspraxia, do you think that your tests might have any application in the treatment of specific learning difficulties?

Yes, certainly! This kind of testing is used to diagnose learning disorders and create a treatment plan. Those types of patients are more uncommon, but I still see them frequently.

Thank you for your response! Could you give me some examples of how you might treat an Asperger's sufferer? Does your research apply to learning disabilities that manifest physically, such as Dyspraxia?

We don't do any research at the practice, but I don't believe we've seen anyone with dyspraxia yet. I think that's because we only do minimal motor testing, mostly geared towards stroke victims, muscular dystrophy, that sort of stuff. I'd be interested to learn more about this though.

As far as treatments, I couldn't say as it is the Ph.D's who formulate the treatment plans. I'm just the patient torturer!

How can I get someone to attack me physically?

You don't need neuroscience to help answer that question ;)

You underestimate the extent of my ignorance.

I'd say start with name calling and roll with it from there

What's a good way to segway from an unpleasant conversation to name calling?

Cool it, you joker!

Have you ever worked on patients with psych issues before?* (AKA crazy people) If so how was it? Would you recommend the job to students majoring in the field of psychology? Also how do you feel about phycology?

Crazy is not really fair, but I assume you mean patients with psych issues and yes I have seen quite a few of those.