Reviving and Refining Psychodynamic Interpretation of the Wechsler Intelligence Tests: The Verbal Comprehension Subtests

ABSTRACT

The Wechsler intelligence tests (currently Wechsler, 2008, 2014) have traditionally been part of the multimethod test battery favored by psychodynamically oriented assessors. In this tradition, assessors have used Wechsler data to make inferences about personality that transcend cognition. Recent trends in clinical psychology, however, have deemphasized this psychodynamic way of working. In this article, I make a conceptual and clinical case for reviving and refining a psychodynamic approach to inference making about personality using the Wechsler Verbal Comprehension subtests. Specifically, I (a) describe the psychological and environmental conditions sampled by the Wechsler tests, (b) discuss the Wechsler tests conceptually in terms of assessing vulnerability to breakdowns in adaptive defensive functioning, (c) review a general framework for inference making, and (d) offer considerations for and illustrate pragmatic application of the Verbal Comprehension subtests data to make inferences that help answer referral questions and have important treatment implications.

Acknowledgments

An earlier version of this article was presented at the Conference of the Society for Personality Assessment, March 2016, Chicago, IL.

I thank Dr. Glen Gabbard, Dr. Jed Yalof, Dr. Linda Helmig Bram, and Dr. Jackeline Sanchez for their contributions. With gratitude to and in memory of Dr. Robert Erard who served as Action Editor for this article and my previous contributions to this journal.

Notes

¹ Here, “Wechsler tests” refers exclusively to the Wechsler intelligence tests (e.g., Wechsler, 2008, 2014).

² Note that on the WISC–V, Information is considered a secondary subtest so is not routinely administered and does not typically contribute to the Verbal Comprehension Index.

³ Note that there are certain Wechsler items and subtests that are relatively more emotionally evocative (see Bram & Peebles, 2014). Also, for some people, such as those with learning disabilities or anxiety and intrapsychic conflicts about achievement, the Wechsler tests overall can be highly stirring emotionally.

⁴ I refer to being diagnostic in a broad sense that is not isomorphic with the taxonomic approach of the Diagnostic and Statistical Manual of Mental Disorders (DSM; e.g., American Psychiatric Association, 2013) or the International Classification of Diseases and Related Health Problems (ICD; e.g., World Health Organization, 1994). See Peebles (2012) and Bram and Peebles (2014) for comparisons of the different frameworks for diagnosis.

⁵ Note that deviations and intrusions can also sometimes be seen on responses ultimately scored as correct. This is illustrated later.

⁶ In this article, I have taken steps to protect test security of Wechsler items by referring to them by item and number (e.g., “the 12th item of Comprehension” or “Comprehension #12”) rather than their verbatim content (APA Standard 9.11; American Psychological Association, 2010). Therefore, I recommend that readers access test forms and manuals for reference.

⁷ Identifying information for all clinical examples in this article is disguised.

⁸ A patient's ceiling on a particular subtest is reached on the item on which he or she begins to obtain the sequence of 0-point responses leading to discontinuation of administration of items on that subtest.

⁹ We would then need to puzzle further with these and other test data (including the patient's attitude toward his responses) to determine to what extent these patterns might point to an underlying developmental disruption involving structural weakness, conflict, character, or trauma (see Bram & Peebles, 2014).

¹⁰ TOL interventions occur after the scorable response is offered. To be clear, responses to TOL interventions do not affect formal scoring, although they can be informative in testing hypotheses and clarifying answers to referral questions.

¹¹ The reason that her self-protective efforts are described as “strained” is that they often were associated with compromised logical reasoning: “Smiling alligators” garnered an INC1; “pigeons with glasses,” FAB1; and “butterfly … with horns,” an INC1.