A quote I love from US TV's Law & Order: SVU: "Even psychos can usually pass a psych exam."
Since I worked in social services for a long time, I know some people who have been in charge of administering and scoring preliminary exams for people who have requested or been referred for services. That quote is very true. "Psychos" are aware of what the stereotypes are, as much as non-psychos, but those questions are on the test, because there are there to catch fakers-- questions like "Do you hear voices other people don't hear?" Genuinely psychotic people who are trying to duck the system say "no," while fakers say yes, because everyone who isn't Amish (and even probably half of them) know that psychotic people "hear voices." On the other hand, odd things that people with certain kinds of mental illnesses answer "Yes" to with high predictability, while non-ill people rarely answer "Yes" to are odd, because they aren't necessarily associated with features of the illness. My favorite example is "Does all food taste the same?" For some reason, people with schizophrenia nearly always answer "Yes," to that, while physical conditions that make things taste the same, or dull a person's sense of taste are very rare, so few non-schizophrenics answer yes, including the fakers, who said they heard voices.
No one has actually studied why schizophrenics overwhelmingly answer "Yes," to that question, because for the purposes of this particular test, it doesn't matter. It may be that schizophrenics overwhelmingly lie on that question. All that matters is the predictive reliability of the question, and because there is such a clear separation of groups there, it's on the test.
It's not the only question. It's a test with hundreds of questions, and there is an interview as well. The worst that happens is that someone scams the system who isn't really unwell, although if someone is that desperate, one wonders how "not unwell" they are-- or that a truly unwell person slips through the cracks, because he doesn't want help, which is sad, but in the end, you can't make someone take it.
Since I worked in social services for a long time, I know some people who have been in charge of administering and scoring preliminary exams for people who have requested or been referred for services. That quote is very true. "Psychos" are aware of what the stereotypes are, as much as non-psychos, but those questions are on the test, because there are there to catch fakers-- questions like "Do you hear voices other people don't hear?" Genuinely psychotic people who are trying to duck the system say "no," while fakers say yes, because everyone who isn't Amish (and even probably half of them) know that psychotic people "hear voices." On the other hand, odd things that people with certain kinds of mental illnesses answer "Yes" to with high predictability, while non-ill people rarely answer "Yes" to are odd, because they aren't necessarily associated with features of the illness. My favorite example is "Does all food taste the same?" For some reason, people with schizophrenia nearly always answer "Yes," to that, while physical conditions that make things taste the same, or dull a person's sense of taste are very rare, so few non-schizophrenics answer yes, including the fakers, who said they heard voices.
No one has actually studied why schizophrenics overwhelmingly answer "Yes," to that question, because for the purposes of this particular test, it doesn't matter. It may be that schizophrenics overwhelmingly lie on that question. All that matters is the predictive reliability of the question, and because there is such a clear separation of groups there, it's on the test.
It's not the only question. It's a test with hundreds of questions, and there is an interview as well. The worst that happens is that someone scams the system who isn't really unwell, although if someone is that desperate, one wonders how "not unwell" they are-- or that a truly unwell person slips through the cracks, because he doesn't want help, which is sad, but in the end, you can't make someone take it.
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