Understanding Norms in Psychological Testing

As a therapist, you’ve likely encountered cut-offs in various psychological assessments, such as the widely-used PHQ-9 Depression Severity scale. The PHQ-9 assigns scores of 0, 1, 2, and 3 to the response categories: “not at all,” “several days,” “more than half the days,” and “nearly every day,” respectively. This results in a total score ranging from 0 to 27. The score is then categorized using specific cut-points: scores of 5, 10, 15, and 20 represent mild, moderate, moderately severe, and severe depression, respectively.

But have you ever wondered how these cut-offs are determined? Or how they ensure fairness in measuring the mental health status of individuals from different backgrounds? This is where the concept of norms becomes crucial. Norms allow us to understand where an individual’s score falls in comparison to a larger, representative population, offering a clearer picture of their mental health relative to others.

In this blog, we’ll dive deep into norms—what they are, why they matter, and how they ensure the accuracy and fairness of psychological test interpretations.

Diving Deeper into Norms: It’s All About Context!

When we talk about norms in psychological testing, there’s a common misconception that they act like a magic mirror, reflecting some absolute truth about a person’s traits or abilities. Imagine it like this: if you score high on the Agreeableness scale from the Big Five Personality Assessment, does that mean you’re just super agreeable? Not quite!

Here’s the thing—norms aren’t as straightforward as they might seem. As Lew Goldberg wisely pointed out,

One should be very wary of using canned “norms” because it isn’t obvious that one could ever find a population of which one’s present sample is a representative subset. Most “norms” are misleading, and therefore they should not be used.

Far more defensible are local norms, which one develops oneself. For example, if one wants to give feedback to members of a class of students, one should relate the score of each individual to the means and standard deviations derived from the class itself. To maximize informativeness, one can provide the students with the frequency distribution for each scale, based on these local norms, and the individuals can then find (and circle) their own scores on these relevant distributions.

Lew Goldberg

Norms should not be seen as an absolute interpretive framework. Instead, they’re more like a snapshot taken from a specific group of people, which is why they’re inherently comparative.

To illustrate, imagine you’re using the Big Five Personality Assessment and your Agreeableness score lands you in the 70th percentile. This means you score higher in Agreeableness than 70% of individuals in the normative sample used to develop the assessment. However, this sample could be from a specific demographic or time period, like college students from the early 2000s. So, your percentile reflects how you compare to that particular group—not necessarily to today’s general population or a different group of adults.

Similarly, let’s revisit the PHQ-9 Depression Severity scale. Scores of 5, 10, 15, and 20 represent different levels of depression severity based on a normative sample. If the norms used to set these cut-offs were derived from a specific population at a certain time, then these thresholds are relative to that group. Therefore, someone scoring a 15 might be categorized as moderately severe in one sample, but this could differ if the norms were based on a different group or era.

Making Norms Work for You

So, how do we make norms useful without getting tangled up in the nitty-gritty of outdated samples or irrelevant comparisons?

1. Local Norms: One approach is to use the sample you have right in front of you. For instance, if you’re giving feedback on the Big Five Personality Assessment to a group of employees in a company, you can tell them how they score relative to their colleagues. This method ensures that comparisons are relevant and contextualized.
2. Comparison Samples: Another approach is to use existing datasets that are relevant to your context. For example, if the Big Five assessment you’re using was normed on a broad population, find a dataset that aligns more closely with your current sample. You might refer to a dataset of adults from a similar demographic if that’s more appropriate. By converting raw scores into z-scores and referring to a normal distribution curve, you can offer a clearer picture of where someone stands relative to a well-defined benchmark.

PsyPack Analytics: Building Community Norms Made Easy

Both local norms and comparison samples are incredibly useful, but let’s be honest—they’re not always easy to build or maintain. Over time, datasets need revision, and accessing the right samples can be challenging. Wouldn’t it be magical to have your own up-to-date local norms that automatically reflect the community you’re serving? This is a problem we’ve been thinking about from the moment we started building PsyPack.

With PsyPack Analytics, that magic becomes reality.

Every time you conduct an assessment, PsyPack Analytics automatically updates your norms based on the latest data—without the manual effort. This ensures that your comparisons stay relevant and accurate as your client base evolves. No more outdated canned datasets; just real-time, precise benchmarks tailored to your population.

Too much talk? Let’s see how it looks in action. Let’s take a practical example: imagine you’re regularly administering the PHQ-9 Depression Severity scale.

In the screenshot, you see three sections, let’s go over each one by one:

1. Scores Distribution: With PsyPack Analytics, you can view the frequency distribution of scores across your community in real time, allowing you to see how many of your client assessments fall into categories like mild, moderate, or severe depression at any given moment.
2. Average Progress: You can also track average weekly progress across clients, helping you visualize trends and understand how interventions are impacting your community over time.
3. Key Metrics: Metrics such as mean and standard deviation, are always at your fingertips, providing valuable insights into the overall distribution of depression severity within your client base. This gives you a clear, real-time snapshot of how your clients are doing, without having to manually crunch the numbers or rely on outdated datasets.

Further, the PsyPack Analytics section allows you to easily toggle between different time frames—last 3 months, 6 months, or a full year. This flexibility helps you analyze data across different periods, depending on your requirement. The default is set to the last 3 months, but if you find thinner data for a particular assessment, you can expand to a larger time frame to get a broader view.

Built with Therapists in Mind

As a therapist practitioner, the ideal way to interpret psychological tests and make the most out of them is to have access to both published norms and community-specific norms. Published norms, recommended by the authors of assessments and based on extensive research, provide a solid reference for understanding your clients’ scores in a broader context.

PsyPack takes care of both these needs seamlessly. Our reports include the published norms from assessment authors, giving you that essential broad perspective. At the same time, our PsyPack Analytics feature offers community-specific norms that are automatically updated with each assessment you conduct. This means you gain real-time insights that reflect the unique characteristics of the individuals you work with.

With PsyPack, you get the comprehensive view you need: reliable benchmarks from published studies and tailored, up-to-date data from your own practice. This dual approach ensures that your interpretations are both well-informed and highly relevant to your clients.

In Summary

PsyPack is designed with therapists in mind, blending innovative features to support your practice from the ground up. By integrating both published norms and community-specific norms, PsyPack ensures you have the most relevant and accurate insights for your clients. Our commitment to continuous improvement and real-time data updates reflects our dedication to meeting the unique needs of your practice.

With these thoughtful features, PsyPack stands out in its field, providing tools that are tailored specifically for therapists and their clients. This approach helps you stay ahead and make informed decisions with confidence, allowing you to focus on what truly matters—your clients’ well-being.