2008 Woodie Awards
Think you're mentally normal? Think again
Issue date: 5/1/08
It's fairly normal for people to wonder whether they are "normal" or not. When performing diagnostic tests or psychological research studies, it is important for doctors to be able to define and determine "normality" as accurately as possible.
A battery of tests - from brain imaging studies to preference surveys to diagnostic tests for mental illness - are dependent on the definition of normal and abnormal scores or outcomes. Usually these values are determined by experts after many rounds of testing.
The problem is, for years researchers have noticed that supposedly normal people don't always test normally. Even the epitome of healthy brain activity can be a little tilted, according to test results.
That poses a challenge for doctors and researchers alike: How are we to divine true abnormalities when even relatively healthy people are giving whacky test results? A new study from Barry Gordon, a Hopkins neurologist, and colleagues at Yale University and Hartford Hospital, both in Connecticut, offers some insights into this phenomenon.
First, they found that the mere fact that someone tests abnormally does not mean they are brain damaged. Healthy people sometimes give odd test results and unhealthy people can sometimes test normally. The important thing is that doctors use common sense - or additional clinical clues - to try to reason whether a person is truly damaged.
Second, these abnormal test results in apparently normal people are not entirely a random effect. People are more likely to score abnormally at least once if they take many tests. If the proper criteria for abnormality are imposed, the likelihood of abnormal tests scores also decreases.
That makes sense: Even if you take a test and get a hundred, that grade really isn't a truly accurate description of your knowledge because if you kept testing over and over, eventually you would probably get one wrong. The military follows this logic when testing applicants; if you get 50/50, your "real" score is 98/100. Hoorah!
A battery of tests - from brain imaging studies to preference surveys to diagnostic tests for mental illness - are dependent on the definition of normal and abnormal scores or outcomes. Usually these values are determined by experts after many rounds of testing.
The problem is, for years researchers have noticed that supposedly normal people don't always test normally. Even the epitome of healthy brain activity can be a little tilted, according to test results.
That poses a challenge for doctors and researchers alike: How are we to divine true abnormalities when even relatively healthy people are giving whacky test results? A new study from Barry Gordon, a Hopkins neurologist, and colleagues at Yale University and Hartford Hospital, both in Connecticut, offers some insights into this phenomenon.
First, they found that the mere fact that someone tests abnormally does not mean they are brain damaged. Healthy people sometimes give odd test results and unhealthy people can sometimes test normally. The important thing is that doctors use common sense - or additional clinical clues - to try to reason whether a person is truly damaged.
Second, these abnormal test results in apparently normal people are not entirely a random effect. People are more likely to score abnormally at least once if they take many tests. If the proper criteria for abnormality are imposed, the likelihood of abnormal tests scores also decreases.
That makes sense: Even if you take a test and get a hundred, that grade really isn't a truly accurate description of your knowledge because if you kept testing over and over, eventually you would probably get one wrong. The military follows this logic when testing applicants; if you get 50/50, your "real" score is 98/100. Hoorah!
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