Contributions of Multimethod Personality Assessment in Indirect Evaluation.

Indirect assessment is a useful tool in forensic evaluation, especially in cases of threat assessment. To this end, we illustrated the ability to conceptualize a complicated case (i.e., Theodore John Kaczynski) using an indirect approach, with a particular emphasis upon dimensional frameworks of personality. Raters who were unrelated to Mr. Kaczynski's case and with expertise in relevant domains were asked to study information available in the public domain about Mr. Kaczynski and provide ratings using several assessment instruments. Our aim was not to provide a professional clinical opinion, but rather engage in scholarly discourse about the utility of instruments. Mr. Kaczynski was rated to demonstrate characteristics associated with lone actor terrorists. He showed an elevation on a measure of psychosis, and raters conceptualized trauma as an important aspect of his functioning. He demonstrated impairments in detachment and psychoticism (Criterion B of the AMPD) and interpersonal functioning (Criterion A of the AMPD). Clinical conceptualizations for Mr. Kaczynski emphasized schizotypal and paranoid personality disorders. This analysis of an infamous case about which considerable data are publicly available demonstrates the ease with which indirect and multimethod assessment can be applied and integrated in forensic assessment, using modern conceptualizations of personality pathology.

MMPI-2-RF Differences Between Violent Offending and Institutional Violence Among Incarcerated Women.

The examination of violence perpetrated by female offenders remains an understudied topic, as research typically focuses on male offender samples. As such, it remains unclear what personality characteristics may be associated with the perpetration of violence among female offenders. This study sought to examine the relationship between personality characteristics, as assessed by the MMPI-2-RF, and engagement in violence, within a sample of 228 incarcerated women. Results indicated that women serving time for a violent offense obtained higher mean scores on MMPI-2-RF scales related to underreporting, atypical thoughts/experiences, and paranoia. Women who obtained disciplinary reports for violence within the institution obtained higher mean scores on MMPI-2-RF scales related to behavior/externalizing dysfunction, overactivation, and aggression. Taken together, violence was most strongly associated with the MMPI-2-RF scales related to paranoia and atypical thoughts/experiences (e.g., THD, PSYC-r). This study provides new data on the viability of the MMPI-2-RF to provide critical insights into violent and aggression behavior in female inmates, an understudied population and demonstrate the instrument's efficacy in assessing characteristics associated with violent behavior.

Professional Practice Guidelines for Personality Assessment.

The current paper conveys guidelines for personality assessment developed by a work group formed by the Society for Personality Assessment (SPA), which are intended to serve as an aid for best practices specific to personality assessment for professionals, and a source of information for consumers and policy makers. The guidelines were developed after a careful and systematic review of the literature on personality assessment and examination of practice patterns, and were refined through multiple rounds of input from stakeholders including members of SPA and other professionals routinely conducting personality assessment. The guidelines address the scope of personality assessment and current practice trends, minimum education and training qualifications, ethical practices, diversity considerations, assessment procedures, and appropriate applications. By following these guidelines and other established professional standards, psychologists can help ensure that they practice ethically, competently, with appropriate attention to diversity, and to the highest standards of the profession. These guidelines can function as a resource for educators and supervisors of personality assessment. Additionally, the guidelines will serve as a benchmark for best practices in personality assessment and, as such, represent a first step in what is hoped to be an evolution of ever improving personality assessment standards of practice.

The association between clinicians' initial judgments of feigning and outcomes on symptom validity measures among pretrial forensic psychiatric inpatients.

Research suggests the use of validated symptom validity tests to detect feigning is imperative to increase accuracy over unaided clinical judgment, especially in forensic settings. This study examined performance on the Miller Forensic Assessment of Symptoms (M-FAST) and Structured Interview of Reported Symptoms (SIRS) during 297 assessments of forensic inpatients. The risk of being identified as feigning on the M-FAST or SIRS was similar for those who were referred for evaluation of feigning compared to those who were not, but individuals with malingering designations prior to the evaluation scored significantly higher than those without on the M-FAST and several SIRS subscales. Findings support the importance of utilizing objective methods of data collection.

The Personality Assessment Inventory (PAI): Treatment Scales and Interpersonal Characteristics in a Sample of Men Charged with or Convicted of a Sexual Offense.

An individual's interpersonal features are pertinent to treatment within clinical populations. The Personality Assessment Inventory (PAI) contains two scales that assess the interpersonal features of warmth (WRM) and dominance (DOM), as well as two additional measures to assess to treatment prediction, process, and rejection (RXR; TPI). The current study examined associations between these PAI scales in a sample of 92 men who underwent comprehensive evaluations of sexual behavior after being charged with or convicted of a sexual offense. Analyses indicated that RXR was positively associated with WRM and DOM, TPI was negatively associated with WRM, and the two interpersonal scales of WRM and DOM were positively correlated with each other. A significant inverse relationship was found between the two treatment scales RXR and TPI indicating that motivation for treatment may have a limited relationship with the treatment process. WRM significantly predicted scores on the TPI, and both WRM and DOM predicted individual scores on RXR. Higher scores on positive impression management (PIM) were predictive of lower TPI and higher RXR, as individuals with higher stakes cases may score higher on PIM and underreport obstacles within treatment or be unwilling to accept the need for treatment. Overall, findings suggest that interpersonal characteristics identified by the PAI scales may be advantageous in approaching treatment within this population.

Use of penile plethysmography in the court: A review of practices in Canada, the United Kingdom and the United States.

Penile plethysmography (PPG) is an objective measure of male sexual arousal in response to the presentation of a series of erotic and neutral stimuli. This measure is now widely recognized as the most reliable means of objectively measuring male sexual arousal to specific stimuli. Many clinicians and researchers consider PPG to be a vital contribution to the assessment and treatment of adult men with paraphilic interests and men who have committed sex crimes. PPG contributes to the clinical assessment of paraphilic interests, appraisal of risk of recidivism, and provides an objective measurement of changes in sexual arousal in response to treatment. There is strong support for the utility of PPG within clinical and legal contexts. This article addresses ways in which PPG has been utilized in the courts as part of expert clinical opinion. History of its use, details regarding admissibility in court, and case law are explored within the legal systems of Canada, the UK and the USA. Support for the inclusion of PPG as expert evidence is provided and judicial misunderstandings on the rationale for PPG use and its clinical utility in forensic assessments are discussed.

Child Pornography and Online Sexual Solicitation.

PURPOSE OF REVIEW: This review highlights recent literature regarding online sexual offending, including the prevalence, characteristics, a brief review of recent typology literature, victimization risk factors, risk factors of being a "crossover" offender, rates and risk factors for recidivism, and a discussion of prevention efforts. RECENT FINDINGS: Online sexual offenders are overwhelmingly White men with relationship problems who were rarely previously arrested for felonies. They score lower on measures of antisocial behavior, compared to offenders who commit contact sexual offenses against children. Individuals who commit pornography offenses are at lower risk to commit contact offenses and their risk factors include having sexual interest in children and antisocial attitudes. Online offenders are different from contact sexual offenders and from offenders who commit both types of offenses. Recidivism in online noncontact offenders is difficult to assess due to the lack of empirically supported tools and the inappropriateness of using popular actuarial tools that lack norms on these offenders, but a new measure (CPORT) is being studied for use with this population.

An Examination of Triarchic Psychopathy Constructs in Female Offenders.

This study sought to expand scientific knowledge on psychopathic personality traits in female offenders by evaluating the relationship between MMPI-2-RF triarchic scales and self-reported external variables in a sample of 205 female offenders. Results indicated that boldness was inversely related to internalizing dysfunction, including suicidal behavior, psychosis, youth conduct problems, problems stemming from alcohol use, and a history of outpatient mental health treatment. Meanness was positively related to internalizing dysfunction as well as youth conduct problems, anger, prison disciplinary reports, and psychosis. Disinhibition was associated with a history of abuse in childhood, suicidal behavior, internalizing dysfunction, problems associated with alcohol and drug use, family history of mental illness, prison disciplinary reports for violence, number of previous criminal charges, and anger. Consistent with views of psychopathy as a configural condition, interactive effects of boldness with disinhibition and meanness were observed for multiple key external variables (e.g., conduct problems, substance use, nonsuicidal self-injurious behavior). This study provides further evidence for the triarchic conceptualization of psychopathy in female offenders and lends additional support for the validity of MMPI-2-RF triarchic psychopathy scales.

Using Technology to Improve the Objectivity of Criminal Responsibility Evaluations.

Criminal responsibility (or insanity) evaluations require forensic clinicians to reconstruct a defendant's decision-making abilities, behavioral control, and emotional state at the time of the criminal act. Forensic evaluators are ultimately tasked to evaluate whether an individual had the capacity to understand right from wrong, and in some jurisdictions, determine whether the defendant lacked substantial capacity to conform his behavior to the requirements of the law as a result of a threshold condition (e.g., mental illness). Insanity evaluations are inherently complex, because they require the clinician to determine someone's mental state at some point in the past (weeks, months, or even years). Recent research on insanity evaluations underscores significant problems with the reliability and validity of these evaluations. However, technological advances including social media (e.g., Facebook and Twitter), mandating that law enforcement videotape interrogations, and the use of body and dashboard cameras can aid clinicians in improving the precision and quality of insanity evaluations. This article discusses practical guidelines and ethics-related concerns regarding the use of technology to improve the objectivity of criminal responsibility evaluations.

Burdensomeness, Belongingness, and Capability: Assessing the Interpersonal-Psychological Theory of Suicide With MMPI-2-RF Scales.

Given the emerging body of literature demonstrating the validity of the interpersonal-psychological theory of suicide (IPTS), and the importance of increasing our understanding of the development of risk factors associated with suicidal behavior, it seems worthwhile both to expand IPTS research via Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) correlates and to expand the availability of methods by which to assess the constructs of the IPTS. The present study attempted to do so in a large adult outpatient mental health sample by (a) inspecting associations between the IPTS constructs and the substantive scales of the MMPI-2-RF and (b) exploring the utility of MMPI-2-RF scale-based algorithms of the IPTS constructs. Correlates between the IPTS constructs and the MMPI-2-RF scales scores largely followed a pattern consistent with theory-based predictions, and we provide preliminary evidence that the IPTS constructs can be reasonably approximated using theoretically based MMPI-2-RF substantive scales. Implications of these findings are discussed.

Mental Disorders Among Criminal Offenders: A Review of the Literature.

This article examines mental illness among adult, juvenile, male, female, jail, and prison inmates. It also explores the way in which mental health diagnoses impact offending and violent behavior. A review of literature pertaining to differences between the genders and age of offenders suggests that psychiatric disorders are more common among criminal offenders than the population at large. Furthermore, it appears that many mentally ill offenders do not receive sufficient treatment during their incarcerations and that barriers inherent to incarceration prevent adequate treatment of mental illnesses.

Improving the Detection of Feigned Knowledge Deficits in Defendants Adjudicated Incompetent to Stand Trial.

Malingering is relatively common in criminal forensic evaluations as base rates of malingering have ranged from 20% to 30%. Given that the most prevalent criminal forensic evaluation is the assessment of competency to stand trial, the assessment of feigning during competency evaluations is necessary for accurate findings. Most of the response style literature focuses on feigning mental health symptoms, but in competency evaluations, individuals may attempt to feign legal knowledge deficits in order to be found incompetent to stand trial. The current investigation includes two studies: 195 students instructed to simulate feigned mental illness or incompetence to stand trial and one using a sample of 130 state psychiatric hospital residents who had been adjudicated incompetent to stand trial. The purpose of the study was to evaluate the Inventory of Legal Knowledge's (ILK; Musick & Otto, 2010) ability to detect individuals who are feigning legal knowledge deficits. Classification utility statistics, including sensitivity, specificity, positive predictive power, and negative predictive power are provided for each cut-score on the ILK beginning with a cut-score of 24 (which is the lower end of the range of chance) are provided. The current cut-score of 47 provided in the professional manual of the ILK was shown to create a large number of false positives and suggests that modifications to this cut-score are required.

Likelihood of obtaining Structured Interview of Reported Symptoms (SIRS) and SIRS-2 elevations among forensic psychiatric inpatients with screening elevations on the Miller Forensic Assessment of Symptoms Test.

The Miller Forensic Assessment of Symptoms Test (M-FAST) was designed as a screening measure for feigned psychiatric symptoms. When M-FAST Total Scores are elevated (raw score ≥6), the test manual recommends follow-up with a more comprehensive measure of feigning, such as the widely used and researched Structured Interview of Reported Symptoms (SIRS) or the revised version of the test (SIRS-2). The purpose of the current study was to evaluate how often M-FAST screening elevations are associated with subsequent elevations on the SIRS or SIRS-2. The sample included archival data from 100 forensic psychiatric inpatients who obtained M-FAST Total Score elevations ≥6 during screening and were subsequently administered the SIRS (that was also rescored using SIRS-2 criteria). Among examinees who elevated the M-FAST over the recommended cutoff, 66.0% met standard SIRS feigning criteria, 42% met SIRS-2 criteria for feigning, and 81.0% obtained at least 1 SIRS/SIRS-2 elevation in the Probable Feigning range or higher. These results are consistent with the M-FAST manual guidelines, which support the use of the ≥6 M-FAST cutoff score to screen for potential feigning (but not as an independent marker of feigning). A higher M-FAST cutoff score of ≥16 was associated with subsequently meeting full SIRS criteria for feigning in 100.0% of protocols. Because the SIRS criteria were designed to have very low false positive rates, these findings indicate that more confident assertions about feigning can be made when elevations reach this level on the MFAST. (PsycINFO Database Record

The Relationship Between Psychiatric and Cognitive Symptom Feigning Among Forensic Inpatients Adjudicated Incompetent to Stand Trial.

The accurate assessment of feigning is an important component of forensic assessment. Two potential strategies of feigning include the fabrication/exaggeration of psychiatric impairments and the fabrication/exaggeration of cognitive deficits. The current study examined the relationship between psychiatric and cognitive feigning strategies using the Structured Interview of Reported Symptoms and Test of Memory Malingering among 150 forensic psychiatric inpatients adjudicated incompetent to stand trial. A greater number of participants scored within the feigning range on the Structured Interview of Reported Symptoms than on the Test of Memory Malingering. Relative risk ratios indicated that individuals shown to be feigning cognitive deficits were 1.68 times more likely to feign psychiatric symptoms than those not shown to be feigning cognitive deficits. Likewise, individuals shown to be feigning psychiatric deficits were 1.86 times more likely to feign cognitive deficits than those not shown to be feigning psychiatric symptoms. Overall, findings suggest that psychiatric feigning and cognitive feigning are related, but can be employed separately as feigning strategies. Therefore, clinicians should consider evaluating for both feigning strategies in forensic assessments where cognitive and psychiatric symptoms are being assessed.

The utility of MMPI-2-RF substantive scales in prediction of negative treatment outcomes in a community mental health center.

This study examined the utility of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) substantive scales in the prediction of premature termination and therapy no-shows while controlling for other relevant predictors in a university-based community mental health center, a sample at high risk of both premature termination and no-show appointments. Participants included 457 individuals seeking services from a university-based psychology clinic. Results indicated that Juvenile Conduct Problems (JCP) predicted premature termination and Behavioral/Externalizing Dysfunction and JCP predicted number of no-shows, when accounting for initial severity of illness, personality disorder diagnosis, therapist experience, and other related MMPI-2-RF scales. The MMPI-2-RF Aesthetic-Literary Interests scale also predicted number of no-shows. Recommendations for applying these findings in clinical practice are discussed.

Reading the Road Signs: The Utility of the MMPI-2 Restructured Form Validity Scales in Prediction of Premature Termination.

This study examined the utility of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) Validity Scales in prediction of premature termination in a sample of 511 individuals seeking services from a university-based psychology clinic. Higher scores on True Response Inconsistency-Revised and Infrequent Psychopathology Responses increased the risk of premature termination, whereas higher scores on Adjustment Validity lowered the risk of premature termination. Additionally, when compared with individuals who did not prematurely terminate, individuals who prematurely terminated treatment had lower Global Assessment of Functioning scores at both intake and termination and made fewer improvements. Implications of these findings for the use of the MMPI-2-RF Validity Scales in promoting treatment compliance are discussed.

The clinical utility of the MMPI-2-RF Suicidal/Death Ideation Scale.

Suicide is a major public health concern, with over 100 individuals dying by suicide per day in the United States alone. Therefore, suicide risk assessment is an essential aspect of mental health care. The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008-2011; Tellegen & Ben-Porath, 2008) has a Suicidal/Death Ideation (SUI) scale consisting of 5 items that describe recent suicidal ideation or behaviors. Although this scale has clear face validity, few studies have examined the clinical utility of this scale. The purpose of the current study was to examine associations between the SUI scale and other established measures of suicidal ideation and behavior, including the Depressive Symptom Inventory Suicidality Subscale (DSI-SS; Metalsky & Joiner, 1997), Beck Scale for Suicide Ideation (BSS; Beck & Steer, 1991; Beck, Steer, & Ranieri, 1988), self-report of lifetime suicide attempts, and clinician ratings of suicide risk. Participants were 998 therapy- and assessment-seeking outpatients. Analyses indicated that the SUI scale was positively associated with other self-reported measures of suicidal ideation and behavior. Significant differences in SUI scale scores also emerged among the clinician rating categories of suicide risk. The SUI scale was able to predict previous suicide attempts over and above age, gender, and other MMPI-2-RF scales related to depression. Finally, relative risk ratios for suicide attempts indicate increased risk of suicidality, with higher T scores on the SUI scale. Overall, findings suggest that the MMPI-2-RF SUI scale may be a useful tool for identifying individuals at risk for suicidal ideation and behavior in clinical settings.