Evaluator empathy in risk assessment interviews.

OBJECTIVE: Should forensic evaluators convey empathy during forensic assessments? Opponents contend that empathy causes harm by leading evaluees to disclose potentially incriminating information, but proponents hold that empathy is crucial for establishing rapport and conveying respect. This study provides a comprehensive examination of experienced forensic evaluators' use of empathy in forensic assessment. HYPOTHESES: The study was exploratory and not hypothesis-driven, but we expected to find identifiable subgroups of evaluators who differed in their use of empathy in the context of a risk assessment interview. We also expected that evaluator subgroups would differ in their attitudes and practices regarding empathy and that higher levels of empathy may be associated with more favorable views of evaluees. METHOD: Experienced forensic evaluators (N = 200) assumed the role of interviewer in a written parole risk assessment interview and chose questions (high or low empathy) they would ask the evaluee if they were conducting the interview. Evaluators also provided ratings of their perceptions of the evaluee and responded to questions regarding their attitudes toward, and use of, empathy in forensic assessment. RESULTS: Latent class analysis results indicated that most evaluators fell into low- (46.0%) or moderate- (43.0%) empathy subgroups, with few falling into a high-empathy subgroup (11.0%). Higher levels of empathy in the interview were associated with attitudes and practices supporting empathy use and higher self-reported understanding of the evaluee, but not with opinions of the evaluee's risk or suitability for parole. CONCLUSIONS: These findings of clear differences in evaluator empathy add to the growing body of research documenting the extent to which forensic evaluators differ in their evaluation styles and tendencies. Although there was support for both very low and very high levels of empathy, support for very high levels of empathy was uncommon. Most evaluators opted for low to moderate empathy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Psychopathy Profiles and Personality Assessment Inventory Scores in a Sex Offender Risk Assessment Field Setting.

A growing body of research suggests there are identifiable psychopathy subtypes among offenders scored on Hare's Psychopathy Checklist-Revised (PCL-R; Hare, 2003). We used latent profile analysis to examine the generalizability of these subtype findings to PCL-R scores (N = 615) assigned in a sex offender risk assessment field setting and to examine how offender subtypes differ on measures of comorbid psychopathology, risk, and treatment amenability from the Personality Assessment Inventory. Consistent with prior research, we identified four subtypes when using PCL-R scores from all offenders: Prototypic psychopathy (n = 239, 38.9%), callous-conning (n = 154, 25.0%), sociopathic (n = 96, 15.6%), and general offenders (n = 126, 20.5%). Prototypic and sociopathic subtypes exhibited the highest levels of comorbid psychopathology and risk for potential violence. We identified classes consistent with primary (n = 66, 36.7%) and secondary (n = 114, 63.3%) psychopathy among offenders with PCL-R total scores ≥ 25, and found higher levels of comorbid psychopathology and potential for violence among those in the secondary psychopathy class. Findings provide support the generalizability of existing PCL-R subtype findings to field scores and show how those with similar PCL-R total scores may differ on scores from commonly used multiscale inventories.

Identifying the Contributions of Maternal Factors and Early Childhood Externalizing Behavior on Adolescent Delinquency.

We examined whether childhood externalizing group subtypes were uniquely related to maternal depression and victimization and whether these subtypes differentially predicted adolescent delinquency. Data were drawn from the Longitudinal Study on Child Abuse and Neglect (LONGSCAN) consortium (N = 1091; 51.3% female, 52.2% African American). Latent class analysis indicated three groups at age 4 (titled "well-adjusted," "hyperactive/oppositional," and "aggressive/rule-breaking"). Caregiver victimization and depression significantly predicted group membership such that aggressive/rule-breaking group had higher levels of maternal depression and victimization although the well-adjusted group had higher levels of maternal victimization relative to the hyperactive/oppositional group. Further, membership in higher externalizing groups at age four is associated with greater risk of adolescent delinquency at age 16. These findings underscore the need to address maternal risk factors in the treatment of childhood disruptive behavior and provide evidence of the continuity of disruptive behaviors from early childhood to adolescence.

Rater experience and the predictive validity of Psychopathy Checklist: Youth Version scores.

We compared the predictive validity of Psychopathy Checklist: Youth Version (PCL:YV) scores assigned by a licensed clinician to scores assigned by a graduate student across a sample of 82 juvenile offenders. Although both raters completed in-depth training and practice scoring cases, the graduate student had no prior clinical experience. The raters showed a high level of agreement in their scoring for 11 reliability check cases (intraclass correlation coefficient, ICCA,1 = .90 for PCL:YV Total score), but the scores assigned by the licensed clinician were better predictors of post-release recidivism (area under the curve, AUC = .77) than those assigned by the graduate student (AUC = .45). There was more variability in the scores assigned by the licensed clinician than those assigned by the graduate student, suggesting that more experienced clinicians' willingness to assign both high and low scores may help explain rater differences in predictive validity.

The Gay Panic Defense: Legal Defense Strategy or Reinforcement of Homophobia in Court?

Gay panic refers to a heterosexual man violently responding to unwanted sexual advances from a gay man. In court, the defendant may argue he was provoked or temporarily insane. This study utilized 352 jury-eligible citizens to assess differences across mediums of gay panic. Participants were asked to read vignettes depicting a control, gay panic as provocation, or gay panic as insanity condition and provide verdicts and ratings of blame and responsibility. Participants also completed measures assessing political orientation and homonegativity. Data were analyzed via a MANCOVA, a chi-square goodness-of-fit test, and general linear modeling. Verdicts, victim blame, and ratings of responsibility differed across vignette conditions, with an observed leniency effect when gay panic was claimed in either context. Homonegativity also exacerbated patterns of prodefendant views, as participants higher in homonegativity assigned higher victim blame, lower defendant responsibility, and more lenient verdicts in the gay panic conditions. The effect of political orientation was nuanced, as only republicans in the provocation condition followed the anticipated pattern in rendering more lenient verdicts. Results provide additional support for the notion gay panic defenses may be, in part, fueled by political beliefs and prejudicial beliefs against persons of sexual minority status. Drawing from a justification-suppression model, it may be that in cases of gay panic, a context is created in which prejudiced ideologies can be openly expressed via leniency on the defendant. Implications may be relevant to future criminal law policies and practices, particularly advocacy and policy efforts, judicial training, and trial consultation to attorneys for juror selection and development of trial strategy.

How does evaluator empathy impact a forensic interview?

We used an experimental design to test the key concern that expressive empathy from evaluators during forensic interviews leads to more disclosure of misbehavior (e.g., stealing, breaking the law, manipulating others) from evaluees. In the context of a psychopathy assessment interview, evaluees (N = 94, 100% male, 57.4% Caucasian) interviewed by an evaluator using expressive empathy techniques were no more likely than those interviewed by an evaluator avoiding expressive empathy techniques to admit to past instances of misbehavior (d = .17, 95% CI [-.24, .57]). Instead, the use of expressive empathy techniques seemed to influence evaluator perceptions of the evaluees. Evaluators using expressive empathy rated evaluees as less psychopathic (d = -.52, 95% CI [-.93, -.11]), more conscientious (d = .72, 95% CI [.30, 1.13]), and as having engaged in less impression management (d = -.54, 95% CI [-.95, -.13]) than evaluators avoiding the use of expressive empathy. Put simply, when evaluators expressed empathy, it influenced the evaluator, not the evaluee. These findings suggest the need to expand professional discourse and research on empathy in forensic evaluations to better understand the possible effects of evaluator empathy on both evaluators and evaluees. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Further evidence that suicide risk is categorical: A taxometric analysis of data from an inpatient sample.

Recent research by Witte and colleagues (2017) revealed a taxonic structure for classifying suicide risk using a sample of predominantly military outpatients. The authors sought to replicate the Witte et al. (2017) findings using data from a sample of 2,385 psychiatric inpatients who completed measures of suicidal ideation and behavior upon admission to the hospital. The comparison curve fit index values for means above minus below a cut (.80), maximum eigenvalue (.71), and latent mode (.52) showed a similar taxonic structure (i.e., dichotomous rather than continuous). Consistent with Witte et al. (2017), differences between the taxon and complement groups were larger for variables conceptually directly related to suicide risk than to broader constructs such as hopelessness or depression. Support for this categorical distinction among a sample of long-term psychiatric inpatients, who are uniformly high in symptom severity, emphasizes the need for additional research on this high-risk group and development of further assessment methods. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Taking forensic mental health assessment "out of the lab" and into "the real world": Introduction to the special issue on the field utility of forensic assessment instruments and procedures.

The last several decades have seen a major upswing in the development and use of psychological assessment instruments in forensic and correctional settings. At the same time, admissibility standards increasingly have stressed the importance of the reliability and validity of evidence in legal proceedings. Recent research has, however, raised serious concerns about (a) the reliability of forensic science evidence in general, (b) the replicability of psychological research findings in general and in field settings especially, and (c) the interrater reliability and predictive validity of forensic psychological assessment evidence in particular. In this introduction to the special issue of Psychological Assessment on the field utility of forensic assessment instruments and procedures, we provide an overview of key issues bearing on field studies, focusing on why such research is critically important to improving the quality of the practice of forensic mental health assessments. We also identify various methodological issues and constraints relevant to conducting research outside of controlled settings. We conclude with recommendations for how future field research can improve upon the current state of the discipline in forensic mental health assessment. (PsycINFO Database Record

Field validity of Static-99/R scores in a statewide sample of 34,687 convicted sexual offenders.

The Static-99 (and revision, the Static-99R) reflect the most researched and widely used approach to sex offender risk assessment. Because the measure is so widely applied in jurisdictions beyond those on which it was developed, it becomes crucial to examine its field validity and the degree to which published norms and recidivism rates apply to other jurisdictions. We present a new and greatly expanded field study of the predictive validity (M = 5.23 years follow-up) of the Static-99 as applied system-wide in Texas (N = 34,687). Results revealed stronger predictive validity than a prior Texas field study, especially among offenders scored after the release of an updated scoring manual in 2003 (AUC = .66 to .67, d = .65 to .69), when field reliability was also stronger. But calibration analyses revealed that the Static-99R routine sample norms led to a significant overestimation of risk in Texas, especially for offenders with scores ranging from 1 to 5. We used logistic regression to develop local Texas recidivism norms (with confidence intervals) for Static-99R scores. Overall, findings highlight the importance of revisiting and updating field study findings, and the potential benefits of using statewide data to develop local norms. (PsycINFO Database Record

Field measures of psychopathy and sexual deviance as predictors of recidivism among sexual offenders.

Offenders with high levels of both psychopathy and deviant sexual interests are often described as being more prone to recidivate than other sexual offenders, and many forensic evaluators report considering this psychopathy and sexual deviance interaction when coming to conclusions about sex offender risk. However, empirical support for the interaction comes from studies using sexual deviance measures that are rarely used in the field. We examined the ability of Psychopathy Checklist-Revised (PCL-R) field scores and possible field measures of sexual deviance (e.g., paraphilia diagnosis, offense characteristics) to predict sexual recidivism among 687 offenders released after being evaluated for postrelease civil commitment (M follow-up = 10.5 years). PCL-R total scores and antisocial personality diagnoses were predictive of a combined category of violent or sexual recidivism, but not sexual recidivism. Paraphilia diagnoses and offense characteristics were not associated with an increased likelihood of reoffending. There was no evidence that those with high levels of both psychopathy and sexual deviance were more likely than others to reoffend. Although the psychopathy and sexual deviance interaction findings from prior studies are large and compelling, our findings highlight the need for research examining the best ways to translate those findings into routine practice. (PsycINFO Database Record

Field reliability influences field validity: Risk assessments of individuals found not guilty by reason of insanity.

Individuals acquitted as not guilty by reason of insanity (NGRI) are usually committed to psychiatric hospitals for treatment until they are considered suitable for conditional release back to the community. The clinical evaluations that inform conditional release decisions have rarely been studied but provide an ideal opportunity to examine the reliability and validity of complex evaluations in the field. For example, to what extent do forensic evaluators agree about an acquittee's readiness for conditional release? And how accurate are their opinions? We reviewed 175 evaluation reports across 62 cases from Hawaii, which requires 3 separate evaluations from independent clinicians for each felony NGRI acquittee referred for conditional release evaluation. Evaluators agreed about an NGRI acquittee's readiness for conditional release in only 53.2% of evaluations (κ = .35). Courts followed the majority evaluator opinion in 79.3% of all cases but ruled in an opposite direction from the majority evaluator opinion in more than a third of cases in which evaluators disagreed. Evaluators accurately differentiated those conditionally released acquittees who remained in the community from those who were rehospitalized in 62.4% of cases. Among the 43 insanity acquittees who were ultimately released, evaluator agreement was significantly associated with rehospitalization within 3 years. When the evaluators unanimously agreed that conditional release was appropriate, only 34.5% were rehospitalized. When the evaluators disagreed, 71.4% were rehospitalized. Overall, results reveal poor agreement among independent evaluators in routine practice but suggest that opinions may be more accurate when evaluators agree than when they disagree. (PsycINFO Database Record

Does the Convergent Validity of the PAI Antisocial Features Scale Depend on Offender Response Style?

Researchers have recently questioned the utility of the response style indicators included on many self-report measures of personality and psychopathology. We examined whether the size of convergent validity coefficients for Personality Assessment Inventory (PAI) Antisocial Features (ANT) scores depends on PAI validity scale scores. Using PAI and Psychopathy Checklist-Revised (PCL-R) scores from 477 offenders evaluated for civil commitment as sexually violent predators, we found that PAI Positive Impression (PIM), Negative Impression (NIM), Malingering Index (MAL), Defensiveness Index (DEF), and Infrequency (INF) scores moderated the association between ANT and PCL-R scores. The association between ANT and PCL-R scores decreased as offenders overstated psychopathology (i.e., higher NIM or MAL scores) or exhibited increasing disengagement (i.e., higher INF scores). However, the association between ANT and PCL-R scores increased as offenders engaged in defensive reporting (i.e., higher PIM or DEF scores). The interaction effects were most common for ANT-E (Egocentricity), and to a lesser extent ANT-A (Antisocial Behaviors). PAI discriminant function validity indexes did not exhibit moderating effects on ANT and PCL-R scores. There was no evidence of validity scale suppression effects. These findings provide support for the potential role of some PAI response style measures for ANT scale interpretation in forensic settings.

Personality Assessment Inventory Scores as Predictors of Evaluation Referrals, Evaluator Opinions, and Commitment Decisions in Sexually Violent Predator Cases.

We used data from more than 1,500 offenders to examine the association between Personality Assessment Inventory (PAI; Morey, 1991 ) scores and progress through the sexually violent predator (SVP) screening, evaluation, and commitment process. There was no clear association between PAI scores and referrals for full evaluations, but PAI scores were small to moderate predictors of evaluator opinions and diagnoses among offenders who underwent full evaluations. Higher Antisocial Features (ANT) scores were associated with diagnoses of antisocial personality disorder, but this association was moderated by offender response style. ANT scores were more strongly associated with antisocial personality disorder diagnoses among those responding defensively (d = .71) than among those responding openly (d = .48). The mean ANT score among defensive responders diagnosed with antisocial personality disorder was about 55T, suggesting that even moderate ANT scale elevations could indicate a clinically significant level of antisocial traits among some offenders.

Psychopathy Checklist-Revised Use and Reporting Practices in Sexually Violent Predator Evaluations.

We surveyed evaluators who conduct sexually violent predator evaluations ( N = 95) regarding the frequency with which they use the Psychopathy Checklist-Revised (PCL-R), their rationale for use, and scoring practices. Findings suggest that evaluators use the PCL-R in sexually violent predator cases because of its perceived versatility, providing information about both mental disorder and risk. Several findings suggested gaps between research and routine practice. For example, relatively few evaluators reported providing the factor and facet scores that may be the strongest predictors of future offending, and many assessed the combination of PCL-R scores and sexual deviance using deviance measures (e.g., paraphilia diagnoses) that have not been examined in available studies. There was evidence of adversarial allegiance in PCL-R score interpretation, as well as a "bias blind spot" in PCL-R and other risk measure (Static-99R) scoring; evaluators tended to acknowledge the possibility of bias in other evaluators but not in themselves. Findings suggest the need for evaluators to carefully consider the extent to which their practices are consistent with emerging research and to be attuned to the possibility that working in adversarial settings may influence their scoring and interpretation practices.

Correspondence between correctional staff and offender ratings of adaptive behavior.

Although several experts have raised concerns about using correctional officers as informants for adaptive behavior assessments, no studies have compared ratings from correctional officers to those from other informants. We compared Adaptive Behavior Assessment System-Second Edition (ABAS-II; Harrison & Oakland, 2003) scores assigned by correctional staff to those assigned by probationers (N = 56) residing in a community corrections facility. Correctional staff assigned markedly lower scores than did probationers on many ABAS-II scales (d = .59 to 1.41 for ABAS-II composite scores). Although none of the probationers qualified for a diagnosis of intellectual disability, 29% received a staff-report ABAS-II composite score that was more than 2 SDs below the normative sample mean, suggesting significant impairment. Correlations between ABAS-II and intelligence measure scores were lower than expected for both types of informants, although they were somewhat stronger for self-report. Lower staff-report scores were associated with higher levels of probationer-reported psychopathology and need for treatment. Overall, these findings highlight limitations of using correctional staff as informants for adaptive behavior assessments. (PsycINFO Database Record

Jurors report that risk measure scores matter in sexually violent predator trials, but that other factors matter more.

After deliberating to a verdict, jurors (N = 462) from 40 sexually violent predator (SVP) trials completed a questionnaire asking them to rate the extent to which risk measure scores, diagnoses, expert witness testimony, and offender characteristics described during the trials influenced their commitment decisions. Jurors reported that offenders' sexual offending history, failure to change, and lack of remorse had the strongest influence on their commitment decisions. They reported that testimony about risk instrument scores (e.g., Static-99) and psychopathy had less influence on their decisions, but those who did report being influenced by instrument results were especially likely to view the offender as being at a high risk for reoffending. Overall, findings suggest that SVP jurors view risk measure results as important, but not as important as other offender, offense, and testimony characteristics, including some that have limited relevance to recidivism risk. Thus, findings also suggest that experts may need to better educate jurors regarding factors that do and do not relate to recidivism risk.

Rater differences in psychopathy measure scoring and predictive validity.

Although field studies reveal that some forensic evaluators tend to assign higher psychopathy measure scores to sexual offenders than others, the extent to which these findings apply to psychopathy measure scoring in other contexts is unclear. And no study has examined the impact of evaluator differences in scoring on predictive validity. We used data from the MacArthur Violence Risk Assessment Study to examine whether there were rater differences in psychopathy measure scoring and predictive effects among trained raters in a rigorous research context. The proportion of variance in Psychopathy Checklist: Screening Version (Hart, Cox, & Hare, 1995) scores attributable to raters was larger for Part 1 (14%) than Part 2 (4%) scores. The association between Facet 4 scores and future violence was stronger among evaluators who assigned higher and more variable Facet 4 scores, but there were no similar effects for other PCL:SV scores. Although there was only limited evidence for an association between PCL:SV scoring tendencies and predictive validity, findings show that mean differences in scoring have implications for score interpretation, with the cut score that indicates a high level of risk being lower when it comes from a rater who assigns relatively low scores compared to a rater who assigns relatively high scores. These findings suggest that evaluators should carefully consider their own psychopathy measure scoring tendencies across cases and the extent to which these tendencies are consistent with the normative sample scores that form the basis of their psychopathy measure score interpretations.

Static-99R reporting practices in sexually violent predator cases: Does norm selection reflect adversarial allegiance?

We surveyed experts (N = 109) who conduct sexually violent predator (SVP) evaluations to obtain information about their Static-99R score reporting and interpretation practices. Although most evaluators reported providing at least 1 normative sample recidivism rate estimate, there were few other areas of consensus. Instead, reporting practices differed depending on the side for which evaluators typically performed evaluations. Defense evaluators were more likely to endorse reporting practices that convey the lowest possible level of risk (e.g., routine sample recidivism rates, 5-year recidivism rates) and the highest level of uncertainty (e.g., confidence intervals, classification accuracy), whereas prosecution evaluators were more likely to endorse practices suggesting the highest possible level of risk (e.g., high risk/need sample recidivism rates, 10-year recidivism rates). Reporting practices from state-agency evaluators tended to be more consistent with those of prosecution evaluators than defense evaluators, although state-agency evaluators were more likely than other evaluators to report that it was at least somewhat difficult to choose an appropriate normative comparison group. Overall, findings provide evidence for adversarial allegiance in Static-99R score reporting and interpretation practices.

Personality Assessment Inventory scores as predictors of misconduct, recidivism, and violence: A meta-analytic review.

More than 30 studies have examined the ability of scores on the Personality Assessment Inventory (PAI; Morey, 1991, 2007) to predict violence or misconduct. The Antisocial Features (ANT), Aggression (AGG), and Violence Potential Index (VPI) Scales of the PAI, in particular, have received substantial attention as predictors of institutional infractions and criminal recidivism. The current study used meta-analysis to provide a comprehensive review of the ability of scores on these and other PAI scales to predict misbehavior. Scores on the ANT (d = .26 to .39) and AGG (d = .23 to .40) scales consistently emerged as small to moderate predictors of misbehavior. Effects tended to be larger in correctional than treatment settings (e.g., ANT d = .44 vs. .20), for institutional misconduct than recidivism (e.g., AGG d = .37 vs. .23), and for institutional misconduct studies with follow up periods of at least 1.5 years (e.g., ANT d = .46). Overall, findings provide support for the predictive validity of multiple PAI scales.

Jurors' views on the value and objectivity of mental health experts testifying in sexually violent predator trials.

Although psychologists and psychiatrists often testify in court, we know relatively little about the extent to which jurors value the testimony they hear from these experts. We surveyed 161 jurors who rendered opinions in 14 sex offender civil commitment trials after hearing testimony from psychologists and psychiatrists serving as expert witnesses. Most jurors reported that the experts they heard testify were honest, and they tended to attribute disagreements among experts to case complexity, as opposed to adversarial allegiance or bias. Most reported that hearing from the experts helped them make better decisions and that experts using risk assessment instruments could make more accurate predictions than those who did not. Jurors were, however, more skeptical about the ability of experts to accurately predict recidivism when they heard testimony from both prosecution and defense experts. Findings suggest that jurors value risk assessment testimony from experts, but that experts must think carefully about how to best make risk assessment instrument results accessible to jurors.