Treating offenders with mental illness: a research synthesis.

The purpose of this research synthesis was to examine treatment effects across studies of the service providers to offenders with mental illness. Meta-analytic techniques were applied to 26 empirical studies obtained from a review of 12,154 research documents. Outcomes of interest in this review included measures of both psychiatric and criminal functioning. Although meta-analytic results are based on a small sample of available studies, results suggest interventions with offenders with mental illness effectively reduced symptoms of distress, improving offender's ability to cope with their problems, and resulted in improved behavioral markers including institutional adjustment and behavioral functioning. Furthermore, interventions specifically designed to meet the psychiatric and criminal justice needs of offenders with mental illness have shown to produce significant reductions in psychiatric and criminal recidivism. Finally, this review highlighted admission policies and treatment strategies (e.g., use of homework), which produced the most positive benefits. Results of this research synthesis are directly relevant for service providers in both criminal justice and mental health systems (e.g., psychiatric hospitals) as well as community settings by informing treatment strategies for the first time, which are based on empirical evidence. In addition, the implications of these results to policy makers tasked with the responsibility of designating services for this special needs population are highlighted.

Diagnostic accuracy of the MMPI-2 Malingering Discriminant Function Index in the detection of malingering among inmates.

The MMPI-2 Malingering Discriminant Function Index (M-DFI) was designed to detect malingerers educated about MMPI-2 validity indicators. However, given current attorney practices, the clinical utility of the M-DFI lies in its ability to detect examinees who are cautioned about the indicators. In this study, we compared 45 inmate simulators cautioned to avoid detection on the MMPI-2 with 46 psychiatric inmates who completed the MMPI-2 under standard instructions. Logistic regression analyses indicated that although the M-DFI performed better than several individual indicators, results were mixed for combinations of indicators, and the M-DFI did not outperform different sets of existing indicators. These findings support existing strategies to detect malingering on the MMPI-2. We discuss considerations concerning the clinical applicability of M-DFI.

Effect of symptom information and intelligence in dissimulation: an examination of faking response styles by inmates on the Basic Personality Inventory.

This study employed the Basic Personality Inventory (BPI) to differentiate various types of dis-simulation, including malingered psychopathology and faking good, by inmates. In particular, the role of intelligence in utilizing symptom information to successfully malinger was examined. On admission to a correctional facility, 161 inmates completed the BPI under standard instructions and then again under instructions to fake good (n = 55) or to malinger psychotic (n = 35), posttraumatic stress disorder (n = 36), or somatoform (n = 35) psychopathology. Unlike symptom information, intelligence evidenced some support for increasing inmates' effectiveness in malingering, although there was no relationship between higher intelligence and using symptom information to successfully evade detection. Overall, the BPI was more effective in detecting malingered psychopathology than faking good. Implications for the detection of dissimulation in correctional and forensic settings are discussed.

An MMPI-2 scale to detect malingered depression (Md scale).

A specialized Minnesota Multiphasic Personality Inventory-2 (MMPI-2) validity scale was constructed to detect individuals who are knowledgeable about either depression or MMPI-2 detection strategies and who subsequently attempt to malinger depressive symptoms on the MMPI-2. The Malingered Depression (Md) scale consists of 32 items that discriminated college students who feigned depression from those who were genuinely depressed. Further information about the incremental validity and the utility of the Md scale was obtained in a cross-validation study with additional college students who feigned depression and a sample of students with clinically significant depressive symptoms. The results indicate that the Md scale possesses promising value in detecting malingered symptoms of depression.

A comparative analysis of MMPI-2 malingering detection models among inmates.

There are several strategies, or models, for combining the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) validity indicators to detect malingered psychiatric symptoms. Some scholars have recommended that an elevated F (Infrequency) score should be followed by the inspection of Fp (Infrequency-Psychopathology), whereas a recent meta-analysis indicated that Fp and Ds (Gough's Dissimulation Scale) should be examined. For correctional settings, one model of malingering suggests that F, Fp, and F - K (Gough's Dissimulation Index) should be inspected for one or more elevated scores. Although a large body of research has examined malingering detection with the MMPI-2, this research has typically focused on the contributions of individual validity indicators to differentiate malingered from genuine psychiatric symptoms. Therefore, the current study compared these models of malingering detection on the MMPI-2. Inmate simulators were contrasted with inmates who were hospitalized for psychiatric treatment. Results from classification and logistic regression analyses supported the sequential use of F and Fp in malingering detection.