RESUMEN
OBJECTIVE: Our first goal in this study was to identify cultural mistrust critical items (CMCIs) on two versions of the Minnesota Multiphasic Personality Inventory (MMPI)-the MMPI-Second Edition-Restructured Form (MMPI-2-RF) and MMPI-Third Edition (MMPI-3)-that might be endorsed by people of color because of cultural mistrust rather than clinical paranoia. Our second goal was to determine whether CMCIs and items on the MMPI-2-RF/MMPI-3 Ideas of Persecution scale (Restructured Clinical Scale 6 [RC6]) were endorsed at different rates across cultural groups in a nonclinical college sample and a forensic inpatient sample. HYPOTHESES: Our primary hypothesis was that expert raters would reliably identify a subset of MMPI-2-RF and MMPI-3 items as reflective of cultural mistrust. Black college students would endorse the highest level of CMCIs, followed by Latina/o students, and then White students. We hypothesized that the same pattern of findings would occur in forensic inpatients but that the differences would be attenuated because of the high base rate of psychiatric symptomatology and the nature of the forensic assessment setting. METHOD: Three Black female and three Black male psychologists rated the degree to which each item on the MMPI-2-RF and MMPI-3 reflected cultural mistrust. Black (n = 90), Latina/o (n = 83), and White (n = 100) college students were compared on CMCIs and on MMPI-2-RF/MMPI-3 RC6 item endorsement. The same comparisons were made among Black (n = 221), Latina/o (n = 142), and White (n = 483) forensic inpatients who completed the MMPI-2-RF. RESULTS: Black college students endorsed the highest levels of cultural mistrust, followed by Latina/o students, and then White students, resulting in small-to-medium effect sizes (Hedges's gs = 0.14-0.52). Although we observed some item-level differences in forensic patients, the overall pattern of item endorsement did not significantly differ in this group. CONCLUSIONS: There are multiple reasons for the reporting of clinical paranoia and cultural mistrust in forensic assessment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Asunto(s)
Psiquiatría Forense , MMPI , Femenino , Humanos , Masculino , Población Negra , Hispánicos o Latinos , Pacientes Internos , Reproducibilidad de los Resultados , Población BlancaRESUMEN
OBJECTIVE: To examine whether Test of Premorbid Functioning (TOPF) and Wide Range Achievement Test-Word Reading subtest (WRAT WR) are interchangeable measures, and the relationship between these measures and intelligence, among patients with schizophrenia. METHOD: In this archival study, the authors examined neuropsychology referrals of an inpatient forensic state hospital. Patients with a schizophrenia spectrum disorder (SSD) who received the Wechsler Adult Intelligence Scale-Fourth Edition or the Wechsler Abbreviated Scale of Intelligence-Second Edition and either TOPF or WRAT WR were considered for inclusion. The final sample consisted of 119 individuals (73.1% male). RESULTS: Although there was a linear relationship between most TOPF variables and WRAT WR, their concordance was weak (concordance correlation coefficients [CCC] < 0.90). Poor concordance was also observed between current FSIQ and all standard scores (SS) derived from word reading measures. FSIQ-word reading measure discrepancy scores differed significantly from a hypothesized mean of 0 (mean discrepancy range = -7.42 to -16.60). Discrepancies greater than one standard deviation (>1 SD) were highest among demographics-based SS (i.e. TOPF Predicted and Simple without TOPF). Performance-based SS, particularly TOPF Actual and WRAT4 WR, had the fewest discrepancy scores >1 SD fromFSIQ. CONCLUSIONS: TOPF and WRAT WR should not be used interchangeably among institutionalized patients with SSDs. TOPF and WRAT WR were discrepant from FSIQ, with demographic variables producing higher SS relative to performance-based variables. Future research is needed to determine which of these measures more accurately estimates intelligence among inpatients withSSDs.
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Pacientes Internos , Inteligencia , Adulto , Femenino , Humanos , Pruebas de Inteligencia , Masculino , Pruebas Neuropsicológicas , Escalas de WechslerRESUMEN
Executive functioning (EF) has been identified as a significant predictor in determining competence to stand trial. Individuals deemed incompetent to stand trial are provided a limited time frame before conservatorship is considered, thus, treatment providers practicing within inpatient facilities have a responsibility to efficiently identify factors that may lead to prolonged hospitalizations, in order to avoid delays in a defendant's legal proceedings. Although previous studies have demonstrated the utility of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Total Index Score in predicting length of stay (LOS), the Neuropsychological Assessment Battery (NAB) Judgment subtest provides a measure of executive function, which is a domain not captured by the RBANS. The current study examined the relationship between both the RBANS and NAB Judgment performance as predictors of LOS among 63 individuals diagnosed with schizophrenia spectrum disorders undergoing competency restoration treatment. Additionally, sensitivity analyses were used to determine cutoff scores for individuals requiring additional competency services. Results indicated that the NAB Judgment subtest was more predictive of LOS than the RBANS Total Index Score. Additionally, a raw score of ≤9 on NAB Judgment was indicative of increased LOS. These results highlight the utility of the NAB Judgment subtest within a forensic inpatient setting.
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Esquizofrenia , Humanos , Esquizofrenia/diagnóstico , Pacientes Internos , Juicio , Reproducibilidad de los Resultados , Pruebas NeuropsicológicasRESUMEN
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.
Asunto(s)
Pacientes Internos , Juicio , Medicina Legal , Psiquiatría Forense , Humanos , Simulación de Enfermedad/diagnóstico , Reproducibilidad de los ResultadosRESUMEN
The accurate evaluation of response style, particularly with respect to overreporting, is imperative in forensic settings wherein an external incentive to feign exists. Given the high cost of false positive errors in this context, as well as the associated cost of false negative errors, evaluators need to ensure that overreporting methods are effective with the unique patient populations with whom they work. Complicating this issue is that forensic samples often differ in predictable ways from the normative samples upon which typical psychological assessment instruments were normed. The purpose of the present investigation was to evaluate the specificity of the overreporting indices on the Personality Assessment Inventory, one of the most commonly used personality inventories, in a forensic sample with no ostensible incentive to feign. Although item endorsement and configural elevations on the Negative Impression Management (NIM) scale and the Malingering Index (MAL) were associated with genuine psychopathology, results indicated that the overall specificity estimates across groups were generally adequate. Further, and consistent with prior research, Rogers Discriminant Function (RDF) performed poorly in this sample.
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Pacientes Internos , Determinación de la Personalidad , Etnicidad , Humanos , Simulación de Enfermedad/diagnóstico , Inventario de Personalidad , Psicometría , Reproducibilidad de los ResultadosRESUMEN
The purpose of this study was to examine associations between substance use disclosure during the clinical interview and on the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) Substance Abuse Scale (SUB) among forensic inpatients. Of the 223 archival reports reviewed that had MMPI-2-RF data, 69% of the MMPI-2-RF protocols were valid based on standard validity criteria, resulting in a final sample of 154 patients (98 men, 56 women). We found that patients who endorsed alcohol or marijuana use during the clinical interview often concurrently denied substance use on the MMPI-2-RF SUB scale (the opposite was found for prescription drug abuse). We also found that the MMPI-2-RF SUB scale and other MMPI-2-RF externalizing scales were meaningfully associated with concurrent substance use variables from a record review form. Finally, we found that the MMPI-2-RF SUB scale demonstrated incremental validity over other MMPI-2-RF externalizing scales in the prediction of substance use problems. These results highlight the utility of SUB scale and other self-report instruments in assessing substance use problems. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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MMPI/estadística & datos numéricos , Autoinforme , Trastornos Relacionados con Sustancias/epidemiología , Adulto , Trastorno Bipolar/epidemiología , Trastorno Depresivo Mayor/epidemiología , Femenino , Psiquiatría Forense , Hospitales Psiquiátricos , Humanos , Pacientes Internos , Defensa por Insania , Masculino , Competencia Mental , Persona de Mediana Edad , Pedofilia/epidemiología , Trastornos Psicóticos/epidemiología , Reproducibilidad de los Resultados , Esquizofrenia/epidemiología , Trastornos Relacionados con Sustancias/diagnósticoRESUMEN
The Americans with Disabilities Act has allowed for greater participation of individuals with disabilities across a variety of contexts, most notably in employment settings. Individuals with intellectual disability (ID) are still precluded, however, from full participation in other contexts, and they are often relegated to the forensic arena without sufficient support, including after being adjudicated incompetent to stand trial (IST). Frequently, individuals who are adjudicated IST due to ID are committed to inpatient psychiatric hospitals that are unable to meet their unique needs. We argue that the provision requiring reasonable accommodations to secure meaningful participation in state-funded restoration efforts, explicitly covered by Title II of ADA, is both relevant and imperative for this group. Further, we argue that simple modifications to the forensic assessment process, as well as the trial itself, can provide the scaffolding to facilitate individuals' full and complete participation in the process, reducing the likelihood of an inappropriate determination as IST. In our opinion, failing to appropriately modify the forensic assessment, treatment, and trial process systematically excludes and uniquely disadvantages this population because individuals with ID are often able to meet the essential functions of participation except for interference from deficits commensurate with ID.
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Derecho Penal/legislación & jurisprudencia , Personas con Discapacidad/legislación & jurisprudencia , Personas con Discapacidad/psicología , Discapacidad Intelectual/psicología , Legislación como Asunto , Competencia Mental/legislación & jurisprudencia , Derechos Civiles , Comunicación , Comprensión , HumanosRESUMEN
Given the diversity of individuals who undergo psychological assessment, examining whether cultural bias exists in psychological assessment instruments (i.e., differential validity) is crucial. This issue occurs when a measure systematically over- or underpredicts a criterion across demographic groups or is associated with the criterion unequally across the groups. We tested the differential validity of a widely used psychological test, the Minnesota Multiphasic Personality Inventory (MMPI)-2-Restructured Form (MMPI-2-RF), as a function of gender (male, female) and ethnicity (Caucasian, African American, and Hispanic/Latino American) in large samples of forensic psychiatric inpatients. Regression models were estimated in a multigroup framework. The analyses yielded negligible to small statistical evidence of differential validity in MMPI-2-RF scores predicting the number of future suicidal behaviors and violent behaviors in the samples. This evidence supports use of the MMPI-2-RF as a generally unbiased instrument for predicting key criteria across genders and ethnicities in a forensic psychiatric population. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Asunto(s)
Negro o Afroamericano , Criminales , Hispánicos o Latinos , MMPI/normas , Escalas de Valoración Psiquiátrica/normas , Suicidio , Violencia , Población Blanca , Adulto , Negro o Afroamericano/estadística & datos numéricos , Criminales/estadística & datos numéricos , Femenino , Hispánicos o Latinos/estadística & datos numéricos , Humanos , MMPI/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Pronóstico , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Reproducibilidad de los Resultados , Factores Sexuales , Suicidio/estadística & datos numéricos , Violencia/estadística & datos numéricos , Población Blanca/estadística & datos numéricosRESUMEN
Recent research (Erdodi et al., 2017) indicated that certain Wechsler Adult Intelligence Scale (WAIS-IV) Processing Speed Index (PSI)-based indices may have some utility as embedded validity indicators (EVIs) among a diagnostically diverse sample of neuropsychology referrals. Individuals with schizophrenia spectrum disorders (SSD) are often evaluated in forensic contexts in which there is incentive to exaggerate deficits. Because individuals with SSD often have limitations in processing speed associated with their disorders, the current study sought to evaluate the false-positive (FP) rates of cutoffs identified by Erdodi et al. on WAIS-IV PSI-based EVIs among forensically committed psychiatric inpatients with SSD who had no known incentive to feign because of the nature of their legal commitments. In the current sample, the previously suggested cutoff scores on PSI-based EVIs resulted in FP rates ranging from 2% to 57% among schizophrenia spectrum patients, with unacceptable FP rates for most indices. In the current sample of SSD patients, WAIS-IV PSI-based EVIs that are calculated based on the relative performance between PSI subtests (as opposed to absolute performance on individual indices) demonstrated acceptable FP rates. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Disfunción Cognitiva/diagnóstico , Simulación de Enfermedad/diagnóstico , Esquizofrenia/diagnóstico , Escalas de Wechsler/normas , Adulto , Disfunción Cognitiva/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Esquizofrenia/complicacionesRESUMEN
The Minnesota Multiphasic Personality Inventory-2 Restructured Form is a widely used measure of psychopathology and includes the Personality Psychopathology Five (PSY-5) scales, which measure dimensional maladaptive personality traits similar to those in the DSM-5 alternative model for personality disorder (PD) diagnosis. The current study evaluated the role of these dimensional personality psychopathology characteristics in a sample of 1,110 inpatients in a forensic psychiatric setting, where personality psychopathology plays a significant but understudied role. The authors examined the extent to which dimensional personality psychopathology characteristics (as measured by the PSY-5) were associated with borderline and antisocial PD diagnoses and institutional aggression. Results support the usefulness of measuring dimensional personality traits for understanding PD diagnoses, as well as incidents of institutional aggression. More specifically, the PSY-5 scales appear to measure the core features of borderline and antisocial PDs. This study supports the inclusion of dimensional personality assessment in understanding aggressive behavior in inpatient settings.
Asunto(s)
Pacientes Internos/psicología , MMPI/normas , Trastornos de la Personalidad/psicología , Psicopatología/métodos , Adulto , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , MasculinoRESUMEN
Past research indicates a need to integrate objective psychological testing with clinical interview data during suicide risk assessment. The current study evaluated the utility of the Minnesota Multiphasic Personality Inventory (MMPI)-2 Restructured Form (MMPI-2-RF) in the prediction of future suicidal behaviors in a sample of 1,110 forensic inpatients (807 males, 303 females). Results indicated that scales from all substantive domains of the MMPI-2-RF were significantly positively associated with future suicidal behaviors. Consistent with expectations, the best predictors were scale scores from the internalizing and externalizing domains of the inventory. Relative Risk Ratios indicated that individuals producing elevations on these scales were at 2 to 4 times greater risk of future suicidal behaviors compared with those who did not produce elevations. Implications of these findings and limitations of this study are discussed. (PsycINFO Database Record
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Pacientes Internos , MMPI , Ideación Suicida , Suicidio/estadística & datos numéricos , Adulto , Femenino , Psiquiatría Forense , Hospitales Psiquiátricos , Hospitales Provinciales , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Pruebas Psicológicas , Medición de Riesgo , Intento de Suicidio/estadística & datos numéricosRESUMEN
Adjudicative competence is the most frequently referred evaluation in the forensic context, and it is because of this that periodic evaluation of competence assessment instruments is imperative. Among those instruments, the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA) has demonstrated adequate psychometric properties suggesting its utility in informing the forensic inquiry. The purpose of the current study was to further investigate the psychometric properties and ultimate utility of subscale scores using archival data from a sample of 103 male and female forensic patients who were hospitalized for competence restoration treatment. Results of the present study suggested adequate internal consistency and good model fit for the factor structure. Interrater reliability was evaluated by comparing the absolute agreement of scores derived from 2 independent research assistants for each of the subscales; 2 of the 3 subscales fell within the acceptable range given established interpretative benchmarks for forensic assessment. Of particular interest was that the Appreciation subscale, while heralding the lowest intraclass correlation coefficient, explained the largest proportion of variance in clinician opinion relative to the other 2 subscales. In other words, the most subjective subscale (as evidenced by the lowest intraclass correlation), explained the largest proportion of variance in ultimate opinion. The authors argue that, although these results are an important consideration in these assessments, they are neither surprising nor entirely problematic when considering the case-specific nature of the inquiries on the subscale, as well as the subjectivity of scoring criteria for each of the Appreciation items. (PsycINFO Database Record
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Criminales , Psiquiatría Forense/normas , Pacientes Internos , Competencia Mental , Trastornos Mentales/diagnóstico , Escalas de Valoración Psiquiátrica/normas , Psicometría/instrumentación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Psiquiatría Forense/métodos , Humanos , Masculino , Trastornos Mentales/psicología , Persona de Mediana Edad , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) F(p) (Infrequency-Psychopathology) scale was developed to measure overreporting in a manner that was minimally confounded by genuine psychopathology, which was a problem with using the MMPI-2 F (Infrequency) scale among patients with severe mental illness. Although revised versions of both of these scales are included on the MMPI-2-Restructured Form and used in a forensic context, no item-level research has been conducted on their sensitivity to genuine psychopathology among forensic psychiatric inpatients. Therefore, we examined the psychometric properties of the scales in a sample of 438 criminally committed forensic psychiatric inpatients who were adjudicated as not guilty by reason of insanity and had no known incentive to overreport. We found that 20 of the 21 Fp-r items (95.2%) demonstrated endorsement rates ≤ 20%, with 14 of the items (66.7%) endorsed by less than 10% of the sample. Similar findings were observed across genders and across patients with mood and psychotic disorders. The one item endorsed by more than 20% of the sample had a 23.7% overall endorsement rate and significantly different endorsement rates across ethnic groups, with the highest endorsements occurring among Hispanic/Latino (43.3% endorsement rate) patients. Endorsement rates of F-r items were generally higher than for Fp-r items. At the scale level, we also examined correlations with the Restructured Clinical Scales and found that Fp-r demonstrated lower correlations than F-r, indicating that Fp-r is less associated with a broad range of psychopathology. Finally, we found that Fp-r demonstrated slightly higher specificity values than F-r at all T score cutoffs. (PsycINFO Database Record
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Etnicidad/psicología , Etnicidad/estadística & datos numéricos , Psiquiatría Forense/métodos , Pacientes Internos/psicología , Pacientes Internos/estadística & datos numéricos , MMPI/estadística & datos numéricos , Adulto , Criminales/psicología , Criminales/estadística & datos numéricos , Femenino , Humanos , Defensa por Insania , Masculino , Psicometría , Distribución por SexoRESUMEN
Contemporary models of psychopathology-encompassing internalizing, externalizing, and thought dysfunction factors-have gained significant support. Although research indicates the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008 /2011) measures these domains of psychopathology, this study addresses extant limitations in MMPI-2-RF diagnostic validity research by examining associations between all MMPI-2-RF substantive scales and broad dichotomous indicators of internalizing, externalizing, and thought dysfunction diagnoses in a sample of 1,110 forensic inpatients. Comparing those with and without internalizing diagnoses, notable effects were observed for Negative Emotionality/Neuroticism-Revised (NEGE-r), Emotional/Internalizing Dysfunction (EID), Dysfunctional Negative Emotions (RC7), Demoralization (RCd), and several other internalizing and somatic/cognitive scales. Comparing those with and without thought dysfunction diagnoses, the largest hypothesized differences occurred for Thought Dysfunction (THD), Aberrant Experiences (RC8), and Psychoticism-Revised (PSYC-r), although unanticipated differences were observed on internalizing and interpersonal scales, likely reflecting the high prevalence of internalizing dysfunction in forensic inpatients not experiencing thought dysfunction. Comparing those with and without externalizing diagnoses, the largest effects were for Substance Abuse (SUB), Antisocial Behavior (RC4), Behavioral/Externalizing Dysfunction (BXD), Juvenile Conduct Problems (JCP), and Disconstraint-Revised (DISC-r). Multivariate models evidenced similar results. Findings support the construct validity of MMPI-2-RF scales as measures of internalizing, thought, and externalizing dysfunction.
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Criminales/estadística & datos numéricos , Pacientes Internos/estadística & datos numéricos , MMPI/estadística & datos numéricos , Trastornos Mentales/diagnóstico , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Pensamiento/fisiología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los ResultadosRESUMEN
Reflecting the need to prevent violence, structured professional judgment assessment tools have been developed specifically to assess the likelihood of future violence. These tools typically integrate data from clinical interviews and collateral records to assist in the conceptualization of violence risk, but objective psychological testing may also be useful in completing the instruments. The authors describe the advantages of using the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in this manner with the Historical Clinical Management-20 Version 3 (HCR-20V3). Accordingly, they have 2 purposes. First, they sought to identify conceptual links between the constructs measured by the tools and introduce a model to integrate MMPI-2-RF findings into an HCR-20V3 risk assessment. Second, although the authors did not have collateral HCR-20V3 ratings, they sought to examine associations between the MMPI-2-RF scales and future violence in a sample of 303 psychiatric patients (233 males, 70 females) adjudicated as not guilty by reason of insanity. The authors found that the MMPI-2-RF scales demonstrated significant, meaningful associations with a count of future violent acts at the hospital. The largest associations involved scales measuring emotional dysregulation and externalizing dysfunction. These associations were qualified by relative risk ratio analyses indicating that patients producing elevations on these scales were at 1.5 to 2.5 times greater risk of future violence than those without elevations. Overall, the findings indicated that most MMPI-2-RF scales conceptually linked to the HCR-20V3 risk factors were associated with future violence. In light of these findings, the authors discuss recommendations for integrating the MMPI-2-RF when interpreting HCR-20V3 risk factors. (PsycINFO Database Record
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MMPI , Medición de Riesgo , Violencia , Femenino , Humanos , Masculino , Trastornos MentalesRESUMEN
The Structured Interview of Reported Symptoms (SIRS) underwent a major revision in 2010 yielding the SIRS-2. The new test has since been criticized for several potential problems, particularly in terms of its sensitivity to feigned psychopathology. For this reason, the purpose of this study was to examine the concordance between SIRS and SIRS-2 classifications and sensitivity estimates in an archival sample of 263 criminal defendants (215 males, 48 females) who were admitted to a high-security state psychiatric hospital for restoration of competency to stand trial. In a subgroup of 39 presumed feigning patients who elevated 1 or more collateral measures of feigning (primarily the M-FAST) at conservative cutoffs, we found marked discrepancies between the sensitivity of the SIRS (.87) and SIRS-2 (.54). The marked differences in sensitivity were partially explained by a global interpretation discordance rate of 47%, with discordance primarily resulting from SIRS-based feigning cases being classified as indeterminate on the SIRS-2. Follow-up analyses of intercorrelations and percentile distributions indicated that the new SIRS-2 scales may lack utility in the assessment of feigning because of problems relating to the construct validity of the scales and their interpretive cutoffs. Future directions in research and clinical practice are discussed, with added emphasis on the significant limitations of archival pretrial forensic samples for identifying presumed genuine groups necessary to calculate specificity estimates (which were meaningfully higher for the SIRS-2 in this sample). Overall, the primary clinical implication is that feigning should remain a strong consideration in SIRS-2 cases yielding an indeterminate classification. (PsycINFO Database Record
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Criminales/psicología , Entrevista Psicológica , Simulación de Enfermedad/diagnóstico , Femenino , Humanos , Pacientes Internos , Masculino , Reproducibilidad de los ResultadosRESUMEN
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
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Criminales/psicología , Simulación de Enfermedad/diagnóstico , Trastornos Mentales/diagnóstico , Escalas de Valoración Psiquiátrica , Adulto , Diagnóstico Diferencial , Femenino , Psiquiatría Forense , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los ResultadosRESUMEN
Two studies were conducted to identify and cross-validate cutoff scores on the Wechsler Adult Intelligence Scale-Fourth Edition Digit Span-based embedded performance validity (PV) measures for individuals with schizophrenia spectrum disorders. In Study 1, normative scores were identified on Digit Span-embedded PV measures among a sample of patients (n = 84) with schizophrenia spectrum diagnoses who had no known incentive to perform poorly and who put forth valid effort on external PV tests. Previously identified cutoff scores resulted in unacceptable false positive rates and lower cutoff scores were adopted to maintain specificity levels ≥90%. In Study 2, the revised cutoff scores were cross-validated within a sample of schizophrenia spectrum patients (n = 96) committed as incompetent to stand trial. Performance on Digit Span PV measures was significantly related to Full Scale IQ in both studies, indicating the need to consider the intellectual functioning of examinees with psychotic spectrum disorders when interpreting scores on Digit Span PV measures.
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Psicología del Esquizofrénico , Escalas de Wechsler , Humanos , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
In this study, we examined whether the 5 Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008/2011) Suicidal/Death Ideation (SUI) items (93, 120, 164, 251, and 334) would provide incremental suicide-risk assessment information after accounting for information garnered from clinical interview questions. Among 229 forensic inpatients (146 men, 83 women) who were administered the MMPI-2-RF, 34.9% endorsed at least 1 SUI item. We found that patients who endorsed SUI items on the MMPI-2-RF concurrently denied conceptually related suicide-risk information during the clinical interview. For instance, 8% of the sample endorsed Item 93 (indicating recent suicidal ideation), yet denied current suicidal ideation upon interview. Conversely, only 2.2% of the sample endorsed current suicidal ideation during the interview, yet denied recent suicidal ideation on Item 93. The SUI scale, as well as the MMPI-2-RF Demoralization (RCd) and Low Positive Emotions (RC2) scales, correlated significantly and meaningfully with conceptually related suicide-risk information from the interview, including history of suicide attempts, history of suicidal ideation, current suicidal ideation, and months since last suicide attempt. We also found that the SUI scale added incremental variance (after accounting for information garnered from the interview and after accounting for scores on RCd and RC2) to predictions of future suicidal behavior within 1 year of testing. Relative risk ratios indicated that both SUI-item endorsement and the presence of interview-reported risk information significantly and meaningfully increased the risk of suicidal behavior in the year following testing, particularly when endorsement of suicidal ideation occurred for both methods of self-report. (PsycINFO Database Record
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Criminales/psicología , MMPI , Ideación Suicida , Adulto , Femenino , Psiquiatría Forense , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Medición de Riesgo , AutoinformeRESUMEN
This study evaluated the specificity and false positive (FP) rates of the Rey 15-Item Test (FIT), Word Recognition Test (WRT), and Test of Memory Malingering (TOMM) in a sample of 21 forensic inpatients with mild intellectual disability (ID). The FIT demonstrated an FP rate of 23.8% with the standard quantitative cutoff score. Certain qualitative error types on the FIT showed promise and had low FP rates. The WRT obtained an FP rate of 0.0% with previously reported cutoff scores. Finally, the TOMM demonstrated low FP rates of 4.8% and 0.0% on Trial 2 and the Retention Trial, respectively, when applying the standard cutoff score. FP rates are reported for a range of cutoff scores and compared with published research on individuals diagnosed with ID. Results indicated that although the quantitative variables on the FIT had unacceptably high FP rates, the TOMM and WRT had low FP rates, increasing the confidence clinicians can place in scores reflecting poor effort on these measures during ID evaluations.