RESUMEN

OBJECTIVE:  Descriptive labels to communicate performance are integral in neuropsychological reports. Although the American Academy of Clinical Neuropsychology (AACN) reached consensus on standardizing uniform labels of performance, consumer understanding of these labels is unclear. This pilot prospective cohort study evaluated patient, family member, and medical provider understanding of neuropsychological performance labels. METHOD:  Patients (n = 62), family members (n = 31), and referral sources (n = 34) completed a 13-question survey evaluating the uniform label system and an alternative, patient-centered language system (PCL). Questions assessed label knowledge and associated percentiles and relative relationships between labels. RESULTS:  Patients had significantly higher accuracy on knowledge questions using PCL labels (54.8%) versus AACN labels (32.2%) as were families (51.6% versus 35.5%). When ranking labels, providers and patients were more accurate when using PCL labels compared to AACN labels, although no significant difference was seen in the family group. Generally, participants were more accurate in identifying highest/lowest scores using AACN labels and more accurate in identifying relatively higher and lower scores using PCL terminology. CONCLUSIONS:  Results illustrate that current and alternative score labels may not be understandable for audiences who read and base decisions on neuropsychological reports. The findings highlight the need for further consideration of patient-centered language to improve understanding of neuropsychological score labels.

RESUMEN

This study sought to examine neuropsychological functioning in men with pedophilic disorder (PD), in order to assess whether findings from prior neuropsychological studies are replicated in a diverse sample including men with non-contact sexual offenses. It was hypothesized that when non-contact offenders are included in the study, a slowed processing speed will emerge as the only finding unique to men with PD. A comprehensive neuropsychological battery was administered to 58 men convicted of a sexual offense, 20 of whom were classified as having PD. The sample included men with contact sexual offenses (n = 33), non-contact sexual offenses (n = 5), and child sexual abuse material (CSAM) offenses (n = 20). Test performance was compared by PD status. Participants with PD performed significantly better on verbal memory and visual discrimination than those without PD. Men with PD made more errors on a set-shifting task but no significant differences were seen in domains of attention, intellectual functioning, visual learning and memory, visuospatial ability, or language ability. Effect sizes were generally small, although some medium effects were seen (visual discrimination and verbal learning and memory). Scores in both groups (with and without PD) were generally in the average range across tasks. Within the subgroup of CSAM offenders, minimal differences emerged between those with and without PD, although those with PD were slower on visuomotor set-shifting but made fewer errors (d = - 0.89). CSAM offenders with PD were in the high average range on many tasks of intellectual functioning; however, a potential trend was identified such that CSAM offenders without PD had lower scores on a task of verbal learning and memory, with medium effect sizes observed. As few differences in neuropsychological functioning emerged when comparing offenders with and without PD, differences demonstrated in prior research may be better attributed to contact offending status rather than sexual interest.

Asunto(s)

RESUMEN

Several meta-analyses of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) have examined these instruments' ability to detect symptom exaggeration or feigning. However, limited research has directly compared whether the scales across these two instruments are equally effective. This study used a moderated meta-analysis to compare 109 MMPI-2 and 41 MMPI-2-RF feigning studies, 83 (56.46%) of which were not included in previous meta-analyses. Although there were differences between the two test versions, with most MMPI-2 validity scales generating larger effect sizes than the corresponding MMPI-2-RF scales, these differences were not significant after controlling for study design and type of symptoms being feigned. Additional analyses showed that the F and Fp-r scales generated the largest effect sizes in identifying feigned psychiatric symptoms, while the FBS and RBS were better at detecting exaggerated medical symptoms. The findings indicate that the MMPI-2 validity scales and their MMPI-2-RF counterparts were similarly effective in differentiating genuine responders from those exaggerating or feigning psychiatric and medical symptoms. These results provide reassurance for the use of both the MMPI-2 and MMPI-2-RF in settings where symptom exaggeration or feigning is likely. Findings are discussed in the context of the recently released MMPI-3.

Asunto(s)

RESUMEN

Coaching individuals on test-taking strategies presents legal and ethical concerns and threatens the validity of psychological test score interpretations, which could lead to inaccuracies in clinical settings and injustices within the legal system. This meta-analysis examined the impact of coaching on the detection of symptom exaggeration or feigning on the MMPI-2. A total of 99 feigning studies (N = 19,536) comparing validity subscale scores between genuine and nongenuine (coached or non-coached) responders were analyzed. Potential moderating effects of control group, type of symptoms, publication status, financial incentive, and non-content validity screening were also examined regarding their impact on the effectiveness of coaching. Findings suggested that detection-based coaching (i.e., coaching regarding the presence of validity scales and detection avoidance strategies within the MMPI-2) improved individuals' ability to elude detection by the MMPI-2 validity scales. Nonetheless, the MMPI-2 validity scales still generated moderate to very large effect sizes in detecting symptom exaggeration or feigning even in the context of coaching (range g = .89 to 1.95). The findings provide reassurance for detection efforts, indicating that while the effectiveness of the MMPI-2 is somewhat diminished, it remains useful in detecting non-genuine responders even in the context of coaching. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Asunto(s)

RESUMEN

Background: The literature has focused on explicit communications of suicidal ideation, although such communications are infrequent and less overt symptoms are comparable indicators of suicide risk. Aims: Our aim was to understand how clinicians consider inexplicit suicide risk factors in assessments of risk. Method: A national sample of 75 psychiatric crisis clinicians were provided with three vignettes, which varied in nine variables related to suicide risk. Clinicians rated imminent suicide risk and identified an appropriate level of care for each hypothetical patient. Results: Prior suicide attempt, intent to die, presence of a suicide plan, desire to die, hopelessness, burdensomeness, and passive suicidal ideation (defined as a combination of hopelessness, burdensomeness, desire to die, and anhedonia) significantly impacted risk perception while depression and anhedonia did not. Level of care was significantly associated with passive suicidal ideation, suicide plan, desire to die, and hopelessness. Limitations: Limitations of the study include its small sample size, experienced clinicians, and reliance on hypothetical patients. The study design did not allow for all variables to be compared against one another. Conclusion: Clinicians considered less overt risk factors for suicide when assessing risk. Future research should examine whether this knowledge is applied in real-life scenarios and if less experienced clinicians equally consider these risk factors.

Asunto(s)

RESUMEN

Research examining victimization and posttraumatic symptomatology among Latinos is lacking in the extant literature. This analysis used the victimized subsample (N = 752) of the Sexual Assault Among Latinas Study. The aim was to evaluate victimization prevalence and test the following hypotheses: (a) that victimization would be associated with higher levels of posttraumatic symptoms, (b) that cultural factors that move away from traditional Latino culture would be associated with higher levels of posttraumatic symptomatology, and (c) that cultural factors associated with traditional Latino culture would be related to lower posttraumatic symptomatology. Average age of the sample was 44.57 years, with three fourths having a high school education or higher, and two thirds having a household income below $30,000. Of exposure types, adulthood threats were most likely to result in Criterion A traumatic events (23.4%). Using the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) based PTSD Checklist, between 8.8% and 45.5% of individuals met presumed PTSD diagnosis based on various PCL cut scores or algorithm criteria. Regression analyses indicated that the combined different types of adult and childhood victimizations, masculine gender role, and negative religious coping were associated with increased symptoms (ßs ranging from .16 to .27). The results suggested a role of culture in posttraumatic symptoms for Latinas.

Asunto(s)