Recent interview-based measures of competency to stand trial: a critical review augmented with research data.

Forensic experts are frequently asked to conduct competency-to-stand trial evaluations and address the substantive prongs propounded in Dusky v. United States (1960). In understanding its application to competency evaluations, alternative conceptualizations of Dusky are critically examined. With Dusky providing the conceptual framework, three interview-based competency measures are reviewed: the Georgia Court Competency Test (GCCT), the MacArthur Competence Assessment Tool-Criminal Adjudication (Mac-CAT-CA), and the Evaluation of Competency to Stand Trial-Revised (ECST-R). This review has a twin focus on reliability of each measure and its correspondence to Dusky prongs. The current review is augmented by new factor analytic data on the MacCAT-CA and ECST-R. The article concludes with specific recommendations for competency evaluations.

Word valence, attention, and hemispheric activity in depressed, remitted, and nondepressed controls.

Clinically depressed (n = 20), previously depressed (n = 28), and nondepressed control (n = 27) individuals, classified according to a structured clinical diagnostic interview, participated in a study employing a modified prior entry (Titchener, 1908) procedure to investigate interrelationships among word (adjective) valence, visual attention, and cerebral hemispheric activity. Overall, positive words were selected more quickly when presented to the right, versus left, visual field (RVF, LVF); the opposite pattern was observed for negative words. While there was no significant group X Valence X Visual Field interaction, planned comparisons revealed that the aforementioned Valence X Visual Field interaction was significant only for the nondepressed control group. Although the remitted group exhibited an overall pattern similar to the control group, the depressed group evinced a pattern in the opposite direction for positive words (i.e., quicker in the LVF than the RVF).

The psychopathy checklist--screening version: an examination of criteria and subcriteria in three forensic samples.

The development and refinement of psychopathy represent a critical issue in clinical and forensic practice. During the last decade, important advances in the operationalization of psychopathy were achieved, primarily through the development of the Psychopathy Checklist (PCL) and its subsequent versions (PCL-R and PCL:SV). PCL ratings are based primarily on item descriptions or subcriteria. The current study serves to break new ground as the first systematic investigation of PCL:SV subcriteria by addressing their psychometric properties and exploring their construct and criterion-related validation. Previously unanalyzed data from three samples were integrated: female offenders, male forensic patients, and male adolescent offenders. Results largely support the use of subcriteria as homogeneous components of criteria and provide strong initial evidence of their construct validity. Results are less conclusive regarding criterion-related validity. For female offenders, they suggested the potential value of specific PCL:SV subcriteria for predicting verbal aggression. Confirmatory factor analysis provided encouraging results on the applicability of the standard two-factor model of psychopathy. However, a first-order principal axis factoring suggested further refinements in our understanding of psychopathy.

Spiritual experience, church attendance, and bereavement.

Examines the empirical relationships among spiritual experience, church attendance, and bereavement adjustment in a sample (N = 85) of individuals grieving the death of a significant person in their lives. Results indicate that those participants evidencing high levels of spiritual experience showed lower levels of problematic grief affect. Notes that church attendance appeared to influence grief adjustment only to the extent that it was positively correlated with spiritual experience. Discusses implications for pastoral caregiving.

Scott and White Grief Study--phase 2: toward an adaptive model of grief.

The current study was a dual investigation focused both on the pathogenesis of grief responses and on factors associated with personal growth as a bereavement outcome in a heterogeneous sample of 85 mourners. To examine the pathogenesis of grief, the authors tested the ability of several high-risk factors to predict mourners' subsequent emotional intensity on 2 dependent measures: the Grief Experience Inventory and the Hogan Grief Reaction Checklist. Three situational variables (traumatic death, younger age of decedent, and perception of preventability) as well as 2 mourner liabilities (history of mental health treatment and greater number of other losses) were associated with higher subjective grief misery scores. When using personal growth as a positive outcome following bereavement, the authors identified 4 behavioral correlates of adaptive grieving: ability to see some good resulting from the death, having a chance to say goodbye, intrinsic spirituality, and spontaneous positive memories of the decedent. The advantages of an adaptive model of grief for generating treatment implications are discussed.

Laterality, word valence, and visual attention: a comparison of depressed and non-depressed individuals.

Thirteen depressed and 13 non-depressed college students attended to valence-loaded word pairs (euphoric/dysphoric, euphoric/neutral, and neutral/dysphoric) on a computer screen. Each pair was observed through a viewing box with a vertical partition, each word in a different visual field. As a prior-entry task (Titchener, 1908) the words were simultaneously replaced by colored bars. Participants indicated which color bar (left or right) was seen first. As predicted, identifications of color bars following euphoric words in the right visual field (left hemisphere) exceeded their identification in the left visual field (right hemisphere). Also, as predicted, the non-depressed participants made identifications following the euphoric word of a pair more often than did the depressed participants. No interaction occurred between laterality and participant classification. Implications for research and therapy are discussed.

Validation of the Millon Clinical Multiaxial Inventory for Axis II disorders: does it meet the Daubert standard?

Relevant to forensic practice, the Supreme Court in Daubert v. Merrell Dow Pharmaceuticals, Inc. (1993) established the boundaries for the admissibility of scientific evidence that take into account its trustworthiness as assessed via evidentiary reliability. In conducting forensic evaluations, psychologists and other mental health professionals must be able to offer valid diagnoses, including Axis II disorders. The most widely available measure of personality disorders is the Million Clinical Multiaxial Inventory (MCMI) and its subsequent revisions (MCMI-II and MCMI-III). We address the critical question, "Do the MCMI-II and MCMI-III meet the requirements of Daubert?" Fundamental problems in the scientific validity and error rates for MCMI-III appear to preclude its admissibility under Daubert for the assessment of Axis II disorders. We address the construct validity for the MCMI and MCMI-II via a meta-analysis of 33 studies. The resulting multitrait-multimethod approach allowed us to address their convergent and discriminant validity through method effects (Marsh, 1990). With reference to Daubert, the results suggest a circumscribed use for the MCMI-II with good evidence of construct validity for Avoidant, Schizotypal, and Borderline personality disorders.

The R-CRAS and insanity evaluations: a re-examination of construct validity. Rogers Criminal Responsibility Assessment Scales.

Insanity evaluations are characterized by continued professional debate and the paucity of empirical research. To address the latter, the construct validity of the Rogers Criminal Responsibility Assessment Scales (R-CRAS; Rogers, 1984) was examined via an extensive re-analysis of 413 insanity cases. A series of six separate discriminant analyses was examined to address major components of insanity evaluations. These analyses yielded highly discriminating patterns (M hit rates of 94.3%) and accounted for substantial proportion of the variance (M=63.7%). In general, predicted relationships between individual variables and the discriminant functions were supported. We also addressed the usefulness of the R-CRAS additional variables for the assessment of insanity. We found that these variables contributed substantially to the determination of criminal responsibility. Finally, we pose important and polemical issues for forensic experts conducting evaluations of criminal responsibility.

The PAI and feigning: A cautionary note on its use in forensic-correctional settings.

Indicators of feigned PAI profiles were derived from comparisons of simulators instructed to feign and genuine patient groups. Concerns are raised regarding whether these indicators are applicable to forensic and correctional populations and can be cross-validated with a known-groups comparison. Compiling data on 57 malingerers and 58 genuine patients from two forensic and correctional sites, three primary indicators of feigning, Negative Impression (NIM) scale, Malingering Index, and the Rogers Discriminant Function (RDF) were investigated. Results suggested that the RDF was not applicable to forensic referrals. However, NIM 77T appeared to be a useful screen for forensic samples. In addition, convergent evidence of feigning was found across designs (simulation and known-groups) and samples (non-forensic and forensic) for extreme elevations on NIM (>/=110T) and Malingering Index (>/=5).

Preliminary validation of the MMPI-A for a male delinquent sample: an investigation of clinical correlates and discriminant validity.

Adolescent psychopathology, until recently, has been a largely neglected area of research and poses unique challenges for psychological assessments. In response to the specific need for adolescent-focused measures, the MMPI-A (Butcher et al., 1992) was among several measures to be developed. Although a sizeable literature exists on the original MMPI (Hathaway & McKinley, 1943) and adolescent populations, relatively few empirical studies have been published on the MMPI-A. The primary purpose of this study was the examination of clinical correlates for the MMPI-A for a male delinquent sample. MMPI-A protocols were collected from 99 adolescents at a North Texas juvenile correctional facility, and systematic comparisons were conducted between the Basic Scales and symptoms/diagnoses derived from the Schedule of Affective Disorders and Schizophrenia for School-Age Children (K-SADS-III-R; Ambrosini, Metz, Prabucki, & Lee, 1989). Using only K-SADS-III-R symptoms with high reliabilities (rs > .80), a comprehensive list of correlates was generated for the Clinical, Supplementary, and Content Scales. Additionally, stepwise discriminant functions successfully classified MMPI-A protocols according to K-SADS-III-R diagnoses. As an exploratory analysis, ethnic differences on MMPI-A profiles were also investigated, revealing significant differences among groups.

Information processing in schizophrenia and bipolar disorder: a discriminant analysis.

Schizophrenia and bipolar disorder are two distinct categories of mental disorders in the DSM-IV. However, it is often difficult to make a differential diagnosis because of the overlapping symptoms. A potential adjunct in the classification of schizophrenia and bipolar disorder is the application of information processing models, as patients with schizophrenia and possibly those with bipolar disorder have information processing deficits. A study was conducted in which a computerized battery of information processing tasks (called COGLAB) was administered to three participant groups: patients with schizophrenia, patients with bipolar disorder, and normal controls. The tasks included the Mueller-Lyer illusion, reaction time, size estimation, a variant of the Wisconsin Card Sorting Test, backward masking, and Asarnow continuous performance. Discriminant analyses were used to investigate the differences among the three groups. Results indicated that COGLAB correctly classified 75.5% of the cases of schizophrenia and bipolar disorder. The Mueller-Lyer illusion and the number of perseverative errors on the card sort most powerfully discriminated the two groups.

A comparison of forensic and nonforensic malingerers: a prototypical analysis of explanatory models.

Explanatory models of malingering strive to understand the primary motivation underlying attempts to feign. Rogers, Sewell, and Goldstein (1994) provided empirical support for the conceptualization of pathogenic, criminological, and adaptational models. In the current study, a prototypical analysis of 221 forensic experts results in a slightly refined formulation: the adaptational models was decomposed into its two broad dimensions (cost-benefit analysis and adversarial setting). An important findings is that the factor structure for the explanatory models remained stable when applied to both forensic and nonforensic cases. As a first investigation, significant differences were observed in prototypical cases of malingering by the category of referral (forensic or nonforensic) and by type of feigning (mental disorders, cognitive impairment, and medical syndromes). Surprisingly, the feigning of medical syndromes appeared to play a relatively prominent role in both forensic and nonforensic cases and to be influenced by the apparent adversarial context of the assessment. Finally, important gender differences were observed, especially with nonforensic prototypical cases of malingering.

Psychopathy and recidivism among female inmates.

Despite a plethora of studies investigating psychopathy among male offenders, little is known about the applicability of this construct to female populations. Research has shown that prevalence rate, symptom presentation, and diagnostic comorbidity differ for females as compared to males. The current study is the first to examine the relationship between psychopathy and recidivism among women. Recidivism data on a sample of 78 female inmates were examined at a 1-year interval in relation to the Psychopathy Checklist-Revised (PCL-R), inclusion criteria for the Antisocial Personality Disorder Diagnosis from the Personality Disorder Examination (PDE), and selected scales from the Personality Assessment Inventory (PAI; Antisocial and Aggression scales). The egocentricity subscale of the PAI, Factor 1 of the PCL-R, and the verbal aggression subscale of the PAI were the best predictors of future recidivism. Specific differences emerged between male and female offenders when comparing the present data with previous studies of male psychopaths.

Construct validity of psychopathy in a female offender sample: a multitrait-multimethod evaluation.

The authors examined the construct of psychopathy as applied to 103 female offenders, using the multitrait-multimethod matrix proposed by D. T. Campbell and D. W. Fiske (1959). Instruments used in the study included the following: (a) Antisocial Scale of the Personality Assessment Inventory (L. C. Morey, 1991); (b) Psychopathy Checklist--Revised (R. D. Hare, 1990); and (c) Antisocial scale of the Personality Disorder Examination (A. W. Loranger, 1988). Criterion-related validity was also evaluated to determine the relationship between psychopathy and staff ratings of aggressive and disruptive behavior within the institution. Results revealed significant convergence and divergence across the instruments supporting the construct of psychopathy in a female offender sample. The measures of psychopathy demonstrated moderate convergence with staff ratings of violence, verbal aggression, manipulativeness, lack of remorse, and noncompliance. It is interesting to note that an exploratory factor analysis of the PCL-R identified a substantially different factor structure for women than has been previously found for male psychopathy.

Detection of feigned mental disorders on the personality assessment inventory: a discriminant analysis.

Psychological assessment with multiscale inventories is largely dependent on the honesty and forthrightness of those persons evaluated. We investigated the effectiveness of the Personality Assessment Inventory (PAI) in detecting participants feigning three specific disorders: schizophrenia, major depression, and generalized anxiety disorder. With a simulation design, we tested the PAI validity scales on 166 naive (undergraduates with minimal preparation) and 80 sophisticated (doctoral psychology students with 1 week preparation) participants. We compared their results to persons with the designated disorders: schizophrenia (n = 45), major depression (n = 136), and generalized anxiety disorder (n = 40). Although moderately effective with naive simulators, the validity scales evidenced only modest positive predictive power with their sophisticated counterparts. Therefore, we performed a two-stage discriminant analysis that yielded a moderately high hit rate (> 80%) that was maintained in the cross-validation sample, irrespective of the feigned disorder or the sophistication of the simulators.

Feigning psychopathology among adolescent offenders: validation of the SIRS, MMPI-A, and SIMS.

Clinical decision rules for the assessment of feigning and related response styles have not been systematically investigated in adolescent populations. For instance, evaluations of feigning on the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A) involve cutting scores extrapolated from adult studies with the MMPI/MMPI-2. Such extrapolations are unwarranted because (a) adolescents perform differently than adults on MMPI/MMPI-2 validity scales and (b) the MMPI-A validity and clinical scales are substantively different than the MMPI/MMPI-2. Given the dearth of adolescent data, this study examined the clinical usefulness of three measures in the assessment of feigning: MMPI-A, Structured Interview of Reported Symptoms (SIRS), and Screening Index of Malingered Symptoms (SIMS). Employing a within-subjects analogue study on 53 dually diagnosed adolescent offenders, we found that commonly used MMPI-A scales (F, F1, and F2) were ineffective, but that F-K > 20 appeared promising. For the SIRS, classification of feigning based on adult criteria yielded moderate positive predictive poser and superb negative predictive power. As a screen, the SIMS proved to be moderately effective in identifying feigned protocols. Finally, two-stage discriminant analysis offered initial support of the incremental validity of a combined SIRS and MMPI-A evaluation of adolescent feigning.

Initial validation of the Personality Assessment Inventory-Spanish version with clients from Mexican American communities.

Psychological assessment of Hispanic populations are thwarted by the absence of clinical research on comparability of Spanish translations and the stability of their findings. In this study we examined the potential usefulness of the Spanish Personality Assessment Inventory (PAI; Morey, 1991) for Hispanic clients residing in Mexican American communities. We administered the Spanish version on two occasions to 48 monolingual clients and the Spanish and English versions to 21 bilingual clients. Results indicated that the clinical scales had a moderate to good correspondence for Spanish-English (M r = .72) and good test-retest reliability for Spanish-Spanish (M r = .79). Much more variation was observed for the validity scales and the treatment/interpersonal scales. Also more variability was observed in the convergence of elevations across administrations. Because of these mixed results, we discuss the potential usefulness of the PAI clinical scales to screen for major psychopathology.

Determinations of dangerousness in forensic patients: an archival study.

The involvement of mental health professionals in determinations of dangerousness is both common and controversial. Among the various contexts for these evaluations, the release of potentially violent forensic patients from maximum security facilities evokes justified concern from involved experts and apprehension to outrage from the immediate community. We sought to examine how conclusions are reached on dangerousness at two sequential stages: clinical recommendations and Manifest Dangerousness Hearings decisions. In an archival study of 245 patients, we found that lack of progress in the institution and physical assaultiveness were the strongest correlates with dangerousness. In contrast, experts and review boards appeared to be relatively less influenced by diagnosis, types of treatment, and sociodemographic variables.

Seasonality of birth in schizophrenia in Taiwan.

The phenomenon of seasonality of birth in schizophrenia is important to the study of the etiology of this mental disorder because it helps give directions for further research. Patients' hospital files from 1981 to 1991 at two of the largest hospitals with psychiatric wards in Taiwan were reviewed, and dates of birth were collected on 3,346 patients diagnosed with schizophrenia. After adjusting for the variations of the total monthly births in the population, an Auto-Regressive Integrated Moving Average model was applied. Results support a seasonality phenomenon and indicate a disproportional excess of births in schizophrenia in the cold months (November to February) compared with the hot months (May to August). These findings are compatible with many other studies in other countries and climates. Further investigations of season-related environmental factors in the etiology of schizophrenia are recommended.