Improving the Detection of Feigned Knowledge Deficits in Defendants Adjudicated Incompetent to Stand Trial.

Malingering is relatively common in criminal forensic evaluations as base rates of malingering have ranged from 20% to 30%. Given that the most prevalent criminal forensic evaluation is the assessment of competency to stand trial, the assessment of feigning during competency evaluations is necessary for accurate findings. Most of the response style literature focuses on feigning mental health symptoms, but in competency evaluations, individuals may attempt to feign legal knowledge deficits in order to be found incompetent to stand trial. The current investigation includes two studies: 195 students instructed to simulate feigned mental illness or incompetence to stand trial and one using a sample of 130 state psychiatric hospital residents who had been adjudicated incompetent to stand trial. The purpose of the study was to evaluate the Inventory of Legal Knowledge's (ILK; Musick & Otto, 2010) ability to detect individuals who are feigning legal knowledge deficits. Classification utility statistics, including sensitivity, specificity, positive predictive power, and negative predictive power are provided for each cut-score on the ILK beginning with a cut-score of 24 (which is the lower end of the range of chance) are provided. The current cut-score of 47 provided in the professional manual of the ILK was shown to create a large number of false positives and suggests that modifications to this cut-score are required.

The clinical utility of the MMPI-2-RF Suicidal/Death Ideation Scale.

Suicide is a major public health concern, with over 100 individuals dying by suicide per day in the United States alone. Therefore, suicide risk assessment is an essential aspect of mental health care. The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008-2011; Tellegen & Ben-Porath, 2008) has a Suicidal/Death Ideation (SUI) scale consisting of 5 items that describe recent suicidal ideation or behaviors. Although this scale has clear face validity, few studies have examined the clinical utility of this scale. The purpose of the current study was to examine associations between the SUI scale and other established measures of suicidal ideation and behavior, including the Depressive Symptom Inventory Suicidality Subscale (DSI-SS; Metalsky & Joiner, 1997), Beck Scale for Suicide Ideation (BSS; Beck & Steer, 1991; Beck, Steer, & Ranieri, 1988), self-report of lifetime suicide attempts, and clinician ratings of suicide risk. Participants were 998 therapy- and assessment-seeking outpatients. Analyses indicated that the SUI scale was positively associated with other self-reported measures of suicidal ideation and behavior. Significant differences in SUI scale scores also emerged among the clinician rating categories of suicide risk. The SUI scale was able to predict previous suicide attempts over and above age, gender, and other MMPI-2-RF scales related to depression. Finally, relative risk ratios for suicide attempts indicate increased risk of suicidality, with higher T scores on the SUI scale. Overall, findings suggest that the MMPI-2-RF SUI scale may be a useful tool for identifying individuals at risk for suicidal ideation and behavior in clinical settings.

Stopping the revolving door: effectiveness of mental health court in reducing recidivism by mentally ill offenders.

OBJECTIVES: This study compared recidivism outcomes among criminal offenders with mental illness who were assigned to a mental health court (MHC) or a traditional criminal court. It also explored potential differences in outcomes between subgroups of offenders, including felony and misdemeanor offenders and violent and nonviolent offenders. METHODS: Data were obtained from court databases. Offenders in the MHC (N=198) and the traditional criminal court (N=198) were matched by propensity scores and followed for 12 months after the index offense. Data for the 12 months preceding the index offense were obtained for MHC participants. Intent-to-treat analyses were conducted, using both between-group and within-subjects designs. RESULTS: After control for covariates, logistic and Cox regressions indicated that MHC assignment predicted a lower overall rate of recidivism and longer time to rearrest for a new charge compared with assignment to traditional court. The groups did not significantly differ on the severity of the offense associated with rearrest. The findings largely held for felony, misdemeanor, violent, and nonviolent offenders, with the exception of analyses involving time to rearrest for violent offenders. Within-subjects analyses suggested that after MHC participation, there were improvements in occurrence of rearrest and time to rearrest but a tendency for rearrest to be associated with more severe offenses. Within the MHC group, recidivism outcomes did not significantly differ by class of offense. CONCLUSIONS: The results suggest that an MHC can be effective in reducing recidivism among offenders with mental illness and also indicate that persons who commit more severe offenses may be appropriate candidates for MHC.

The impact of judge-defendant communication on mental health court outcomes.

Previous research has shown that mental health courts have been successful in reducing the rates of recidivism among mentally ill offenders. However, none of these studies, to date, have examined exactly what aspects of the courts reduce these rates of recidivism and what makes them successful. The current study utilized a sample of 291 mentally ill criminal offenders participating in a mental health court to examine whether those participants who were addressed by and communicated with the judge had a reduction in recidivism rates and the severity of new charges in comparison to those who did not. The hypotheses regarding greater judge-defendant communication and recidivism were not supported. This suggests that communication in and of itself is not sufficient to reduce recidivism. Future research of a qualitative nature is essential to identify if the frequency, tone, and valence of the communication results in improved outcomes. In addition, these results may indicate a necessity for more stringent training and guidelines for the maintenance of Mental Health Courts. Results of the current study suggested differences between genders, such that females were spoken to by the judge more frequently than were men.

The evaluation of mental health screening practices within a population of incarcerated women.

Screening for mental illness within prison populations is vital to the safety and well-being of prisoners and to the operation of an institution. Although prisons are currently mandated to screen for mental illness, there are no standardized methods for doing so. Some prisons use specialized mental health screening measures while others simply ask a few face-valid mental health-related questions. The current study examined the validity of the latter method within a population of female prisoners. Quickview questions, selected to serve as mental health screening questions, were compared with the Minnesota Multiphasic Personality Inventory-2, a widely used forensic assessment measure. Results did not provide support for using the Quickview questions as a method for prison mental health screening. Implications and future directions are discussed.

Child sexual abuse and the superfluous association with negative parenting outcomes: the role of symptoms as predictors.

The purpose of this study was to investigate the relationship between child sexual abuse and high-risk maternal parenting indicators and the extent to which maternal depression and self-perceived parenting competence influence that relationship. Using path analysis, results indicate maternal depression and parenting sense of competence mediate the relationship between child sexual abuse and outcome variables. Post hoc analyses indicated that child sexual abuse was significantly associated with decreased parenting sense of competence, controlling for depression. These results highlight that the pathways for increased risk in parenting outcomes for child sexual abuse survivors may be indirect and associated with beliefs of their own sense of competence and depression as opposed to a direct association with sexual abuse itself. Implications are discussed.

The influence of gender role on the prediction of antisocial behaviour and somatization.

BACKGROUND: Previous research has demonstrated a sex-differentiated relationship between antisocial behaviour and somatization. One explanation posited is that societal expectations about male and female behaviour may influence a sex-differentiated expression of a common diathesis, but this idea has not been directly tested. AIMS: The current study examined the potential contribution of gender role in the prediction of antisocial and somatic symptomatology, controlling for biological sex, impulsivity and negative affect. METHODS: Linear regression was used to examine the influence of gender role on somatic and antisocial symptomatology. Path analysis was used to examine whether relationships among these variables differed significantly for men and women. Participants were 349 undergraduate students in southeastern USA. RESULTS: Masculine gender role was positively related to antisocial behaviour, while feminine gender role was negatively related to antisocial behaviour. Gender role did not predict somatization. CONCLUSIONS: Gender role may be important to the expression of antisocial behaviour, but does not influence somatic symptoms. Current findings underscore the need to consider that observed sex differences in antisocial behaviour might actually be affected by gender role, and highlight the importance of considering societal expectations of male and female behaviour when examining apparent sex differences in behaviour.

Examining the impact of gender on the factor structure of the Psychopathic Personality Inventory-Revised.

Research on the factor structure of psychopathy has yielded mixed results, supporting anywhere from one to three factors. Additionally, most of this research has used all-male samples, and the possibility of structural invariance across gender has not been examined. Using a mixed-gender sample of 360 undergraduates, the factor structure of the Psychopathic Personality Inventory-Revised was examined using confirmatory factor analysis and multiple group analysis. One-, two-, and three-factor models were tested and compared with each other. When males and females were combined, none of the three models provided adequate fit to the data. Multiple group analyses revealed partial invariance across gender for all three models. Model comparison criteria supported use of both the one- and two-factor models, taking into account variable factor structure across gender. The importance of considering structural differences based on biological sex when assessing psychopathic traits is discussed.

The effectiveness of sexual offender treatment for juveniles as measured by recidivism: a meta-analysis.

Published and unpublished data from nine studies on juvenile sexual offender treatment effectiveness were summarized by meta-analysis (N=2986, 2604 known male). Recidivism rates for sexual, non-sexual violent, non-sexual non-violent crimes, and unspecified non-sexual were as follows: 12.53%, 24.73%, 28.51%, and 20.40%, respectively, based on an average 59-month follow-up period. Four included studies contained a control group (n=2288) and five studies included a comparison treatment group (n=698). An average weighted effect size of 0.43 (CI=0.33-0.55) was obtained, indicating a statistically significant effect of treatment on sexual recidivism. However, individual study characteristics (e.g., handling of dropouts and non-equivalent follow-up periods between treatment groups) suggest that results should be interpreted with caution. A comparison of odds ratios by quality of study design indicated that higher quality designs yielded better effect sizes, though the difference between groups was not significant.