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The Psychological Assessment of Female Offenders
Abstract
Historically, the cornerstone of the psychologist’s identity rested on providing competent in-depth psychological assessment (Rapaport, Gill, & Schafer, 1946). The ability to utilize a battery of assessment methods to elucidate complex issues makes the psychologist unique among other mental health professionals. Recent trends, however, have tarnished that cornerstone. Not surprisingly, the movement away from proficiency in psychological assessment has led to a decline in the need for psychologists. In this chapter, we discuss these harmful trends, define psychological assessment, offer a model for assessing female offenders, and provide examples of how record review, clinical interview, the Hare Psychopathy Checklist-Revised (PCL-R), Personality Assessment Inventory (PAI), and Rorschach Inkblot test can be useful with female offenders. We discuss the interpersonal aspects of the assessment process, evaluate gender specific patterns for several PCL-R criteria (also see Appendices A & B), and provide caveats for assessing female offenders. We conclude with a case study.
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The authors investigated the validity of the Antisocial Features (ANT) scale of the Personality Assessment Inventory (PAI; L. C. Morey, 1991) with respect to assessments of psychopathy in 2 offender samples. Study 1 included 46 forensic psychiatric inpatients who were administered the Screening Version of the Hare Psychopathy Checklist (PCL:SV; S. D. Hart, D. N. Cox, & R. D. Hare, 1995). In Study 2, 55 sex offenders were administered the Hare Psychopathy Checklist–Revised (PCL–R; R. D. Hare, 1991). ANT scores correlated highly with the PCL:SV total score (r = .54) and moderately with the PCL–R total score (r = .40). ANT tapped primarily behavioral symptoms of psychopathy rather than interpersonal and affective symptoms. Also, ANT had low to moderate diagnostic efficiency regarding diagnoses of psychopathy, suggesting that it may be better used as a dimensional rather than categorical measure of this construct.
Psychologists have debated the clinical utility of the Rorschach for many years. In an effort to bring greater clarity to the relevant issues, a Special Series was organized for this journal. With the exception of a neutral, meta-analytic review, articles for the Special Series were solicited from scholars known to have opposing views on the Rorschach. The authors agreed to engage in a structured, sequential, and scientifically grounded dialog that focused on strengths and limitations when using the Rorschach in applied clinical settings. The debate takes place over the course of three iterations, with later articles building on and reacting to those generated earlier. This Introduction provides a rationale and overview for the full Special Series. In addition, it briefly describes the five Special Section articles published in this issue of Psychological Assessment. Five additional articles are expected to be published in an upcoming Special Section. In combination, these two Special Sections should provide clinicians, researchers, educators, and students with the most thorough, empirically rigorous, and up-to-date evaluation of the Rorschach’s clinical utility.
It is essential to understand that CS validity research does not translated directly to the R-PAS. In this article we dicuss essential issues to consider prior to using the R-PAS in an applied context.
In several articles, my colleagues and I have addressed concerns regarding methodological issues with the recent RIM research (see Cunliffe et al., 2012; Gacono, Loving, &Bodholdt, 2001; Smith et. al., 2018). In many studies, the impact of these issues is frequently hidden, masked in a description of statistical procedures and shrouded by the umbrella of a meta-analysis. Findings from these flawed studies influence conclusions that may appear "controversial" but are in actuality an artifact of the individual studies' inadequate design. Alarmingly, such method-related practices negatively impact the scholarly perception of the Rorschach and are frequently cited by editors for rejecting submitted Rorschach studies for publication, based largely on the presence of "controversy" which does not exist. In this brief commentary, the importance of Lambda to the generalizability of Rorschach findings is discussed.
Mihura’s (2019) recent commentary on Smith et al.’s (2018) article, “A Scientific Critique of Rorschach Research: Revisiting Exner’s Issues and Methods in Rorschach Research (1995)” raised several issues surrounding our internal validity criteria and our approach to validating Rorschach research. Mihura also conducted additional statistical analyses that failed to address important, critical issues. In this article, we further clarify the importance of refining internal validity criteria for Rorschach research and Rorschach meta-analytic studies (our 2018 article). We offer this information and analysis to guide the Rorschach consumer toward a better understanding of how to assess the validity of Rorschach data and empirical findings. Criticisms of our criteria for evaluating Rorschach research (inter-rater reliability, IQ/Education level, Rorschach Responses, Lambda/F%, sample size) and our recommendation to include descriptive data for critical variables in all published Rorschach studies contradict accepted standards for Rorschach research. Mihura stated that “the associations between the Rorschach and self-report measures were not used to determine the validity of Rorschach variables” (p. 171) in her meta-analyses. Consequently, we applied our methodological criteria to only Mihura’s externally assessed criteria studies (removing self-report studies; 67%) and found that 91% had three or more problems related to internal validity (13 had counter-intuitive findings). In addition, other central issues related to meta-analyses, application/validation studies, and counter-intuitive findings regarding the Rorschach were discussed.
Psychopathy is an essential construct in forensic mental health. While male psychopathy and aggression has been thoroughly studied, less is known about this relationship with female psychopathy. In this article, the relationship between female psychopathy (Psychopathy Checklist-Revised [PCL-R] total, factor, and facet scores) and the Rorschach Aggression indices (Aggressive Movement [AG], Aggressive Content [AgC], Aggressive Past [AgPast], Aggressive Potential [AgPot], Sadomasochistic Aggression [SM]) were examined. Rorschach Aggression indices between female psychopathic (PCL-R total score ≥ 30; N = 84) and non-psychopathic female offenders (PCL-R total score ≤ 24; N = 39) were also compared. PCL-R total score was significantly correlated (p <.05) with AgC,
AgPast, AgPot, and SM and there were also significant correlations between the Aggression scores and PCL-R Factor/facet scores. The female psychopaths produced more AgC, AgPast, and AgPot responses than the non-psychopathic females. Rorschach aggression indices supported theory and suggested that the violence in psychopathic women stems from their identification with aggression and pervasive feelings of entitlement. Psychopathic women evidenced higher levels of these variables than the non-psychopathic offenders. The results add to the link between aggression and psychopathy as well as a better understanding of aggression in female offenders.
In this study, PCL-R scores were used in correlational analyses with PAI scales in a sample of incarcerated women (N = 133). The total PCL-R score was significantly correlated with many PAI scales including ANT, DRG, and AGG. Categorical analyses were also used where the psychopathic women (N = 71; PCL-R ≥ 30) were significantly higher on the PAI scales of MAN, VPI, PAR, BOR, ANT, AGG, DOM; the non-psychopathic women (N = 28; PCL-R total score ≤ 24) scored higher on the RXR scale. These results further elucidate the conceptualization of female psychopathy (borderline and histrionic personality traits) and were consistent both with clinical observations, theoretical conceptualizations, and previous Rorschach research. Clinical implications were provided for working with incarcerated psychopathic women.
The Rorschach Comprehensive System Egocentricity Index (EGOI) and its component variables have been useful in understanding antisocial and psychopathic individuals (Gacono & Meloy, 1994; Gacono, Meloy, & Heaven, 1990). In this study, the EGOI, Personality Assessment Inventory (PAI) scales and the Psychopathy Checklist-Revised (PCL-R) were used with a sample of incarcerated women. The EGOI, Fr + rF, and pairs were examined in relation to PCL-R Items 1 (Glibness/Superficial Charm) and 2 (Grandiose Sense of Self-Worth), PCL-R Factor 1, PCL-R facet 1, and the PAI MAN-G and ANT-E scales. The EGOI and reflections were significantly correlated with PCL-R Item 1 and a combination of PCL-R Items 1 and 2. Unlike highly narcissistic male offenders where grandiosity elevates reflections and EGOI, female psychopaths (PCL-R total score ≥ 30; N = 85) and non-psychopathic females (PCL-R total score ≤ 24; N = 40), did not demonstrate a significant difference for their mean EGOI; however, female psychopaths were more likely to produce protocols with a high EGOI (≥ 0.44) with and without reflections and they had more pairs (a finding consistent with conceptual differences between male and female psychopaths). The utility of the EGOI with incarcerated women is discussed.
In this study, the Psychopathy Checklist-Revised (PCL-R), the Rorschach, and the Personality Assessment Inventory (PAI) were used to elucidate the personality functioning of incarcerated females with sex offenses against minors (FSOAM; N = 31). There was significant convergence among the PCL-R, PAI, and Rorschach data. Both the PAI and Rorschach suggested: 1) borderline/psychotic reality testing and idiosyncratic thinking; 2) damaged sense of self, entitlement, and victim stance; 3) abnormal bonding and dependency; 4) affective instability; 5) impulsivity; and 6) chronic anger. Our comparison with a sample of male pedophiles (N = 36) highlighted gender specific issues with the women. Specifically, the women had more emotional deficits, ego-syntonic aggression, idiosyncratic thinking, and inappropriate attachments. A case study and our findings suggest a conceptual model for understanding the dynamics that result in female sexual offending behavior.
Various studies have shown that women with psychopathy tend to commit crimes that are less violent than those of psychopathic men. The present study was designed to address the influence of psychopathy on the crimes committed by female offenders. A national sample of female offenders found NGRI or of diminished responsibility and at risk for criminal recidivism (OPG patients) was compared with a sample of female offenders who were convicted and imprisoned. Results of this comparison between the two groups of female offenders indicate that psychopathy is a transversal psychopathological dimension which may or may not be associated with other mental disorders. In both samples, the most commonly reported offenses among women with high PCL‐R scores were minor offenses, not particularly violent, but they appear to be related to typical psychopathic features such as superficial charm, pathological lying, and manipulation.
Childhood abuse is associated with increased psychopathic features among girls, but most prior research is based on data from correctional samples of female delinquents and less is known about how specific forms of childhood abuse affect specific features of psychopathy. Using a school-based community sample of 696 girls aged 9-17 years from Barbados and Grenada, the current study examined latent profiles of psychopathic personality traits and their associations with physical, emotional, and sexual abuse. Latent profile analysis (LPA) revealed four distinct psychopathy groups among girls, including a 'low psychopathy' group (41.9% of girls), 'high psychopathy' group (4.8%), 'high interpersonal manipulation and egocentricity' group (37.4%), and a 'moderate psychopathy' group (16%). There was considerable evidence of physical abuse, emotional abuse, and sexual abuse among participants. Sexual abuse was associated with a 116% increased likelihood of membership in the high psychopathy group and a 57% increased likelihood of membership in the high interpersonal manipulation and egocentricity group. These results indicate that sexual abuse is a powerful distal factor in the development of psychopathic personality functioning, especially more severe variants.
Exner’s (1995a) Issues and Methods in Rorschach Research provided a standard of care for conducting Rorschach research; however, the extent to which studies have followed these guidelines has not been examined. Similarly, meta-analytic approaches have been used to comment on the validity of Exner’s Comprehensive System (CS) variables without an evaluation as to the extent that individual studies have conformed to the proposed methodological criteria (Exner, 1995a; Gacono, Loving, & Bodholdt, 2001). In this article, 210 studies cited in recent meta-analyses by Mihura, Meyer, Dumitrascu, and Bombel (2013) were examined. The studies were analyzed in terms of being research on the Rorschach versus research with the Rorschach and whether they met the threshold of validity/generalizability related to specific Rorschach criteria. Only 104 of the 210 (49.5%) studies were research on the Rorschach and none met all five Rorschach criteria assessed. Trends and the need for more stringent methods when conducting Rorschach research were presented.
Psychopathy is considered an essential construct in forensic work (Gacono, 2016). Most methodologically sound studies have involved males rather than females (Smith et al., 2014). Gender differences have been found to be, and continue to be considered important in the assessment and management of forensic populations (Cunliffe et al., 2016). Male psychopaths present as pathologically narcissistic whereas female psychopaths manifest a malignant form of hysteria. Both are pathologically self-focused; however, the grandiosity in males is contrasted by women’s negative self-view. In the current study, male and female psychopaths (males = N = 44; PCL-R M = 33.13; females = N = 46; PCL-R M = 32.93) were compared using select Comprehensive System Rorschach variables. Female psychopaths produced more painful rumination (SumV), helplessness (SumY), and poor self-regard (EGOI ≥ .44 & Fr + rF = 0) than the males. Males were more detached (SumT) than females. Implications for future research, recommendations for these populations, and suggestions for using the PCL-R to assess female offenders are discussed.
Psychology celebrates diversity, recognizes the value and legitimacy of diverse beliefs, and strives to be inclusive. Yet, the profession lacks sociopolitical diversity. Most psychologists are politically liberal, and conservatives are vastly underrepresented in the profession. Moreover, when sociopolitical views guide the research, advocacy, or professional practice of psychologists, those views most often are liberal. The lack of political diversity in psychology has unintended negative consequences for research, policy advocacy, clinical practice, the design and implementation of social interventions, and professional education. It excludes or marginalizes conservatives and conservative views, having detrimental effects on the profession in each of these areas. This article examines the importance of political diversity and the negative consequences of its absence and provides strategies for increasing sociopolitical pluralism in psychology.
This study presents the results of an exploratory bibliometric " topical " analysis with regard to mainly primary research regarding the Rorschach published in journal articles 2000-2016. The major aim is to a) determine the scope and breadth of investigatory areas most emphasized by researchers during this time frame, and b) prompt more advanced bibliometric study of the extant Rorschach literature in order to map the structure of scholarship and research domain regarding this popular assessment method. The database PsycINFO was selected to obtain the pool of references based on a " keyword " search of the term Rorschach. The search identified a total of 838 peer-reviewed articles from 2000 to 2016; of these, 747 were determined to be mostly " primary " articles and served as the data-set for the analysis. The author tagged each article with a topical descriptor and maintained a scoring template based on frequency counts across categories. The analysis identified 29 topical categories which represented at least 1% of the total distribution. The most prevalent researched topics were (in rank order): Norms, psychotic states, eating disorders, historical aspects, psychosomatic factors, treatment planning/outcome, aggression/hostility, personality, psychodynamic issues, depression, and personality disorders. Neglected areas of research were noted such as, assessment training, differential diagnosis, anxiety states, racial/ethnic differences, and social desirability. The focus on norms/normative comparisons was quite apparent. The potential impact of editorial preference/bias was discussed and limitations of the study were noted. Based on this analysis, it appears that recent Rorschach scholarship is a) not cohesive in character, and b) reflects diverse research domains representing disparate research interests. Hence, despite an extensive repository of literature, the Rorschach remains an emerging area of study with an opaque sense of direction for future research.
Code for Hermann: Enhanced Structural Summary and Supplementary Scales (CHESSSS©; Fontan et al., 2013) is a free, open source software program using Microsoft Excel© to assist in computing Rorschach Comprehensive System (Exner, 2003) variables . The program scores protocols for children, adolescents, and adults. Further, the program offers the option to score Supplementary Scales including Rorschach Oral Dependency Scale (Masling, Rabie, & Blondheim, 1967), Mutuality of Autonomy (Urist, 1977) scale, Extended Aggression Scores (Gacono & Meloy, 1994), Ego Impairment Index-2 (Viglione, Perry, & Meyer, 2003) and six R-PAS scores (Meyer, Viglione, Mihura, Erard, & Erdberg, 2011). CHESSSS differs from other Rorschach software (RIAP and ROR-SCAN) in that the program is free and it is open source allowing its users to manage their data and modify the program. For an in-depth understanding of CHESSSS, see a recent Rorschachiana article written by Fontan et al. (2013). CHESSSS is routinely updated by the developer (P. Fontan) who is willing to help with questions and responds to feedback in a timely manner.
In the present chapter, we discuss the role of the Hare Psychopathy Checklist-Revised (PCL-R) and Rorschach in forensic psychological assessment. We stress the importance of using a multi-method over a mono-method assessment approach and advocate for the incremental validity of psychological testing over interviews alone as an essential aspect of assessment practice. The ability to integrate the nomothetic strengths of the PCL-R with the idiographic potential of the Rorschach allows for conclusions to be refined into nuanced person-context interactions most useful in areas such as risk assessment, forming diagnostic impressions, and determining treatability. A case example involving an incarcerated antisocial male with a history of exclusively affective violence is presented.
This paper presents survey data, based on 4 studies on test usage in the field of forensic psychology, over the past 10 years. The author argues that the high degree of variability in the most popular testing instruments is largely based on the training, group affiliation, theoretical orientation of individual assessors, and the specific organizational setting where the testing is conducted. This variability in test usage is a) compounded by specific referral issues addressed in forensic consultation, and b) detrimental in establishing admissibility criteria pertaining to the Frye or Daubert standards in reference to test use in legal settings.
Wood et al. (2010) published a meta-analysis in which the authors challenged the utility of the Rorschach Inkblot Test in delineating key differences between psychopathic and non-psychopathic individuals identified by the Psychopathy Checklist-Revised (PCL-R; Hare, 1991/2003). In this article, Gacono et al.’s (2001) five conceptual and four methodological criteria for the evaluation and interpretation of psychopathy/Rorschach literature were employed to provide a detailed review of the approach and procedure used by Wood et al. (2010). We identify and discuss a number of conceptual and methodological problems with the meta-analysis including confusion of the related but distinct terms of diagnosis and assessment, selection of studies, categorical versus dimensional interpretations of data, characterization of PCL-R and Rorschach findings, and meta-analytic methodology. Finally, recommendations for the essential components of well designed and implemented PCL-R and Rorschach studies are provided.
Is the Exner Comprehensive System the most frequently used method or approach to Rorschach analysis? In addition to the existing literature on assessment practices, the results of a citation analysis of the PsycLIT database confirms that the Exner system is the most widely used method in research.
Female psychopathy has been conceived as a malignant form of hysteria organized at the borderline level of personality function. In this study, the PCL-R was used to assess psychopathy, and the Rorschach Comprehensive System, Extended Aggression Scores, Rorschach Defense Scales, Rorschach Oral Dependency, Trauma Content Index, and Primitive Modes of Relating scoring systems were used to examine psychodynamic variables in female psychopaths. Our findings support the conceptualization of female psychopathy as a malignant form of hysteria and lead us to suggest the need for modifying several PCL-R items with female offenders.
CHESSSS is an open source project we propose to the Rorschach community. It can be freely distributed and adjusted to one’s particular needs. We have paid much attention to make it as efficient and user-friendly an application as possible. Its use and even its programming do not require a high level of skills in informatics. This project provides solutions for issues concerning computing Rorschach Supplementary Scales, interrater reliability, standardization of Form Quality tables across countries, the search for items in the FQ tables, and the creation of databases. It also addresses the complexity of RCS interpretation. We do hope that CHESSSS will help clinicians, researchers and students to manage their own data as desired in a free and autonomous manner. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
The Rorschach Performance Assessment System (R-PAS) was introduced
in 2011 as an alternative to Exner’s Comprehensive System
(CS). This article critically evaluates the contemporary use of
the R-PAS in forensic contexts. The standing of the R-PAS in
relation to relevant legal standards, professional guidelines, and
published professional models is considered. Normative reference
data, revised administration procedures, and general acceptance
are discussed, and questions surrounding the comparability of
the R-PAS to the CS are explored. Historical transitions to revised
versions of existing assessment procedures are reviewed with particular
attention to the recurrent question of comparability and how
such concerns were addressed. Although the R-PAS shows significant
promise, fully adopting it into current forensic practice may
be premature.
A computer-based search of Rorschach legal citations between 1945 and 1995 was conducted. The Rorschach test was cited in 247 cases in state, federal, and military courts of appeal, averaging 5 times per year. Twenty-six cases were identified in which the reliability or validity of the Rorschach findings were an issue (10.5%). Despite occasional disparagement by prosecutors, the majority of the courts found the test findings to be both reliable and valid. When Rorschach testimony was limited or excluded, it was usually due to invalid inferences that the expert had made from the test data.
The Hare Psychopathy Checklist-Revised (PCL-R) and its screening version, the Hare PCL:SV, provide reliable and valid assessments of the traditional clinical construct of psychopathy. They are used widely for research purposes and for making decisions in the mental health and criminal justice systems. They are strong predictors of recidivism and violence in offenders and psychiatric patients, form a key part of current risk assessment procedures, and play an important role in many judicial decisions. However, problems arise when the PCL-R and PCL:SV are used improperly. In this article I briefly describe these instruments, with emphasis on their use in the criminal justice system. I then discuss some of the concerns I have about their misuse.
Recent empirical investigations utilizing male prisoners have begun to validate clinical conceptualizations of primary and secondary psychopathy subtypes. We extended this literature by identifying similar psychopathic subtypes in female prisoners on the basis of personality structure using model-based cluster analysis. Secondary psychopaths (n = 39) were characterized by personality traits of negative emotionality and low behavioral constraint, an early onset of antisocial and criminal behavior, greater substance use and abuse, more violent behavior and institutional misconduct, and more mental health problems including symptoms of post-traumatic stress disorder and suicide attempts. Primary psychopaths (n = 31) exhibited few distinguishing personality features but were prolific criminals especially in regards to non-violent crime, and exhibited relatively few mental health problems despite substantial exposure to traumatic events. The results support alternative etiological pathways to antisocial and criminal behavior that are evident in personality structure as well as gender similarities and differences in the manifestation of psychopathic personalities.
We describe a new psychological testing procedure used on a consecutive series of 14 patients with multiple personality and dissociative disorders who met DSM-III-R and research criteria for dissociative disorders. Once dissociative phenomena were accounted for in testing, most patients displayed response patterns markedly different from those of schizophrenic and borderline patients. Patients showed striking variability on cognitive and projective tests, often related to posttraumatic intrusions. Rorschach protocols showed unusual thinking accompanied by psychological complexity and highly developed self-observing capacity. In contrast to classical conceptualizations about these patients, most subjects had personality profiles that were intellectualized, obsessive, and introversive, not histrionic or labile.
Despite widespread use of the Rorschach for the study of defense mechanisms, few recent Rorschach scales have been developed for the study of defensive functioning. We critically review previous empirical research and describe the Rorschach Defense scales. These scales provide criteria for rating both lower level defense mechanisms, such as splitting and primitive idealization, as well as higher level defenses, such as intellectualization and isolation. The scales utilize a broad range of content including all Rorschach responses, associative content, and verbalization of the tester-patient relationship. Data on interrater reliability and preliminary validity are presented.
In this chapter, we provide a theoretical and empirically based understanding of antisocial and psychopathic women. We begin by clarifying the differences between psychopathy, sociopathy, and ASPD, and then provide a historical perspective of hysteria. While the underlying personality of the female psychopath is paranoid, malignant hysteria is their predominant personality style (Gacono & Meloy, 1994). Overviews of the Hare Psychopathy Checklist-Revised (PCL-R), Personality Assessment Inventory (PAI), and Rorschach are offered as a refresher for those experienced clinicians and as a resource for those that are not. Finally, we present group PAI and Rorschach data (also Trauma Symptom Inventory-2 [TSI-2]) for 337 female offenders including subsets of psychopathic (N = 124) and non-psychopathic (N = 57) females. We make note of the differences between female and male psychopaths.
The Rorschach test is widely used in both clinical and forensic evaluations, but a standard of practice for its use in courtroom testimony has not been articulated. The author develops six guidelines for expert witnesses who testify about the scientific data generated by the Rorschach: training and use of a scoring system, accurate scoring, knowledge of validation research, avoidance of overinterpretation of the data, use of plain language to describe Rorschach variables, and the appropriate material to bring to the witness stand to ethically protect the security of psychological tests and measures.
The primary aim of this article is to aid clinicians in differentiating true posttraumatic stress disorder from malingered posttraumatic stress disorder. Posttraumatic stress disorder and malingering are defined, and prevalence rates are explored. Similarities and differences in diagnostic criteria between the fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders are described for posttraumatic stress disorder. Possible motivations for malingering posttraumatic stress disorder are discussed, and common characteristics of malingered posttraumatic stress disorder are described. A multimodal approach is described for evaluating posttraumatic stress disorder, including interview techniques, collection of collateral data, and psychometric and physiologic testing, that should allow clinicians to distinguish between those patients who are truly suffering from posttraumatic disorder and those who are malingering the illness.
There are a number of legal and professional standards that guide admissibility of expert testimony and psychometric evidence. The most important legal tests for admissibility include the Federal Rules of Evidence (1992), the Frye test (United States v. Frye, 1923), and the Daubert standard (Daubert v. Merrell Dow Pharmaceuticals, Inc., 1993). Within the profession, Heilbrun (1992) and Marlowe (1995) have outlined criteria for the selection of psychological tests in forensic settings. Using these legal and professional standards, the Rorschach is analyzed according to individual criteria Although several issues require additional research, it is concluded that the status of the Rorschach Inkblot Method is such that it satisfies legal tests of admissibility and professional criteria that have been suggested. In those cases where the Rorschach is apt to be deemed inadmissible, it is likely due to how data from the instrument are utilized, rather than characteristics of the instrument itself.
This paper describes an early phase in the development of new research scale for the assessment of psychopathy in criminal populations. The scale is meant to be a sort of operational definition of the procedures that go into making global ratings of psychopathy. While the interrater reliability of these ratings is very high ( > 0.85) they are difficult to make, require a considerable amount of experience, and the procedures involved are not easily communicated to other investigators. Following a series of analyses, 22 items were chosen as representative of the type of information used in making global ratings. Two investigators then used interview and case-history data to complete the 22-item checklist for 143 male prison inmates. The correlation between the two sets of total checklist scores was 0.93 and coefficient alpha was 0.88, indicating a very high degree of scale reliability. The correlation between the total checklist scores and global ratings of psychopathy was 0.83. A series of multivariate analyses explored the factorial structure of the scale and demonstrated its ability to discriminate very accurately between inmates with high and low ratings of psychopathy. Preliminary indications are that the checklist will hold up well to crossvalidation.
As mental health resources dwindle, efficient use of available services becomes an economic and ethical necessity. Integral to this process are screening, assessment, and treatment planning. Treatment planning is especially critical in correctional settings where change-resistant Antisocial Personality Disordered (ASPD) individuals compose a disproportionate percentage of the population. Not a homogeneous group, some ASPDs are treatable, some are not. The Hare Psychopathy Checklist-Revised (PCL-R) and Rorschach Test aid the clinician in formulating diagnoses, assessing treatment amenability, targeting areas for intervention, and, with the Rorschach, monitoring treatment progress. This article discusses the PCL-R's and Rorschach's role in treating ASPD patients. Two low-Lambda, introversive, T = 1, ASPD Rorschach protocols highlight treatment planning and treatment progress assessment.
This paper reviews the evidence for the existence of a complex form of post-traumatic disorder in survivors of prolonged, repeated trauma. This syndrome is currently under consideration for inclusion in DSM-IV under the name of DESNOS (Disorders of Extreme Stress Not Otherwise Specified). The current diagnostic formulation of PTSD derives primarily from observations of survivors of relatively circumscribed traumatic events. This formulation fails to capture the protean sequelae of prolonged, repeated trauma. In contrast to a single traumatic event, prolonged, repeated trauma can occur only where the victim is in a state of captivity, under the control of the perpetrator. The psychological impact of subordination to coercive control has many common features, whether it occurs within the public sphere of politics or within the private sphere of sexual and domestic relations.
The past decade has witnessed a growing interest in risk assessment. Reliable and valid instruments, such as the Revised Hare Psychopathy Checklist (PCL-R; Hare, 1991), form one essential component of this evaluation. They allow clinicians to anchor opinions in actuarially-based nomothetic data. In this article we provide the reader with a context for evaluating the role of the PCL-R in risk assessment. Specifically, we offer suggestions related to the use of PCL-R scores within a clinical/forensic context. Borrowed from essays on public health policy, we apply the concept of harm reduction to risk assessment and a select case example.
The past several years have witnessed an increase in psychological journals offering “pseudo-debates” concerning the relevance of various assessment methods or psychological tests to clinical and forensic practice (Gacono, Loving, & Bodholdt, 2001; Meyer, 1999, 2000; Weiner, 2001). Dedicated researchers and practitioners have produced enormous bodies of validating research, as well as a wealth of clinical/forensic experience concerning the inestimable value of these instruments in delivering mental health services as diagnostic consultants (Meyer, 2000; Wiener, 2001). Persistent detractors have seldom demonstrated the same level of scientific rigor, that is, weighing all available evidence, discriminating between compelling and questionable research findings, and drawing conclusions on the basis of a balanced and open-minded determination of where the facts lie (Wiener, 2001). Regardless of their merit, these articles eventually find their way into the court room and provide another source of distraction in an already difficult work arena. Forensic psychologists must be prepared for challenges to their assessment methods. With this in mind, this article introduces a series of articles that provide guidelines for the forensic use of the PCL-R, Rorschach, MMPI-2, MCMI-III, and PAI.
The correlation of Army Alpha with academic marks in high schools and military academies yields an appreciably higher correlation for the latter group. This suggests to the authors that methods of instruction in the military academy are more apt to hold the student to his maximum intellectual ability. The low correlation generally found between intelligence and academic marks may be to a considerable extent due to the fact that methods of school instruction do not hold students to their maximum efficiency. From Psych Bulletin 18:05:00296. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The authors review the treatment literature for conduct disorder, antisocial, and psychopathic personalities. The chapter begins with a critical assessment of the social deviancy model that guides current classifications of psychopathy in the present DSM system of classifying mental disorders. The authors contrast the clinical characteristics of this diagnostic category with other psychometric classifications of psychopathy and introduce a number of conceptual dilemmas affecting the identification of appropriate treatments and treatment outcomes. Because psychopathy is one of the personality disorders with long-standing links to criminality (T. Millon et al, 1998), this chapter provides readers with a clear and organized overview on treating a population of offenders that has fascinated clinical professionals for more than 200 years. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The relative utility of psychological tests for addressing legal issues is an area of considerable debate in the field. Regardless of the merits of psychological testing, it is apparent that such instruments are used widely both to address specific psycholegal issues and to evaluate offender populations more generally. One instrument gaining prominence in terms of its use in both forensic and correctional settings is the Personality Assessment Inventory (PAI; Morey, 1991), which was developed to assess various constructs relevant to clinical settings (e.g. psychopathology, response distortion, and personality traits). This paper reviews the psychometric properties of the PAI specifically in reference to its ability to assess factors relevant to forensic decision-making, as well as its utility to provide clinically relevant information about offender populations more generally. Copyright © 2001 John Wiley & Sons, Ltd.
We investigated the constructs of anxiety and attachment in a group of 42 offenders who met the DSM-III-R criteria for antisocial personality disorder. Each antisocial subject's level of psychopathy was assessed with the Hare Psychopathy Checklist (PCL). Three Rorschach variables related to attachment, anxiety, and coping were compared between subjects scoring greater than or equal to 30 (N = 21) on the PCL and subjects scoring less than 30 (N = 21). Comparison Rorschach variables are also presented from a sample of 60 antisocial personality-disordered offenders. Moderate psychopaths (PCL score, less than 30) produced texture and diffuse shading responses at a significantly greater frequency than severe, or primary, psychopaths (PCL score, greater than or equal to 30). There was no significant difference in the two groups' propensity for producing vista responses. Although there were no significant differences between the coping index scores, the trend suggests less conflictual functioning in the severe psychopaths. A virtual absence of texture responses in the severe psychopaths, and a significantly greater frequency of diffuse shading responses in the moderate psychopaths, add construct validity to the lack of attachment in psychopaths and the role of anxiety in differentiating secondary from primary psychopathy. We view the presence of vista responses in this population as a measure of a failed grandiose self-structure, and note that it often occurs in the records of moderate psychopaths who also present achromatic color responses.