LOUISIANA JUDICIAL COLLEGE 2016 Spring Conference for Judges
April 14 and 15 Double Tree by Hilton, Lafayette
Psychological Evaluations: Who, What, When, Where and How for Judges DR. JOHN SIMONEAUX Professional Training Resources
1
Psychological Testing
Presented By:John C. Simoneaux, Ph.D.
I’m not going to show you the mole on my butt.
My purpose, in part, is to raise the bar for my profession
Beware of experts who “dabble” ‐‐ this process can be dangerous
General Caveats:
I’ll try to focus on what you don’t know already
If some element cannot be explained logically, it is probably “witchcraft”
Generic Problems & Limitations
1. Concerns over the lack of an adequate knowledge base, particularly of a scientific kind
2. The variability and the lack of standardization in procedures
3. The variability in the criteria used or emphasized by different evaluators
4. The large opportunity for biases to play a role
5. Questions about appropriate qualifications for evaluators
6. Concerns about dual roles or role conflicts
2
Frequently Used Tests
Grisso has insisted that when psychologists venture into courtrooms as expert witnesses, they are obligated to adjust their procedures to the needs of the legal system
Too many professionals, however, expect the legal system to adjust to the practices they find familiar and comforting
Some of these practices involve experts using reports, anecdotes, and other less than reliable data, to form part of their diagnostic impressions.
Frequently Used Tests
The most frequently used test is the Minnesota Multiphasic Personality Inventory‐2
The Rorschach is the second most frequently used instrument
The Millon instruments were the next most frequently used
The use of some of the specific psychological tests constitute remarkably poor judgment.
Minnesota Multiphasic Personality Inventory ‐ II
3 Primary Validity Scales
10 Clinical Scales
11 Supplemental Scales
15 Content Scales
Harris‐Lingoes Subscales
Various Critical Item Sets
MMPI Description
3
Minnesota Multiphasic Personality Inventory ‐ II
Sample Profile
History First published in 1943 by Hathaway and McKinley
Designed for routine diagnostic assessments
Empirical keying approach
Originally 504 true‐false statements ‐‐ now 567
724 Minnesota”normals” and 221 psychiatric patients
Originally 8 clinical scales plus validity scales
– MF and Si added later (items increased to 566)
History MMPI-2 Yields individual’s clinical profile compared with the normative sample
Much of research on interpretation from MMPI applies to MMPI‐2
Most frequently used personality test in the US for adults and adolescents
4
Administration and Scoring
Administered individually or in groups
– not a “take home” test
– computerized version available
Administration time is approximately 1 to 1.5 hours
Scored by hand or computer
Must be interpreted by qualified professionals
For use with individuals 18 years and older
Can break test session up into shorter segments
– MMPI‐2 for 18‐year‐olds who are in college, working or living independently
Validity Scales (cont.)
Lie (L) Scale
15 items
extent to which client is “faking good” or describing self in an overly positive manner
K scale(30 items)
More subtle and sophisticated index of “faking good” or “faking bad”
Higher scores indicative of ego defensiveness and guardedness
Persons of higher intelligence and psychological sophistication may score high on K and low on L
Validity scales (cont.)Variable Response Inconsistency Scale (VRIN)
An additional validity indicator developed for MMPI‐2
Measures tendency to respond inconsistently to MMPI‐2 items
47 pairs of items with similar or opposite content
True Response Inconsistency Scale (TRIN)
To identify an all true (acquiescence) or all false (non acquiescence) response style
20 pairs of items that are opposite in content
5
Test-taking Attitude Average completion time is 1.5 hours
– Longer could mean indecisiveness, psychomotor retardation, confusion, passive resistance
– Shorter could mean impulsiveness
Look at behavior during testing
– Could be indicative of behavior under stressful situations
Number of omitted items
Look at validity scales
Faking Good Profile Faking Bad Profile
All True Responding All False Responding
What can the MMPI tell us?
Based on analysis of two‐ and three‐ point codes:
Symptoms
Major needs (dependency, achievement, autonomy)
Perceptions of the environment – especially significant others
Reactions to stress (e.g. coping strategies, defenses)
Self‐concept
Sexual identification
Emotional control
Interpersonal relationships
Psychological resources
6
Projective Tests Assess the unconscious desires, emotions, experiences, memories and imaginations of individuals.
Assess violent tendencies in convicts, mental stability of people, aggression in children, and sexual abuse in children.
Tests often have little or no validity for these purposes.
The Rorschach ‐‐ An example of a controversial “test”
Consists of 10 card ‐‐ some color, some black & white
Examinees report what they see ‐‐ free association
There are no “right” answers
Inkblots – Test or Not?
7
The Rorschach ‐‐ An example of a controversial “test”
There have been many scoring systems
Exner’s system is in vogue
Most validity research is poor
Inkblots – Test or Not?
The Rorschach ‐‐ An example of a controversial “test”
Complex to administer, score, and interpret
Many examiners do not score
Ask for detailed scoring records ‐‐ have them reviewed by experts
Major Problems with the Rorschach
Simulated Blots
8
Rorschach Test (cont.) Can detect thought disorders such as schizophrenia and manic
depression.
– Can be detected in other valid and objective ways.
Not equipped to identify psychiatric conditions.
Not valid for detecting sexual abuse in children, violence, impulsiveness, criminal behavior.
Unrepresentative of the general population, and therefore are subject to over‐diagnosing psychiatric conditions.
Appropriate Uses Not a cognitive or neuropsychological measure
Not necessarily the best measure for prediction of behavior
Best if used as part of a battery
Best if questions concerns a description of psychological operations, needs, styles, habits
Scoring
Location
Determinants
Content
Popularity
15 special scores
6 Special Indices
9
Draw-a-Person Test Requires the participant to draw a picture.
Base their interpretation and analysis of the participant depending on the drawings characteristics.
Psychologists often over‐diagnose and people who lack artistic ability are more likely to be diagnosed with a mental illness.
Projective Drawings
Various drawing techniques have been used
House, tree, person, family, etc.
Numerous scoring systems ‐‐ no data
No standardization
Inadequate norms
Validity and reliability not demonstrated
Generally useless and prejudicial
What Can Be Assessed Through Drawings?
“Projective drawing suggest an individual who is experiencing distress.”
“He has problems being able to convey this to others and there is over control.”
“There is dependence, anxiety, anger, and there has been conflict in the home.”
“There are problems trusting others, he (sic) having difficulty with control and there being immaturity.”
Typical (bad) Projective Drawing Interpretation
10
“Comments suggest an individual who has problems with self‐perception. There is a need for support and there are feelings of having treated (sic) in a harsh fashion. She is concerned about the home being incomplete and the damage that has been done to it. The drawings indicate dependence, feelings of inadequacy, difficulty communicating her emotions to others and need to watch people closely. She is distrustful and feels a need to watch people so as to try to please others. She has difficulty in her interactions with others. Comments suggest an individual who feels that she has had bad things happen to her.”
Typical (bad) Projective Drawing Interpretation
Conclusion Projective tests should be used in limited circumstances.
Methods of assessment seem to lack incremental validity and empirically‐based validity.
Many innocent people suffer from the false diagnosis and the custody ruling and criminal court decisions based on these tests.
Custody Specific Tests
Three major instruments have been developed explicitly for custody evaluations:
Bricklin Perceptual Scales (BPS)
Perception of Relationships Test (PORT)
Ackerman‐Schoendorf Scales for Parent Evaluation of Custody (ASPECT)
11
Series of short answer sentence completions:
If I had a chance to speak to the judge, I would say _____.
If the jury finds me guilty, I _____
Short form is 5 sentences, long form is 22 sentences:
Sentences are scored “0” for an incompetent response, “1” for a fairly competent response, and “2” for a competent response
Very low scores indicate malingering
High interrater reliability and internal consistency
High rates of false positives
Competency Screening Test
Guidelines for a 21 questions tapping into 3 dimensions.General legal knowledge
Job of the judge
Job of lawyers
Does not delve into mental illness issues
Focuses upon behavioral aspects of competency
Results highly correlated with the results of other independent measures of competency
Georgia Court Competency Test
MacArthur Structured Assessment of Competence ‐‐Criminal Defendants
Set of open‐ended questions containing 82 different scenarios
Long form (two hours to administer)
Short form (22‐item clinical version)
Validity and reliability are promising, but not well‐established.
MacSAC-CD
12
Competence Assessment for Standing Trial ‐‐Mental Retardation
Specialized instrument for defendants with mild to
moderate mental retardation ‐‐Psychometric data is suspect.
CAST-MR
Psychopathy Checklist Revised ‐‐ Youth Version (PCL‐YV)
Rapid Risk Assessment for Sexual Offense Recidivism (RRASOR)
Sex Offender Risk Appraisal Guide (SORAG)
HCR‐20 (Historical, Clinical, and Risk Management)
Minnesota Sex Offender Screening Tool (MnSOST)
Plethysmograph ‐‐ Client age and denial compromise validity
Forensic Instruments
Psychological TestsHistorical, Clinical, Risk Management ‐ 20 (HCR‐20)
Most frequently empirically investigated instrument
The only research guided, non‐actuarial instrument
20 risk considerations are assessed
– 10 historical
– 5 clinical in nature
– 5 represent risk management concerns
Each item is rated 0, 1 or 2 and the overall rating ranges from 0 to 40.
Reliability and validity are acceptable
13
Historical, Clinical, Risk Management ‐ 20 (HCR‐20)
H1 Previous Violence
H2 Young Age at First Violent Incident
H3 Relationship Instability
H4 Employment Problems
H5 Substance Use Problems
H6 Major Mental Illness
H7 Psychopathy
H8 Early Maladjustment
H9 Personality Disorder
H10 Prior Supervision Failure
Psychological Tests
C1 Lack of Insight
C2 Negative Attitudes
C3 Active Symptoms of Major Mental Illness
C4 Impulsivity
C5 Unresponsive to Treatment
RISK MANAGEMENT SCALE
R1 Plans Lack Feasibility
R2 Exposure to Destabilizers
R3 Lack of Personal Support
R4 Noncompliance with Remediation Attempts
R5 Stress
HISTORICAL SCALE CLINICAL SCALE
Violence Risk Appraisal Guide (VRAG) Designed to assess the violence risk in previously convicted violent offenders,
not specifically the sexual violence potential for sex offenders.
12 items:
– Elementary school maladjustment
– Diagnosed personality disorder
– Age at index offense
– Lived with parents until at least age 16
– Failure on prior conditional release
– Criminal history score for nonviolent offenses
– Marital status
– Diagnosis of schizophrenia
– Degree of victim injury in index offense
– History of alcohol abuse
– Victim gender in index offense
Psychological Tests
Sex Offender Risk Appraisal Guide (SORAG) A variation of the VRAG designed specifically for sex offenders
It was not designed to assess the risk for sexual violence per se
It was developed to assess the likelihood for general violence
SORAG results are correlated with sexual recidivism, but not to the same extent that it correlates with violent recidividism in general
Highly correlated with the VRAG
Three unique items involve
– Penile plethysmographic results
– Criminal history score for violent offenses
– Number of previous convictions for hands‐on sexual offenses
Psychological Tests
14
Rapid Risk Assessment for Sex Offense Recidivism (RRASOR)
Contains only four items covering:
– Prior sex offenses
– Offender age
– Having sexually victimized a male
– Having sexually victimized outside the offender’s family.
Psychological Tests
Scoring is related to the scoring on the Static‐99
Scores range from 0 to 6
High interrater reliability and predictive/postdictive validity
May not be comprehensive enough
Static‐99 Incorporated the RRASOR along with other items from the Structured
Actuarial Clinical Judgment ‐Minimum
Other items include:
– Number of sentencing occasions 5+ vs. <4
– Conviction for noncontact sexual offenses
– Convictions for nonsexual violent offenses at same time as index sexual offense
– Any stranger victim to sexual offense
– Ever lived with lover for 2 consecutive years
These items are scored “1” or “0”
Psychological Tests
Minnesota Sex Offender Screening Tool ‐‐ Revised (MnSOST‐R)
Consists of 16 items: Number of sex‐related convictions Length of sexual offending history Having been under supervision when committing a charged sexual offense
Having committed a charged sexual offense in a public place
Having used force within any charged sexual offense
Having done multiple acts on a single victim within any charged sexual offense
Number of victim age groups for charged sexual offenses
History of victimizing 13‐ to 15‐year‐old within any charged sexual offense
Stranger victim within charged sexual offense
Adolescent antisocial behavior Drug/alcohol abuse Employment history Discipline history during incarceration Substance abuse tx. history Sex offender treatment Age of offender
Psychological Tests
15
SIRS Scales Rare Symptoms
Symptom Combinations
Improbable and Absurd
Blatant Symptoms
Subtle Symptoms
Selectivity of Symptoms
Severity of Symptoms
Reported vs. Observed Symptoms
Direct Appraisal of Honesty
Defensive Symptoms
Overly Specified Symptoms
Symptom Onset and Resolution
Inconsistency of Symptoms
Structured Inventory of Malingered Symptomatology
Malingering75‐item, multiaxial, self‐administered screening instrumentDesigned to assess symptoms of both feigned psychopathology and cognitive function.
Psychosis (P) ‐‐ 15 items ‐‐ bizarre or unusual psychotic symptoms not usually seen in actual patients.
Neurologic Impairment (NI) ‐‐ 15 items ‐‐ illogical or atypical neurological symptoms
Amnestic Disorders (AM) ‐‐ 15 items ‐‐memory impairment that is inconsistent with known conditions
Low Intelligence (LI) ‐‐ 15 items ‐‐ fabricates/exaggerates intellectual deficits Affective Disorders (AF) ‐‐ 15 items ‐‐ atypical symptoms of depression and anxiety
Total (75 items) ‐‐ Summary score reflective of general malingering
Step 1For each block of four questions, the interviewer inquires whether each symptom/characteristic constitutes a major problem for the client. For example:
Do you have any major problems with1. . . . People reading your mind? X 0 1 22. . . . Getting motivated? X 0 1 23. . . . Having thoughts about suicide? X 0 1 24. . . . Expressing strong feelings? X 0 1 2
Step 2The client has endorsed items 2 and 4 as major problems. The interviewer returns to these questions after completing the block of four items. The two follow‐up inquiries would be as follows:
The problem you mentioned with getting motivated . . . Is it unbearable?The problem that you mentioned with expressing strong feelings . . . Is it unbearable or too painful to stand?
Administration of Detailed Inquires: An Example
16
Assessment of Malingering -- Rey’s 15-Item Visual Memory Test
Malingering
A B C1 2 3a b c l ll lll
John C. Simoneaux, Ph.D., is a licensed psychologist who practices in Central Louisiana. He attended Nicholls State University where he received his B.A. and M.A. degrees in Psychology, and Texas Tech where he earned his Ph.D. For the past 30 years he has been involved in the assessment and treatment of children, adolescents, and adults for the courts, the Office of Community Services, the Social Security Administration, and others. Dr. Simoneaux has consulted with various facilities including Central Louisiana State Hospital (Forensic Services), Huey P. Long Memorial Hospital, etc., providing diagnostic and program development direction. Over the past 20+ years, Dr. Simoneaux’s direct clinical work has focused on diagnostic assessments for various agencies, facilities, and the courts, He testifies frequently in various jurisdictions regarding these evaluations. He has been presenting seminars for mental health professionals for almost 20 years.