Psychopathy screening of incarcerated juveniles: a comparison of measures

How well do brief screening measures correspond with a full-scale assessment of psychopathy among juvenile offenders? This study compared 3 independent screening measures (the Antisocial Process Screening Device [APSD] Self-Report [A. A. Caputo, P. J. Frick, & S. L. Brodsky, 1999], the APSD Staff Rating [P. J. Frick & R. D. Hare, 2001], and the Psychopathy Content Scale [D. C. Murrie & D. G. Cornell, 2000] on the Millon Adolescent Clinical Inventory [T. Millon, 1993]) with the Psychopathy Checklist: Youth Version (PCL:YV; A. E. Forth, D. S. Kosson, & R. D. Hare, in press) in a sample of 117 incarcerated male juveniles. Modest correlations (.30-.49) were found between PCL:YV scores and those of the 3 screening measures, and there was moderate accuracy (67%-82%) in identifying youth who scored relatively high (> or = 25) on the PCL:YV. Although these results support the construct of adolescent psychopathy, they indicate substantial limitations in the use of psychopathy screening measures with juvenile offenders.     

The Millon adolescent clinical inventory and psychopathy

We investigated the ability of the Millon Adolescent Clinical Inventory (MACI; Millon, 1993) to assess psychopathy as measured by the Psychopathy Checklist--Revised (PCL-R; Hare, 1991). Participants were 90 adolescents in an inpatient psychiatric unit. The MACI Substance Abuse Proneness (r = .47), Unruly (r = .43), and Submissive (r = -.42) scales correlated most strongly with the PCL-R. Using a discriminant function analysis, the Substance Abuse Proneness scale correctly distinguished between high- and low-psychopathy groups in 79% of cases. Using a rational approach, we developed a psychopathy content scale using 20 MACI items. This content scale correlated with the PCL-R (r = .60) and distinguished high- and low-psychopathy groups in 83% (kappa = .66) of cases (sensitivity = 85%, specificity = 81%).     

Screening for malingering in a criminal-forensic sample with the personality assessment inventory

In this study, the authors examined how overreporting of psychopathology indices on the Personality Assessment Inventory (PAI; L. C. Morey, 1991) performed as screening measures for malingering in a sample of 166 defendants undergoing pretrial court-ordered evaluations in the federal criminal justice system. Using results from the Structured Interview of Reported Symptoms (SIRS; R. Rogers, R. M. Bagby, & S. E. Dickens, 1992) as the criterion measure of malingering, the authors found that the Negative Impression scale (NIM) was the most effective PAI screening measure (cut score > or = 81 T). NIM performed as well as an established comparison measure from the Minnesota Multiphasic Personality Inventory--2 (J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989; Infrequency [F] cut score > or = 95 T), supporting the use of either of these indices as reasonable screening measures to identify potential malingerers for subsequent evaluation.     

Psychopathy scores and violence among juvenile offenders: a multi-measure study

This study examined the relations between psychopathy scores and violent behavior in 113 incarcerated adolescents. We compared the results of four different instruments designed to assess psychopathy features among juveniles-the Psychopathy Checklist: Youth Version (PCL:YV), two versions of the Antisocial Processes Screening Device (APSD), and a Psychopathy Content scale on the Millon Adolescent Clinical Inventory (MACI). We found that PCLY:YV scores were significantly correlated with violent offense history, unadjudicated violence, and institutional violence, as well as measures of the severity and instrumentality of prior violence. Receiver operating characteristic analyses generated statistically significant effect sizes (AUC values) ranging from 0.64 to 0.79. The three other measures generated statistically significant correlations with one or more of the violence criteria, although correlations and effect sizes tended to be smaller in magnitude. Our results offer some support for the validity of these measures of psychopathic features, and the value of the PCL:YV in particular, with respect to short-term measures of violence outcome among juvenile offenders.     

Competency to stand trial evaluations: A state-wide review of court-ordered reports

Competence to stand trial (CST) evaluations are a critical part of certain criminal proceedings, and competence-related evaluation and treatment are an increasing part of public mental health services. Whereas more research describes the defendants undergoing competence evaluations, less research has examined the actual reports detailing those competence evaluations. This study reviewed 3,644 court-ordered CST evaluation reports submitted by 126 evaluators in Virginia since Virginia initiated an oversight system allowing for comprehensive review. The base rate of incompetence opinions was 38.8%, but these rates varied significantly across evaluation type (initial versus post-restoration efforts) and evaluators (ranging from 9.1% to 76.8% incompetence rate). Results suggest generally strong compliance with state statutes guiding CST evaluations, but also highlight marked variability in forensic conclusions and reveal a few areas in which some reports fell short of statutory requirements and practice guidelines.     

Field validity of the Psychopathy Checklist-Revised in sex offender risk assessment

Several studies have concluded that scores from Hare's (2003) Psychopathy Checklist-Revised (PCL-R) predict reoffense among sexual offenders, but most of those studies examined the predictive validity of scores from trained research staff, not clinicians in the field scoring the measure as part of actual forensic assessments. Therefore, we examined the field validity of PCL-R scores that forensic evaluators assigned to 333 male sexual offenders who underwent evaluations during a civil commitment selection process. Overall, no PCL-R score was a significant predictor of sexually violent recidivism. Facet 4 was the only PCL-R score with an area under the curve (AUC) greater than .50 (AUC = .53, p = .85) and the only PCL-R score that approached statistical significance for predicting the combined category of violent or sexually violent offending (AUC = .63, p = .08). However, scores from a subset of evaluators revealed stronger predictive effects, indicating that predictive validity was higher for scores from some evaluators than others. Overall, these results suggest that the stronger predictive validity values in controlled research studies may not apply to all evaluators when the PCL-R is administered in the field.     

Jurors' Views on the Value and Objectivity of Mental Health Experts Testifying in Sexually Violent Predator Trials

Although psychologists and psychiatrists often testify in court, we know relatively little about the extent to which jurors value the testimony they hear from these experts. We surveyed 161 jurors who rendered opinions in 14 sex offender civil commitment trials after hearing testimony from psychologists and psychiatrists serving as expert witnesses. Most jurors reported that the experts they heard testify were honest, and they tended to attribute disagreements among experts to case complexity, as opposed to adversarial allegiance or bias. Most reported that hearing from the experts helped them make better decisions and that experts using risk assessment instruments could make more accurate predictions than those who did not. Jurors were, however, more skeptical about the ability of experts to accurately predict recidivism when they heard testimony from both prosecution and defense experts. Findings suggest that jurors value risk assessment testimony from experts, but that experts must think carefully about how to best make risk assessment instrument results accessible to jurors. Copyright © 2014 John Wiley & Sons, Ltd.     

Opinion formation in evaluating sanity at the time of the offense: an examination of 5175 pre-trial evaluations

Sanity evaluations are high-stake undertakings that explicitly examine the defendant's culpability for a crime and implicitly explore clinical information that might inform a plea agreement. Despite the gravity of such evaluations, relatively little research has investigated the process by which evaluators form their psycholegal opinions. In the current study, we explore this process by examining 5175 sanity evaluations conducted by a cohort of forensic evaluators in Virginia over a ten-year period. Our analyses focus on (i) the clinical, criminal, and demographic attributes of the defendant correlated with opinions indicative of insanity; (ii) the clinical content of the evaluations and the legal criteria referenced as the basis for the psycholegal opinion; (iii) the process and outcome differences in the sanity evaluations conducted by psychologists versus psychiatrists; and (iv) the consistency in these opinions over a ten year period. Analyses predicting an opinion of insanity indicate a positive relationship with psychotic, organic, and affective diagnoses and previous psychiatric treatment. Analyses also indicate a negative relationship with prior criminal history, drug charges, personality disorder diagnosis, and intoxication at the time of the offense. Modest racial disparities were observed with evaluators offering opinions that the defendant was insane more often for white than for minority defendants despite comparable psychiatric and criminal characteristics.