Examination of the screening properties of the personality diagnostic questionnaire 4+ (PDQ-4+) in a prison population

There is a high prevalence of personality disorder in most prison populations. Many pass through the system undiagnosed. A screening instrument would improve identification. This study examined the screening properties of the Personality Diagnostic Questionnaire-4+ (PDQ-4+) in prisoners convicted of violent and sexual offenses. A sample of British prisoners completed the self-report PDQ-4+ and were interviewed using the Structured Clinical Interview for DSM-IV Axis II disorders. When used to generate a total score, the PDQ-4+ had an acceptable overall accuracy as measured by the area under the Receiver Operating Characteristics (ROC) curve. The PDQ-4+ appears to have the properties suitable for use as a screening instrument, particularly when screening for the presence or absence of personality disorder rather than for individual personality disorder categories. A graph is presented from which choices of cut-off score for different combinations of sensitivity and specificity can be made. A cut off total score of 25 or above yielded near optimal sensitivity and specificity. The suggested cut off score for this population is lower than that previously suggested.     

Reflections during a study on family therapy with drug addicts

This article presents ideas and reflections emerging during a project on family therapy with drug abusers. Initially inspired by the writings of Stanton and Todd on the subject, the project developed into a recursive and self-reflective process, characterized by increasing doubts about the usefulness of categorization of families, of pre-planning therapy, and of the therapist as an "expert." The limitations of approaches that emphasize the importance of understanding the family structure as the basis for changing it are discussed, particularly with respect to how they decrease therapist flexibility and may block the family's finding their own solution. Alternative approaches to practice and research are also discussed, bearing on ideas particularly formulated by theoreticians and practitioners inspired by second-order cybernetics.     

Rorschach administration: a comparison of the effect of two instructions given to an inpatient sample of drug addicts

The effect of administering the Rorschach Inkblot Method under two instructional sets was compared on three classes of outcome variables: the frequency with which subjects asked questions about the test; the frequency of brief protocols (fewer than 14 responses); and 17 traditional Rorschach structural summary scores. Sixty subjects, obtained from three inpatient psychiatric clinics treating drug addicts, randomly received either the short pre‐testing instruction “What might this be?” originally developed by Herman Rorschach and recommended in the Comprehensive System, or a longer and more elaborated instruction, which for many years has been the standard instruction in Norway. Compared with the Norwegian instruction, the short instruction produced significantly more questions to the examiner about the test. For the other outcome measures no differences were observed.     

Behavioural characteristics of offenders with mental health disorders in a South African prison population

This exploratory study profiled behavioural characteristics of a non-random sample of 91 offenders with mental illness in a South African correctional facility. The sample is directly related to diagnosed cases from the correctional psychiatrist's case load. The most prevalent mental disorders diagnosed amongst the research participants of this sample specific profile were schizophrenia (33%), major depressive (27.5%), bipolar mood (12.1%) and psychotic disorders (11%).     

Detection of malingering in psychiatric unit and general population prison inmates: a comparison of the PAI, SIMS, and SIRS

In this study, we compared the utility of three instruments, the Personality Assessment Inventory (PAI; Morey, 1991), the Structured Inventory of Malingered Symptomatology (Smith & Burger, 1997), and the Structured Interview of Reported Symptoms (SIRS; Rogers, Bagby, & Dickens, 1992) to detect malingering among prisoners. We examined 4 inmate samples: (a) prisoners instructed to malinger, (b) "suspected malingerers" identified by psychiatric staff, (c) general population control inmates, and (d) psychiatric patients. Intercorrelations among the measures for the total sample (N = 115) were quite high, and receiver operating characteristic analyses suggested similar rates of overall predictive accuracy across the measures. Despite this, commonly recommended cut scores for these measures resulted in widely differing rates of sensitivity and specificity across the subsamples. Moreover, although all instruments performed well in the nonpsychiatric samples (i.e., simulators and controls), classification accuracy was noticeably poorer when attempting to differentiate between psychiatric patients and suspected malingerers, with only 2 PAI indicators significantly discriminating between them.     

Screening for personality disorders in a nonclinical population

Based on the Inventory of Interpersonal Problems (IIP), the IIP-PD and the IIP-C screening scales were developed to distinguish personality disorder (PD) from non-PD and Cluster C from other PD, respectively, in a clinic population. Two studies were conducted to determine (a) validity and reliability of these IIP scales for PD screening in a nonclinical population, (b) specificity of IIP-C for identifying Cluster C, and (c) usefulness of the IIP scales for screening Cluster A. College students were screened using the IIP scales (Study 1, N = 454, Study 2, N = 87). High and low scorers completed PD-related questionnaires in Study 1 and a clinical interview for PD symptomatology in Study 2. Results indicated strong test-retest reliability, internal consistency, and factorial, convergent, and external validity. The scales tapped a common deficit in interpersonal relatedness, with some distinction between externalizing and internalizing dimensions, respectively, and both scales were positively and significantly associated with schizotypal traits. In conclusion, the IIP-PD and IIP-C are useful and valid screening instruments for identifying any versus no PD in nonclinical populations.     

Dimensional personality profiles of borderline personality disorder in comparison with other personality disorders and healthy controls

The present study examined the sensitivity and clinical specificity of dimensional personality profiles associated with borderline personality disorder (BPD) by comparing three groups of patients: (a) patients with BPD according to DSM-IV criteria (n = 31); (b) patients with other DSM-IV PD (n = 31); and (c) general population controls (n = 31). All three samples were matched for age and gender and the two patient samples were matched for chronicity and depressive symptoms. All patients were given the Six-Factor Test measuring the five-factor model of personality (FFM), the Temperament and Character Inventory (TCI), and the Dimensional Assessment of Personality Pathology (DAPP). Nonparametric statistics were applied to analyze the data (Mann-Whitney-U-tests for group comparisons; Spearman's coefficients for correlational analyses). Neuroticism (FFM), Self-Directedness (TCI), and Emotional Dysregulation (DAPP) were identified as general markers of personality pathology, which were significantly interrelated in all three samples. BPD patients also showed a specific profile compared with other PD patients with lower scores on Agreeableness (FFM), higher scores on Novelty Seeking and Self-Transcendence (TCI), and higher scores on the DAPP higher-order dimensions of Emotional Dysregulation, Dissocial Behavior, and Inhibitedness. Results support the assumption that BPD can be characterized by dimensional approaches with sufficient sensitivity in comparison with healthy controls and specificity in comparison with other PD patients.     

Prospects behind bars: Analyzing decisions under risk in a prison population

Criminal activity often involves considerable risks. It is therefore not surprising that criminals have been speculated to differ from noncriminals in risk attitude. Yet, few data exist to support this assumption. Moreover, the psychological underpinnings of differences in risk attitude are currently little understood. We presented prisoners and controls with sets of risky decision tasks and modeled their responses using cumulative prospect theory (CPT). The two groups showed several differences. Prisoners were more risk seeking than nonprisoners in lotteries involving losses, but they were less risk seeking in lotteries involving high-probability gains. Bestfitting CPT parameters indicated a reduced sensitivity to outcomes, for both gains and losses, and a stronger loss aversion among prisoners. In addition, prisoners showed a diminished sensitivity to the probability of gains. Our results contribute to a better understanding of prisoners’ risk attitudes and the underlying mechanisms that distinguish prisoners from nonprisoners and may thus help improve interventions designed to prevent crime.