The Detection of Malingering in Criminal Forensic Groups: MMPI Validity Scales

Despite the value of the MMPI to the forensic assessment of malingering (exaggeration) of psychopathology, few studies have assessed the accuracy of the MMPI validity scales in criminal forensic populations. We administered the MMPI to 35 insanity defendants undergoing evaluation for fitness to stand trial and/or sanity at the time of the crime, who stood to benefit from being assessed as psychologically disturbed, and 39 subjects previously found not guilty by reason of insanity (NGRI), who did not stand to gain from such an assessment. Insanity defendants showed significantly more malingering than NGRI subjects, p < .05. Racial differences did not affect the data. These findings support the efficacy of MMPI validity scales in assessing malingering within criminal forensic groups, and support the generalizability of the scales across race.     

A Psychometric Study of Stereotypes: Assessment of Malingering in a Criminal Forensic Group

This research investigates the validity of the stereotype of insanity defendants as malingerers by analyzing the proportions of insanity defendants who exaggerate psychopathology at the pre- and postacquittal stages of the legal process and by assessing the severity of psychopathology among preacquittal defendants. We administered the Minnesota Multiphasic Personality Inventory (MMPI) to 49 insanity defendants evaluated for fitness to stand trial and/or sanity at the time of the alleged crime and to 52 subjects previously found not guilty by reason of insanity. Results indicated: (a) Contrary to the stereotype, a minority (14% to 41%) of insanity defendants clearly malingered, whereas 22% to 39% showed evidence of minimizing psychopathology. (b) Eighty-one percent of these subjects had MMPI profiles suggestive of psychosis, but relatively few showed evidence of primarily antisocial behavior. Thus, the malingering stereotype may be application to only a minority of insanity defendants and is specifically inapplicable to a substantial proportion who minimized psychopathology or showed evidence of psychosis consistent with the claim of insanity.     

A psychometric study of stereotypes: assessment of malingering in a criminal forensic group

This research investigates the validity of the stereotype of insanity defendants as malingerers by analyzing the proportions of insanity defendants who exaggerate psychopathology at the pre- and postacquittal stages of the legal process and by assessing the severity of psychopathology among preacquittal defendants. We administered the Minnesota Multiphasic Personality Inventory (MMPI) to 49 insanity defendants evaluated for fitness to stand trial and/or sanity at the time of the alleged crime and to 52 subjects previously found not guilty by reason of insanity. Results indicated: (a) Contrary to the stereotype, a minority (14% to 41%) of insanity defendants clearly malingered, whereas 22% to 39% showed evidence of minimizing psychopathology. (b) Eighty-one percent of these subjects had MMPI profiles suggestive of psychosis, but relatively few showed evidence of primarily antisocial behavior. Thus, the malingering stereotype may be application to only a minority of insanity defendants and is specifically inapplicable to a substantial proportion who minimized psychopathology or showed evidence of psychosis consistent with the claim of insanity.     

Characteristics and outcomes of insanity acquittees in Oklahoma

The insanity defense is perhaps the most vigorously debated topic at the interface of the legal and mental health systems. This article addresses the need for empirical evidence by providing data on insanity acquittees and their later outcomes in Oklahoma, a jurisdiction not previously studied. Information was obtained on the demographic, legal, psychiatric, hospitalization, and post-hospitalization characteristics of all 61 defendants acquitted not guilty by reason of insanity (NGRI) and treated on the state forensic unit during a 5-year period. Insanity acquittees had few resources, significant psychopathology, and extensive involvement with the legal and mental health systems prior to the NGRI offense. Follow-up of three groups of discharged patients--those released at an initial court review, those who completed the NGRI treatment program, and those who absconded from the forensic unit--revealed that those who escaped from the unit had significantly more arrests and subsequent legal charges than regularly discharged patients.     

Homicide and the insanity defense: A comparison of sane and insane murderers

A sample of 50 homicide defendants acquitted by reason of insanity (NGRI) was compared with a group of 50 defendants who were evaluated for insanity and found to be criminally responsible (CR). Significant differences were found between the two groups in terms of prior psychiatric and criminal histories and nature of the homicide (i.e., relationship to victim). The dispositions of those found NGRI were also examined on the above variables.     

The effects of neuroimaging and brain injury on insanity defenses

Although neurological evidence is used with increasing frequency in criminal trials, there is limited research examining the effects that this evidence has on juror decision-making in insanity trials. Participants (396) were presented with a case summary and psychological testimony and asked to render either a verdict of guilty or not guilty by reason of insanity in a 2 (psychosis or psychopathy) x (presence or absence of an MRI indicating a brain lesion) x (presence or absence of testimony describing a car accident that caused injury to the brain) factorial design. Defendants diagnosed with a psychotic disorder, defendants who could demonstrate the existence of a brain lesion via MRI, and defendants who had a history of brain injury were more likely to be found not guilty by reason of insanity than those defendants who did not present any neurological testimony. Participants who reported they were more influenced by the psychological and neurological testimony were almost six times more likely to render a verdict of NGRI than those participants who reported that the psychological and neurological testimony and evidence did not influence their decision regarding verdict.     

Detection of malingering of psychiatric disorder with the personality assessment inventory: an investigation of criminal defendants

To assess the diagnostic accuracy of the Personality Assessment Inventory (PAI; Morey, 1991) Validity scales for the detection of malingered psychiatric disorders, we divided a sample of criminal defendants referred for forensic evaluation by the federal courts into malingering and not malingering groups based on their performance on the Structured Interview of Reported Symptoms (Rogers, Gillis, & Bagby, 1990). Logistic regression analyses (LGAs) revealed that there were no differences between the malingering and not malingering groups with respect to age, race, years of education, history of drug abuse, or number of previous felony convictions. LGA with malingering versus not malingering as the criterion revealed that the PAI Negative Impression Management (NIM) scale but not the Rogers Discriminant Function (RDF; Rogers, Sewell, Morey & Ustad, 1996) nor the Malingering index (MAL; Morey, 1996) significantly differentiated the malingering from the not malingering group. Receiver operating characteristics analyses demonstrated acceptable sensitivity and specificity for the NIM scale but not the RDF scale or the MAL index. We discuss the results in terms of the suggested cutoff scores for the PAI Validity scales in detecting criminal defendants who are attempting to feign psychiatric disorder.     

The Impact of the Guilty but Mentally III Verdict on Juror Decisions: An Empirical Analysis

The present study attempted to determine the impact of alternative verdict choices on the decisions of mock jurors. Subjects used in this study as mock jurors were all college undergraduates. They were shown one of two versions of a videotaped simulated murder trial. Both films presented a defendant who appeared to be suffering emotional difficulties, but in one film the defendant had clearly committed the act while in the other film the defendant's actions were less certain. Subjects than gave their individual verdicts and, after deliberation with other subjects, a total jury verdict. The verdicts available to the subjects varied across three conditions such that the subjects in one condition were only allowed to find the defendant to be innocent or guilty. In another condition the subjects could find the defendant innocent, guilty or not guilty by reason of insanity (NGRI). In the third condition the subjects were allowed to choose between innocent, guilty, NGRI, and guilty but mentally ill (GBMI). The results indicated that the addition of the "mental health" verdicts had a significant impact on the decisions of the jurors. In particular, it appears that only defendants who would otherwise have been found innocent were likely to be found NGRI. This study also indicated that the GBMI verdict is very attractive to mock jurors. Indeed, even innocent defendants were found to be GBMI, a form of guilt, when this alternative was made available. These findings raise potentially important constitutional and practical issues for the trial of emotionally disturbed criminal defendants.     

Itemmetric and scale analysis of a new computer-assisted competency assessment instrument (CADCOMP)

Male defendants (n = 99) who had been court ordered to a forensic treatment facility as incompetent to stand trial were tested using the Computer-Assisted Determination of Competency to Proceed (CADCOMP) instrument soon after admission (median days = 15). Shortly thereafter, competency was assessed by a forensic psychiatrist and by a majority decision of three mental health professionals who viewed a videotape of the forensic psychiatrist's interview. From the CADCOMP item pool, 18 scales were constructed on conceptual grounds. Internal consistency analyses revealed that most scales had reasonable item homogeneity and scale reliability. In addition, item and scale analyses, with few exceptions, followed predicted patterns of intercorrelation and association with competency as determined by both criteria. Scales and items measuring serious psychopathology, psycholegal ability, and criminal history demonstrated the strongest associations with competency. These findings suggest that additional research on CADCOMP is warranted. The instrument shows promise for use in forensic research and assessment.     

The question of sanity restoration in jail

Severe mental illness, especially psychotic disorders that are worsening, acute or complicated, normally require intensive psychiatric care and treatment that is most appropriately provided in a mental hospital. For criminal defendants, transfer to a forensic security hospital has traditionally been the means of achieving hospital care for mentally disordered defendants who have been found incompetent to stand trial or not guilty by reason of insanity. In recent years, with the shortage of intermediate and long-term hospital beds in the United States, including forensic security hospital beds, jail-based competency restoration programs are being established, seemingly obviating hospital transfer. Potential advantages of and concerns about jail-based, as opposed to hospital-based, competency restoration programs are discussed in the literature. If defendants with severe mental illness traditionally treated in a forensic security hospital for competency restoration are now treated for competency restoration in jail, it is not inconceivable that insanity acquittees could one day be treated in jail for sanity restoration. With the premise that it is better to consider the potential consequences before this becomes a serious proposal and is implemented, this analysis examine the advantages and concerns that have been put forth for jail-based competence restoration programs as they may or may not apply to jail-based sanity restoration programs. Substantial commonality is recognized, but also some differences, as well as reason for skepticism of the purported virtues of either alternative to care and treatment in forensic security hospitals.     

Mock Juror Attribution of Criminal Responsibility: Effects of Race and the Guilty But Mentally III (GBMI) Verdict Option1

The present study examined three questions relevant to the insanity defense: Does the availability of the alternative verdict “Guilty But Mentally III” affect juror assessment of criminal responsibility? Does race of defendant significantly affect juror decision-making about who should be acquitted under the insanity defense? And does race of victim significantly influence how jurors decide their final insanity defense verdicts? Race of defendant (black or white), race of victim (black or white), and verdict choice set [(Not Guilty by Reason of Insanity (NGRI), Guilty, and Not Guilty) vs. (Guilty but Mentally III (GBMI), NGRI, Guilty, and Not Guilty)] were systematically varied. The mock-trial was presented to 197 college student subjects by means of an audiotape and slide show. Following the re-enacted trial, subjects answered a series of questions regarding the case. The main dependent variable was the rendered verdict. Both χ²loglinear analyses revealed a significant relationship between race of defendant and verdict such that the defendant, when presented as black, was acquitted NGRI significantly more often than when the defendant was presented as white. No significant effects were found for race of victim. The availability of the GBMI verdict option resulted in a twofold effect: There was a two-thirds reduction in both NGRI and straight guilty verdicts when the GBMI verdict option was made available. The implications for legal policy and future research are discussed.     

The utility of the MMPI-2 malingering discriminant function index in the detection of malingering: a study of criminal defendants

This study examined the utility of the Minnesota Multiphasic Personality Inventory-2's (MMPI-2) malingering discriminant function index (M-DFI), recently developed by Bacchiochi and Bagby, in the detection of malingering in a forensic sample. Criminal defendants were divided into "malingering" and "not malingering" groups using the structured interview of reported symptoms (SIRS) criteria proposed by Rogers. Logistic regression analysis (LRA) revealed that the MMPI-2 infrequency (F) scale had the best predictive utility of the traditional infrequency scales. Although the M-DFI did significantly differentiate the malingering from the not malingering groups, it did not add significantly to the predictive utility of the MMPI-2 F scale. Receiver operating characteristics analyses demonstrated acceptable sensitivity and specificity for the MMPI-2 F scale, but poor sensitivity for the M-DFI scale. The results are discussed in terms of the utility of the M-DFI in detecting malingering and problems of extending the findings of simulation studies to the forensic context.     

Validity of the M Test: simulation-design and natural-group approaches

The utility of the M Test (Beaber, Marston, Michelli, & Mills, (1985) as a screening measure for malingering was assessed using simulation-design (subjects asked to fake mental illness) and natural-group (forensic assessment cases suspected of malingering) approaches. A total of 318 subjects from community, clinical, and correctional settings completed the M Test under instructions to respond honestly or to simulate a major mental disorder. A factor analysis of the M Test items supported the original rationally based scale assignment, and the scales were found to have adequate internal reliability. To examine the predictive validity of the M Test, results revealed that sensitivity using the cutting scores suggested by Beaber et al. (1985) was much higher for simulating subjects (79.8%) than for the suspected malingerers (40.0%). The findings emphasize the danger of exclusive reliance on simulation studies for validating measures of malingering. It was concluded that, in its present form, the M Test does not constitute a good screening measure for assessing malingering.     

Are release recommendations for NGRI acquittees informed by relevant data?

We conducted a retrospective review of factors involved in clinical recommendations for release of patients adjudicated not guilty by reason of insanity (NGRI). Medical records from 91 patients in a maximum security forensic hospital who participated in a formal hearing process to determine suitability for release were reviewed. The purpose of the study was twofold: (1) to examine the process involved in day to day clinical decision-making regarding release from a maximum security forensic hospital and (2) to determine what factors in a patient's clinical and legal history were related to recommendation decisions. Multivariate statistical methods revealed that among the clinical, demographic, and legal information available to clinicians at the time a formal release recommendation was made two factors emerged that were significantly related to release recommendations: PCL-R score and the age at which the patient committed his first criminal offense. Patients with high levels of psychopathy and those who engaged in criminal behavior at a younger age were less likely to be recommended for release from a maximum security forensic hospital.     

The competency of criminal defendants to refuse,for delusional reasons,a viable insanity defense recommended by counsel

This article addresses the issues of whether mentally ill defendants charged with serious crimes who refuse to plead a viable and counsel-recommended insanity defense for delusional reasons (but who are otherwise competent to stand trial) should be considered to be competent, or incompetent, to stand trial; whether such defendants should be allowed to represent themselves with a delusional defense; and whether an insanity defense may properly be imposed upon such defendants. Based on an analysis of relevant Supreme Court decisions and other relevant cases, it is concluded that such defendants should not be allowed to go forward with a delusional defense (at least until reasonable efforts to treat the defendants' delusions are made). It is also argued, however, that unless an insanity defense would be viable (as well as recommended by counsel) delusional defendants who are otherwise competent to stand trial should be permitted to go forward, and represent themselves, with the defense of their choosing.     

The impact of expertise and sufficient information on psychologists' ability to detect malingering

Twenty-two forensic diplomates and 22 general clinical psychologists were asked to review a variety of psychological data from one of four cases (two cases of malingering and two cases of legal insanity) to determine whether data suggested malingering or insanity. Of the 44 psychologists who reviewed cases, 86.4% accurately determined whether their protocol was from a malingerer or an insane person. Forensic diplomates and clinical psychologists were equally accurate in their determinations; only three subjects from each group misidentified their case. In spite of their success, confidence levels for both groups were reported as moderate. These results contradict previous studies that have found psychologists to not only be poor detectors of malingering, but also overconfident in their ability to detect it. It is believed that the success of psychologists in this study compared to previous studies was due to improved methodology.     

Fixing forensic patients: Psychiatric recommendations for treatment in pretrial settings

This article is concerned with psychiatric recommendations for treatment at the Metropolitan Toronto Forensic Service (METFORS), a clinical assessment agency providing both 1-day and 30-day evaluations of criminal defendants in Toronto, Canada. Analysis of both psychiatric reports and quantitative research instruments demonstrated the saliency of treatment as a central forensic issue at METFORS. Among a sample of 592 defendants, 134 were considered in need of outpatient care. Persons recommended for hospitalization were most likely to exhibit histories of mental health rather than criminal justice contacts; to be arrested for nonviolent offenses; to manifest psychotic behavior while at METFORS; to be found unfit for bail, incompetent to stand trial, in need of further assessment and dangerous to self; and to experience higher rates of hospitalization, but lower levels of criminalization during the two years following their initial forensic assessment. Psychiatric reports at METFORS tended to merge recommendations for treatment and assessment; to suggest prison or probation as means for securing clinical treatment; and to provide little written support for judgments about the need for intervention. Along with competency and dangerousness, treatment is a key issue in forensic practice, and warrants further attention in the psycholegal literature.     

Diagnostic Accuracy of the MMPI–2 Malingering Discriminant Function Index in the Detection of Malingering Among Inmates

The MMPI–2 Malingering Discriminant Function Index (M-DFI) was designed to detect malingerers educated about MMPI–2 validity indicators. However, given current attorney practices, the clinical utility of the M-DFI lies in its ability to detect examinees who are cautioned about the indicators. In this study, we compared 45 inmate simulators cautioned to avoid detection on the MMPI–2 with 46 psychiatric inmates who completed the MMPI–2 under standard instructions. Logistic regression analyses indicated that although the M-DFI performed better than several individual indicators, results were mixed for combinations of indicators, and the M-DFI did not outperform different sets of existing indicators. These findings support existing strategies to detect malingering on the MMPI–2. We discuss considerations concerning the clinical applicability of M-DFI.     

Neuroimage evidence and the insanity defense

The introduction of neuroscientific evidence in criminal trials has given rise to fears that neuroimagery presented by an expert witness might inordinately influence jurors' evaluations of the defendant. In this experiment, a diverse sample of 1,170 community members from throughout the U.S. evaluated a written mock trial in which psychological, neuropsychological, neuroscientific, and neuroimage-based expert evidence was presented in support of a not guilty by reason of insanity (NGRI) defense. No evidence of an independent influence of neuroimagery was found. Overall, neuroscience-based evidence was found to be more persuasive than psychological and anecdotal family history evidence. These effects were consistent across different insanity standards. Despite the non-influence of neuroimagery, however, jurors who were not provided with a neuroimage indicated that they believed neuroimagery would have been the most helpful kind of evidence in their evaluations of the defendant.