Postcards from the Id

The Minnesota Multiphasic Inventory - Second Edition - Restructured Format

I’ve finally had a chance to use the MMPI-2-RF on enough occasions to render a tentative verdict: it is as effective as the MMPI-2, and in some ways (primarily length), it’s better.  This may be serious “shoptalk” to those of you unfamiliar with psychological testing, but for those of us who use tests regularly, this “restructuring” is important, as the MMPI-2 may be the single most important psychological test (along with the WAIS) used today.  When there is a change to something as big as the MMPI-2, you’d better pay attention if you are in the business of evaluations.

Briefly, then, I’ll point out the main benefit to the restructured format - time.  Shortened by more than two hundred questions, the test doesn’t take nearly as long to administer.  This allows for the examinee to complete the test without the fatigue and boredom that often accompanies the completion of the longer test.  This translates into a test that received improved attention to the responses (at least in some cases), otherwise known as a more valid response (the test measured what it purported to measure).  Now, working in forensics, I don’t hold any illusions; I know most of my administrations will come back invalid, in my case due to an over-reporting of symptoms.  Even so, the shortened administration time is valuable, in that I can then work with the individual on other tasks with the freed up time. 

Another feature I like with this format is a increased focus on the somatic presentation of the examinee, including the validity of somatic complaints.  This is particularly helpful in a correctional setting, where many inmates pine for limited resources - accurate assessment of somatic concerns can help save money, as well as allow for resources to be directed to those most in need.  Other minor improvements, such as certain re-categorizations, are also beneficial.

Conversely, I've read some of the criticisms of the new structure (primarily the switch from the old clinical scales to the new RC scales - more shop talk), and while the concerns are reasonable (1) the new test focuses more on overt and/or different pathology than clinical/personality presentation, 2) though the new scales are "more pure" - no item overlap - this doesn't jive with clients, who often have multiple, overlapping problems, and 3) debates about the complexity of the new scales versus the old in assessing the subtleties such as defense mechanisms, etc.), I don't think they warrant too much worry, as least in my case (selfish me!).  For the time being, clinician's can use either test, and as long as both tests continue to receive ongoing examination and research, they should both be effective tools for assessment.

Now, the research will have to come out and  continue support the initial reports of the viability of the new instrument, above and beyond the initial efforts (which appear significant).  As the items are based on the items from the MMPI-2, this shouldn’t be much of a problem, but one needs to establish the validity and reliability anyway.  I recently read this article, published in Psychological Assessments (full text available by purchase only), which indicated the validity of the new L and K scales on the MMPI-2-RF are effective in sorting out under-reporting of symptoms (which is a necessary function in numerous contexts, including custody evaluations, assessment for need for treatment, etc.)  Obviously there is much more to the article than this, but that isn't the primary point of this post.  As the research on the various scales continues to come out, I’ll try to post links, if not summaries.

Review of Article on Sexual Offending - “On Sexual Violence”

I recently began a new thread on the topic of the sanity defense, and I noted in the thread that I wanted to address more issues related to forensic and correctional psychology, in addition to the clinical psychology topics I’ve been covering. I mentioned having several forensic psychology threads going at once would be a way to increase the total amount of forensic psychology posts. Another way to do this in a manner that will be productive for both me and this blog is to review research articles that address forensic psychology and related topics.

With this in mind, the article I will review for this post is entitled “On Sexual Violence.” It was written by John M.W. Bradford, and was published in the journal “Current Opinion in Psychiatry” in 2006. The article is actually a review of much of the relevant research on sexual violence that was published in 2005. The author broadly categorized the research he summarizes into four categories: 1) sexual homicides and sexual sadism; 2) Internet sexual offending; 3) typology and characteristics of various types of sexual offending; and 4) statistical surveys and meta-analyses of sex offenders. Overall, the article attempts to provide an overview of the most relevant findings from the research in each of these four subgroups, no small feat. Each section of the article does offer data points regarding the research reviewed, albeit in very small doses. However, it is enough information to narrow one’s efforts in deciding whether to follow-up on a particular article. In fact, the article is useful in two ways; it allows the reader to get a general sense of the broad trends and finding in the area of sex offender research (at least in 2005), and it provides a nice reference point to obtain articles of interest based on the summary of their findings. From this article, I plan on reviewing at least ten articles reviewed, in order to obtain more detailed information.

Now I’ll address some specifics. Again, these are not findings from research conducted by this author - he has simply provided a summary of relevant findings in 2005. If subsequent article reviews that stem from reading this article prove interesting, I’ll provide a more thorough review. For now, here are a couple of the most interesting/relevant findings noted by Bradford:

* He cited research noting an association between sexual sadism and brain damage, usually located in the anterior temporal lobe of the brain. One study found an association between the presence of brain abnormalities and more deviant sexual murders. A sample of sexually motivated murders was divided into those with versus without brain abnormalities. The group with the brain abnormalities had a history of more behavioral problems, more paraphilias, younger victims, and other difficulties.

* One study noted that many Internet pornography offenders (out of a sample of 201) had engaged in other forms of “sexual deviance,” and had been charged with previous sexual offenses. In addition, the offenders most likely to re-offend were those that had committed a prior or current sex offense.

* Research was reviewed examining subgroups of incest perpetrators. Specifically, differences were noted based on the victim’s age. Incest perpetrators with victims under the age of six were more likely to experience comorbid psychopathology and substance abuse problems, compared with incest perpetrators whose victims were older. Both groups demonstrated deviant sexual arousal towards children, as well as problems with normal sexual functioning.

* One study noted the practice of obscene phone calls has elements associated with stalking.

* Several studies examined treatment of sex offenders, including the role of cognitive distortions and fantasies in offending and treatment. One study examined the type of sexual fantasies reported by adolescent sex offenders engaged in treatment. The pattern that emerged was of normal sexual fantasies being reported at the beginning of treatment, with more deviant fantasies being acknowledged in the middle of treatment. As treatment approached the end, a decline in reported deviant sexual fantasies was observed.

* Differences in IQ were noted between two groups of inmates, those incarcerated for sexual offenses versus non-sexual offenses.

As noted earlier, I plan on reviewing at least a couple of these articles in more detail. In terms of forensic psychology, the articles of mst use will have to prove with risk assessment, treatment possibilities, etc. In particular, I am interested in examining research on treatment outcome. I tend to be skeptical of any treatment measures that rely on the self-report of internal experiences, particularly when the sources are individuals who 1) have relatively little insight to begin with, and 2) are extremely motivated (both intrinsically and extrinsically) to lie about what is going on in their head. Until someone develops an error-free way of assessing the truthfulness of one’s self-reports, we really need to be cautious of just how much we accept the validity of offenders’ disclosures.