This study analyzed data from 1710 criminal defendants referred by federal courts throughout the United States. We examined 12 categories of criminal charges with respect to diagnosed psychopathology and opinions related to competence to stand trial (CST) and criminal responsibility (CR) at the time of the alleged offense. Overall, 18% of the present sample were found to be incompetent to stand trial, while 12% were found to be not criminally responsible or 'insane.' In this study, crimes were associated with rates of psychopathology and rates of opinions regarding CST and CR. The findings of this study suggest that individuals who are charged with different crimes have different mental states and psychopathology and are therefore found to have differential rates of competence and sanity.
Mixed group validation (MGV) is offered as an alternative to criterion group validation (CGV) to estimate the true positive and false positive rates of tests and other diagnostic signs. CGV requires perfect confidence about each research participant's status with respect to the presence or absence of pathology. MGV determines diagnostic efficiencies based on group data; knowing an individual's status with respect to pathology is not required. MGV can use relatively weak indicators to validate better diagnostic signs, whereas CGV requires perfect diagnostic signs to avoid error in computing true positive and false positive rates. The process of MGV is explained, and a computer simulation demonstrates the soundness of the procedure. MGV of the Rey 15-Item Memory Test (Rey, 1958) for 723 pre-trial criminal defendants resulted in higher estimates of true positive rates and lower estimates of false positive rates as compared with prior research conducted with CGV. The author demonstrates how MGV addresses all the criticisms Rogers (1997b) outlined for differential prevalence designs in malingering detection research.
Common rates employed in classificatory testing are the true positive rate (TPR), false positive rate (FPR), positive predictive power (PPP), and negative predictive power (NPP). FPR and TPR are estimated from research samples representing populations to be distinguished by classificatory testing. PPP and NPP are used by clinicians to classify test takers into populations. PPP and NPP depend on the base rate (BR) of population members in the clinician's sample. The authors introduce the test validation summary (TVS) as a means to report within a single graph the FPR and TPR and the ranges of PPP and NPP across all potential sample BRs for any chosen cut score. The authors investigate how the TVS has other applications, including the estimation of local BR for the condition of interest and the estimation of standard errors for FPR and TPR when estimated across multiple independent validation studies of the classificatory test.
This article describes how a 2-alternative, forced-choice response technique was applied to a nonverbal test of cognition in order to generate measures of noncompliance and serve as a means to detect malingering. Three studies were conducted. Study 1 used a 2-alternative, forced-choice test format comprising 100 nonverbal test items of a hierarchy of difficulty presented in a random order. In a simulation study, a combination of decision rules regarding (a) performance curves slope; (b) a measure of response consistency ("consistency ratio"); and (c) the product of the slope and consistency ratio resulted in high discriminability among the test results of normal and cognitively impaired controls and simulating malingerers. A replication, Study 2, yielded similar findings. Study 3 demonstrated the robustness of these decision rules. Most subjects (73%) who simulated malingering after receiving accurate information on how to avoid detection were still classified as malingerers.Psychologists currently have no established objective methods of detecting malingering on the most commonly used instruments of cognitive, intellectual, or neuropsychological ability. The expanded use of such tests in both criminal and civil forensic evaluations increases the likelihood of impaired performances for secondary gain and necessitates the development of indicators of response validity (Bash & Alpert, 1980;Hiscock & Hiscock, 1989). This article describes how a test of cognitive ability was altered so that it could yield quantitative measures of noncompliance.Studies of clinical detection of malingering on cognitive tests are not encouraging. Patients are able to produce realistic findings of impairment on neuropsychological tests (Mensch & Woods, 1986), whereas clinicians are generally unable to detect malingered performance at better than chance levels (Faust,
This study uses a new method to summarize diagnostic validity information to explore which constructs are captured by malingering tests. The Test Validation Summary applies mixed-groups validation to investigate the meaning of test constructs and to estimate test classification characteristics when test validation groups are not "pure" criterion groups (ie, "compliant" vs "malingering"), but members have variable probability of malingering. The method permits the use of tests with relatively low validity to validate tests of greater validity. In our initial analysis, we argue that the Rey 15-Item Memory Test is best construed as an "intention test" (capturing the intention of testtakers when taking a test) as opposed to an "effort test." Using the Test Validation Summary and mixed-groups validation, we demonstrate that as an indicator of "intention to feign cognitive impairment," the Rey 15-Item Memory Test has estimated false-positive rate (FPR) = 0.02 and true-positive rate (TPR) = 0.57. We then explore the meaning of failure on the Word Memory Test (WMT), which uses a dichotomous classification of performance as valid or invalid. Although the WMT is commonly referred to as an "effort test," we argue that it likely captures both "intention" and "effort" but collapses this information into a single dichotomous classification of symptom validity. We demonstrate that, as a result of this dichotomous classification process, the WMT likely has a problematic FPR. In our analysis of previously published WMT data, the WMT FPR is estimated at 0.12 when there is no predisposition to perform poorly but rises dramatically and unrealistically as the predisposition to perform poorly increases. We compare these findings to those of the Validity Indicator Profile (VIP), which captures both intent and effort to classify 4 different sorts of response styles in cognitive testing. In our analyses, the VIP demonstrates that FPR = 0 and TPR = 0.86 when the construct being measured is "intent to perform poorly," and reveals that FPR = 0.06 and TPR = 0.63 when the construct being measured is "inconsistent responding" or "poor effort." We were able to demonstrate for the VIP the same "oversensitivity" shown by the WMT when the VIP was interpreted only as a dichotomous classification test. These results indicate that researchers who attempt to generate classification characteristics for malingering tests must carefully consider what constructs are being captured by the test.
Two-alternative, forced-choice tests are commonly used to assess cooperation in examinations of neurocognitive functioning. Most commercially available tests do not primarily depend on comparing the total correct responses to the number expected by guessing. Nevertheless, the tests afford an opportunity to make stronger judgments about the cooperation of test-takers when the test score is lower than the range of scores expected for guessing. Unfortunately, many researchers and clinicians make serious errors in communicating what is "guessing" and what is "worse than guessing" (or malingering). This article describes proper methods of evaluating total correct responses on a forced-choice test.
P. A. Arbisi and Y. S. Ben-Porath (1995) originally proposed that the Infrequency Psychopathology scale, F(p), be used as the final step in an algorithm to determine the validity of a Minnesota Multiphasic Personality Inventory-2 (MMPI-2) protocol. The current study used taxometric procedures to determine the latent structure of F(p) among examinees with profiles that would necessitate the interpretation of F(p) when using Arbisi and Ben-Porath's proposed algorithm. Participants included a subsample of 289 consecutively referred pretrial forensic examinees adjudicated incompetent to stand trial with high Infrequency (F) scale scores, thereby providing a sample that would be expected to have a high base rate of persons with bona fide psychopathology and persons with incentive to overreport psychopathology. Using MAMBAC and MAXEIG, F(p) produced a taxonic latent structure within the subgroup of examinees who obtained raw scores on F of greater than 17. These results support Arbisi and Ben-Porath's original proposal to use F(p) to identify a distinct subgroup of overreported MMPI-2 protocols within forensic psychiatric examinees with high elevations on F. Implications and suggestions for future research are provided.
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