Assessment

The author analyzes the scores of inpatient psychiatric patients with varying degrees of cognitive impairment who met criteria for a psychotic disorder on the following tests: the Test of Memory Malingering (TOMM), the California Verbal Learning Test-Second Edition, Conner’s Continuous Performance Test-Second Edition, and the Brief Psychiatric Rating Scale-Expanded Version. Group 1 consisted of psychotic-disordered patients with significant concentration problems (concentration impersistence = 29). Group 2 consisted of psychotic disordered patients without significant concentration problems (no concentration impairment = 21). Although psychotic patients with concentration problems showed greater variability across TOMM trials, both groups obtained mean scores above 45 on Trial 2 and the retention trial on the TOMM. These findings indicate that cognitive impairment associated with psychosis generally does not negatively impair TOMM performance to such a level that would produce a false positive on the TOMM. Implications for forensic assessment, study limitations, and future directions are discussed.

The reliable digit span (RDS) performance of chronic pain patients with unambiguous spinal injuries and no evidence of exaggeration or response bias (n = 53) was compared to that of chronic pain patients meeting criteria for definite malingered neurocognitive dysfunction (n = 35), and a group of nonmalingering moderate-severe traumatic brain injury (TBI) patients (n = 69). The results demonstrated that scores of 7 or lower were associated with high specificity (> .90) and sensitivity (up to .60) even when moderate to severe TBI are included. Multiple studies have demonstrated that RDS scores of 7 or lower rarely occur in TBI and pain patients who are not intentionally performing poorly on cognitive testing. This study supports the use of the RDS in detecting response bias in neuropsychological patients complaining of pain as well as in the assessment of pain-related cognitive impairment in patients whose primary complaint is pain.

Criterion-referenced (Livingston) and norm-referenced (Gilmer-Feldt) techniques were used to measure the internal consistency reliability of Folstein’s Mini-Mental State Examination (MMSE) on a large sample (N = 418) of elderly medical patients. Two administration and scoring variants of the MMSE Attention and Calculation section (Serial 7s only and WORLD only) were investigated. Livingston reliability coefficients (rs) were calculated for a wide range of cutoff scores. As necessary for the calculation of the Gilmer-Feldt r, a factor analysis showed that the MMSE measures three cognitive domains. Livingston’s r for the most widely used MMSE cutoff score of 24 was .803 for Serial 7s and .795 for WORLD. The Gilmer-Feldt internal consistency reliability coefficient was .764 for Serial 7s and .747 for WORLD. Item analysis showed that nearly all of the MMSE items were good discriminators, but 12 were too easy. True score confidence intervals should be applied when interpreting MMSE test scores.

This study evaluated the structural reliability, construct-related validity, and cultural validity generalization of the Hare Psychopathy Checklist: Screening Version (PCL:SV) in a sample of more than 560 male and female Swedish forensic psychiatric treatment patients, forensic evaluation patients, and criminal offenders. Structural reliability was excellent for most indices. PCL:SV scores were higher for males than females for total and Part 1 scores (interpersonal/affective features) but not for Part 2 (behavioral features). With some exceptions, PCL:SV scores were meaningfully related to aggression to others, a measure of risk for violence, substance use problems, personality disorder (positive), and psychosis (negative). Correlations between PCL:SV and aggression were larger for females than males, although the difference was smaller when personality disorder was held constant. The structural reliability and pattern of validity coefficients were comparable in these Swedish samples to other non-North American samples. Implications for the cross-cultural manifestation and correlates of psychopathy are discussed.

The psychometric properties of the Acceptance of Coercive Sexual Behavior (ACSB), a multimedia measure of adolescent dating attitudes, were examined. The ACSB is an interactive instrument that uses video vignettes to depict adolescent dating situations. Analyses of the measure’s factor structure, internal consistency, test-retest reliability, and validity were conducted with separate samples of male (n = 106) and female (n = 114) high school students. Validity was evaluated in relation to subscales on the Sexual Attitudes Survey and self-reports of dating and sexual experiences. Factor analyses on the ACSB yielded two factors, Coercion and Consent. The ACSB demonstrated acceptable psychometric properties. Advantages of using a multimedia assessment of sexually coercive attitudes with adolescents are discussed.

The authors report differential item functioning (DIF) between Black and White participants completing the 60-item Padua Inventory (PI) for obsessive-compulsive disorder (OCD). The authors use an Internet-generated sample that included 105 Blacks, 67 Hispanics, 582 Whites, and 136 additional participants reporting an OCD diagnosis. Factor analysis replicated prior work indicating the PI consists of four factors: contamination fears, checking behaviors, impaired control over thoughts, and fear of losing control over impulses. On the contamination subscale, nonclinical Black and Hispanic mean scores were as high as the OCD group. Comparing Blacks to Whites, the authors applied an item response theory, DIF-graded response model to each factor and found significant DIF on eight items, with biased items in each factor. Results suggest that extraneous factors contribute to racial differences on scores. Cultural practices and fear of being negatively stereotyped may contribute to item bias.

The Personality Psychopathology Five (PSY-5) is a five-factor personality trait model designed for assessing personality pathology using quantitative dimensions. Harkness, McNulty, and Ben-Porath developed Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scales based on the PSY-5 model, and these scales were recently added to the standard MMPI-2 profile. Although the PSY-5 constructs are multidimensional in definition, explicit subscales for the broader PSY-5 scales have not been developed. The primary goals of this study were to empirically derive subscales for the MMPI-2 PSY-5 scales using principal components analysis (PCA) and to replicate these subscales with an independent sample. Individual PSY-5 scales were analyzed using PCA with an initial sample of 4,325 MMPI-2 protocols, and the component structure was replicated with a second sample of 4,277 MMPI-2 protocols. A third sample of 4,327 protocols was used to further evaluate the internal consistency reliabilities of the resulting facet subscales. Overall, replicable facet subscales were identified with content areas that are largely congruent with Harkness and McNulty’s model.

The extent to which the Comprehensive System for the Rorschach is reliably scored has been a topic of some controversy. Although several studies have concluded it can be scored reliably in research settings, little is known about its reliability in field settings. This study evaluated the reliability of both response-level codes and protocol-level scores among 84 adolescent psychiatric inpatients in a clinical setting. Rorschachs were originally administered and scored for clinical purposes. Among response codes, 87% demonstrated acceptable reliability(> .60), and most coefficients exceeded .80. Results were similar for protocol-level scores, with only one score demonstrating less than adequate reliability. The findings are consistent with previous evidence, indicating reliable scoring is possible even in field settings.

The authors examined the Trauma Symptom Inventory’s (TSI) ability to discriminate 88 student post-traumatic stress disorder (PTSD) simulators screened for genuine PTSD from 48 clinical PTSD-diagnosed outpatients. Results demonstrated between-group differences on several TSI clinical scales and the Atypical Response (ATR) validity scale. Discriminant function analysis using ATR revealed 75% correct patient classification but only 48% correct simulator classification, with an overall correct classification rate of 59% (positive predictive power [PPP] = .71; negative predictive power [NPP] = .51). Individual ATR cutoff scores did not yield impressive classification results, with the optimal cutoff (T score = 61) correctly classifying only 61% of simulators and patients (PPP = .66, NPP = .54). Although ATR was not developed as a malingered PTSD screen, instead serving as a general validity screen, caution is recommended in its current clinical use for detecting malingered PTSD.

Strong associations between civilian posttraumatic stress disorder (PTSD) scales and measures of general psychological distress suggest that the scales are nonspecific to PTSD. Three common PTSD scales were administered to 122 undergraduates who had experienced an emotionally salient, nontraumatic event: a college examination. Results indicated that normal levels of anxiety associated with the examination were positively correlated with scores on the Impact of Event Scale-Revised, Revised Civilian Mississippi Scale, and PTSD Checklist-CivilianVersion. Multiple regression analyses indicated that substantial variance in the PTSD scales was accounted for by trait characteristics such as negative and positive affectivity and affect intensity (R ² .29 to .53). Negative affectivity correlated as highly with PTSD measures (r = .46 to .71) as those measures correlated with each other (r = .48 to .65). A high proportion of participants exceeded clinical cutoffs on these measures. The findings suggest that these PTSD scales may be overly sensitive to nontraumatic stressors such as everyday distress and trait characteristics.

A sample of 119 female suicide attempters completed the Beck Scale for Suicide Ideation (BSS). Although confirmatory common factor analyses of BSS items failed to support previously hypothesized one-, two-, or three-factor models, confirmatory principal components analyses substantiated hypothesized one- and two-dimensional models. Heuristics for the number of factors converged on two latent dimensions and exploratory principal components analyses verified the presence of two previously hypothesized suicide ideation factors: motivation and preparation. Scales based on this two-dimensional model demonstrated convergent validity with other suicide indices.