ASSESSMENT OF PERSONALITY DISORDERS:Reasons for referral, Personality Inventories

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Forensic Psychology (PSY - 513)

Lesson 26

ASSESSMENT OF PERSONALITY DISORDERS

Objectives:

To understand the use of personality inventories for the assessment of risk and personality

disorders in forensic settings.

To understand the use of projective tests for the assessment of risk and personality

disorders in forensic settings.

To get an insight about the draw backs of using personality inventories and projective

tests from legal and psychological point of view.

To understand the use of benefits and draw backs of the use of check lists for assessment.

Assessment of personality disorders is another task for which court can ask a Forensic psychologist

to provide expertise. How a Forensic Psychologists do assesses personality disorder? How do they

assess the risk that a mentally retarded/ learning disabled will commit a crime in a specific situation.

Reasons for referral

While assessing Reason for referral is usually the most crucial clue. for instance if the source is

claiming that the person is very violent and have no regard for other's right a forensic psychologist

is more likely to administer psychological tests measuring ASPD.

But if the source is saying that individual is suicidal then psychological tests measuring Borderline

Personality Disorder will be used.

And if source states that person is very troublesome and thinks he/she is the president of Pakistan

and mistrustful about the meals. More likely assessment would be using psychological tests

targeting paranoid personality disorder.

Personality Inventories

Personality Inventories are quite often used to make assessments and usually found in booklets with

hundreds of questions. An individual taking that test is required to answer all those questions in

order to make judgments. But for making assessments one essential thing is that the person endorse

all items with honesty and tell truths. When working with pathological liars we can not assume that

they will tell truth. So, results do not depict the real and desired picture. Few tests can tell whether

the test taker is telling lie or not but that is not enough because then we would not be able to

diagnose the personality disorder.

1. Minnesota Multiphase Personality Inventory (MMPI)

2. MCMI ( Millon Clinical Multiaxial Inventory)

3. PAI (Personal Assessment Inventory)

4. CPI (California Personality Inventory)

MMPI

The Minnesota Multiphasic Personality Inventory (MMPI) is one of the most frequently used

personality tests personality assessment but it is very long and has some very old scales, Although it can

measure whether the person is telling lie or not.

MCMI ( Millon Clinical Multiaxial Inventory)

The Millon Clinical Multiaxial Inventory is relatively new instrument that is a self-report instrument

designed to help the clinician assess DSM-IV-related personality disorders.

Forensic Psychology (PSY - 513)

PAI (Personal Assessment Inventory)

It assesses a broad range of psychological conditions, including personality disorders, anxiety,

depression, mania and schizophrenia. It encompasses 344 items although while compared to the MMPI

however, it is about 40% shorter.

CPI (California Personality Inventory)

It was created in a similar manner to the Minnesota Multiphasic Personality Inventory (MMPI), but

unlike the MMPI, it is not concerned with maladjustment or clinical diagnosis, but concerned itself with

more "normal" aspects of personality.

Personality inventory may not be suitable though these are still widely used

All these tests are self report inventories, even though widely used but a person who is involved in

multiple tedious crimes; we can not expect truth from him. So in my opinion personality inventories are

absolutely unreliable in crime settings. If Personality Inventories are not suitable then how to assess.

In selecting psychological tests, the forensic evaluator should seek tests that are appropriate for legal

decision making, thereby avoiding tests that are unreliable. Similarly, an evaluator should use only tests

for which the evaluator has adequate training in administration and interpretation. Because

psychological tests are best used as a source of potential hypotheses, they are best administered early in

the assessment. Tests can then be scored and used to provide direction for the assessment process. This

practice necessitates either seeing the plaintiff on multiple days and/or having the ability to score the

tests quickly. Actuarially constructed tests like the MMPI should be given in this way, as they provide

only possible hypothesis and cannot be purported as proof of anything.

Projective tests

As compared to Personality inventories, a projective test is a better option. A personality test let a

person respond to ambiguous stimuli, presumably revealing hidden emotions and internal conflicts, So

unconscious motives and desires are uncovered. This is different from a "Personality inventories" in

which responses are analyzed according to a universal standard (for example, a multiple choice exam)

rather than an individual's judgment.

Few best known Projective tests are:

Rorschach inkblot test

Thematic Apperception Test

House Tree Person

Rorschach inkblot test

Rorschach inkblot test, in which a patient is shown irregular spot of ink, and asked to explain what they

see; the response is then analyzed in various ways, noting not only what the test taker said, but the time

taken to respond, what aspect of the drawing was focused on, and how the response compared to other

responses for the same drawing. For example, if someone consistently sees the images as threatening

and frightening, the psychiatrist may infer that he or she may suffer from paranoia.

Thematic Apperception Test

Another popular projective test is the Thematic Apperception Test (TAT) in which a test taker views

ambiguous images of people, and is asked to describe various aspects of the scene and write a story; for

example, the patient may be asked to describe what led up to this scene, the emotions of the characters,

and what might happen afterwards. The forensic psychologist then evaluates these descriptions

Psychologists attempting to discover conflicts and hidden emotions. Stories can be interpreted in

flexible way, in this way experts work toward a successful judgment and assessment of personality.

Forensic Psychology (PSY - 513)

The House-Tree-Person Test

The house-tree-person test (HTP) is a projective personality test, in which individual is asked to draw a

house, tree and person. In the HTP, the test taker is asked to draw houses, tree, and persons, and these

drawings provide a measure of self-perceptions and attitudes. As with other projective tests, it has

flexible and subjective administration and interpretation.

Usually house refers to the family factors

Tree depicts ego strength, growth possibilities and therapeutic relationship.

Person shows self image, self esteem and ego strength.

Projective Tests suitable but problematic from a legal point of view

Analysis of HTP and other projective test can give valuable judgments but have problems from legal

point of view. Two psychologists can interpret the same drawing or test differently. The psychologist`s

report presented by defense lawyer presents a person innocent and the report from prosecution lawyer

portrays a person guilty and responsible for the crime.

So projective tests are good from psychological perspective and reveal more valuable information but

has legal problems. On the contrary hand Personality inventories are frequently used but from

psychological point of view the integrity of those results is questionable.

Personality Checklists

Nowadays use of Personality Checklists is considered suitable. Such check lists allow to make

judgments on the basis of multiple sources like:

Observations

Multiple sources like interview from family, warden or prison guard etc.

They are filled using a variety of sources.

Information from staff is also typically obtained

One imminent benefit of check lists is the legal validity. The court or jury feels more comfortable and

confident if psychologist states that he has garner information from variety of sources.

Personality Checklists requires that the results of psychological tests should not be used in isolation

from history, medical findings, and observations of behavior made by others. When using psychological

tests, it is important to recognize that most were developed from traditional psychotherapeutic needs

rather than for forensic evaluation of specific traumatic effects. While check list can be used according

to the requirements of each unique case.

In addition to psychological tests, the forensic evaluator needs to obtain a full history, both of the

plaintiff's life and of the specific employment situation. Various structured information forms and

interviews may be of use in this process. When multiple plaintiffs are involved in a single legal action, it

is advisable to use the same protocol, including a structured interview, with all plaintiffs. To the fullest

extent possible, all issues being evaluated should be assessed through multiple methods. This process

conforms to the best standards of obtaining information and developing conclusions. Although the

potential for error of each method of assessment may be high, the probability of error decreases greatly

when the same information is obtained and corroborated through multiple independent means.

The Problem with Checklists

1. These are typically problem specific

If a person comes with the referral source illustrating him as psychopath, this does not give a clear

picture. Psychologist may use checklist measuring psychopathy and after administering that check list

come to know that the individual does not have psychopathy, may have Asperger's syndrome. But all

range of psychological tests is neither possible nor practical. Because check lists are specific to one

specific personality disorder like

Forensic Psychology (PSY - 513)

Personality Disorders (PD) specific

Anti Social Personality Disorder (ASPD) specific

Borderline Personality Disorder (BPD) specific

Autism specific

2. File information could be unreliable and based on non-verifiable sources

File information some times become a myth. For instance, a person when first time was locked in jail at

the age of 18 years, had a quarrel with prison officer in the first week of his entry in jail. He punched

and broke his teeth; as a result prison officer wrote a biased report portraying him as a very violent

aggressive criminal, who has no regard authorities and fire fascinate him etc. (although it was a lie)

Before interviewing that boy, psychologist visited prison officer who told him all negative things about

him and told that fire fascinate him. But when during interview he was asked "are you found of lighting

fire". Boy condemned that. But psychologist assumed that he is lying too. And a similar report was

submitted from the psychologist.

3. Broad categories

Unlike personality inventories, check lists have broad categories like for assessing depression; a

personality inventory may require a person to answer 20 questions. But in check list only one item is

specified for this purpose (looked depressed). So, meticulous details are missing.

4. Subjective labels

Many times subjective labels are assigned to individuals with out reaching the real reason like, a person

is lying to you because wants to get freedom from jail and a subjective label of "pathological liar" is

tagged.

5. Express value judgments

Many times social factors are also need crucial consideration but value judgments can hinder this. Like

a person is has inconsistent job pattern, not because of any personality disorder but the all of jobs really

had problems like rude attitude of boss, nature of work or unsatisfactory environment.

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