Joyce L. Carbonell

Operant clinical intervention: Behavior management or beyond? Where are the data?

Operant studies published in Behavior Therapy, Behaviour Research and Therapy , and the Journal of Applied Behavior Analysis from 1972–1973 were reviewed to determine whether clinically applied operant research extends beyond short-term behavioral management toward lasting, generalizable behavior changes. Each investigation was classified as to presence or absence of long-term follow-up data, and of stimulus and response generalization data (whether short- or long-term). Studies were further identified as to target behaviors studied, nature of data collected, settings studied, and outcome. Findings suggest that researchers are not extensively studying the operant approach beyond the demonstration that shortterm changes are possible given adequate environmental engineering. Evidence relating to long-term and/or generalizable changes is conspicuous by its absence; and the meager evidence available raises serious doubts about our ability to go “beyond management.”

Female Violence and Personality Evidence for a Pattern of Overcontrolled Hostility among One-Time Violent Female Offenders

The present study investigated the validity of the overcontrolled hostility construct in explaining violent crime among 186 female state-prison inmates who were classified as nonviolent (NV), one-time violent (OV), or repeat violent (RV) offenders. The womens prison records were reviewed, and a complete Minnesota Multiphasic Personality Inventory (2nd ed.) (MMPI-2) protocol and Spielberger et al.s Anger Expression Scale were administered. Overcontrolled Hostility (O-H) scale scores on the MMPI-2 effectively differentiated the OV group from the NV and RV offender groups. The OV women were overrepresented among female violent offenders, had significantly shorter nonviolent criminal histories than the other two groups, and were more likely to have committed an extremely violent act than the RV group. The RV offenders reported greater acting out when angered and exhibited more prison aggression compared to the other two groups. These data highlight the importance of the overcontrolled hostility construct and the undercontrolled/overcontrolled distinction in the analysis of violent offending among female inmates.

Florida physician and nurse education and practice related to domestic violence

T he high incidence of the crime of woman battering translates into a public health epidemic. There are battered women in every medical practice, clinic, emergency room, and hospital. Some are recognized, most are not.’ One response by the health professions’ leadership is to encourage formal education on domestic violence for students and continuing education for practitioners. T g 2P3 he oals of the education are to increase awareness of battered women as patients, to provide specific techniques that facilitate identification of such patients, and to identify procedures that result in immediate support and referral to local community resources. One assumption is that this knowledge will modify the learner’s clinical behaviors to the benefit of the battered woman. In this article, we present survey data about the domestic violence education of physicians and nurses practicing in Florida and their use of that education in clinical settings. The findings include practitioner interest in learning more about domestic violence and a disparity of relevant education in clinical practice.

Stopping the revolving door: effectiveness of mental health court in reducing recidivism by mentally ill offenders.

OBJECTIVES This study compared recidivism outcomes among criminal offenders with mental illness who were assigned to a mental health court (MHC) or a traditional criminal court. It also explored potential differences in outcomes between subgroups of offenders, including felony and misdemeanor offenders and violent and nonviolent offenders. METHODS Data were obtained from court databases. Offenders in the MHC (N=198) and the traditional criminal court (N=198) were matched by propensity scores and followed for 12 months after the index offense. Data for the 12 months preceding the index offense were obtained for MHC participants. Intent-to-treat analyses were conducted, using both between-group and within-subjects designs. RESULTS After control for covariates, logistic and Cox regressions indicated that MHC assignment predicted a lower overall rate of recidivism and longer time to rearrest for a new charge compared with assignment to traditional court. The groups did not significantly differ on the severity of the offense associated with rearrest. The findings largely held for felony, misdemeanor, violent, and nonviolent offenders, with the exception of analyses involving time to rearrest for violent offenders. Within-subjects analyses suggested that after MHC participation, there were improvements in occurrence of rearrest and time to rearrest but a tendency for rearrest to be associated with more severe offenses. Within the MHC group, recidivism outcomes did not significantly differ by class of offense. CONCLUSIONS The results suggest that an MHC can be effective in reducing recidivism among offenders with mental illness and also indicate that persons who commit more severe offenses may be appropriate candidates for MHC.

Examining the Impact of Gender on the Factor Structure of the Psychopathic Personality Inventory—Revised

Research on the factor structure of psychopathy has yielded mixed results, supporting anywhere from one to three factors. Additionally, most of this research has used all-male samples, and the possibility of structural invariance across gender has not been examined. Using a mixed-gender sample of 360 undergraduates, the factor structure of the Psychopathic Personality Inventory—Revised was examined using confirmatory factor analysis and multiple group analysis. One-, two-, and three-factor models were tested and compared with each other. When males and females were combined, none of the three models provided adequate fit to the data. Multiple group analyses revealed partial invariance across gender for all three models. Model comparison criteria supported use of both the one- and two-factor models, taking into account variable factor structure across gender. The importance of considering structural differences based on biological sex when assessing psychopathic traits is discussed.

A Systematic Clinical Demonstration Methodology A Collaboration Between Practitioners and Clinical Researchers

Research, quantification, and verification of treatment approaches are vital to any treatment field. This paper reviews the problems and challenges to testing new psychotherapy treatment procedures and suggests an innovative way to deal with the problems associated with researching new and innovative treatments. It is suggested that innovative practitioners be assisted in the demonstration and evaluation of their approaches by researchers, allowing the clinicians to demonstrate their method while researchers evaluate the effectiveness of the approach. This approach, the Systematic Clinical Demonstration (SCD) which combines the skills of clinicians and researchers, is described and discussed.

Inmate Classification Systems A Cross-Tabulation of Two Methods

Following a suggestion by Warren (1971) two inmate classification systems were cross-tabulated to examine the concordance between them. Jesness Sequential I-level ratings and MMPI types were obtained on a sample of inmates admitted to a Federal Corrections Institution. I-level subtypes and MMPI types were collapsed into subsets and cross-tabulated. Although there was a significant chi-square, the only groups that appear to be concordant between the systems are those that each system labels as most pathological. Regression analysis provided support for this finding, as only a small proportion of the variance in I-level is accounted for by MMPI. It appears that MMPI and I-level, while both capable of classifying inmates, perform their classifications on different dimensions.

Child sexual abuse and the superfluous association with negative parenting outcomes: the role of symptoms as predictors

The purpose of this study was to investigate the relationship between child sexual abuse and high-risk maternal parenting indicators and the extent to which maternal depression and self-perceived parenting competence influence that relationship. Using path analysis, results indicate maternal depression and parenting sense of competence mediate the relationship between child sexual abuse and outcome variables. Post hoc analyses indicated that child sexual abuse was significantly associated with decreased parenting sense of competence, controlling for depression. These results highlight that the pathways for increased risk in parenting outcomes for child sexual abuse survivors may be indirect and associated with beliefs of their own sense of competence and depression as opposed to a direct association with sexual abuse itself. Implications are discussed.

The clinical utility of the MMPI-2-RF Suicidal/Death Ideation Scale.

Suicide is a major public health concern, with over 100 individuals dying by suicide per day in the United States alone. Therefore, suicide risk assessment is an essential aspect of mental health care. The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008-2011; Tellegen & Ben-Porath, 2008) has a Suicidal/Death Ideation (SUI) scale consisting of 5 items that describe recent suicidal ideation or behaviors. Although this scale has clear face validity, few studies have examined the clinical utility of this scale. The purpose of the current study was to examine associations between the SUI scale and other established measures of suicidal ideation and behavior, including the Depressive Symptom Inventory Suicidality Subscale (DSI-SS; Metalsky & Joiner, 1997), Beck Scale for Suicide Ideation (BSS; Beck & Steer, 1991; Beck, Steer, & Ranieri, 1988), self-report of lifetime suicide attempts, and clinician ratings of suicide risk. Participants were 998 therapy- and assessment-seeking outpatients. Analyses indicated that the SUI scale was positively associated with other self-reported measures of suicidal ideation and behavior. Significant differences in SUI scale scores also emerged among the clinician rating categories of suicide risk. The SUI scale was able to predict previous suicide attempts over and above age, gender, and other MMPI-2-RF scales related to depression. Finally, relative risk ratios for suicide attempts indicate increased risk of suicidality, with higher T scores on the SUI scale. Overall, findings suggest that the MMPI-2-RF SUI scale may be a useful tool for identifying individuals at risk for suicidal ideation and behavior in clinical settings.

The role of intelligence on performance on the Inventory of Legal Knowledge (ILK)

Previous research has shown that individuals with intellectual disabilities perform in the feigning range on malingering measures even when other data suggest that they are performing optimally. However, few studies to date have gone beyond intellectual disabilities and studied the full range of intelligence. Additionally, there are no data available examining the relationship between intelligence and performance on the Inventory of Legal Knowledge (ILK). The relationship between intelligence and performance on malingering tests is important because individuals with intellectual deficits may be incorrectly identified as malingering on these tests. The current study used a sample of state psychiatric hospital residents, adjudicated incompetent to proceed, and a sample of undergraduate university students to examine the relationship between intelligence and performance on the ILK. Results indicated three items on the ILK are correlated with intelligence and total scores were moderately correlated. Participants were further broken into groups using categorical ranges of Intelligence Quotient (IQ). Results were mixed regarding the relationship between ranges of IQ and performance on the ILK. Future directions and implications of this study are discussed.