Alcohol/drug problems and noncompliance with medication were the most important factors related to frequency of hospitalization. Preventing these behaviors through patient education may reduce rehospitalization rates.

No abstract

Despite the value of the MMPI to the forensic assessment of malingering (exaggeration) of psychopathology, few studies have assessed the accuracy of the MMPI validity scales in criminal forensic populations. We administered the MMPI to 35 insanity defendants undergoing evaluation for fitness to stand trial and/or sanity at the time of the crime, who stood to benefit from being assessed as psychologically disturbed, and 39 subjects previously found not guilty by reason of insanity (NGRI), who did not stand to gain from such an assessment, Insanity defendants showed significantly more malingering than NGRI subjects, p less than .05. Racial differences did not affect the data. These findings support the efficacy of MMPI validity scales in assessing malingering within criminal forensic groups, and support the generalizability of the scales across race.

In place of the individualistic-subjective approaches to insanity evaluations, a specific criterion-based construct of insanity is proposed and examined. This construct entails the presence of a severe mental disorder which has substantially impaired the individual's cognitive and/or behavioral control. The construct was tested through the utilization of a specifically designed protocol (RCRAS) on 73 insanity evaluations from three forensic settings. Estimates of inter-rater reliability were obtained by independent rating of 25 cases, and yielded satisfactory to exceptionally high reliability coefficients (mean kappa r = 0.77). Results of a discriminant analysis and MANOVA generally confirmed the validity of the construct, demonstrating that insane patients were evaluated as having more severe psychopathology and a greater loss of cognitive and behavioral control.