Differential patterns of responding among three groups of chronic, psychotic, forensic outpatients

Abstract

Elements of response style were examined among three groups of chronic, psychotic, forensic patients: paranoid schizophrenics (N ϭ 89); undifferentiated-disorganized schizophrenics (N ϭ 38); and schizoaffective patients (N ϭ 53). Forensic patients with elevated MMPI-2 L Scales produced increased percentages of Pure Form (F %) on the Rorschach. A similar relationship occurred when the Rorschach was used as the independent measure. Schizoaffective patients reported more psychotic symptoms on the MMPI-2 and lower F % (Rorschach) than both schizophrenic groups. Although undifferentiated schizophrenics evidenced the most psychopathology on the Rorschach (impaired reality testing and perceptual accuracy disturbance), all three groups produced lower than expected frequencies for Rorschach variables commonly associated with thought disorder and poor reality testing (Exner, 1995b). The clinical importance of using the MMPI-2 and Rorschach in tandem with forensic psychiatric patients is discussed. Our empirical findings suggest the need for forensic evaluators to consider the important relationship between psychiatric diagnosis and response style (defensiveness, denial, illness chronicity, medications, and concurrent Axis II psychopathology) when interpreting oftenconstricted psychological testing protocols in chronic forensic patient populations.

Rorschach Oral Dependency in psychopaths, sexual homicide perpetrators, and nonviolent pedophiles

“…First, our results demonstrate the utility of projective assessment in detecting implicit needs and motives that may not otherwise be acknowledged (McClelland, Koestner, & Weinberger, 1989). Bannatyne et al (1999) and Gacono et al (2002) state that the Rorschach is especially helpful in assessing forensic patients who tend to misrepresent themselves in traditional selfreport measures. Since dependency is often unacknowledged by SHPs, NVPs, and NSOPs, and because dependent and aggressive impulses are often associated within these individuals, it appears that the ROD is a meaningful tool by which to further elucidate the psychopathology of these individuals beyond traditional self-report measures.…”

Assessing Antisocial and Psychopathic Personalities

“…Evaluators should also be familiar with a growing database of forensic Rorschach samples (Bannatyne, Gacono, & Greene, 1999;Cunliffe & Gacono, 2008;Gacono, Meloy, & Bridges, 2000Singer, Hoppe, Lee, Olesen, & Walters, 2008), keeping in mind how these samples differ from Exner's nonpatient and clinical norms (Exner & Erdberg, 2005). A series of studies with antisocial and psychopathic patients (Gacono, 1988(Gacono, , 1990Gacono & Meloy, 1991, 1992, 1994Gacono, Meloy, & Heaven, 1990;Meloy, Gacono, & Kenney, 1994;Young et al, 2000) have validated the use of the Rorschach as a nomothetically sensitive instrument in discriminating between psychopathic ASPD and nonpsychopathic ASPD subjects (also see Smith, Gacono, &Kaufman, 1995, andRussell, 2000, for an extension of these findings to conduct-disordered adolescents), and supported the assertion that these individuals…”

“…Since response style should be considered (Bannatyne et al, 1999;, and distortion should be assumed in all forensic evaluations (Meloy, 1989), the MMPI-2 validity scales take on special importance when assessing psychopathy. It appears that Scales L and F remain the most useful in classifying fake-bad and fake-good profiles (Timbrook, Graham, Keillor, & Watts, 1993), but attention must be paid to the relative configurations of VRIN, TRIN, Fb, Ds, and F(p).…”

Association of Rorschach and MMPI Psychosis Indicators and Schizophrenia Spectrum Diagnoses in a Russian Clinical Sample

“…MMPI = Minnesota Multiphasic Personality Inventory; ICD = International Classification of Diseases; SCZI = Rorschach Schizophrenia Index (Exner, 1993); PTI = Rorschach Perceptual-Thinking Index (Exner, 2000); Sc = Russian-normed MMPI clinical scale for psychosis (Berezin, Miroshnikov, & Sokolova, 1994 Note. MMPI = Minnesota Multiphasic Personality Inventory; Moscow School = Traditional Soviet/Russian diagnostic system (Snezhnevskii, 1983); SCZI = Rorschach Schizophrenia Index (Exner, 1993); PTI = Perceptual-Thinking Index (Exner, 2000); Sc = Russian MMPI clinical scale for psychosis (Berezin, Miroshnikov, & Sokolova, 1994 Bannatyne, Gacono, and Greene (1999;d = 0.11, n = 180). Compared to Meyer's (as cited in Jørgensen et al, 2000; n = 158) sample, there was a small effect size difference of d = -0.39.…”