Neuropsychological,Psychological, and Vocational Assessment of High Achievers in a Medicolegal Context

High achievers are a unique subset of persons referred for neuropsychological and psychological assessments in medicolegal contexts, including personal injury, disability, and workers’ compensation cases. Literature in this area is limited and poorly integrated, and neither a conceptual model nor best evidence-informed practices for the assessment of high achievers in the medicolegal context have yet emerged. Construct and methodological issues also hamper the ability of assessors to accurately and fairly assess this specialist group, which is particularly troubling in high-stakes forensic assessments. This paper reviews the current methodological issues involved in the assessment of high achievers and proposes an integrated, multimethod assessment model based on a particular vocational group, namely that of business leaders and entrepreneurs, that draws from available empirical research in different fields of psychological inquiry.     

Symptom Validity Testing in Somatoform and Dissociative Disorders: A Critical Review

When patients present with unusual, atypical, and difficult-to-understand complaints known as dissociative and somatoform disorders or medically unexplained symptoms, clinicians may administer symptom validity tests (SVTs) to determine whether or not the patient exhibits negative response bias. Such tests are especially informative in a context where incentives play a substantial role (e.g., the legal arena). If patients fail SVTs and exhibit negative response bias, how should that bias be interpreted? Some authors have argued that psychological problems (e.g., unconscious conflicts and depression) and circumstances (e.g., a cry for help) may explain such bias. In the current article, we critically review this “psychopathology = superordinate” position. We argue that (1) there is no empirical evidence to suggest that psychological problems may foster SVT failure per se and (2) that the “psychopathology = superordinate” position invites circular argumentation: to clarify the nature of the atypical symptoms, SVTs are administered and a negative response bias is found, which is explained away by the atypical symptoms. Negative response bias allows for only one conclusion: the patient’s self-report of symptoms and life history can no longer be taken at face value.     

A Clinical Comparison,Simulation Study Testing the Validity of SIMS and IOP-29 with an Italian Sample

The Inventory of Problems–29 (IOP-29) was recently introduced as a brief, easy-to-use measure of non-credible mental and cognitive symptoms that may be applied to a wide variety of contexts or clinical conditions. The current study compared its validity in discriminating bona fide versus feigned (via experimental malingering paradigm) psychopathology against that of the Structured Inventory of Malingered Symptomatology (SIMS). Specifically, 452 Italian adult volunteers participated in this study: 216 were individuals with mental illness who were asked to take the SIMS and IOP-29 honestly, and 236 were nonclinical participants (experimental simulators) who took the same two tests with the instruction to feign a psychopathological condition. Two main, broad categories of symptom presentations were investigated: (a) psychotic spectrum disorders and (b) anxiety, depression, and/or trauma-related disorders. Data analysis compared the effect sizes of the differences between the patients and experimental simulators, as well as the AUC and classification accuracy statistics for both the SIMS and IOP-29. The results indicate that the IOP-29 outperformed the SIMS, with the differences between the two tools being more notable within the psychotic (IOP-29 vs. SIMS: d?=???1.80 vs. d?=???1.06; AUC?=?.89 vs. AUC?=?.79) than within the anxiety, depression, and/or trauma related subgroup (IOP-29 vs. SIMS: d?=???2.02 vs. d?=???1.62; AUC?=?.90 vs. AUC?=?.86). This study also demonstrates that the IOP-29, with its single cutoff score, is generalizable culturally and linguistically from the USA (English) to Italy (Italian).     

Optimization of Performance Validity Test (PVT) Cutoffs across Healthy and Non-Referred Clinical Research Samples

Performance validity tests (PVTs) effectively detect suboptimal test performance, but cutoff scores for a given test may differ between populations. This research examines how optimal PVT cutoffs differ in a collegiate research population when mental health and clinical conditions are considered. Healthy controls (n = 328) and non-referred students with self-reported clinical conditions (n = 42) were assigned to perform their best while others simulated ADHD symptoms (n = 123). PVT indices were derived from a stand-alone measure (Victoria Symptom Validity Test) and embedded measures (California Verbal Learning Test – Second Edition; Wechsler Adult Intelligence Scale – Fourth Edition, Digit Span). PVT cutoffs with the highest sensitivity, while maintaining adequate specificity, were identified when the control groups were considered together, and when students with reported clinical conditions were considered separately. Mean differences in PVT performances were found between the simulation group and control groups, but not between clinical and nonclinical controls. The optimized cutoffs differed for five of eight PVT indices when all controls were considered together versus the clinical control group, only. When discordance was observed, cutoffs tended to be lower (less stringent) for the non-referred clinical control group. Together, these optimized cutoffs tended to be more stringent than previously established cutoffs. This study suggests that PVT cutoffs may be responsibly altered in a research context in the presence of a clinical condition. Future research should investigate if PVT classification accuracies can be improved in clinical and forensic samples while considering clinical conditions.     

Use of the SIRS in Compensation Cases: An Examination of Its Validity and Generalizability

The Structured Interview of Reported Symptoms (SIRS; Rogers et al., Structured interview of reported symptoms (SIRS) and professional manual, 1992) is a well-validated psychological measure for the assessment of feigned mental disorders (FMD) in clinical, forensic, and correctional settings. Comparatively little work has evaluated its usefulness in compensation and disability contexts. The present study examined SIRS data from 569 individuals undergoing forensic neuropsychiatric examinations for the purposes of workers’ compensation, personal injury, or disability proceedings. Using bootstrapping comparisons, three primary groups were identified: FMD, feigned cognitive impairment (FCI), genuine-both (GEN-Both) that encompasses both genuine disorders (GEN-D) and genuine-cognitive presentation (GEN-C). Consistent with the SIRS main objective, very large effect sizes (M Cohen’s d = 1.94) were observed between FMD and GEN-Both groups. Although not intended for this purpose, moderate to large effect sizes (M d = 1.13) were found between FCI and GEN-Both groups. An important consideration is whether SIRS results are unduly affected by common diagnoses or clinical conditions. Systematic comparisons were performed based on common disorders (major depressive disorder, PTSD, and other anxiety disorders), presence of a cognitive disorder (dementia, amnestic disorder, or cognitive disorder NOS), or intellectual deficits (FSIQ < 80). Generally, the magnitude of differences on the SIRS primary scales was small and nonsignificant, providing evidence of the SIRS generalizability across these diagnostic categories. Finally, the usefulness of the SIRS improbable failure-revised (IF-R) scale was tested as a FCI screen. Although it has potential in ruling out genuine cases, the IF-R should not be used as a feigning screen.

Testing an Integration of Control Theories: The Role of Bonds and Self-Control in Decision Making

Since the redefinition of self-control (Hirschi, 2004) social bonding measures have been utilized as predictors or indicators of revised or decisional self-control. This approach departs from the prior literature which has hypothesized a selection effect of self-control on social bonds. To reconcile this discrepancy and explain the relationship among two self-control measures (attitudinal and revised self-control), an alternate model is proposed that explains the process of self-control on refrainment from offending at the situation level. Surveys using the vignette method for a hypothetical drunk-driving decision-making task were collected from large samples of young adults and inmates. Path analysis is used to model bonds and self-control as determinates of decisional self-control, thus indirectly influencing self-reported estimates of drunk-driving likelihood. Decisional self-control, attitudinal self-control and social bonds also directly affect intentions to drive drunk. Overall, the proposed model is supported. A strong direct effect of attitudinal self-control on drunk-driving likelihood remains while controlling for decisional self-control. There are relatively smaller indirect effects of social bonds and attitudinal self-control on drunk-driving likelihood, through their effects on decisional self-control. These findings support the need for the conceptual separation of bonds, attitudinal and decisional self-control as well as increased attention to differential effects of self-control.     

Fairness and Health Care Decision Making: Testing the Group Value Model of Procedural Justice

Considerable research has supported the notion that procedural justice is important to individuals independent of outcome considerations. Tyler and his associates (Lind and Tyler, 1988; Lind and Earley, 1992; Tyler, 1989) proposed that this is so because procedural justice serves a group value function. In the present research, we explored aspects of this group value formulation in a real life health care context. Specifically, we assessed the relationship between individuals' appraisals of procedural justice following health care treatment decisions as well as (i) expectations for different consequences to self; (ii) estimates of how they were viewed by the health care authorities; (iii) attributions about the reasons for their treatment; and (iv) ratings of emotional reactions. Results confirmed many components of the relational, group value model of procedural justice (Lind and Tyler, 1988; Lind and Earley, 1992; Tyler, 1989). Specifically, respondents who felt that they had been treated fairly expected that their status and their relationship with the health care decision maker and others in their health care group would improve; perceived that the health care decision maker would rate them positively on a variety of personality dimensions; felt that the health care decision maker's interactions with them revealed quite a lot about the decision-maker's personality characteristics; and indicated increased levels of pride and pleasure as well as lower levels of anger as a result of their treatment. Results were discussed from several frameworks including Markus and Kitayama's (1991) concept of the independent and the interdependent self.     

Patients Are More than their Illnesses: The Use of Story in Medical Education

[W]hen a poet's mind is perfectly equipped for its work, it is constantly amalgamating disparate experiences; the ordinary man's experience is chaotic, irregular, fragmentary. The latter falls in love, or reads Spinoza and these experiences have nothing to do with each other, or with the noise of the type-writer or the smell of cooking; in the mind of the poet these experiences are always forming new wholes. —T.S. Eliot     

Further Validation of the Test of Memory Malingering (TOMM) Trial 1 Performance Validity Index: Examination of False Positives and Convergent Validity

Assessment of performance validity is an essential part of a neuropsychological evaluation, with the inclusion of two or more performance validity tests (PVTs) becoming routine practice. Considering the time to administer multiple tests, there has been some support for use of the Test of Memory Malingering (TOMM) Trial 1 (T1) as an independent, “one and done” PVT. Notably, cutoffs for TOMM T1 need further validation, with an emphasis on minimizing false-positive classifications among those with bona fide cognitive impairment. In a clinically referred sample of 127 veterans, this study examined the role of cognitive impairment in TOMM performance and the utility of a TOMM T1 as an independent PVT. Examinees were administered the TOMM and three additional PVTs as part of a comprehensive neuropsychological battery. Sixty-eight percent of examinees were classified valid (35% of valid examinees were cognitively impaired). TOMM T1?≤?40 had excellent observed sensitivity (83%) and specificity (93%) overall, with minimal false-positive classification. TOMM T1 was also significantly correlated and concordant with other memory-based PVTs. Given score ranges and failure rates for TOMM T1?≤?40 among those with neurological/neurocognitive conditions, scores in the 37–40 range may merit administration of additional TOMM trials to maximize accuracy in identifying valid-cognitively impaired versus noncredible performance. Otherwise, an abbreviated TOMM administration (i.e., only T1) using a cutoff of ≤?40—in conjunction with one or more additional PVTs—may be sufficient for detecting noncredible/invalid test performance in the absence of known or suspected neurological/neurocognitive disorders.     

Criminal Recidivism Among Juvenile Offenders: Testing the Incremental and Predictive Validity of Three Measures of Psychopathic Features

We studied the predictive, comparative, and incremental validity of three measures of psychopathic features (Psychopathy Checklist: Youth Version [PCL:YV]; Antisocial Process Screening Device [APSD]; Childhood Psychopathy Scale [CPS]) vis-à-vis criminal recidivism among 83 delinquent youth within a truly prospective design. Bivariate and multivariate analyses (Cox proportional hazard analyses) showed that of the three measures, the CPS was most consistently related to most types of recidivism in comparison to the other measures. However, incremental validity analyses demonstrated that all of the predictive effects for the measures of psychopathic features disappeared after conceptually relevant covariates (i.e., substance use, conduct disorder, young age, past property crime) were included in multivariate predictive models. Implications for the limits of these measures in applied juvenile justice assessment are discussed.     

When Social Norms and Pressures Are Not Enough: Environmental Performance in the Trucking Industry

Why do some business firms and not others work hard to advance regulatory values such as environmental protection and comply with regulations? Previous research indicates that business firms are influenced in that regard by a number of variables—not merely the perceived likelihood of legal punishment but also the risk of negative reactions by societal actors (which we call “social license pressures”) and the intensity of managers' commitment to norms of law‐abidingness and environmentalism. This article reports on a study of control of diesel emissions in the trucking industry, a highly competitive market with many small firms, mobile pollution sources, expensive “best control technologies,” and weak regulatory demands. In contrast to findings in studies of large firms, we found that social license pressures on small trucking firms are minimal. Trucking companies' environmental performance—good and bad—flows from managers' economic choices, which are influenced by their particular market niche. In such highly competitive, small‐firm market contexts, these findings imply, significant improvement in environmental performance is not likely without strong direct regulatory pressures.     

Making Use of Paradoxes: Law,Transboundary Hydropower Dams and Beyond the Technical

Law’s regulation of transboundary hydropower dams is a field of study brimming with paradoxes. The most notable being the paradox of a hydropower dam solving one problem and creating another. From a logical perspective, such a paradox would typically be viewed as an obstacle to be avoided because it brings everything to a standstill. But from a social perspective, paradoxes are not necessarily negative, as managing them also potentially enlightens and transforms planning systems. The latter perspective, which brings to analysis a kind of dynamism, is employed in this text. In order to work out the reoccurring patterns under which law might productively make use of paradoxes, this text therefore proposes the methodological tools of exposing and building upon paradoxes. Exposing paradoxes sets out to make more visible some of the unthought limitations, self-deceptions and self-contradictions which arise in modern planning practices, while building upon paradoxes attempts to open up headways towards a more adequate conceptualisation of the solutions which law can offer. The overall intention here being to offer a Luhmannian-inspired theoretical framework which illuminates the value of social systems theory as a methodological tool for describing the communicative challenges facing law’s regulation of transboundary hydropower power dams.     

Coexistence of Subdural Hematoma and a Rare Cardiopathy in an Infant: Etiological and French Medicolegal Discussion

During legal proceedings following the unexpected death of an infant, the magistrate calls on an expert to clarify the causes of death and to decide on the course to be taken. A report was made following the death of a 7‐month‐old baby girl after recovery from cardiac arrest when investigations of the cause revealed a subdural hematoma (SDH). We discuss the interconnection of these two entities and their role in the lethal process. In this infant, two distinct lesions with medicolegal implications were simultaneously present: on the one hand histiocytoid cardiopathy, and on the other hand SDH, which could result from ill‐treatment. The case of this infant reminds us that the role of the pediatrician is to report the suspicion, whereas the role of the medical expert is to inform the magistrate as to the reality of abuse and its implication in the lethal process.     

The Contexts of Regulation: The Impact Upon Health and Safety Inspectorates in Britain

It is argued that the systematic study of regulation should include an analysis of the structural contexts within which agencies with enforcement authority are embedded. At least four contexts affect indirectly and directly the process of regulation: the political, the economic, the scholarly and the media. The period of the mid- 'eighties in Britain is characterized and trends in that period are described. The decline in resources, a political and scholarly environment of "de-regulation" and increased media interests in aspects of regulation in general, it is argued, shape regulation in Great Britain. The authors use records, field and interview data from an on-going research program on health and safety regulation in England and the structure and operations of the Health and Safety Executive (HSE) at the Centre for Socio-legal Studies, Oxford, to a) examine structural changes in the organization(s) of which the HSE is constituted b) identify stresses and conflicts within the HSE c) record resultant patterns of morale and performance and d) describe efforts at achieving rationalization and formalization. It is concluded that in the context of declining resources and pressures to appear efficient, potentially divisive stresses and conflicts in regulatory bodies, if the HSE is at all representative, will continue and will underlie changes and developments that can be expected to emerge.     

DOING GOOD WELL: The Use of Quantitative Social Science Data in Advocacy Proceedings

When social scientists participate in advocacy proceedings as expert witnesses, they find themselves subjected to pressures beyond those of scientific quality. This paper considers a range of problems when the demands of scientific merit interact with the exigencies of vigorous advocacy and suggests some rough guidelines for expert testimony.     

The Justice Sensitivity Inventory: Factorial Validity, Location in the Personality Facet Space, Demographic Pattern, and Normative Data

This article investigates the psychometric properties of a self-report inventory for measuring individual differences in four components of justice sensitivity (JS): victim sensitivity, observer sensitivity, beneficiary sensitivity, and perpetrator sensitivity. A representative sample (N = 2510) was employed to (a) estimate the reliability of a newly developed perpetrator sensitivity scale, (b) test the factorial validity of this scale together with three previously developed scales (victim, observer, and beneficiary sensitivity), (c) estimate correlations between JS and demographic variables (gender, age, education, employment status, marital status, and residency in East versus West Germany), and (d) provide normative data for the computation of standard scores. A demographically heterogeneous convenience sample (N = 327) was used to locate the JS dimensions in the personality space of narrow facet factors. Results from confirmatory factor analyses demonstrated the factorial validity of the JS scales. Regression analyses with JS scales as criteria and personality facet scales as predictors suggested that JS cannot be reduced to combinations of personality facets. Demographic effects were small, explaining a maximum of 1.4% of JS variance. Women and East Germans were found to be more justice sensitive than men and West Germans, respectively. Victim sensitivity decreased with age; perpetrator sensitivity decreased with education. Taken together, our results corroborate the validity of the JS Inventory and contribute to a better psychological understanding of JS.