B. Diagnostic Instruments
Using diagnostic tools, personnel can verify or rule out various mental disorders, as defined and described in the Diagnostic and Statistical Manual of Mental Disorders IV–Text Revision (DSM IV–TR) (American Psychiatric Association, 2000). Though in some cases, forensic staff will rely on a structured interview to confirm or deny the presence of mental disorders as identified in the DSM IV–TR, more typically they will administer formal tests that assess subjects against DSM criteria. For example, the Minnesota Multiphasic Personality Inventory–2 (MMPI–2) is a commonly used mental health assessment for determining whether the subject harbors particular mood or personality disorders included in the DSM IV–TR. The MMPI–2 is a self-appraisal inventory that uses 567 true/false questions to measure subjects’ scores on 10 scales (hypochondriasis, depression, paranoia, psychoasthenia, schizophrenia, masculinity/ femininity, hysteria, psychopathic deviance, social introversion, and hypomania) (Butcher et al., 2001). Use of the MMPI–2 is common in the classification of inmates but is used more sparingly, such as to confirm mental illness where there are other indicators of the same, in populations of individuals under community supervision. Because the MMPI–2 must be scored by a clinician, it is too costly for broad application where the disorders being measured are not widespread.
Some mental disorders, such as alcohol and drug addiction, are common in offender populations. Instruments such as the Substance Abuse Subtle Screening Inventory (SASSI), Addiction Severity Index (ASI), and the Drug Abuse Screening Test (DAST) experience widespread use in both community and institutional corrections. In contrast with the MMPI–2, instruments for the measurement of substance abuse are easily administered and scored by nonclinical staff.
C. Personality Inventories
Unlike diagnostic tools, which were developed for the population as a whole, most personality inventories used in offender classification were designed solely for use with offenders. The presumption behind use of personality inventories in correctional contexts is that different personality types require diverse officer interaction styles, supervision intensity, and treatment. Though they are not intended to be risk assessment tools, some personality inventories provide useful predictions of recidivism and institutional adjustment. Because they tend to take longer to administer and score relative to risk/needs instruments, personality inventories are usually too costly for use with probation and parole populations. Typical applications include prisons and other residential settings.
Of the many personality inventories currently available for use in classification, commonly used instruments focus on measures of commitment to criminal values and lifestyle. The Psychopathy Checklist–Revised (PCL–R), for example, is a highly regarded instrument for identifying the most antisocial of offenders. Psychopathy is a formal construct consisting of 20 distinct interpersonal, affective, and behavioral characteristics, including glibness/ superficial charm, grandiose sense of self-worth, need for stimulation, pathological lying, conning, lack of remorse or guilt, shallow affect, lack of empathy, parasitic lifestyle, poor behavioral controls, promiscuous sexual behavior, early behavioral problems, lack of realistic long-term goals, impulsivity, irresponsibility, failure to accept responsibility for one’s own actions, many short-term marital relationships, juvenile delinquency, revocation of conditional release, and criminal versatility. Upon completion of a semi-structured 3-hour interview, a clinician assigns each item a score of 0, 1, or 2. A score of 0 means the factor is not present, and a score of 2 means the factor is strongly present. A total score of 25 to 30 indicates that the subject is a psychopath.
Though never intended as a risk assessment tool, the PCL–R is frequently used as one. Research finds that psychopaths are more likely to reoffend following release from prison than nonpsychopaths; that psychopathic sex offenders are far more likely to reoffend, including nonsexually, than nonpsychopathic sex offenders; and that treated psychopaths are more likely to reoffend than nontreated psychopaths (Hare, 2003).
The Psychological Inventory of Criminal Thinking Styles (PICTS) is an 80-item, self-report instrument that measures the offender on each of eight dimensions supportive of criminal lifestyles. These include mollification, cutoff, entitlement, power orientation, sentimentality, superoptimism, cognitive indolence, and discontinuity. The instrument, which can be easily scored by nonclinical staff, shows promise in predicting institutional adjustment, recidivism, and program completion. Because it measures dynamic factors, the PICTS can be used to measure change in criminal attitudes over time, through repeated testing (Walters, 2002).