32

9.

10.

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STONE, L. A., COLES, G. J. and LINDPM, A. C. Multidimensional Evaluation Structure Analysis (MESA) : A complete multidimensional scaling system usable for a muliipl~ciiy of purposes. Grand Forks, N. D.: Judgmetrics, 1970. '

STONE, L. A., COLES, G. J., SINNETT, E. It. and SHERMAN, G. L. Multidimensional scaling used to evaluate students residing in a rehabilitation unit. PsychoE. Rep., 1971, 28, 879-886.

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14. WIGGINS, J. Content dimensions in the MMPI. In Butcher, J. N. (Ed.) 2I4MPI: Research Developments and Clinical Applications. New York: McGraw-Hill, 1969, pp. 127-180.

12.

13.

RELATIONSHIP OF MMPI ALCOHOLISM, PRISON ESCAPE, HOSTILITY CONTROL AND RECIDIVISM SCALES TO CLINICAL JUDGMENTS

NORMAN JOHNSTON AND GERALD COOKE

Center for Forensic Psychiatry Ann Arbor, Mich.

Wayne State University

PROBLEM Psychologists who evaluate patients for competency to stand trial on criminal

charges must often answer questions concerning the patient's control of his hostility, tendency toward escape and recidivism, and use of alcohol. Several MMPI scales have been developed to answer these sorts of questions: Hostility Control (Hc), Prison Escape (Ec), Recidivism (Rc) and Alcoholic differentiation (AH) c 3 ) . The Hc scale(5) was derived by item analysis of the MMPI for extreme groups determined by therapist ratings. The Ec scale") was derived and was validated by comparison of prisoners who attempted to escape with those who did not. The Rc scale@) was developed and cross-validated on a comparison of Army AWOL first offenders with repeaters. The AH scale(*) was found to differentiate alcoholics from normals but not from a mixed psychiatric group.

Some of these scales have been used with mentally ill populations and some with offenders but as yet none has been applied to the mentally ill offender popula- tion. The present authors currently are engaged in a 2-year follow-up of com- petency evaluation patients to determine the predictive validity of these and other actuarial measures relative to clinical predictions. The first stage in this research has been to investigate the relationship among these scales, standard MMPI scales, patients' prior behavior, and clinical judgments made independent of knowledge of the scales by a psychiatrist-psychologist-social worker team during evaluation.

METHOD The sample consisted of 235 testable males referred during an 18 month period

to the Michigan Center for Forensic Psychiatry for evaluation of competency to stand trial. The mean age of the patients was 29.2 years and mean I& was 95.9. There were 170 Caucasians and 65 Blacks. The patients were referred on a wide variety of criminal charges, most frequently for Type I crimes' (67%) and were most frequently diagnosed as character disorders (63%) or functional psychotics (25%).

Standard MMPI scale scores, relevant patient prior behavior and clinical judgments were abstracted from information routinely collected on patients as part

'In the F.B.I. Uniform Crime Report, Type 1 crimes include crimes against persons plus burglary, larceny, and auto theft.

MMPI ALCOHOLISM, PRISON ESCAPE, HOSTILITY CONTROL AND RECIDIVISM SCALES 33

of the general evaluation. Experimental RUUPI scale scores were calculated in- dependent of the protocols. Offenses on which patients were referred were classified as to the degree of aggression involved. Aggressive crimes included homicide, rape, robbery and assault. Nonaggressive crimes included all others. Placement represents the cliriical judgment of staff as to the type of hospitalization recommended for incompetent patients and the degree of security required. Escape precautions are judgments of the medical and security staff as to the likelihood that inpatients will attempt to escape during the evaluation period. Those thought to be escape-prone were put on escape precautions and are under close supervision. Alcoholic diagnosis indicates the presence or absence of alcohol abuse as part of the more general di- agnosis.

RESULTS AND DISCUSSION Correlational analysis of the scale scores with the standard MMPI scales

(Table 1) indicates that Hc and Ec are related strongly to general manifestations of pathology. Rc is related to psychotic pathology and AH is inversely related to pathology.

TAI~LI.: 1. COIMI..I~.ITION OF Hc, Ec, Ilc, AND AH SCALLS AND STANDARD MMPI SCALICS -

MMPI Scale AH Ec Hc Itc

L F K Hs D HY

MF P D

PA PT s c MA

SI AH Ec Hc

.17 - .46**

.so** - .16 - .24** - .07

.07

.03 - .34** - .38** - .39** - .21* - .38**

- .59** .65**

- .62** .36** .53** .37** .53** .26** .58** .67** .71** .47** .44**

- ,38**

- .41** .78**

- .67** .36** .55** .29** .45** .21* .72** .68** .74** .37** .60**

- .49** .71**

- .41** .25**

- .39** - . l o

.Ol - .07

.28**

.16

.16

.17*

.19*

.40**

.12

.02

.42**

.32** ~

* p < .01; **p < .001.

The means and standard deviations on Hc, Ec, Rc and AH for the prior be- havioral and clinical judgment categories are presented in Table 2.

For Hc, there were no significant differences between patients charged with aggressive us. nor!aggressive crimes. Similarly, there were no differences between the Hc scores of incompetent patients placed in a maximum security hospital be- cause of dangerousness and those placed in less secure area hospitals. The scale was found to be unrelated to both.

The mean EC score difference for patients placed on escape precautions during the evaluation and those not on escape precautions was in the predicted direction ( p < .06). However, the Ec difference for subsequent placement in the maximum security hospital was not significant. Rc scores were found to be unrelated to escape precautions and recommended placement.

34 NORMANJOHNSTONANDGERALDCOOKE

TABLE 2. SCALE MEANS AND STANDARD DEVIATIONS FOR BEHAVIORAL AND CLINICAL JUDGMENT CATEGORIES

Category

Offense Aggressive (N = 126) Non-aggressive (N = 110)

Placement Maximum Security (N = 9) Non-security (N = 19)

Escape Precaution Ordered (N = 23) Not ordered (N = 80)

Alcoholic (N = 73) Non-alcoholic (N = 163)

Diagnosis

Hc

x SD

10.7 4.5 11.1 4.6

12.3 3 . 1 10.5 4 . 5

11.5 4 .4 10.6 4.9

10.8 4.0 11.0 4 .7

Ec

X SD

17.3 6 . 1 17.4 5 . 9

17.9 5 . 3 17.6 4 .4

19.5 5 .5 17.0 5 .9

17.6 5 . 3 17.2 6 .2

Rc

x SD

9 .0 2.4 9.6 2.2

9.6 2 . 3 8.7 1.7

9.0 2.6 8.9 2.4

9.6 2.4 9.2 2.3

AH

x SD

22.5 4.3 23.2 4.8

19.0 3.3 21.8 3.8

22.3 4.5 23.2 4.6

22.9 4.6 22.7 4 .5

Comparison of mean AH scores made for alcoholic and nonalcoholic diagnostic groups showed no overall differences. However, when four levels of alcoholic diagno- sis were considered, AH scores were significantly higher ( p < .05) for addicted and episodic alcoholics as compared with habitual alcoholics and nonalcoholics (re- spectively, 24.2, 24.0, 21.4, and 22.7).

SUMMARY The Hc, Ec, Rc and AH experimental scales from the MMPI were investigated

to determine their relationship with standard MMPI scales and relevant behavioral and clinical judgments. The Ec and AH scales appeared to be related to some clinical judgments, but the Rc and Hc scales did not. Conclusions on the com- parative validity of the actuarial and clinical predictions for this population must await completion of the follow-up study in progress.

REFERENCES 1. BEALL, H. S. and PANTOK, J. H.* Use of the MMPI as an index of escapism. J . d i n . Psychol.,

2. CLARK, J. H. Application of the MMPI in differentiating AWOL recidivists from non-recidivists. J . clin. Psychol., 1948, 26, 229-234.

3. DAHLSTROM, W. G. and WICLSH, G. S. A n M M P I Handbook. Minneapolis: University of Minnesota Press, 1960.

4. HOYT, D. P. and SICDLACKK, G. M. Differentiating alcoholics from normals and abnormals with the MMPI. J . clin. Psychol., 1958, 14, 69-74.

5. SCHULTZ, S. D. A differentiatlon of several forms of hostility by scales empirically constructed from significant items on the MMPI. Ph.D. Dissertation, Pennsylvania State University, 1954 (Dissertation Abstracts, 1955, 17, 717-720).

1956, 18, 392-394.