Another Tool in the Tool Box? The Utility of the MMPI-2-RF in Sexual Violence Risk Assessment
In a sample of German inmates in an inpatient psychological treatment setting, MMPI-2-RF externalizing scales had the strongest associations with measures of violence and sexual violence risk assessment. Furthermore, the externalizing scales on the MMPI-2-RF may be useful in examining more dynamic factors in conjunction with other static and dynamic risk assessment tools in evaluating sexual violence risk. This is the bottom line of a recently published article in the International Journal of Forensic Mental Health. Below is a summary of the research and findings as well as a translation of this research into practice.
Featured Article | International Journal of Forensic Mental Health | 2020, Vol. 19, No. 4, 403-415
Jaime L. Anderson, Sam Houston State University
Robbi Brockhaus, Institut fur Psychologische Diagnostik und Begutachtung
Julia Kloefer, Correctional Facility (JVA) Ludwigshafen and Private Practice
Marten Sellbom, University of Otago
The prediction of sexual violence recidivism is an important societal concern and has been the frequent subject of psychological research. Although research has supported the use of the MMPI-2-RF in violence risk assessment, there is a paucity of research related to sexual violence risk assessment. The present study evaluated the convergent validity of the MMPI-2-RF with measures used in sexual violence risk assessment evaluations (i.e., the Static 99, SVR-20, and PCL:SV) in a sample of German inmates in a psychological treatment setting. Analyses generally showed an expected pattern of results, with MMPI-2-RF externalizing scales having the strongest associations with measures of violence and sexual violence risk assessment. Indeed, although smaller associations were found with Static-99 scales, there were moderate to large associations between SVR-20 and PCL:SV scores and MMPI-2-RF externalizing scales. Taken together, these findings suggest that, although the MMPI-2-RF does not appear to be associated with specific static risk factors (e.g., previous victim qualities,
type of sexual offenses), the externalizing scales on the MMPI-2-RF are useful in examining more dynamic factors (e.g., those assessed on the SVR-20) in conjunction with other dynamic and static risk tools (e.g., SVR-20, Static-99) in sexual violence risk evaluations.
MMPI-2-RF, sexual violence, risk assessment, psychopathy, SVR-20
Summary of the Research
“Risk assessment is an important clinical task in forensic psychological settings, including the assessment of sexual violence recidivism…Actuarial risk assessment instruments (ARAIs) have dominated the sexual violence risk assessment literature…with static factors such as previous sexual and/or violent offending…and age at first offense…representing robust predictors of future sexual violence recidivism…However, dynamic risk factors, such as current mental health symptoms and personality factors, are also important to assess…” (p.403).
“The Minnesota Multiphasic Personality Inventory (MMPI; Hathaway & McKinley, 1942) and its subsequent iterations, the MMPI-2…and the MMPI-2-Restructured Form (MMPI-2-RF…) have a long history of use and acceptance in forensic settings, including in risk assessment contexts…Despite evidence suggesting that the MMPI-2-RF may be useful in assessing both risk and psychopathic traits, minimal research has examined the use of this instrument specifically in sexual violence risk assessment…The current study aimed to examine the convergence between relevant MMPI-2-RF scales and measures frequently used in sexual violence risk assessment evaluations (i.e., the Static 99, SVR-20 [Sexual Violence Risk – 20], and PCL:SV [Psychopathy Checklist: Screening Version)…we aimed to take a targeted approach by examining the utility of the MMPI-2-RF by selecting specific scales that are most likely to be relevant in the assessment of risk…the majority of our hypotheses include associations between specific risk factors and externalizing scales. However, in many cases, we propose that additional scales on the MMPI-2-RF may also be useful…” (p.404-405)
“Generally speaking, the MMPI-2-RF showed utility in assessing many risk factors, particularly those associated with dynamic personality factors and externalizing behaviors. More specifically, the current results added to the already growing support for the utility of the MMPI-2-RF in assessing various aspects of psychopathy…As expected, the majority of meaningful associations were with externalizing scales…although there were numerous other correlations that were statistically significant, these associations were small in magnitude, suggesting that the current MMPI-2-RF scales may better capture the externalizing/behavioral components of psychopathy better than the affective components…meaningful correlations were found between Part 1 [of the PCL:SV] and the interpersonal scales, suggesting that the MMPI-2-RF adequately captures the interpersonal deficits seen among those with psychopathic traits…” (p.409-410).
“Unsurprisingly, there were minimal associations between MMPI-2-RF scales and the static risk factors measured on the Static-99-R. Although the total score was associated with broad externalizing psychopathology…there were few associations with specific Static-99-R items. The exception was Prior Sentencing Dates, suggesting that externalizing psychopathology scales on the MMPI-2-RF capture a history of criminal offending…However, the externalizing scales showed moderate to strong associations with several important dynamic factors assessed in sexual violence risk evaluations. Indeed, the MMPI-2-RF’s coverage of areas such as impulsivity, behavior problems, substance abuse, and social support appeared to overlap with several areas covered on the SVR-20, particularly Psychosocial Adjustment factors…” (p.411).
Translating Research into Practice
“Taken together, the current study suggests that there is substantial overlap in many of the constructs being evaluated in sexual violence risk assessment. Not surprisingly, the externalizing and interpersonal scales on the MMPI-2-RF may be particularly useful in these evaluation contexts. Of note, however, its utility appears relatively limited to the assessment of dynamic, rather than static, risk factors…Therefore, one would expect this test to prove more useful in examining more dynamic risk factors. Furthermore, we do not assert that the MMPI-2-RF should serve as a replacement for measures commonly administered in sexual offender risk assessment contexts…However, based on the current findings, we propose that the MMPI-2-RF would make a useful addition in these evaluations. Given the high stakes involved in such clinical decisions, it seems prudent to collect information from a variety of sources, including self-reported symptoms of current psychological functioning…” (p.411-412).
Other Interesting Tidbits for Researchers and Clinicians
“…associations between the SVR-20 Major Mental Illness item and scales on the MMPI-2-RF were not consistent with hypotheses. This may have occurred due to the historical nature of the SVR-20 and the present context of the MMPI-2-RF. However, although a history of major mental health diagnosis is relevant in assessing risk…an evaluation of current psychiatric symptoms may be more relevant in an evaluation of current risk…Therefore, we suggest that the MMPI-2-RF not only shows conceptual overlap with many dynamic risk factors, but may also add substantive information relevant to risk that is not adequately assessed elsewhere” (p.411).
“Furthermore, there were surprising findings between the SUI [suicide] scale and several factors on the SVR-20. SUI was associated with several factors on the SVR-20. SUI was associated with several scales on the SVR-20, including the total score, Major Mental Illness…Notably, the Suicidal/Homicidal Ideation scale on the SVR-20 showed stronger associations with aggressive behavior…rather than over[t] suicidal content…Although limited additional information is available, we hypothesize that higher scores on the SVR-20 may suggest an increased vulnerability in this population. Similarly, a low level of hopelessness…was associated with supervision failure…” (p.411).
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Authored by Amber Lin
Amber Lin is a clinical psychology doctoral student at Fairleigh Dickinson University. Her research interests include forensic assessment, competency to stand trial, and the refinement of instruments used to assess the psychological states of criminal defendants.