February 9, 2014

Risk researchers launching premium literature service

The Alliance for International Risk Research (AIRR) is launching an excellent new risk assessment resource for mental health, correctional, and legal professionals. The AIRR Executive Bulletin is being called "an exceptional resource that lawyers on both sides, judges, examiners and the rest of us practitioners in these areas of forensic mental health, treatment and law should subscribe to in order to begin to implement a uniform body of current literature and ‘Best Practices’ that continually updates going forward to facilitate development of a legal and constitutional body of law."

The subscription-based service is designed for busy professionals who want to stay up to date but simply do not have the time to locate and read the voluminous literature published each month. It aggregates research on risk assessment for violence, sex offending and general recidivism among adults and juveniles.

AIRR researchers Jay Singh and Kevin Douglas
An expert team led by top risk assessment researchers Jay Singh and Kevin Douglas systematically searches more than 80 journals and identifies every new risk assessment article published each month. The average is around 20 articles. Doctors Singh and Douglas then purchase and read every article and write a one-page, easy-to-digest summary without statistical jargon.

In addition to the monthly summary of literature, subscribers also get four online risk assessment training seminars per year from top clinical researchers, and an exclusive monthly interview with an industry leader. It's a convenient way to get continuing education credits, because the trainings are eligible for American Psychological Association and Canadian Psychological Association credits.

A sample issue is available HERE

You can sign up for either an individual or a group subscription HERE.  For questions, contact lead reasearcher Jay Singh (HERE).

February 4, 2014

Research review II: Sexual predator controversies

Following up on last week’s research review, here are some new articles from the ever-controversial practice niche of sexually violent predator cases:

Facts? Who cares about the facts?!

Once a jury is empaneled to decide whether someone with a prior sex offense conviction is so dangerous to the public that he should be civilly detained, the verdict is a foregone conclusion. Dangerousness is presumed based on the prior conviction, rather than having to be proven.


Researchers Nicholas Scurich and Daniel Krauss confirmed this by giving jury-eligible citizens varying degrees of information in a Sexually Violent Predator (SVP) case and asking them to vote. Some mock jurors were told only that the person had a prior conviction for a sex offense. Others were also given information that the person had a mental abnormality that made him likely to engage in future acts of sexual aggression.


It mattered not a whit. The mock jurors voted to civilly commit at the same rate, whether or not they had heard evidence of current dangerousness.


“The mere fact that a respondent had been referred for an SVP proceeding was sufficient for a majority of participants to authorize commitment,’ the researchers found. “These findings raise concerns about whether the constitutionally required due process occurs in SVP commitment proceedings.”


No surprise, really. In this practice niche more than others, fear and hype often overshadow reason. Sex offenders are not the most appealing human beings, and no one wants to shoulder the responsibility of voting to release someone who could go out and rape or molest again.


The study is:

The presumption of dangerousness in sexually violent predator commitment proceedings, Nicholas Scurich and Daniel A. Krauss, Law, Probability and Risk. A copy may be requested from the first author (HERE).





Sexual disorder diagnoses not reliable



Meanwhile, even when jurors do hear evidence of mental abnormality, it is not especially accurate.


Examining the diagnoses given to 375 sex offenders referred for civil commitment in New Jersey, researchers found “questionable” diagnostic reliability to be a widespread problem across the range of clinicians.


Pedophilia was the only diagnosis in which two evaluators were likely to agree at a level above chance. The rates of agreement were far worse for other disorders that are typically rendered in SVP cases, including “Paraphilia Not Otherwise Specified,” Sexual Sadism, Antisocial Personality Disorder and Exhibitionism. In fact, among the six cases in which Exhibitionism was diagnosed, there was not a single case in which both clinicians agreed.


The study, by Anthony Perillo of John Jay College and colleagues, adds to a burgeoning body of literature (some of which I’ve previously reported on) suggesting that psychiatric diagnoses in SVP evaluations are often dubious and not to be trusted.


The article is:

Examining the scope of questionable diagnostic reliability in Sexually Violent Predator(SVP) evaluations, Anthony D. Perillo, Ashley H. Spada, Cynthia Calkins and Elizabeth L. Jeglic, International Journal of Law and Psychiatry. A copy may be requested from the first author (HERE).





Race bias in actuarial risk prediction



Okay, so the diagnoses aren’t reliable. But we’ve still got another tool of science up our sleeves -- actuarial risk assessment.


Not so fast.


As I’ve previously reported, the predictive accuracy of actuarial risk assessment tools is pretty wimpy. And now, researchers from Sam Houston State University are finding that the most widely used actuarial tool, the Static-99, doesn’t work at all with Latino offenders.


The findings are based on research with a large sample of about 2,000 sex offenders, almost 600 of whom were Latino.


“Findings have implications for fairness in testing and highlight the need for continuedresearch regarding the potentially moderating role of offender race/ethnicity in risk research,” note researchers Jorge Varela and colleagues.


The study is:

Do the Static-99 and Static-99R Perform Similarly for White, Black, and Latino Sexual Offenders? Jorge G. Varela , Marcus T. Boccaccini, Daniel C. Murrie, Jennifer D. Caperton and Ernie Gonzalez Jr. International Journal of Forensic Mental Health. To request a copy from the first author, click HERE.





How to lie with statistics: “The Area Under the Curve”



Listen to any defender of actuarial risk prediction for a few minutes, and you will likely hear "Receiver Operating Characteristics” and “The Area Under the Curve” touted as indicators of statistical accuracy.


But in a new study in the Journal of Threat Assessment, two European scholars argue that these arguments are “fundamentally misleading.” Using the Risk Matrix 2000 instrument -- widely deployed in the United Kingdom -- as an exemplar, they found that a prediction of reoffense for an offender who scored in the “Very High Risk” range will be wrong an astounding 93 percent of the time.


“The numbers necessary to detain in order to prevent one instance of recidivism are large,” write David Cooke and Christine Michie. “On further reflection, from a statistical rather than a psychological perspective, should we be surprised? It has long been recognized that low-frequency events are hard to predict.”


The authors argue that the weak performance of actuarials is being systematically camouflaged by “statistical rituals” that are confusing and non-transparent, raising fundamental questions of fairness in legal decision-making.


The article is:

The Generalizability of the Risk Matrix 2000: On Model Shrinkage and the Misinterpretation of the Area Under the Curve. David Cooke and Christine Michie. Journal of Threat Assessment and Management. To request a copy from the first author, click HERE.





Counterpoint



Not everyone agrees with Cooke and Michie’s analysis. One detractor is Douglas Mossman, of the Department of Psychiatry at the University of Cincinnati College of Medicine. Using a fictional scenario, he attempts to illustrate how "group data have an obvious application to individual decisions.” His paper goes on to argue that “misinterpretations of mathematical concepts and misunderstanding of the aims of risk assessment have led to mistakes about the applicability of group data to individual instances.”


The paper is:

From Group Data to Useful Probabilities: The Relevance of Actuarial Risk Assessment in Individual Instances. (Unpublished.) Douglas Mossman. Paper available online (HERE).





Who is minding the store?



If nothing else, the above research snippets demonstrate the high level of controversy and complexity in the implementation of Sexually Violent Predator laws. If psychologists -- who must master psychometrics and statistics in order to earn our PhD’s -- have a hard time with these concepts, imagine how difficult it is for attorneys. With people’s lives at stake, do they have the knowledge base necessary to avoid being hoodwinked, and to educate jurors and judges?


In a new paper, prolific legal scholars Heather Cucolo and Michael L. Perlin of the New York School of Law argue that more stringent standards for representation are necessary for effective assistance of counsel in SVP cases.


They propose that counsel should be required to “demonstrate a familiarity with the psychometric tests regularly employed at such hearings, and with relevant expert witnesses who could assist in the representation of the client.” Furthermore, they argue for a pool of court-appointed experts who could be appointed at no cost, similar to those provided in insanity cases.


“There is no question that the population in question is the most despised group of individuals in the nation. Society’s general revulsion towards this population is shared by judges, jurors and lawyers. Although the bar pays lip service to the bromide that counsel is available for all, no matter how unpopular the cause, the reality is that there are few volunteers for the job of representing these individuals, and that the public's enmity has a chilling effect on the vigorous of representation in this area.”


The paper is:

'Far from the Turbulent Space': Considering the Adequacy of Counsel in the Representation of Individuals Accused of Being Sexually Violent Predators. Heather Cucolo and Michael L. Perlin. It is available online HERE.


January 30, 2014

Research roundup

The articles are flooding in at an alarming rate, threatening to bury me under yet another avalanche. Before I am completely submerged, let me share brief synopses of a few of the more informative ones that I have gotten around to reading.


Assessor bias in high-stakes testing: The case of children’s IQ


I’ve blogged quite a bit about bias in forensic assessment, reporting on problems with such widely used tests as the Psychopathy Checklist and the Static-99R. As I’ve reported, some of the bias can be chalked up to adversarial allegiance, or which side the evaluator is working for, whereas some may be due to personality differences among evaluators. Now, researchers are extending this research into other realms -- with alarming findings.


In a study of intelligence testing among several thousand children at 448 schools, the researchers found significant and nontrivial variations in test scoring that had nothing to do with children’s actual intelligence differences. The findings, reported in the journal Psychological Assessment, are especially curious because scoring of the test in question, the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV), seems relatively straightforward and objective (at least as compared to inherently subjective tests like the Psychopathy Checklist, for example).


The article is:

  • Whose IQ Is It? Assessor Bias Variance in High-Stakes Psychological Assessment.  McDermott, Paul A.; Watkins, Marley W.; Rhoad, Anna M. Psychological Assessment, Published online on Nov 4 , 2013. To request a copy from the first author, click HERE.





Beware pseudo-precision in expert opinions


I’ve never forgotten a video I saw a long time ago, in which the filmmakers drove up to random strangers and asked for directions to a nearby landmark. Some of the good samaritans gave enthusiastic instructions that were completely wrong, while other people gave correct directions but in a more tentative fashion. The trouble is, the more confident someone appears, the more we judge them as knowing what they are talking about.  


One way we gauge a presenter’s confidence, in turn, is by their level of precision. In a new study, researchers found that participants were more likely to rely on advice given by people who provided more precise information. For example, they were more likely to trust someone who said that the Mississippi River was 3,992 miles long, rather than 4,000 miles long.


What this means in the forensic realm is that we should not make claims of false precision, when our evidence base is weak. For example, we should not claim to know that someone has a 44 percent chance of violent reoffense within three years. Such misleading claims-making lends an aura of confidence and expertise that is not warranted.


The article is:




Ethics and the DSM-5


Speaking of avalanches, the volume of critical response to the DSM-5 is lessening now that the tome has been on the bookshelves for eight months. Trying to keep my finger on the pulse because of my training activities on the manual’s forensic implications, I found an interesting summary of the ethical dilemmas of the latest trends in psychiatric diagnosis.


The author, Jennifer Blumenthal-Barby, is an ethics professor at Baylor College of Medicine’s Center for Medical Ethics and Health Policy. In her critique, published in the Journal of Medical Ethics, she focuses on consequence-based concerns about the dramatic expansion of psychiatric diagnoses in the latest edition of the American Psychiatric Association’s influential manual. Concerns include:


  • False positives, or over-diagnosis, in clinical (and I would add forensic) practice
  • Risks associated with pharmacological treatments of new conditions
  • Neglect of larger structural issues and reduction of individual responsibility through medicalization
  • Discrediting of psychiatry through the trivialization of mental disorders
  • Efforts to eradicate conditions that are valuable or even desirable


Although her discussion is fairly general, she does mention a few of the proposed diagnostic changes of forensic relevance that I’ve blogged about. These include the proposed hypersexual disorder and a proposal to eliminate the age qualifier (of 18 and above) for antisocial personality disorder, to make it consistent with all of the other personality disorders.


It’s a good, brief overview suitable for assignment to students and professionals alike.


The article is: 
  • Psychiatry’s new manual (DSM-5): ethical and conceptual dimensions. Journal of Medical Ethics. Published online on 10 Dec. 2013. To request a copy, click HERE.




Dual relationships: Are they all bad?


We’ve all seen the memo: Dual relationships are to be avoided.


But is that always true?


Not according to ethics instructor Ofer Zur.


Multiple relationships are situations in which a mental health professional has a professional role with a client and another role with a person closely related to the client. In a new overview, Zur asserts that, not only are some multiple relationships ethical, they may be unavoidable, desirable, or even -- in some cases -- mandated.


In delineating the ethics and legality of 26 different types of multiple relationships, Zur stresses that in forensic settings, most multiple relationships should be avoided.


The article, Not All Multiple Relationships Are Created Equal: Mapping the Maze of 26 Types of Multiple Relationships, is another good teaching tool, and is freely available online at Zur’s continuing education website.

By the way, if you are in California and are looking for more ethics training, Zur and two of my former colleagues from the state psychological association’s Ethics Committee -- Michael Donner, PhD and Pamela Harmell, PhD -- are co-presenting at an interactive ethics session at the upcoming California Psychological Association convention. The convention runs April 9-13 in Monterey, and the ethics conversation -- “Ethics are not Rules: Psych in the Real World” -- is on Saturday, April 12.

January 26, 2014

Psycholegal evaluations in Immigration Court: Free online training series

Feb. 5 UPDATE: The first webinar in this series was a huge success. To register for any or all of the remaining three webinars, click HERE.

Torture victims from El Salvador. Gay people from Uganda. Immigrants with elderly dependents who are U.S. citizens.

In our increasingly multicultural society, more and more people find themselves in U.S. Immigration Court. And, often, psychological evaluations play a role in deciding their fates. Unfortunately, most immigrants applying for political asylum or hardship waivers have very little money, creating an acute need for psychologists willing and able to provide low-fee evaluations.

Working to fulfill this need is my hard-working colleague Anatasia Kim, a professor at the Wright Institute in Berkeley and chair of the Immigration Task Force of the California Psychological Association. Dr. Kim is spearheading a drive to train a cadre of psychologists to conduct these evaluations. In exchange for conducting low-fee or pro bono evaluations, psychologists and students will get free mentorship by expert forensic psychologists and attorneys in the field.  

As part of the campaign, the Immigration Task Force is hosting a four-part Webinar series in February aimed at teaching the basic competencies. Immigration attorneys and psychologists will train virtual attendees on the nuts and bolts of conducting psycholegal evaluations in immigration courts.

Best of all, the series is entirely FREE. You can even earn continuing education credits (one unit per session).

The four workshops, each running from noon to 1:00 p.m. (Pacific Standard Time) on
a Tuesday, are:

Feb. 4: Basics of Conducting a Psychological Evaluation for Immigration Court. Nancy Baker, Ph.D., ABPP, Diplomate in Forensic Psychology, Director of Forensic Concentration at Fielding Graduate University

Feb. 11: Legal Relevance of Psychologists’ Opinions in the Immigration Context. Robin Goldfaden, Esq., Senior Attorney, Immigrant Justice, Lawyers’ Committee for Civil Rights of the San Francisco Bay Area, and Lisa Fryman, Esq., Associate Director/Managing Attorney, Center for Gender and Refugee Studies at U.C. Hastings College of Law

Feb. 18: Recommended Immigration Evaluation Process for Hardship Cases. Margaret Lee, Ph.D., Clinical Psychologist and Adjunct Professor, Alliant International University, San Diego and Former Clinical Director at Survivors of Torture International

Feb. 25: Writing Psychological Assessment Reports for Immigration Court. James Livingston, Ph.D., Senior Staff Psychologist, Center for the Survivors of Torture in San Jose.


You can register for the first training HERE

If you have any questions, email Dr. Kim HERE.  

January 23, 2014

California conference to highlight juvenile treatment

Michael Caldwell, co-founder of the Mendota Juvenile Treatment Center in Wisconsin, will share his Center’s innovative approach to treating hard-core juvenile offenders at this year’s Forensic Mental Health Association of California (FMHAC) conference.

Caldwell, whose research on juvenile risk assessment has been highlighted on this blog, says the Mendota approach has been proven to reduce violent offense among the extreme end of intractable juvenile delinquents who absorb such a disproportionate amount of rehabilitation resources and account for a large proportion of violent crimes.

His two workshops are part of a special juvenile track that will also feature a session on introducing the practice of mindfulness to incarcerated juveniles.

The juvenile track is one of five special tracks at this year’s FMHAC conference, coming up March 19 in beautiful Monterey, California. The other tracks are clinical/assessment, legal, psychiatric and, of course, the omnipresent sex offender track.

More details and registration information can be found HERE.The FMHAC's website is HERE.

January 20, 2014

Orange is the New Black -- Read the book!

Taylor Schilling plays Piper Kerman in the TV series
Hollywood prison scenes are so revolting. Most revolting are the depictions of women’s prisons. They superimpose onto female prisoners the worst stereotype of male prisoners as hulking, sexually aggressive brutes. And, even more so than for male prisons, the public has little direct information to counter this distorted image.

Blasting apart this image is Piper Kerman’s outstanding memoir. Detailing her year in a minimum-security federal camp, Orange is the New Black is a first-rate effort to educate the public about the realities of women’s prison.

Promo for blockbuster Netflix spinoff
Kerman tiptoed into prison with the trepidation one might expect of a white, college-educated woman thrown into the lion’s den. But instead of prisoner-on-prisoner predation, she found a sense of community, where women survived by forging family-like relationships among their “tribes.” The greatest dangers in prison came not at the hands of other women, Kerman found, but from the agents of bureaucracy who wielded the threat of the SHU* (Security Housing Unit) or loss of good-time credits for any petty misstep.

I found myself grateful that, once in a blue moon, a middle-class person with a social conscience is sent to prison. Kerman’s bad luck is the public’s fortune. With the overwhelming mass of prisoners voiceless, who else can speak the truth and be heard? Kerman is the everywoman; through recognizing ourselves in her, we feel the prisoner’s plight as our own.

Her sense of not belonging among the underclass was shared by correctional officers and prisoners alike, who more than once asked the blond-haired, blue-eyed Smith College graduate: “What’s someone like you doing in a place like this?!”

Laverne Cox as trans prisoner Sophia Burset
Don’t think that if you’ve seen the blockbuster TV spinoff, you know the story. While colorful, the series is by comparison shallow and exploitive. Netflix does a public service by counteracting Hollywood’s crude stereotypes, portraying incarcerated women as diverse human beings, but the semi-fictional show’s biggest accomplishment may be to steer intelligent viewers toward the book. (As an aside, it has also given greater visibility to the issues of transgender women of color, with trans actress Laverne Cox outstanding in the role of a transwoman prisoner.)

For a real-life visual representation of the lot of the woman prisoner, I recommend the documentary Crime After Crime. The story of battered woman Debbie Peagler’s struggle for justice is far more heart-wrenching than Kerman’s memoir, but both dramatize how a soulless bureaucratic machine chews up and spits out human potential.

The real-life Piper Kerman
Kerman is a fluid story-teller, and her saga is intrinsically gripping. But, as writer Mary Karr points out in a recent interview, the "through-line" of an effective memoir is the character’s transformation. Seeing herself through the eyes of other women in the bleak prison milieu, Kerman realizes virtues in herself that she never knew. And she confronts for the first time her own complicity in her comrades' oppression, through her former role as an international heroin smuggler.

The sincerity of Kerman’s transformation is evident in her life since leaving prison nine years ago. She serves on the board of the non-profit prison reform group Women’s Prison Association and does public education on the plight of women prisoners -- especially the two-thirds who are mothers -- through influential media outlets such as National Public Radio. As she writes in a recent op-ed in the New York Times:  
"Harshly punitive drug laws and diminishing community mental health resources have landed many women in prison who simply do not belong there, often for shockingly long sentences. What is priceless about JusticeHome, however, is that it is working not only to rehabilitate women but to keep families together -- which we know is an effective way to reduce crime and to stop a cycle that can condemn entire families to the penal system."

* * * * *

*I listened to the audiobook version. The reader was quite good. Her only false steps came in reading the word "SHU": She read it aloud as "S-H-U," instead of the way it is actually pronounced in prison ("shoe"). The SHU is too ubiquitous to merit three syllables at every utterance.


(c) Copyright Karen Franklin 2014 - All rights reserved