Murder and Criminal Responsibility: An Examination of MMPI Profiles

Richard Rogers, Ph.D. William Seman, Ph.D.

ABSTRACT

The clinicalforensic applications of the MMPI in: (I) the identification of violent behavior, including murder, and (2) the determination of sanity, is briefly reviewed. Samples of evaluatees charged with murder were obtained in Chicago and Toledo, and were examinedfor differenceson MMPIprofiles for evaluatees clinically determined to be sane versus insane. Further comparisons were made between these evaluatees and a group of treated patientspreviously found not guilty by reason of insanityfor murder. Results suggested that the MMPI is limited in its discriminability between sane and insane evaluatees, and specifically questioned the usefulnessof certainprofiles in rendering sanity opinions. The MMPI did demonstrate expected differences bet ween insane evaluatees and their treated counterparts.

sychologists in recent years have experienced an expansion in their role in the pretrial evaluations of patient-defendants on the issue of criminal responsibility (Le., was the patient-defendant sane or insane at the time of an alleged crime?). This expanded role has been observed in the increased willingness for jurisdictions to hear psychological testimony on criminal responsibility (Sobel, 1979), discussion of psychologists unique contributions to insanity proceedings (Delman, 198l), and studies stressing the particular expertise of psychologists in completing insanity evaluations (Poythress & Pettrella, note 1). Despite these changes, there has been little systematic research on the

1. Poythress, N.G. & Petrella, R. The quality of forensic examinations: An interdisciplinary study. Paper presented at the American Psychology and Law Society Meeting, Baltimore, October 1979.

Richard Rogers, Ph.D., is Assistant Professor of Psychiatry and Psychology at Rush Medical College, Chicago, Illinois. William Seman, Ph.D., is Executive Director of the Court Diagnostic and Treatment Center, Toledo, Ohio. Please address reprint requests and correspondence to: Dr. Richard Rogers, Isaac Ray Center, 1720 West Polk Street, Chicago, Illinois 60612.

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utilization of psychological tests in the examination of criminal forensic patients. From this perspective, Poythress (1979) indicated that standardized psychological tests were not designed to address specific legal questions, and therefore, their generalizability for this purpose has remained unestablished. Several prominent forensic psychologists, (e.g., Whitaker, 1976) have questioned the clinical utility and validity of test interpretations under such highly specific conditions such as an alleged murderer being assessed for sanity at the time of the crime. Ziskin (1981) specifically addressed the issues of reliability, validity, and generalizability, in the employment of MMPI in criminal forensic evaluations. He stated that while the MMPI has demonstrated perhaps the greatest promise in such evaluations, it was limited by low test-retest reliability, problems in the identification of response sets, variable effectiveness in discriminating psychiatric diagnosis, and use of out-moded criterion groups. In light of these criticisms of the MMPI and its potential usefulness in criminal responsibility evaluations, the authors have selected a group of evaluatees, who were charged with murder, and examined their MMPI profiles for differentiating patterns between those clinically judged sane and insane. From an empirical perspective, the relationship of violent behavior (including murder) to the MMPI has been examined through two distinct approaches, The first is the establishment of differentiating MMPI patterns utilizing the standard scales with specific criteria as criminal recidivism (Canton, 1962), violent behavior in a correctional setting (Jones, Beidleman, & Fowler, 1981), and sexual aggression (Rader, 1977). Sutker, Allain, and Geyer (1978) found, in a study of 22 female murderers in comparison with 40 nonviolent female offenders, that the murderers scored significantly lower on scales F and 4, and higher on K and 5 . Further, they found a preponderance of normal profiles among the murderers and a concentration of conduct disorders for the nonviolent offenders. No additional studies were found which specifically addressed differences between murderers and non-murderers. A second approach is the construction of specific scales for the differentiation of violent individuals from other MMPI groups. This approach was attempted by Freeman and Mason (1952) and in extensive work by Megargee and his associates on the development of the overcontrolled hostility scale (Megargee, Cook, and Mendelsohn, 1967; Megargee, 1970). These studies have not, however, focused specifically on murderers. Only one study was found (Kurlychek and Jordan, 1980) which examined the clinical utility of the MMPI in discriminating between sane and insane criminal defendants. This study examined a total of 50 male defendants (20 insane and 30 criminally responsible) on the basis of their validity and clinical scales. The study found no significant differences in comparison of raw scores between the two groups. The authors attempted a chi-square analysis of 2-point codes between the responsible and insane subgroups; this analysis, while producing significant differences, violated the basic requirements for chi-square through its insufficient sample size. The study therefore provides
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only preliminary data suggesting the nondiscriminability of the MMPI with regards to the individual scales, and no statistically interpretable information with respect to specific two-point code types. In the present study, the clinical usefulness of the MMPI in differentiating between sane and insane evaluatees charged with murder was examined, based on a comparison with psychologists expert opinions regarding sanity and the respective MMPI profiles. It was assumed that, for the MMPI to be clinically effective, significant differences must be observed in individual scales or in patterns of scales. The study did not address either the accuracy of the psychologists opinion or the validity of the underlying construct of insanity. A second research question posed in the present study was whether the MMPI could differentiate between treated patients previously adjudged insane on charges of murder and currently determined to be no longer in need of hospitalization, from insane evaluatees. It is hypothesized that treated patients should manifest differentiating profiles on the MMPI (i.e., generally less elevated) on the basis of such treatment than their hospitalized counterparts.

METHOD
The sample (N = 77) was collected retrospectively and, because of the low frequency of insanity evaluations, represented all the available cases of psychological evaluations on murderers at the data collection sites. The data were gathered at two outpatient forensic centers: the Isaac Ray Center in Chicago (including all cases from January 1979 to March 1982), and the Court Diagnostic and Treatment Center in Toledo, Ohio (including all cases from January 1975 to March 1982). The psychological evaluations were completed by doctoral-level psychologists experienced in forensic evaluations, who, on the basis of the MMPI and additional interview and test results, rendered a diagnosis and an opinion regarding sanity at the time of the alleged crime. MMPI data, diagnosis, expert opinion regarding sanity, and demographic data were retrieved from test files. Psychological evaluations were available on 77 individuals charged with murder who were either evaluatees being examined for sanity, or treatment patients previously adjudicated as not guilty by reason of insanity. The evaluatees were further assigned to groups of sane (N = 40)and insane (N = 12) evaluatees on the basis of the psychologists conclusions. The treatment patients (N = 25) adjudged insane, had received extensive inpatient treatment, = 27.2 months) and had progressed to the point that they had been subsequently discharged to outpatient treatment. For the treatment group, the MMPI was administered after acceptance into outpatient treatment and not as a determinant in the decision regarding discharge. Differences on individual MMPI scales among the three groups were examined statistically by an analysis of variance with Duncans multiple range test (alpha = .05). Intergroup comparisons of MMPI scales patterns were examined through multivariate analysis; this analysis was completed for both the entire sample as well as a refined sample excluding those profiles with possible

(x

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malingering (F - K index > 7; based on generally accepted clinical rules: Dahlstrom, Welsh, and Dahlstrom, 1972; Grow, Eno, McVaugh, 1980). Discriminant analysis was also employed as a measure of the discriminability of MMPI profiles. Discriminant analysis is a statistical method involving the relative weighting of the individual scales to provide the maximal differentiation in patterns between criterion groups (sane and insane evaluatees). The discriminant function was formed on one-half of the sample (randomly assigned) and cross-validated on the remaining sample. Finally, the Henrichs revision of Meehl-Dahlstrom decision rules (see Dahlstrom, et al, 1972) were applied to the protocols for assigning individuals as having a psychosis, neurosis or character disorder. This was computed for each test evaluation and examined through a chi-square analysis to test significant differences between sane and insane evaluatees on these decision rules.
RESULTS

Comparisons of evaluatees and treatment patients on the individual validity and clinical scales are presented in Table 1 . The MANOVA for examining overall group differences was significant with Wilks (26,126) = A .5611, p = .05. Employing the REGM program (Wilkinson, 1975) for identifying contrasts among groups, both sane and insane evaluatees differed from treatment patients, but not from each other. A discriminant analysis for the maximal differentiation between sane and insane evaluatees correctly classified 75 .O% and 83.3% of the sane and 68.8% and 50.0% of the insane. The canonical loadings for this discrimination were: F(.430), L(.363), K(.169), I(-.239), 2(-.254), 3(-.368), 4(-.543), 5(-.015), 6(-.551), 7(-.317), 8(-.518), 9(.393), and 10 (-.283). Attempts to improve the differences between sane and insane evaluatees through the exclusion of potential malingerers (F - K Index > 7) was unsuccessful. No significance was established with Wilks (26,100) = .5493, p = .15. Further, Heinrichs revision of Meehl-Dahlstrom decision rules was inconclusive with X 2 = 7 . 0 9 , = ~ .07. Unexpectedly, it assigned 62.5% of the sane and 50.0% of the insane evaluatees as psychotic.
DISCUSSION

Comparison of insane and sane evaluatees on the individual MMPI scales yielded generally nonsignificant results with the only exception being Scale 5 . This differentiation has little clinical relevance since Scale 5 is the least welldeveloped and standardized scale and its role has not been clearly established with regard to psychopathology (Greene, 1981). The discriminant analysis which attempted to develop patterns between sane and insane evaluatees was minimally successful, correctly identifying 68.8% of the sane, and 50.0% of the insane in the cross validation (the cross validation being the more rigorous test of consistent discrimination). Thus, both individual scales and patterns of
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Group Means

Scales

Group 1: Sane Evaluatees

52.38 70.58 51.05 68.85 71.65 69.15 78.08 57.18 73.00 74.93 83.00 69.15 57.98
I

Group 2: Group 3: Insane Insane Evaluatees Tx. Patients

51.33 74.00 52.75 62.25 66.92 64.00 77.17 65.17 68.42 76.92 81.00 70.08 58.00 57.48 61.88 54.20 60.12 63.44 60.08 68.08 60.92 63.52 62.76 67.88 62.92 53.52
I

Duncans Multiple Range Test (.05 Level) 1 vs 2 1 vs 3 2 vs 3

L F K
1

sig sig sig sig slg s!g sg sig

sig

2 3 4 5 6 7 8 9 10

MMPI scales were not statistically differentiated between sane and insane evaluatees. Because of the retrospective nature of this study, it is impossible to assess to what extent the examining psychologists actually employed the MMPI in making their expert determinations. A prospective study would be particularly helpful in assessing on what basis and to what extent MMPI profiles may be utilized in insanity evaluations. These results must be considered in light of Poythress observation (1979), that psychological tests were developed to address deficits in psychological functioning and not specific legal questions. The MMPI may therefore provide corroborating information regarding the examinees honesty and current psychopathology; this may subsequently assist in establishing the diagnosis and opinion regarding sanity. The finding that neither the individual scales nor the MMPI profiles systematically differentiate between the two evaluation groups raises several issues: First, how were the MMPI results incorporated into the final determination of sanity? Second, what are the interrelationships between the mental disorder and the alleged criminal behavior? The study does argue against the use of specific profile types as necessarily indicative of insanity or criminal responsibility. For example, elevations on scales 4 and 9 which are frequently associated with sociopathy were nearly identical for the evaluation groups. Further, both groups had marked elevations on Scale 8 which is frequently associated with disorganized thinking and schizotypal or schizophrenic disorders. Thus, MMPI profiles and scale configurations can not be readily translated into an opinion regarding sanity.
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Additional comparison of evaluatees with treated insane patients were somewhat more encouraging. Results of the MANOVA with Duncans multiple range test indicated significance, particularly between the sane evaluatees and treatment patients (on scales 1, 3 , 4 , 6 , 7 , and 8 in the expected direction), and between insane evaluatees and treatment patients (on scales 4 and 7 in the expected direction). The comparison of insane evaluatees and the treatment patients is clinically relevant since such decisions must be made on when an insane patient should be discharged to outpatient treatment. Relative decrements on scale 4 were encouraging, suggesting the reduction of authority and interpersonal conflict, and sociopathic orientation in discharged treatment patients as compared to insane evaluatees. Likewise, the reduction in scale 7 (which taps anxiety and obsessive-compulsive features) was a potentially positive indicator in the clinical management of discharged patients found not guilty by reason of insanity. Further, overall differences between evaluatees and treatment patients were observed in less elevated profiles for the treatment group. An additional attempt to differentiate between insane and sane evaluatees was made by excluding potential malingerers with F-K index greater than 7. This appeared to have no substantive effect in establishing differences between clinically determined sane and insane evaluatees, and resulted in a nonsignificant MANOVA. Finally, Henrichs revision of Meehl Dahlstrom rules for profile discrimination were employed between the sane and insane evaluatees to assess, according to a rationalistic approach, any differences in diagnostic assignment (psychotic vs. nonpsychotic) between the two groups; this approach was likewise unsuccessful. The study raises questions concerning the clinical usefulness of the MMPI in criminal responsibility evaluations with respect to murder. Neither individual scales nor MMPI profiles appear to differentiate between the two groups. With respect to the MMPIs discriminability between insane evaluatees and discharged treatment patients, the results are clearly more positive. Similarly, the utilization of other psychological tests instead of or in addition to the MMPI has generally not been examined empirically for insanity evaluations. Clinicians might consider the employment of structured interviews, as the Schedule of Affective Disorders and Schizophrenia (Rogers and Cavanaugh, 1980,1981) and specifically designed protocols (Rogers and Cavanaugh, 1981; Robers, Dolmetsch, and Cavanaugh, 1981;Rogers, Seman, Wasyliw, in press; Rogers, Wasyliw, and Cavanaugh, in press) which have demonstrated clinical utility in discriminating between sane and insane evaluatees. Finally, it must be emphasized, that further examination of the MMPI with respect to different offenses and incorporating a prospective design is imperative before any conclusive statements may be made concerning the MMPIs degree of discriminability in insanity evaluations.

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REFERENCES
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