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Journal of Forensic Psychology Practice

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Introduction to a Special Series: Forensic

Psychodiagnostic Testing
a
Carl B. Gacono PhD
a
Austin, Texas

Version of record first published: 15 Oct 2008

To cite this article: Carl B. Gacono PhD (2002): Introduction to a Special Series: Forensic Psychodiagnostic Testing, Journal of
Forensic Psychology Practice, 2:3, 1-10

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 Introduction to a Special Series:
Forensic Psychodiagnostic Testing
Carl B. Gacono, PhD
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ABSTRACT. The past several years have witnessed an increase in

psychological journals offering pseudo-debates concerning the rel-
evance of various assessment methods or psychological tests to clini-
cal and forensic practice (Gacono, Loving, & Bodholdt, 2001; Meyer,
1999, 2000; Weiner, 2001). Dedicated researchers and practitioners
have produced enormous bodies of validating research, as well as a
wealth of clinical/forensic experience concerning the inestimable
value of these instruments in delivering mental health services as di-
agnostic consultants (Meyer, 2000; Wiener, 2001). Persistent detrac-
tors have seldom demonstrated the same level of scientific rigor, that
is, weighing all available evidence, discriminating between compel-
ling and questionable research findings, and drawing conclusions on
the basis of a balanced and open-minded determination of where the
facts lie (Wiener, 2001). Regardless of their merit, these articles even-
tually find their way into the court room and provide another source of
distraction in an already difficult work arena. Forensic psychologists
must be prepared for challenges to their assessment methods. With
this in mind, this article introduces a series of articles that provide

Carl B. Gacono is a Licensed Psychologist who maintains a clinical and forensic

private practice in Austin, Texas.
Address correspondence to: Carl B. Gacono, PhD, P.O. Box 140633, Austin, TX
78714.
The author extends special thanks to Drs. Bannatyne and Evans for their helpful
comments and suggestions.
The views in this article may or may not reflect the views of any of the authors past,
present, or future affiliations.
Journal of Forensic Psychology Practice, Vol. 2(3) 2002
http://www.haworthpressinc.com/store/product.asp?sku=J158
2002 by The Haworth Press, Inc. All rights reserved. 1
 2 JOURNAL OF FORENSIC PSYCHOLOGY PRACTICE

guidelines for the forensic use of the PCL-R, Rorschach, MMPI-2,

MCMI-III, and PAI. [Article copies available for a fee from The Haworth Document
Delivery Service: 1-800-HAWORTH. E-mail address: <getinfo@haworthpressinc.com>
Website: <http://www.HaworthPress.com> 2002 by The Haworth Press, Inc. All rights
reserved.]

KEYWORDS. Forensic assessment, forensic use

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The past several years have witnessed a disturbing increase in psychologi-

cal journals offering pseudo-debates concerning the relevance of various as-
sessment methods or psychological tests to clinical and forensic practice
(Gacono, Loving, & Bodholdt, 2001; Meyer, 1999, 2000; Weiner, 2001).1
Dedicated researchers and practitioners have respondedby producing enor-
mous bodies of validating research as well as a wealth of clinical/forensic ex-
perience concerning the inestimable value of these instruments in delivering
mental health services as diagnostic consultants (Meyer, 2000; Wiener, 2001).
Persistent detractors have seldom demonstrated the same level of scientific
rigor, that is, weighing all available evidence, discriminating between compel-
ling and questionable research findings, and drawing conclusions on the basis
of a balanced and open-minded determination of where the facts lie (Wiener,
2001a). Rather their rhetoric and tactics have been likened to advocacy. As
Wiener (2001, p. 7) stated, An irony in this situation is the fact that contem-
porary Rorschach critics, while waving the banner of scientific legitimacy, are
pursuing slash-and-burn tactics that have far more in common with advocacy
than with science. The result is that these pseudo-debates have an arm-
chair quality about them (Hare, 1998; p. 188),2 that does little to further scien-
tific exploration (Meyer, 2000).
The lack of applied knowledge on the part of assessment detractors, who are
often not qualified clinical or forensic experts, often results in a distorted pic-
ture of the issues. Their flawed or superficial understanding of essential ap-
plied theoretical and methodological issues directly impacts the manner in
which the debated issues are presented. More akin to politics than science,
the authors demonstrate a very selective attention to the literature, ignoring the
good studies, while emphasizing and summarizing any study they can find that
seems to suggest something negative about the instrument (Meyer, 2000;
Weiner, 2001a). Although their straw person arguments sound reasonable to
the naive reader, the erroneous conclusions actually provide little useful infor-
mation to the practitioner who struggles with the ethical application of assess-
 Carl B. Gacono 3

ment measures; additionally, these attacks on psychological assessment and

psychological testing weaken rather than strengthen the view of applied psy-
chology.
Like it or not, these pseudo-debates, and the associated literature contain-
ing articles that do not meet the rigors of good science, eventually find their
way into the court room and provide another source of distraction in an already
difficult work arena. Forensic psychologists find themselves in the embarrass-
ing and awkward position of having to educate the courts about inaccuracies
on the part of these so called experts.3 Even psychologists very well quali-
fied to educate the court and defend psychological assessment methods against
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these pseudo-debates often find themselves in lengthy and tedious cross-ex-

aminations designed to diminish the impact of their findings, often by numb-
ing juries with highly technical scientific debate and thus losing the point of
the forensic evaluation.
The above issues require active intervention by the forensic practitioner
(Gacono et al., 2001; Gacono, in press). We must no longer be passive con-
cerning educating our peers and others concerning what we do and how it
works. Biased attacks on one assessment instrument detract from the general
practice of psychological assessment. In this spirit, I have edited this series on
forensic personality assessment. These articles offer guidelines for specific psy-
chological tests (Rorschach, MMPI-2, MCMI-III, PAI) and one semi-structured
interview schedule (PCL-R) used by forensic psychologists. Readers are re-
ferred to a second series in the International Journal of Offender Therapy and
Comparative Criminology (Gacono, in press) for articles on the clinical appli-
cation of the PAI, MCMI-III, MMPI-2, PCL-R, and Rorschach to offender
treatment.

FORENSIC PSYCHOLOGICAL ASSESSMENT

What is it? First and foremost, it does not equal psychological testing!
Viewing the two as synonymous demonstrates a lack of understanding of fo-
rensic work (Gacono, Loving, & Bodholdt, 2001; Gacono & Bodholdt, 2002),
detracts from the unique contribution of forensic psychologists (conducting
assessment), and encourages the current de-emphasis of well balanced and
in-depth clinical training in graduate psychology programs. Although the ar-
ticles in this series provide guidelines for the use of personality tests fre-
quently used in forensic work, assessment is more broadly defined as a
process that . . . integrate[s] the results of several carefully selected tests
with relevant history information and observation . . . enabl[ing] the sophisti-
cated clinician to form an accurate, in-depth understanding of the patient; for-
 4 JOURNAL OF FORENSIC PSYCHOLOGY PRACTICE

mulate the most appropriate and cost-effective treatment plan; and later,
monitor the course of intervention (Meyer et al., 1998). Or alternately, As-
sessment is a process of deduction, selective inquiry, and also inference . . .
rooted in a knowledge of developmental psychology, personality and individ-
ual differences, statistics and measurement, with knowledge of limits (e.g., in
prediction), in cognitive science, ethics, abnormal psychology including dy-
namics and defenses. . . . Assessment forms the cornerstone of the forensic
mind-setone that is data based, utilizing test data, observation, interviewing,
and multi-sources of substantiated historical information in forming, testing,
and modifying hypotheses. . . . Assessment is a multifaceted, ongoing, interac-
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tive process . . . (Gacono, 2000, pp. 194-195). Forensic psychologists are al-
ways aware that psychological testing is only one component of psychological
assessment and that personality tests are not designed to directly assess psy-
cho-legal issues (see Otto, in press).4
Subsequent to clarifying the psycho-legal issue in question, Monahan and
Steadmans (1994) risk assessment model, although not intended to do so, pro-
vides a useful guide for choosing specific assessment methods (semi-struc-
tured interview, psychological testing, and so forth). Monahan, Steadman,
Silver, Appelbaum, Robbins, Mulvey, Roth, Grisso, and Banks (2001) empha-
sized the need for gathering data using multiple methods from multiple do-
mains:

1. Dispositional Factors (including anger, impulsivity, psychopathy, and

personality disorders);
2. Clinical or Psychopathological Factors (including diagnosis of mental
disorder, alcohol or substance abuse, and the presence of delusions, hal-
lucinations, or violent fantasies);
3. Historical or Case History Variables (including previous violence, arrest
history, treatment history, history of self-harm, as well as social, work,
and family history);
4. Contextual Factors (including perceived stress, social support, and
means for violence).

After the psychologists role (relevant psycho-legal issue, etc.) is clearly

defined, the forensic psychologist must determine which, if any, of the above
domains provide information needed to address the referral question (psy-
cho-legal issue). Next, reliable and valid methods and instruments for obtain-
ing and organizing this data are chosen.5 The use of multiple assessment
methods, such as review of collateral materials and records, clinical and
semi-structured interviewing, standardized psychological testing and so forth,
is a must in forensic work. Some methods, such as the PCL-R (Hare, 1991) and
 Carl B. Gacono 5

other semi-structured interviews, are useful for collecting and quantifying cer-
tain dispositional and historical variables, while other methods such as the
MMPI-2 and Rorschach add to understanding certain clinical and dispositional
variables.
The psychologist operates from the assumption that assessment is a multi-
faceted, ongoing, interactive process involving a continuous process of form-
ing, testing, and modifying hypotheses. While the psycho-legal issues guide
the choice of assessment methods, the Federal Rules of Evidence guide the ad-
missibility of psychological testimony. These guidelines require that expert
testimony be relevant to the psycho-legal issue, be of assistance to the fact
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finder, provide information beyond the understanding of a lay person, and not
be overly prejudicial (Otto, in press). Like sound assessment strategy, admissi-
bility guidelines require that assessment methods, including psychological
tests, have relevance to the forensic issue.

FORENSIC ASSESSMENT:
ASSESSING HISTORICAL, DISPOSITIONAL, CLINICAL,
AND CONTEXTUAL FACTORS

The following approach to assessing violence risk illustrates a forensic as-

sessment strategy. First, a thorough review of documented historical and col-
lateral information is necessary. Documentation relating to history of violence
(including sexual assault), previous offenses, weapon use, and so forth, pro-
vide historical and contextual information critical to forming an opinion. Con-
temporary data including mental status markers, acute paranoid ideation,
delusions, and so forth add clinical and dispositional factors that require sub-
stantiation from a review of treatment records, staff interviews, and other cor-
roborative sources. Antecedents and consequents surrounding previous
violent acts (contextual and dispositional) should be noted along with the
mode or type of violence (affective versus predatory). Interviews and collat-
eral information allow an evaluation of a patients past violence including as-
sessment of the cognitive, affective and behavioral patterns prior to, during,
and consequent to violent episodes, as well as any current situational or dy-
namic factors that could be impacted by immediate intervention.6 In addition
to relevant historical, dispositional, clinical factors, and contextual factors,
victim characteristics (e.g., age, gender, and circumstances) should also be
noted.
Subsequent to assessing history and mental status (review of records and
documentation, conducting forensic and collateral interviews), opinions re-
lated to risk, can be anchored by completing an established actuarial risk as-
 6 JOURNAL OF FORENSIC PSYCHOLOGY PRACTICE

sessment instrument. Historical, clinical, dispositional, and contextual

variables are quantified through the completion of these procedures. The Vio-
lence Risk Appraisal Guide (VRAG) and the Sex Offender Risk Appraisal
Guide (SORAG; Quinsey et al., 1998) are two protocols that produce a vio-
lence prediction probability estimate based on the summation of demographic,
historical and clinical findings, with a significant contribution made by the pa-
tients psychopathy level assessed by the PCL-R (requiring record review and
semi-structured interview; Hare, 1991). Although this actuarial data estab-
lishes an essential basis for forming opinions, the forensic psychologist must
consider the limitations of primarily static, unchangeable data that are ac-
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quired through these methods (see Zamble & Quinsey [1997] concerning the
problems of tombstone predictors).
Evaluation of the above assessment domains provides a basis for case con-
ceptualization. In addition, personality testing (like the Rorschach; see Gacono,
Evans, & Viglione, in press) refines our understanding of dispositional or clini-
cal factors such as impulsivity, levels of anger and hostility, presence of thought
disorder, problems with affect regulation, methods of coping with emotions,
and so forth (Gacono & Meloy, 1994, in press; Gacono et al., 2001). Standard-
ized psychological testing aids in teasing out the similarities and differences
among individuals to an extent not possible with risk assessment guides and
instruments such as the PCL-R which provide primarily nomothetic compari-
sons (Gacono, 1998). Combined historical information, risk assessment guide
scores, PCL-R scores, and personality testing data allow the psychologist to
provide opinions highlighting individualized context-person dynamics; that is,
under what circumstances a given patient is more likely to perpetrate a certain
type of violence toward a particular type of victim.

CONCLUSION

In many jurisdictions, psychologists are called upon to articulate how con-

clusions were derived (see Daubert v Merrell Dow Pharmaceuticals, 1993).
Under Daubert the factors that guide the trier of fact in evaluating the assess-
ment methods utilized include whether: (1) the underlying theory or technique
can and has been tested, (2) the methodology employed has been subjected to
scrutiny via peer review and publication, (3) rates of error and classification
obtained when using the technique are known and acceptable, and (4) the de-
gree to which the technique is accepted within the scientific community. While
these criteria are particularly relevant to specific methods of gathering data
(individual tests), the use of the Monahan and Steadman (1994) domains for
 Carl B. Gacono 7

organizing global assessment strategies increases our ability to articulate the

entire assessment process.
Additionally, forensic psychologists are cognizant of the nature and limita-
tions of their data. Some data are static, while others are dynamic (change-
able). Test scores are considered within the context of a range of scores and
compared to corresponding normative data. Group comparisons (nomothetic
data) may be only inferentially relevant to an individual case. In this manner,
nomothetic data provides a starting point for interpretation; however, individ-
ual differences, teased out through multi-methods and multi-levels of assess-
ment (collecting assessment data from multiple domains), are necessary to
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forming opinions. One must understand how psychological tests work. This is
essential to interpreting apparent discrepancies among tests. Particularly rel-
evant to the forensic context is the fact that results from self-report measures
such as the MMPI-2 and MCMI-III (McCann, in press) measure self-percep-
tion, that is either how people see themselves or how they would like to ap-
pear. Subsequently, a given profile may not be an accurate measure of the
existent psychopathology. In this regard, forensic psychologists consider the
potential impact of the response style to the assessment process (Bannatyne,
Gacono, & Greene, 1999). This is best assessed through a battery of tests,
which access different aspects of personality. In this manner the Rorschach
contributes uniquely to forensic practice (Gacono et al., in press).
In this series, the authors provide criteria for understanding how several as-
sessment methods (PCL-R, Rorschach, MMPI-2, MCMI-III, & PAI) contrib-
ute to forensic psychological assessment. Sophistication and applied (rather
than exclusively textbook or academic) knowledge of psychological assess-
ment and psychological testing, an understanding of psycho-legal issues and
the rules of evidence, and experience with forensic populations, are essential
to understanding the role of psychological testing to forensic practice and of-
fering informed commentary on its efficacy. These articles will aid readers in
critically evaluating various pro and con statements concerning the use of fo-
rensic psychological testing, will educate concerning the strengths and weak-
nesses of personality tests, and will inform a standard of care for forensic
psychodiagnostic personality testing.

NOTES
1. I say disturbing because unqualified individuals, often academics, are elevated to
the expert role through their association with legitimate experts in psychological as-
sessment. As Weiner (2001a) stated concerning certain Rorschach detractors, Weve
got some people who have come along and are raising criticisms, and these are people
who have never published any Rorschach research of their own and know very little
 8 JOURNAL OF FORENSIC PSYCHOLOGY PRACTICE

about how to use the Rorschach in practice. They seem to be on some kind of crusade to
bad-mouth the instrument (p. 7).
2. Concerning the arm chair quality Gacono and Bodholdt (2001) noted, . . . we
would extend by drawing attention to the occasional recourse to rhetorical devices, in-
cluding the straw man, and selective abstraction of a backwater of supposed conclu-
sions, which on careful reading, run counter to the prevailing tone, substance or
conclusion of the source-proper (p. 65-79).
3. Some thoughts on how psychologists can handle challenges: Voir dire should be
utilized to challenge the qualifications of these people related to their licensing status,
their actual practice of psychological assessment (do they see and assess people), their
knowledge of forensic practice and guidelines, their advanced standing in any recog-
nized professional personality assessment group (i.e., fellow status in the Society for
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Personality Assessment), and so forth, before considering their testimony.

4. Paradoxically, psychological assessment and testing have been de-emphasized
during a time when their usefulness has been clearly articulated (Meyer, Finn, Eyde,
Kay, Kubiszyn, Moreland, Eisman & Dies, 1998). In clinical settings, the de-emphasis
of assessment has been rationalized as (1) too costly without a balanced accounting
of the costs involved when it is ignored; and/or, (2) too time intensive (actually it is
the skill level of the clinician that prolongs the administration, scoring, and interpreta-
tion of the datanot inherent qualities of the test). There is also the practice of utilizing
easily administered paper and pencil tests, that require minimal contact with the pa-
tient, with little consideration for the actual purpose of the evaluation (little if any rela-
tionship between the test and the referral question). Of no surprise, these poorly
conceived window dressing assessment protocols result in findings of little value; a
finding that is subsequently used to justify the de-emphasis of formal assessment.
5. The usefulness of psychological tests depends on the individual assessment con-
text. For example, when assessing competency to stand trial, routine cases require
semi-structured interview questions to ascertain an individuals understanding of their
current legal situation, their ability to cooperate with counsel, and so forth; in a given
case, personality testing may not be necessary. However, in the case of an identified
psychopath (PCL-R > 30) suspected of malingering schizophrenia, the evaluation of
malingering may necessitate administration of the SIRS (Rogers, 1986), observation of
ward behavior, and assessment of thought disorder with the Rorschach. The same logic
can be applied to other forensic issues including the assessment (not diagnosis) of psy-
chopathy.
6. Record review and clinical interview allow identification of specific person-con-
text factors (e.g., medication noncompliance, alcohol or drug use, level of supervision
or custody) expected to mitigate or amplify more immediate risk of re-offense, includ-
ing violent re-offense.

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 Carl B. Gacono 9

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