Cognitive markers of paranoid styles on subtests of the WAIS-III and MMPI-2 with a forensic inpatient psychiatric population.

摘要

"Paranoia," a term that is frequently used, is a construct that is not clearly understood, defined, or examined. Research has demonstrated a modest, although significant, association with the presence of paranoid diagnoses and an increased risk for violent behaviors. Due to the dangerous behaviors potentially being exacerbated by paranoia, the identification of the paranoia construct is especially significant. Shapiro (1994) offered a theoretical conceptualization of paranoia that suggests the functional presence of paranoia to be observed through hypervigilance.;The present investigation was an archival study examining an in-patient forensic psychiatric population. Participants were divided into paranoid and non-paranoid groups dependent on preadmission diagnostic criteria. The division yielded a paranoid group of n = 25 and non-paranoid group of n = 44. The primary investigation examined the ability of the WAIS-III subtests of Picture Completion and Matrix Reasoning to predict paranoid group membership. Due to Picture Completion and Matrix Reasoning tendency to assess visual scanning, it was hypothesized that individuals in the paranoid group would score higher than individuals in the non-paranoid group on these subtests. The study also examined Picture Completion and Matrix Reasoning scores in relation to individuals' mean performance subtest score. In addition, the use of the MMPI-2 with a forensic psychiatric population is questionable, with mixed results regarding the utility of the Paranoia scale. This study compared all three measures (Picture Completion, Matrix Reasoning, and MMPI-2 Paranoia scale) in their ability to predict paranoid group membership.;Given that paranoia raises the risk of violence, and given that situationally determined impression management clouds results of forensic assessments, especially with self-report tests, there is a need to determine more subtle indicators of the condition. This study looked at the potential of cognitive markers to identify the presence of paranoia. Using logistic regressions, it was determined that of all variables considered, Picture Completion, relative to mean performance score, was the only variable that was consistently able to marginally differentiate paranoid from non-paranoid participants, over and above the covariates, Matrix Reasoning, or the Paranoia scale of the MMPI-2. In addition, using the dissimulation index, a slight majority of MMPI-2 profiles were shown to be invalid. Clinical, assessment, and research implications are discussed.