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Misuse
of Psychological Tests in Forensic Settings: Some Horrible
Examples
Ralph
Underwager and Hollida Wakefield*
Psychological
tests are often used inappropriately and are misinterpreted
and overinterpreted in the forensic setting. This harms
the person being evaluated and interferes with the cause of
justice. It also does a disservice to the reputation of
psychologists and the science of psychology. Actual
examples of misuse of particular techniques and tests and
misinterpretation illustrate what has been done in forensic
settings.
A
forensic evaluation is different from a clinical evaluation.
When an evaluation is done in the clinical setting, the
conclusions are used to develop a treatment plan. These
conclusions form working hypotheses which can be confirmed or
rejected during treatment. However, in the forensic
setting, a one-time decision is made about the individual —
a decision which can markedly affect the person's life.
If
tests are misinterpreted in the clinical setting, the
treatment plan developed from the evaluation may not be the
most effective for the client. However, since treatment
plans are generally modified and revised throughout the course
of treatment, the mistaken conclusions can be corrected.
But, an erroneous decision in the forensic setting can result
in immediate and severe consequences, such as losing custody
of a child or being jailed. If decisions and
recommendations by the psychologist are not based on adequate
data, the psychologist is acting both incompetently and
unethically.
In
addition, conclusions drawn by the psychologist are subject to
cross-examination in the adversarial setting. If the
conclusions are not based upon adequate data, the
psychologist's testimony will be discredited or impeached by a
skillful opposing attorney. Therefore, the psychologist
should only present conclusions in reports and testimony which
can be defended when challenged in cross-examination.
In
the course of examining hundreds of reports, we have seen many
examples of tests that are misadministered, misinterpreted,
overinterpreted, or should never have been given in the
particular setting. We are presenting a sample of these
to illustrate what should be avoided by any psychologist who
does forensic evaluations.
DRAWINGS
Tests
such as the House-Tree-Person (HTP) and Kinetic Family
Drawings are often overinterpreted and misinterpreted.
There is a lack of validity and reliability in the use of
drawings as projective assessment devices. In a review
of the Draw-A-Person test in the Seventh Mental
Measurements Yearbook, Harris (1)
notes that there is very little evidence for the use of
"signs" as valid indicators of personality
characteristics. With children's drawings there is
so much variability from drawing to drawing that particular
features of any one drawing are too unreliable to say anything
about them. The Tenth Mental Measurements Yearbook
(2),
in reviews by Cundick and Weinberg (p.422-425) continues the
consistent finding since the first edition, 1938, that
interpretations of drawings (as are often done in forensic
evaluations) are unsupported by empirical evidence. Both
reviewers note that there are no normative data establishing
reliability and validity of the Kinetic Drawing System.
Projective
tests generally, and the symbolic interpretation of drawings
specifically, should be used only with great caution and with
full acknowledgment of their lack of demonstrated validity and
reliability. If used, drawings should be interpreted
conservatively as a means of generating hypotheses to be
explored. If unusual elements are present in the
drawings, the client should be asked about them.
Example
1
The
father, in a divorce and custody dispute, was accused of tying
up his three-year-old son with a bicycle chain and then
sexually abusing him. Both parents were evaluated by a
psychologist. The father was tested and interviewed by
the psychologist who left the office, leaving him to finish
the drawings. He took them home, finished them with the
use of drafting instruments, and brought them to her office
the next day.
The
psychologist stated that the response style to the projective
drawings suggested "obsessive-compulsive tendencies, high
defensiveness and an intense need to control ... (and) his
rigidly defensive posture does not adequately bind the
underlying anxiety and trepidation of doing poorly."
However, his Bender is completely normal. His
House-Tree-Person (HTP) drawings are careful and detailed.
He clearly had attempted to do as good as job as possible.
Given that his understanding was that these drawings would be
interpreted to indicate whether or not he was an abuser, his
choice to carefully complete them at home demonstrates an
understandable effort to comply with the instructions and do
the best job he could. None of this was noted in the
report. There are no scientific data to support the
interpretive comment quoted above. It is meaningless
jargon with no connection to an empirical base.
Example
2
A
four-year-old girl was asked to draw a picture of herself and
the family doing something. She instead, according to
the school psychologist who was evaluating her, "seemed
to be preoccupied with drawing circles within circles which
she called 'caves.' Her second representation bore a
significant resemblance to male genitalia (when asked what it
represented, she reported that it was a ball rolling into a
lion's cave)." This was interpreted as being
suggestive of sexual abuse and the fact that the child has
been subjected to some type of traumatic experience.
When
we saw the child, now age five, we tested her and found
borderline to low-average intelligence and no ability to draw
anything other than scribbled circles. The child clearly had
difficulties with visual motor perception and indeed, could
not draw, a fact which was ignored by the other evaluator.
This example, therefore, illustrates the importance of
recognizing the child's developmental level.
Example
3
In
a similar example with an older child, a 15-year-old boy's
drawings of a person were interpreted as "rather
primitive for an adolescent of his age and ... suggests that
(the boy) has the psychological characteristics of a person
who acts out their anger in sexualized ways." But
when we tested this boy, we discovered that he was blind in
one eye, performed below what was expected for his age on the
Porteus and the Bender, and had a performance IQ on the WISC-R
of 67. This is why his drawings were
"primitive." None of this had been assessed or
discussed as a possibility.
Example
4
A
seven-year-old girl was asked to draw a picture of her family
doing something. She drew a picture of herself and her
sister with their hands up in the air with the father standing
next to them and smiling. The child told the
psychologist that she and her sister were "cheering at a
show."
The
psychologist disregarded what the child told her about the
drawing and claimed that this really signified a
"helpless posture." She saw it as significant
that there were no fingers drawn on the hands and that the
hands were large on the father. She asserted that abused
children put large hands on the drawings of their
perpetrators. She also claimed that the thick lines in
the crotch in the picture of the father meant an emphasis on
genitals, was probably a penis, and showed anxiety about the
father. She therefore concluded that the girl, who
denied the allegations of sexual abuse by the father, had most
likely been sexually abused by him and should "be
protected from further abuse by him." The behavior
of the psychologist in her interpretation is particularly bad
because she ignored what the child herself said about the
drawing.
Example
5
A
four-year-old girl's drawing of a tree in the HTP was
considered significant because the child, when asked to draw a
tree, also drew a cactus. This was interpreted in terms
of "unconscious expression of danger and
fearfulness." However, the child was not asked if
she had a cactus in her yard (this was in Texas).
The
child also brought a drawing of a clown's face to the
therapist which she had ostensibly drawn while in the waiting
room with her parents. The clown was interpreted as
being significant because "there is an element of sadness
in the clown's eyes." This clown is of much greater
sophistication and detail than the child's other drawings.
When pressed about this in his deposition, the psychologist
acknowledged that the parents probably drew it and she colored
it. This example illustrates both problems in
administration and in interpretation.
Example
6
This
was a day care case with allegations of ritualistic satanic
abuse complete with costumes, masks, dead animals, sacrificed
babies, blood, feces, skeletons, and monsters. These
bizarre allegations surfaced during therapy. The
therapist who saw two of the children depended heavily upon
the children's drawings in forming conclusions about
ritualistic, satanic abuse.
The
case file included a large stack of drawings over a two-year
period — probably over 500 from the two girls. These
drawings are typical of the types of scribbles and rudimentary
figures drawn by three- and four-year-olds. These had
been saved because they were considered significant. In
her deposition the psychologist was asked about the drawings
in detail. What she believed was significant included:
Shapes
that are untypical for three- and four-year-old children
Shapes that are phallic symbols
Jiggly lines that indicate anxiety
Straight mouths that mean people can't say anything.
Jagged mouths that mean anxiety
A mouth that is open and oval shaped
Darkened eyes
Eyeballs that are scribbled around
Eyes that are two different colors
Drawing something and then covering it up
Drawings something and not talking about it
Colors are very important and significant:
Black
means the child is frightened or distressed; black is a morbid
down color
Red means angry, unless the child is drawing a pretty red
flower, when it is healthy
If every thing is the picture is red or red and black, this is
very suspicious.
Blue, brown, and orange mean fear, anger, and depression
Pink, red, and green are healthy colors
There
is no empirical evidence to support any of these theories.
Also, these were not House-Tree-Person drawings or Kinetic
Family Drawings but were simply drawings done in therapy
sessions or at home and brought to the therapist by the
parent. There was no effort to standardize the
administration.
Example
7
This
example shows a gross overinterpretation of a Bender given to
an adult. Whereas the Bender is a useful screening test
for possible organic dysfunction and is an efficient measure
of perceptual-motor development in young children, its use as
a projective technique for emotional psychopathology is
questionable. When used as a personality instrument or
projective technique, great caution should be used and it
should never be used as the main measure of psychopathology (3).
In
this custody evaluation, the psychologist gave three
personality tests, Bender Gestalt, HTP, and TAT, all which
were interpreted in the direction of finding extreme
psychopathology. MMPIs or other objective testing were
not used. The Bender interpretation for the woman is:
There
appears to be no visual/motor neurological dysfunction with
the Bender Gestalt. Personality interpretation reveals
difficulty with dissonant elements of her personality,
anxiety, timidity, possible paranoia, and marked ambivalence.
She seems emotionally constricted, may lack impulse control,
is perfectionistic and obsessive-compulsive, and may manifest
dissociation, splitting, or isolation mechanisms. She
may feel impotent. In addition she indicates much
difficulty with sexuality and aggression. She may have a
fear of penetration, anxiety about phallic symbols, or
castration anxiety. She may have a desire to return to
the womb and/or possible suicidal tendencies. She may
have significant problems with ego boundaries.
The
HTP and TAT were similarly interpreted as indicating extreme
psychopathology and the psychologist concluded that the woman
had major weaknesses in areas crucial to parenting and was in
need of long-term, intensive, analytically-oriented therapy,
and therefore the father should have custody.
Millon
Clinical MultiaxIal Inventory (MCMI and MCMI-Il)
Practically
any computerized Millon Clinical Multiaxial Inventory
interpretation can serve as a horrible example when the
interpretation is used as part of a forensic (as opposed to a
clinical) evaluation and the test is not interpreted
accordingly. Very often, what we see is the computerized
interpretation of the MCMI-II lifted verbatim and without
qualification from the computerized printout which accompanies
the test scoring. This is a violation of the ethical
standards for psychologists who use computerized test
interpretations.
This
practice is a particular problem with the MCMI-II, which is
normed on and intended to be used for a clinical population.
When used for other assessment purposes, the MCMI-II must be
interpreted extremely cautiously because of its tendency to
overpathologize. The result of using these computerized
interpretations therefore greatly exaggerates psychopathology.
The
problem is not in the test, but in its misuse. The test
is normed entirely on clinical samples and is only intended
for persons who have psychological symptoms and are being
assessed for treatment and evaluation. The manual (4)
clearly states that this test is "not a general
personality instrument to be used for 'normal' populations or
for purposes other than diagnostic screening or clinical
assessments." Millon has repeatedly warned against
using the inventory with people who are not psychiatric
patients because the test norms may not be valid if the
subject does not fit the standardizing (psychiatric) group (5).
We
do use this test as part of our overall assessment but
interpret it cautiously and conservatively with the above in
mind. When used in this way, it can provide useful
information. Choca, et al. (5)
state that there is nothing intrinsically wrong with using the
MCMI to test "normal" people as long as the
evaluator is aware that the test was designed for and
standardized with a psychiatric population. The user
will have to make the appropriate adjustments and alter the
narratives. The computerized narrative must never be
lifted verbatim into the report since it will find serious
psychopathology and personality disorders in just about
everyone.
RORSCHACH
Few
evaluators using the Rorschach acknowledge its limitations.
If the Rorschach is used, its limitations should be clearly
noted unless the Exner system is used. And then, it is
necessary to say what is being scored by the Exner system.
But often, idiosyncratic interpretation techniques are used to
form conclusions and make recommendations which affect the
lives of people.
There
is no empirical support for the validity of the Rorschach,
except when the Exner system is used. Reviews in the Buros
Mental Measurement Yearbook for every year in which this
test has been reviewed state that there is no research
demonstrating its validity. For example, in the Eighth
Mental Measurements Yearbook (6)
Peterson concluded: "The general lack of predicted
validity for the Rorschach raises serious questions about its
continued use in clinical practice."
In
commenting upon the use of the Rorschach, Dawes (7)
writes:
Now
that I am no longer a member of the American Psychological
Association Ethics Committee, I can express my personal
opinion that the use of Rorschach interpretations in
establishing an individual's legal status and child custody is
the single most unethical practice of my colleagues. It
is done, widely. Losing legal rights as a result of
responding to what is presented as a "test of
imagination," often in the context of "helping"
violates what I believe to be a basic ethical principle in
this society — that people are judged on the basis of what
they do, not on the basis of what they feel, think, or might
have a propensity to do. And being judged on an invalid
assessment of such thoughts, feelings, and propensities
amounts to losing one's civil rights on an essentially random
basis.
Example
8
The
psychologist in this example interpreted the Rorschach as
reflecting:
[a]
... highly defensive stance which is accompanied with
blocking, censoring, and inhibition of his underlying affect
... an undercurrent of anxiety, unrequited love, and cloaked
sexuality ... difficulty with relating appropriately to others
... latent polymorphous perverse orientation to the
environment ... fantasies (that may include) homosexual,
bisexual, and exhibitionist feelings ... hostility toward
women ...
Examination
of the man's actual responses to the Rorschach yields no
evidence for interpreting his Rorschach as pathological.
Although there is indication of scoring, apparently using the
Klopfer or Beck scoring approaches, there is no report of any
of the ratios and no attempt to base any of the
interpretations upon either a scoring summary or specific
responses. Within the Rorschach literature the actual
responses of the client do not warrant these interpretations.
They are personal, subjective, and idiosyncratic
interpretations. The interpretations assert the reality
of inferred unconscious processes going on inside the client.
There are no scientific data to support postulation of these
intervening variables. The phrase, "latent
polymorphous perverse orientation to the environment," is
meaningless jargon with no referent in reality.
MMPI
Ziskin
(8)
notes that the MMPI better fits the forensic requirements for
evidence to be believable and understandable than do other
assessment methods. The MMPI has years of validation
research and the data obtained from it are objective and
quantifiable. The MMPI-2 was developed so that the
research on the original MMPI is still relevant and usable.
In fact, the MMPI-1 profile can be drawn using the table in
the back of the MMPI-2 manual.
Nevertheless,
MMPIs are often overinterpreted and misinterpreted. Such
erroneous interpretations are not simply a matter of a
difference of opinion; the horrible examples we have seen
result from idiosyncratic interpretations without a basis in
the empirical literature. In addition, as with the MCMI-II,
sometimes computerized interpretations are used without
qualification. Not all computerized MMPI interpretative
programs are equally good (9).
Scale
5: Example 9
This
profile, in which scale 5 was at 82 and scales 3 and 9 at 70,
was seen as "very consistent" with someone who
sexually abuses a child. The scale 5 elevation was seen
as particularly significant and as reflecting sexual conflict
and sexual dissatisfaction. The psychologist testified
that this elevation indicates somebody who is in trouble
because of their sexual behavior. He denied, under
cross-examination, that a high scale 5 can reflect a college
education or high degree of education. He asserted the
MMPI indicated that the client had a tendency to act out
sexually with a child.
It
is mistake to interpret an elevation on scale 5 as reflecting
sexual conflicts or as meaning it is likely that the
individual is homosexual or a child molester since there are
many factors behind such an elevation. Such an elevation
generally reflects an intelligent, imaginative, sensitive, and
passive individual with a wide range of interests which do not
fit the masculine stereotype. Lachar (10)
reports that the college educated frequently obtain elevations
in this range. Fowler (11)
points out that scale 5 is a nonpathological scale.
Graham (12)
notes that scores on scale 5 are related to intelligence,
education, and socioeconomic level and that a T-score of 80 is
only a moderate elevation for an educated middle-class person.
Duckworth (13)
states that an elevation on scale 5 suggests a passive person
with aesthetic interests and notes that elevations are typical
of males with college education. Other MMPI experts
report similar characteristics associated with scale 5
elevations. There is no indication in the MMPI
literature that child molesters or other sex offenders are
more likely to score high on scale 5. (It is of note
that the MMPI-2 norms result in much lower scale 5 elevations
in males.)
Overinterpretation
of the K Scale In Court or Custody Settings
An
overinterpretation of a high K scale in a court or custody
setting is a common error. Any conclusions about
defensiveness on the MMPI must be qualified in terms of the
testing situation. Elevations on the K scale in persons
taking the MMPI in custody and court situations are common and
must not be interpreted as signifying defensiveness as a
personality characteristic. It is a normal and adaptive
response to the situation and must not be overinterpreted.
Reports in which there is a K elevation should include the
information that persons taking the MMPI as part of a custody
or court evaluation commonly have elevations on scale K.
Graham (14)
notes that if he doesn't see an elevation on K in a custody
evaluation, he wonders what is the matter — doesn't the
person want the child?
Example
10
This
was a divorce and custody evaluation which was complicated by
allegations of sexual abuse against the father. The
scale K elevation was at 70 in an otherwise within normal
limits MMPI and this was interpreted by the psychologist as
"clinically significant." He claimed this
meant that the client was defensive and was trying to
"present himself in the best light psychologically and
emotionally." He said that "he was trying to
answer the questions in the direction of looking good,"
and asserted, "Sexually, this kind of thing (an elevation
on the K scale) is expected." There were no
qualifications in terms of the setting in which the MMPI was
taken.
In
addition, this was a professionally and occupationally
successful man with college education. Such persons
routinely have higher K elevations, which indicates good ego
strength and competence.
Failure
to Recognize the Situational Factor. In a Scale 6 Elevation:
Example 11
This
man, who had been accused of sexual abuse which he denied, had
a scale 6 elevation which was interpreted as indicating high
defensiveness, anger, distrust, sexual conflict, poor
behavioral controls, and tendencies toward acting out
conflicts and impulses. It was labeled "seriously
abnormal," a "very pathological profile,"
"scary" and very unusual and abnormal.
However,
an elevation in scale 6 is a common response in persons who
have been accused of sexual abuse and who deny the
allegations. This is due to the affirmation of such
items as: I know who is responsible for most of my
troubles, Someone has it in for me, I believe I am being
plotted against, I am sure I am being talked about.
Rather than reflecting anger, hostility, suspiciously, and
paranoia as pathological personality traits, the endorsement
of these persecutory items reflects the individual's current
reality and is a normal response to the situation.
We
have done research on this (15,
16).
Ziskin (8)
also discusses such situational effects on scales 6 and
recommends caution in interpreting scale 6 elevations in such
circumstances.
Failure
to Use Adolescent Norms for an Adolescent: Example 12
A
15-year-old boy was given an MMPI as part of an evaluation
regarding a claim by his sister that he had sexually abused
her. Both were adopted minority children who came from
troubled backgrounds. The boy stoutly denied the
allegations, which arose after he, while babysitting, had put
his sister to bed early as punishment for misbehavior.
The
boy did not complete the MMPI items, so the psychologist
called him and read the items to him over the telephone.
The MMPI was then computer scored using the adult norms.
The interpretation given by the evaluator was that the MMPI
indicated the boy had significant problems with anger
management, interpersonal relations, impulsivity,
unpredictability, and hostile and sexual acting out. She
concluded that he had, in fact, sexually abused his sister and
recommended that he be placed in an adolescent perpetrator
program. However, when the adolescent norms for the
boy's MMPI are used, the only elevation is on scale 3.
Scales 4, 8, and 9 are well within normal limits.
The
literature on the MMPI indicates that it is standard procedure
to use the adolescent norms in order to draw conclusions about
pathology in a given adolescence and it is standard practice
to plot both profiles. Although adult norms may be used
in research since we need to see the contrast between
adolescents and adults, the adult norms must not be used
forensically. The meaning "disturbed" or
"abnormal" can only be established against
adolescent norms.
This
should no longer be a problem now that the MMPI-A (17)
is available. This MMPI revision is intended for adolescents
age 14 to 18 and should be used for this group rather than the
MMPI-2.
Departing
from Standard Administration Procedures: Example 13
In
this custody evaluation, the psychologist sent the MMPIs home
to be finished, even after the husband had told him about an
earlier MMPI taken by his wife in which she talked to him
about what answer to put down on some of the items.
Whereas
psychologists may sometimes do this with therapy clients, it
is never acceptable for a forensic evaluation where the
results of the evaluation are to be presented in the justice
system and are to be used in making decisions about people's
lives. Ziskin (8)
warns against this practice:
The
"take home" MMPI should be avoided in the forensic
situation ... This practice can lead to questions as to
whether the individual took the test in the standard way and
whether all of the responses are purely his own, as
highlighted by Graham's amusing anecdote about the mental
hospital patient who had his ward colleagues assist him by
voting on the appropriate answers.
Overinterpretation
of the MMPI Supplementary Scales
The
supplementary scales must be interpreted cautiously when the
basic clinical scales are within normal limits and the
interpretations must be on the basis of rules that are based
on research.
Example
14
In
this custody evaluation, the clinical scales for the father
were all well within normal limits but the dominance scale was
elevated above 70. The MMPI was therefore interpreted as
indicating that the individual had a "highly assertive
and domineering style," whose leadership is
"characterized by determination, inflexibility, and an
almost autocratic control." In his trial testimony,
the psychologist said that the client is "a very willful
man" who has "not played the game right" and
added that "All the time, I suspect what I saw in my
tests undercuts that quite a bit, because assertiveness, being
aggressive, dominance, can become autocratlcness, and I think
that's what has happened."
This
is a misinterpretation of a dominance scale elevation in an
otherwise within normal limits profile. Caldwell (18)
says the following about the appropriate interpretation of the
Do (Dominance) supplementary scale:
Although
based on peer nominations of subjects as strong, confident,
influential, unintimidated in face-to-face situations, and
showing initiative and leadership ... the title
"dominance" may be partially misleading. That
is, the scale reflects taking charge of one's own life — or
not taking charge — considerably more than bossiness or
being overbearing ... Do should be interpreted as taking
charge of one's life ... e.g. as self-organizing, making
workable plans, and meeting deadlines.
This
description, was, in fact, quite accurate for this man.
MULTIPHASlC
SEX INVENTORY
The
Multiphasic Sex Inventory (MSI) (19)
is a self-report questionnaire which consists of statements
about sexual activities, problems and experiences. It
has scales which assess the level of openness about the
deviant sexual behaviors. It has been reported to be
useful in assessing sex offenders in order to develop
treatment plans. It may also be used during treatment to
assess progress. However, it is now sometimes being used
to assess an individual who denies sexual abuse to determine
whether the individual actually is an abuser.
This
test is not intended for this purpose. The manual
accompanying the MSI states "[I]t is important to
remember that the MSI is not appropriate for use in the legal
pursuit of guilt or innocence. The alleged offender must
acknowledge culpability in order for the inventory to be
used" (19).
It must never be used on an individual who denies being a sex
offender or as part of an assessment to determine whether
someone who denies an alleged sex offense is likely to have
actually done it (20).
Example
15
The
sexual abuse allegations arose when the child was supposed to
be returned from a visitation with the mother (the father had
custody). The MSI, which was part of the court-ordered
evaluation, was interpreted in terms of a "fake
good" response (which means that the respondent either is
lying about his sexually deviant interests or does not in fact
possess these interests) and it was concluded that the client
had an "elevated level of denial" and was not
telling the truth.
PENILE
PLETHYSMOGRAPH
The
plethysmograph is a useful technique in developing
individualized treatment program for sexual offenders.
However, it is an error to use it with someone who denies
committing a sexual offense in order to determine the veracity
of the denial (21).
William R. Farrall, the major manufacturer and provider of
plethysmographs and trainer of the use of penile
plethysmographs, says that the plethysmograph must never be
used in this way because it produces too many false positives
— that is, deviant elevations in persons who are not sex
offenders (22).
The consensus of the experts in the field is that
plethysmography is useful in treatment, has limited use in
predicting future behavior of known sex offenders, but is of
no use in screening a normal population. It cannot be
used to determine whether a person who has been accused of sex
molestation and is denying it is telling the truth.
Research
indicates that normal heterosexual males with no indication of
any sexual interest in children frequently respond with some
evidence of penile engorgement to the presentation of the
stimuli used to present aberrant sexuality, including
children. The data also show that responses to the
plethysmograph can be manipulated and faked in any direction
the subject chooses (23-26).
Example
16
A
client was given the penile plethysmograph and it was found
that his highest level of arousal was to adult females
followed by four-year-old females and 12-year-old females.
This was used to support the conclusion that the client was a
possible pedophile who therefore had been untruthful in his
denial of child sexual abuse.
OTHER
"TESTS"
There
has been much criticism of the use of the anatomical dolls in
assessments of children suspected of sexual abuse. The
anatomical dolls sometimes are used as a type of test and the
behavior of the child in interacting with the dolls is used to
draw conclusions about abuse. Two American Psychological
Association committees (the Committee of Children, Youth, and
Families and the Committee on Psychological Testing and
Assessment) (27)
determined in a March, 1988 meeting that the dolls "are
considered to be a psychological test and are subject to the
standards when used to assess individuals and make inferences
about their behavior" (28).
We
have frequently criticized the use of the dolls and the way
interactions with the dolls are often interpreted (15,
29-31).
To date, there are no standardized or normative data for the
dolls, a fact acknowledged by the APA Council of
Representatives in 1991 (32).
Nevertheless, a whole paper could be written on horrible
examples using the dolls. We have addressed this
elsewhere and will not discuss this further here.
However,
many other techniques are used by psychologists and other
evaluators, such as games, puppets, story telling, play
observations, projective cards, and play dough (33).
When the psychologist goes beyond these techniques as a way of
encouraging the child to talk and uses them as indications or
evidence of abuse, they are subject to the same criticisms
leveled against the dolls and the drawings.
Example
17
In
an evaluation session, a three-year-old girl poked a toy cat
with a tinkertoy. Her parents also reported that she
tried to poke the cat at home. (The parents gave great
attention to this behavior, which, not surprisingly, continued
and escalated.)
This
was interpreted by the evaluator in terms of reenactment and
repetition and was seen as supporting the belief that the
child had had a tinkertoy stuck up her genitals by a
four-year-old boy at the day care center (this supposedly
happened in the lunch room with a teacher present). The
poking of the toy cat with the tinkertoy was seen as symbolic
for the boy poking her. The evaluator claimed that the
child was working through her trauma by repeating her own
victimization. The play was interpreted as supporting
the reality of the alleged abuse (which was unsubstantiated by
child protection).
Example
18
The
therapist claimed that she was able to tell whether the
alleged events (ritualistic, satanic abuse) actually happened
or didn't happen by observing such things as a "white
face" or "dark eyes" when the child was talking
about the events.
Example
19
The
child was described as having the "hardened, drawn,
demeanor of an abused child." This was used as
evidence that the child had, in fact been abused.
(Photographs of the child taken during this period show a
normal appearing, attractive child.)
Example
20
A
baby was returned to the foster mother following a visit with
the parents and was described as having the "smell of
sex." An emergency hearing was held in which social
services attempted to cut off visits because this "smell
of sex" triggered the suspicion that the parents were
having sex with their baby. A psychologist agreed that
the sex smell was significant and indicated probable abuse on
the part of the parents. Fortunately, the parents had
been at a church potluck dinner during the entire visit so
they were able to disprove, the accusations.
RELEVANT
ETHICAL PRINCIPLES
Several
ethical principles for psychologists are relevant to these
examples. These are found in both the applicable principles
from the Ethical Principles of Psychologists (34)
and the revised Ethical Principles of Psychologists and Code
of Conduct (35)
which will take effect on December 1, 1992. These
principles stress the fact that psychologists bear a heavy
social responsibility since their recommendations and actions
may alter the lives of others. They therefore must
maintain high standards of competence and only provide
services for which they are qualified by training and
experience. When using psychological testing, they must
maintain knowledge of the relevant literature and understand
validation problems and test research. When reporting
the results of their assessments, they must indicate any
reservations they have regarding test validity or reliability
because of the circumstances of the assessment or the
inappropriateness of the norms for the person tested.
They guard against the misuse of assessment results by others.
The
American Psychological Association's (36)
Standards for Educational and Psychological Testing stresses
the necessity for following the standardized procedures for
test administration and scoring specified by the test
publisher. If any changes in these procedures are made,
this should be described in the report, along with appropriate
cautions about the possible effects on the validity of the
results. Psychologists must not imply that their test
interpretations are based upon a empirical evidence of
validity unless such evidence exists.
The
American Psychological Association's Guidelines for
Computer-Based Tests and Interpretations (27)
states that computer-generated interpretive reports should be
used only in conjunction with professional judgment. The
psychologist must determine for each individual the validity
of the computerized test report based on the test taker's
characteristics along with the context of the testing
situation.
CONCLUSIONS
Forensic
psychologists have a duty to do a careful assessment and to
report their conclusions in a responsible manner since their
conclusions can affect the lives of others. The
psychologist should only present conclusions which are based
on empirical research and which can be adequately defended.
If decisions and recommendations by the psychologist are not
based on adequate data, the psychologist is acting both
incompetently and unethically.
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