Few would argue that adequate law enforcement is a critical component of any viable society. The challenge is to provide a well-trained professional force that serves all members of society. Law enforcement, for the most part, is a routine, often boring profession throughout the country with the exception of “high crime areas.” Training and professionalism is most critical in societies like the United States where law enforcement personnel are licensed to bear and use firearms. Both education (college or university degree) and professional training (police academy) are interrelated components of a professional police department regardless of level—federal, state, county, municipal, or local. The Omnibus Crime Control and Safe Streets Act served as the impetus for universal training standards, while the 9-11 terrorist attacks on the United States drew attention to the need for better channels of communication and information sharing. Modern technology and a larger number of recruits pursuing college-level degrees have addressed this major concern stemming from the problems endemic within the nation’s highly decentralized law enforcement picture leading up to the turbulent era of the 1960s and 1970s. What is often lacking is adequate assessment of law enforcement personnel both at the entry level and continuing throughout this career lifespan. Today, we have a better understanding of the biology of human behavior, including impulse dysregulation, traumatic stress, and brain injuries. Reliable psychological assessments have also been present since the Second World War, techniques that provide the foundation of the behavioral profiling so popular in the forensic fields today. Thanks to new brain-imaging techniques over the past twenty-five years, new insights into the functioning of the brain have emerged and have addressed long-held misconceptions about human development and culpability. These insights have challenged judicial cultural lags, including such issues as treating juveniles or mentally deficient individuals as rational adults, hence deserving of society’s harshest punishments, especially if they are members of the perceived minority out-groups. These major changes are as follows:
In Roper v. Simmon, the U.S. Supreme Court ruled that the Constitution forbids the execution of those convicted of murder who were under age eighteen at the time of the offense. This ruling ended this practice used in nineteen states, negating the death sentences of about seventy juvenile murderers at that time and barring states from executing minors in the future. In Roper the American Psychological Association (APA) acted as a “friend of the Court” and presented research on the development of the brain from childhood to young adulthood—notably the pruning of dendrites beginning at puberty and the slow process of myelination of the frontal lobe neurons (seven years following the cessation of physical growth 18 + 7 = age 25). The APA argued that the psychological consequences of this neurophysiological process included impulsivity, which is due to an immature frontal lobe capacity relevant to the central nervous system “executive functioning”—a critical factor regarding “mens rea” (rational intent and culpability). Moreover, a common outcome was group impulsivity, known as the risky-shift phenomenon, and that substance use/abuse merely exacerbated the individual’s potential for self-control.
In Miller v. Alabama, these conditions were again presented before the high court when it was found that many states were doling out first degree murder sentences of “life without parole” for juvenile homicide offenders, ignoring these physiological and psychological processes whereby those under age eighteen (many clinicians would argue age twenty-five) should automatically fall into a special classification with these conditions constituting strong mitigating circumstances. Miller represented the practice of many states that automatically gave youth, once death qualified, sentences of “life without parole.” The Miller case was actually a consolidation of two cases, Miller v. Alabama [no. 10-9646] and Jackson v. Hobbs [no. 10-9647]. In Miller, Evan Miller, age fourteen, was convicted of murder after he and another boy set fire to a trailer where they had bought drugs. In Jackson, Kuntrell Jackson, age fourteen, was with two other teens who went into a video store to rob it. Jackson was the outside lookout. One of his colleagues shot and killed the clerk. Jackson, like Miller, was charged as an adult and also given the maximum sentence of “life without any possibility of parole.” Both youth were of African American descent. In the five to four decision, Justice Elena Kagan wrote: “Miller did not outlaw mandatory life sentences without possibility of parole for youth . . . it merely stated that this process could not be automatically assigned whenever the courts decide to adjudicate a juvenile as an adult for a crime related to a homicide—even if they did not commit the murder or intended to do so.”1
Another consideration relevant to both offenders and law enforcement personnel is the prevalence of traumatic stress, including traumatic brain injuries. The first challenge in determining the presence of a mental disturbance is to attempt to discern between transitory and pervasive disorders. It is also important to attempt to separate personality disorders from clinical diagnoses, although this is not always an easy task, especially since baselines are not readily available. Also, a differential assessment needs to be made concerning substance-related disorders, which often complicates determining which diagnoses are primary and which are associated or comorbid features of the presenting mental problem. Transitory mental disorders include the adjustment disorders that are quite common for returning veterans or refugees. A serious consequence of untreated transitory disorders is anomic suicide. These disorders reflect conditions, if left untreated, that could manifest as a major clinical disorder. Fortunately, transitory mental conditions often lend themselves to effective treatments, namely psychopharmacology and cognitive behavioral therapies. The pervasive mental illnesses, notably those that are prone to be of a genetic or organic origin, such as major depression, bipolar depression, schizophrenia, delusional disorders, obsessive-compulsive disorder, and impulse control disorders, including paraphilia, are more complex to treat and often require a long-term treatment protocol. Included here are psychological outcomes from traumatic brain injuries (TBIs). Often diffuse (closed) head injuries are more difficult to identify than those injuries with a focal injury. Symptoms are associated with not only the type of TBI (diffuse of local) but are specific to the region of the brain insult. With mild TBIs, the person may remain conscious or only lose consciousness for a few seconds or minutes. These are often concussions and present with headache, vomiting, nausea, poor motor control, dizziness and balance problems, lightheadedness, blurred vision, ringing in the ears, fatigue/lethargy, and somatic difficulties. Behavioral problems include mood changes, confusion, memory problems, and difficulty concentrating or thinking. Moderate or severe TBIs, while more obvious, also present with a host of physiological and psychological problems, including persistent headaches, vomiting/nausea, convulsions, slurred speech, aphasia, weakness or numbness of limbs, poor motor coordination, confusion, and agitation or impulsive outbursts. Behavioral problems can include deficits in social judgment, inappropriate social interactions, and cognitive problems associated with memory, attention, and executive functioning. The treatment and rehabilitation needs of TBI patients include protocols that address: improving memory and problem-solving skills; managing stress and emotional problems, including temper and impulsive outbursts; and providing social and occupational skills.2
Examples of Police Assessment and Aggregate Profiling
Law enforcement assessments need to address both competency and suitability. A single measure is not adequate in addressing the issues of intelligence, education, personality, and aptitude. Thus, a battery of instruments is needed, with the interview driven by the Mental Status Exam, which will also highlight neurological deficits. Moreover, aptitude and suitability needs to include more than an interview with the hiring police official(s). Here, the strongest predictive instrument, and one widely used in police selection, is the Minnesota Multiphasic Personality Inventory (MMPI).
The Minnesota Multiphasic Personality Inventory
The MMPI is the most widely used tool for screening police candidates, mainly due to its capacity to satisfy two primary conditions: psychopathological (clinical) screening and the prediction of occupational success. Retrospective studies have led to a wealth of data relevant to both professional attitude and mental health status. This is one of the most studied psychological assessment tools with thousands of published reports. All versions—the MMPI, MMPI-2, and MMPI-A—provide a graphic profile based on a t-score distribution where fifty is the mean and the standard deviation is ten. Two standard deviations signify “statistical significance” within this format.
The MMPI consists of three validity scales (Lie, Validity, Corrections) and ten clinical scales. There are also a number of supplementary scales and critical items. Among the numerous predictive profile sets, the MMPI provides both forensic and police profiles, including those predicting: Good Cop Profile, Bad Cop Profile, Mad Cop Profile. The MMPI is one of the most widely used tools, along with the MSE, for screening for mental illness and is the leading assessment for predicting occupational success, including mental health professionals, law enforcement, and legal professionals. The MMPI was first standardized in 1943 and readied for use. Its reliability and validity is not so much due to its original construction validation sample, which was poor by current standards, but to the numerous sets of predictive data generated by the MMPI during its more than seventy years of retrospective research relevant to both concurrent and predictive studies. Its predictive strength comes from the instrument being administered to all individuals entering academic and/or professional studies at the time of their entry into these programs. This represented the concurrent study data, whereby aggregate profiles were later developed reflecting those who were successful or unsuccessful in these professions, hence leading to the MMPI’s predictive strength. These retrospective studies have led to a wealth of data in the areas of professional aptitude and mental health status. Clearly, this is one of the most studied assessment tools with thousands of published reports, including samples, worldwide.
The Validity Scales. The original MMPI consists of three validity scales (Lie, Validity, and Corrections). The Lie scale (L) is based on a group of items that place the respondent in a favorable light but are unlikely to be truthfully answered as being true. The Validity scale (F) consisted of unfavorable items unlikely for any respondent to answer all as relevant to his or her life. Accordingly, high F scores reflect a number of responding errors: carelessness in responding, gross eccentricity, or deliberate malingering (faking bad). The Correction scale (K) again uses specifically chosen items that measure test-taking attitudes. A high K score most likely indicates defensiveness or an attempt to fake good. A low K score, on the other hand, may reflect frankness and self-analysis or yet another attempt to fake bad. The K score also provides a computed correction factor that is added to certain clinical scales in order to provide a weighted adjusted scale: scale 1 (Hs) = +0.5K; scale 4 (Pd) = +0.4K; scale 7 (Pt) = +1K; scale 8 (Sc) = +1K; and scale 9 (Ma) = +0.2K. These weighted factors are provided on the MMPI Profile and Case Summary sheet, which presents a graphic representation of the MMPI scores based on a t-score distribution.
The Clinical Scales. The body of the original MMPI consists of ten clinical scales that correspond to the major clinical syndromes posited by the diagnostic and statistical manuals.
Supplemental Scales. A number of additional scales, many outside the clinical criteria outlined in the DSM, are part of the more recent MMPI-2. Even with about twenty years of data available, most of these additional scales are not yet considered to have the reliability and validity of the original thirteen scales. However, four supplementary scales are common to both the MMPI and the MMPI-2. These scales appeared as a modification to the original MMPI and many practitioners used the expanded MMPI continue to draw on these items when using the MMPI-2.
A Scale. High t-score on this item reflects miserable and unhappy individuals.
R Scale. On the other hand, high scores on this scale reflect individuals who are careful and cautious.
Combined A/R Scales. U.S. Veterans Administration data profiled the A/R combinations among its patients. Depressive diagnoses were associated with the high A–high R profile, while personality disorders were mostly associated with the low A–low R profile.
Es Scale. High scores on this item are indicative of stability and good mental health.
MAC-R Scale. This scale does not measure if a person is a problem drinker as much as it indicates his or her potential to exhibit problems if he or she drinks. High t-scores on this item indicate individuals who present themselves as being socially extroverted, self-confident, and assertive but are also likely to be exhibitionistic and risk takers.
Two- and Three-Point Code Types Relevant to Police Profiles
Hs (1)/D(2) Code: High t-scores on these two clinical items indicate somatic discomfort and pain and can be considered as the “fatigue scale” for law enforcement personnel.
Hs(1)/Pd(4) Code: Although rare and mostly affecting males, individual with high t-scores on these clinical items can present with problems with the opposite sex and a drinking problem, despite the outward appearance of being social extroverts. This profile could point to officers likely to have family problems and who may be subject to sexual harassment complaints.
Hs(1)/Ma(9) Code: Persons with high t-scores on these clinical items present as being verbal, socially extroverted, aggressive, and belligerent, when, in fact, they are basically passive/dependent individuals trying to conceal their basic characterlogic tendencies.
D(2)/Pd(4) Code: High t-scores on these clinical items indicate an impulsive profile, including substance abuse, illicit behaviors, and family discord, features likely to be exacerbated by occupational stress and corresponding behaviors.
D(2)/Pt(7) Code: These officers would be tense, anxious, nervous, and excessively worried about the hazards of their job. Moreover, they tend to be rigid in their thinking and of the law. They may also be excessively religious and extremely moralistic, hence less tolerant to those they perceive as being deviant (out-groups).
Hy(3)/Pd(4) Code: Persons with a high t-score profile on these clinical items tend to harbor hostile and aggressive impulses and are unable to express their negative feelings appropriately. If scale three is the higher scale, indirect expression of anger is likely. Persons with a higher four scale are over-controlled most of the time but have the potential for brief violent episodes, which can manifest themselves during a crisis situation.
Pd(4)/Pt(7) Code: High t-scores on these clinical items are indicative of episodes of acting out, including substance abuse and sexual promiscuity. Individuals with this profile may also report feeling tense, fatigued, and exhausted.
Hs(1)/Hy(3)/D(2) Code: Individuals with high t-score profiles on these clinical items have a tendency for conversion symptoms, where stress is often converted into physical symptoms. While presenting as sociable, they tend to be passive-dependent in their interactions. Look for an officer who pursues workmen’s compensation following stressful duty.
D(2)/Pd(4)/Pt(7) Code: A high t-score profile on this clinical set indicates a passive-aggressive personality, which is often manifested by substance abuse and family and marital problems. Despite strong achievement needs, these individuals tend to be angry, hostile, and immature with undercontrolled impulses.
Political Correctiveness and MMPI Revisions. The genesis of the current review of the predictive effectiveness of psychological testing was rooted in the U.S. Civil Rights Act of 1964, Section H of Title VII, which specifically makes reference to the use of nondiscriminatory tests for employment decisions. This, and other civil rights cases, led to the restructuring of the original MMPI. A major decision was the Soroka v. Dayton-Hudson case, better known as the Target case, which was filed as a class action on September 7, 1989. The case involved the use of a preemployment psychological screening device for security officers working for Target stores. The significance of the Soroka case was that it coincided with passage of the Americans with Disabilities Act of 1990, which underscored the importance of keeping the invasiveness of psychological inquiries in preemployment testing to a minimum. At that time, the Target stores used the Rodgers Condensed CPI-MMPI, which was developed in 1966. The California Psychological Inventory (CPI) augmented the MMPI by looking at attributes of one’s personality using a twenty-scale format, compared to the MMPI’s traditional ten clinical scales. However, the CPI also used 194 MMPI items in its 462-item measure. Security officer applicants screened out by Rodgers CPI-MMPI claimed that the inventory was not job related and was offensive and intrusive. Part of the problem with the Rodgers assessment tool was that no empirical data was available related to its administration, norming, standardization, and interpretation, even though such standards existed independently for the CPI and the MMPI. Hence, in August 1989, the MMPI-2 was introduced. This version came forty-six years after the original MMPI. The reason for a change in the MMPI was not that it needed re-norming (subsequent normings of the original has greatly increased its reliability and validity) but was to replace outdated items. Toward this end, the MMPI-2 omitted the sixteen repeat items, religious and sexual preference items, and what was felt to be outdated items. In all, 107 items were eliminated due to these reasons, but 108 items were added. Some of these new items pertain to revisions in the validity scales while others pertain to new scales and measures such as family dynamics, Type A behavior, eating disorders, substance abuse, and suicide.
The MMPI-2 is even longer (567 items) than the original MMPI (566 items). The norming sample for the MMPI-2 consisted of respondents who had higher educational levels than that of the general public, thereby contributing to a t-score distribution flaw where now T = 65 (a standard deviation and a half) indicates statistical significance instead of the traditional two standard deviations (T = 70 or more). In order to use the decades of reliability and validity associated with the original MMPI, the first 370 items of the revised MMPI-2 are said to correspond to the three validity and ten clinical scales of the MMPI, without of course the items measuring religiosity and sexuality. Given the significant changes reflected in the MMPI-2, many clinicians question the transferability of the original MMPI’s predictive validity, especially when measuring mental pathology and critical occupational suitability to the new versions. For one, hyperreligiosity and hypersexuality are common features of manic episodes.
A protocol used by forensic psychologists who prefer the greater reliability, validity, and predictability of the original MMPI is to alert those being tested as to archaic terms and the flexibility of tense (past or present). The authors found that 10 of the 566 items raised the most questions among those taking the MMPI:
Item 48: When I am with people I am bothered by hearing very queer things.
Item 57: I am a good mixer.
Item 70: I used to like drop-the-handkerchief.
Item 105: Sometimes when I am not feeling well I am cross.
Item 118: In school I was sometimes sent to the principal for cutting up.
Item 129: Often I can’t understand why I have been so cross and grouchy.
Item 236: I brood a great deal.
Item 381: I am often said to be hotheaded.
Item 471: In school my marks in deportment were quite regularly bad.
Item 506: I am a high-strung person.
Being able to define these items in contemporary terms is the only adjustment that is required for the continued use of the original MMPI and its seventy years of post facto predictive validity. The original MMPI assessment, at the time of job entry, should be conducted along with a mental status exam, with the MMPI score constituting a baseline profile. Subsequently, the abbreviated MMPI assessment, consisting of the first 360 items covering the three validity scales and ten clinical scales, can then be administered as needed with these profiles compared with the initial MMPI baseline profile.
In 1992, the MMPI-A (adolescent version) was introduced based mainly on the items from the original MMPI. The MMPI-A comes in both a long form (478 items) and a short form (350 items). Most recently, the MMPI-2-RF (restructured form) is an attempt to give the MMPI-2 clinical scales the same validity of those in the original MMPI. Yet many clinicians see these efforts as further complicating the assessment role of the MMPI, especially regarding major clinical syndromes and personality disorders. The added content scales of the MMPI-2, such as the Dominance Scale, Addiction Potential Scale, Addiction Acknowledgement Scale, Social Discomfort Scale, Type A Scale, Overcontrolled Hostility Scale, Marital Distress Scale, and Psy-5 Scales, all seem to add to the original problem as to why the MMPI was changed in the first place—claiming intrusive attributes of human behavior that may not stand up in a court of law when their reliability and validity is challenged, let alone what they purport to measure.3
Mental Status Examination
The Mental Status Examination (MSE) covers six categories of mental status that are generally observed during the initial clinical consultation. There are various methods of conducting the MSE, with most trained clinicians using the casual conversational approach so as to not startle the interviewee and further elevate his or her stress level.
Appearance, Attitude, and Activity. Appearance is the assessment of the physical characteristics of the client, including physical disabilities or abnormalities as well as the client’s dress, hygiene, grooming. This observation needs to be in concert with the client’s cultural norms and social class and not necessarily that of the clinician. Attitude is how the client reacts to the questions during the intake process—the factors here are cooperativeness, hostility, or overdependency. Activity looks at the client’s physical demeanor during the interview. What is their activity level, especially that which seems abnormal for the situation—sitting rigidly, involuntary tics or tremors, fidgeting, unique mannerisms, and such.
Mood and Affect. Mood and affect are sometimes difficult to distinguish from each other. Mood is how the person describes his or her feelings, while affect is the external manifestation of these feelings. The continuum for mood and affect runs from depression to mania. Generally speaking, mood and affect fall into six categories: euthymic (e.g., calm, friendly, pleasant); angry (e.g., belligerent, confrontational, hostile, irritable, oppositional, outraged); euphoric (e.g., cheerful, elated, ecstatic); apathetic (e.g., flat affect, dull, bland); dysphoric (e.g., despondent, grieving, hopeless, distraught, sad, overwhelmed); and apprehensive (e.g., anxious, fearful, nervous, tense, panicked, terrified).
Speech and Language. Speech looks at fluency of the language spoken. Also, note if this is the client’s original language or a second language. This category of the MSE looks at the following language functions: fluency of speech, repetition, comprehension, naming, writing, reading, prosody (variations in rate, rhythm, and stress in speech), and quality of speech. Portions of standardized intelligence tests such as the Wechsler batteries and the Stanford-Binet test can be used to determine many of these features. Disorders to look out for during this phase of the MSE include cluttering, dysgraphia, dyslexia, echolalia, mutism, palilalia, pressured speech, stuttering, and word salad, among others.
Thought Process, Thought Content, and Perception. Thought process involves evaluating the organization, flow, and production of thought, looking for abnormalities such as flight of ideas, loose associations, tangentiality, clang associations, echolalia, perseveration, thought blocking, and word salad. Thought content and perception looks for delusions, homicidal or suicidal ideations, magical thinking, overvalued ideas, obsessions, paranoia, phobias, preoccupation, rumination, suspiciousness, depersonalization, derealization, hallucinations, and illusions.
Cognition. Cognition is the ability to think using one’s intellect, logic, reasoning, and memory. The cognitive testing sequence involves: 1) orientation × 4—person, place, time, and situation; 2) attention and concentration; 3) registration and short-term memory; 4) long-term memory (verbal and nonverbal); 5) constructional and visuospatial ability; and 6) abstraction and conceptualization. Standardized tests used for attention and concentration include the Trail-Making Tests, Symbol Digit Test, and the Stroop Color-Word Test, while the Digit Span (forward and backward) subtest of the Wechsler IQ batteries is used for attention. Short-term memory is usually tested by giving the client three common words (e.g., cat, blue, bike) at the beginning of the session and then having them repeat these words back to you at least fifteen minutes into the session. Visual memory and construction and visuospatial ability can be tested with the Bender-Gestalt, Draw-A-Clock, Rey-Osterrieth Complex Figure Test, or Trail-Making Tests.
Insight and Judgment. Insightfulness includes the capacity for abstraction and the ability to communicate effectively with appropriate cognitive functioning while having a stable mood and affect and not manifesting any thought disorder. Insight and judgment are seen as being interrelated in that the ability to make sound judgments or decisions is dependent upon an adequate level of insight. Insight is the ability to be self-aware—being conscious of one’s feelings, ideas, and motives. Intrusive defense mechanisms such as repression, displacement, dissociation, reaction formation, and intellectualization often arise during this portion of the MSE, as well as acting out, externalization, idealization, projection, and denial and distortions. These are features that impair one’s insight and judgment.
The Mini-Mental Exam
This exam is an abbreviated form that is often used in hospital intakes. It consists of five categories: orientation; registration; attention and calculation; recall; and language. Under orientation, the client is asked the year, month, season, and day, as well as where he or she is at that time. Under registration, the client is asked to name three objects that you present and asked to repeat them back to you. In attention and calculation, have the client count back from one hundred by sevens. Stop after five answers. Under recall, ask for the three objects repeated earlier. With language, have the client name a pencil, and observe; have them repeat “No ifs, ands, or buts”; and then have them follow a three-stage command (take a paper in your right hand and fold it in half and put it on the floor). Then have them read a sentence and then write it followed with having the client copy a geometric design. These are usually scored and are used primarily with people suspected of brain damage, including those with TBIs.4
Other Assessments
While clearly the MMPI and MSE are the standard bearers of clinical assessment tools for a number of professions, including law enforcement, other instruments have surfaced that may supplement the MMPI and MSE. The Matrix-Predictive Uniform Law Enforcement Selection Evaluation Inventory (M-PULSE) (2004) is a relatively new instrument consisting of eighteen liability scales designed to predict officer misconduct; empirical scales to measure attitudes, values, and beliefs; and two validity scales to measure response bias. It consists of 455 statements and has mixed results regarding its validity in prescreening law enforcement and correctional officer candidates. Studies based on the M-PULSE liability scales found that the use of biographical information like this was not, in itself, predictive of police suitability on the job.5
Both the MMPI and MSE have the potential to address situational personality and/or mental disturbances such as suicide ideation, posttraumatic stress, substance abuse, potential for violence, and impulsive dysregulation secondary to brain trauma. This is especially relevant when military veterans are hired as civilian police officers. Quick assessment tools include those that address depression, anxiety, hopelessness, and suicide ideation. Screening instruments used for traumatic stress include the Impact of Events Scale (IES-R), General Health Questionnaire (GHQ 60), Symptom Checklist 90, Traumatic Symptom Inventory (TSI), Davidson Trauma Scale (DTS), Mississippi Scale for PTSD, Historical Clinical Risk Management (HCR-20), and the Detailed Assessment of Posttraumatic Stress (DAPS), to mention a few. For suspected brain injuries, use the McCormick TBI Interview, in addition to the neurological components of the MSE.6