Christoph Leonhard

Finding and maintaining employment is difficult for ex-offenders due to their criminal history but often required for community supervision. How ex-offenders discuss criminal history can influence their employment chances. Research has not yet explored moderating effects of race and ethnicity on ex-offender impression management when seeking employment. This study investigates how impression management strategies affect ex-offender hiring and whether race or ethnicity moderates such effects. College students ( N = 198) were randomly assigned to vignettes describing an ex-offender job applicant which varied in impression management and race and ethnicity. Participants rated applicants on factors related to hiring decisions. Results indicate ex-offenders who apologized when discussing criminal history received stronger hiring recommendations. Race and ethnicity of the participant or ex-offender did not moderate the effect of impression management on hiring. Overall, ex-offenders benefitted equally from an apologetic strategy when discussing their criminal history regardless of their or the hiring manager’s race or ethnicity.

Forensic neuropsychological examinations with determination of malingering have tremendous social, legal, and economic consequences. Thousands of studies have been published aimed at developing and validating methods to diagnose malingering in forensic settings, based largely on approximately 50 validity tests, including embedded and stand-alone performance validity tests. This is the first part of a two-part review. Part I explores three statistical issues related to the validation of validity tests as predictors of malingering, including (a) the need to report a complete set of classification accuracy statistics, (b) how to detect and handle collinearity among validity tests, and (c) how to assess the classification accuracy of algorithms for aggregating information from multiple validity tests. In the Part II companion paper, three closely related research methodological issues will be examined. Statistical issues are explored through conceptual analysis, statistical simulations, and through reanalysis of findings from prior validation studies. Findings suggest extant neuropsychological validity tests are collinear and contribute redundant information to the prediction of malingering among forensic examinees. Findings further suggest that existing diagnostic algorithms may miss diagnostic accuracy targets under most realistic conditions. The review makes several recommendations to address these concerns, including (a) reporting of full confusion table statistics with 95% confidence intervals in diagnostic trials, (b) the use of logistic regression, and (c) adoption of the consensus model on the “transparent reporting of multivariate prediction models for individual prognosis or diagnosis” (TRIPOD) in the malingering literature.

Forensic neuropsychological examinations to detect malingering in patients with neurocognitive, physical, and psychological dysfunction have tremendous social, legal, and economic importance. Thousands of studies have been published to develop and validate methods to forensically detect malingering based largely on approximately 50 validity tests, including embedded and stand-alone performance and symptom validity tests. This is Part II of a two-part review of statistical and methodological issues in the forensic prediction of malingering based on validity tests. The Part I companion paper explored key statistical issues. Part II examines related methodological issues through conceptual analysis, statistical simulations, and reanalysis of findings from prior validity test validation studies. Methodological issues examined include the distinction between analog simulation and forensic studies, the effect of excluding too-close-to-call (TCTC) cases from analyses, the distinction between criterion-related and construct validation studies, and the application of the Revised Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2) in all Test of Memory Malingering (TOMM) validation studies published within approximately the first 20 years following its initial publication to assess risk of bias. Findings include that analog studies are commonly confused for forensic validation studies, and that construct validation studies are routinely presented as if they were criterion-reference validation studies. After accounting for the exclusion of TCTC cases, actual classification accuracy was found to be well below claimed levels. QUADAS-2 results revealed that extant TOMM validation studies all had a high risk of bias, with not a single TOMM validation study with low risk of bias. Recommendations include adoption of well-established guidelines from the biomedical diagnostics literature for good quality criterion-referenced validation studies and examination of implications for malingering determination practices. Design of future studies may hinge on the availability of an incontrovertible reference standard of the malingering status of examinees.

The thoughtful commentaries in this volume of Drs. Bush, Jewsbury, and Faust add to the impact of the two reviews in this volume of statistical and methodological issues in the forensic neuropsychological determination of malingering based on performance and symptom validity tests (PVTs and SVTs). In his commentary, Dr. Bush raises, among others, the important question of whether such malingering determinations can still be considered as meeting the legal Daubert standard which is the basis for neuropsychological expert testimony. Dr. Jewsbury focuses mostly on statistical issues and agrees with two key points of the statistical review: Positive likelihood chaining is not a mathematically tenable method to combine findings of multiple PVTs and SVTs, and the Simple Bayes method is not applicable to malingering determinations. Dr. Faust adds important narrative texture to the implications for forensic neuropsychological practice and points to a need for research into factors other than malingering that may explain PVT and SVT failures. These commentaries put into even sharper focus the serious questions raised in the reviews about the scientific basis of present practices in the forensic neuropsychological determination of malingering.

This study examined PrEP attitude and HIV risk factors associated with PrEP motivation and evaluated the efficacy of a mock public health video that addresses both motivational and stigma issues for improving PrEP uptake over a standard educational video. Gay, bisexual, and other men who have sex with men (GBMSM; N = 604) were enrolled. One-way between subject analysis of variance (ANOVA) and post-hoc comparisons revealed that GBMSM in later stages of change had significantly higher endorsement of positive PrEP attitudes, PrEP stigma, objective and perceived HIV risk, HIV worry, and valued health benefits of PrEP more. Stepwise multiple regression revealed five significant predictors of PrEP motivation: HIV worry, objective HIV risk, anticipated PrEP stigma, positive PrEP attitudes, and perceived social consequences of PrEP use. Video conditions did not differ in their impact on PrEP attitudes or motivation; however, regardless of video condition, participants experienced a pre- to post-video increase in positive PrEP attitudes and motivation. Findings suggest HIV worry, objective HIV risk, positive PrEP attitudes, and perceived PrEP health benefits are important factors to optimize PrEP motivation, which can inform secondary prevention efforts. Further study is needed on promotional PrEP campaigns that disconfirm stigmatizing PrEP misconceptions.

Gambling disorder is a “hidden disease” due to the lack of visible markers. It often negatively affects multiple domains of a person’s life and predicts adverse physical, mental, social, and financial outcomes. Health service settings are suited for early detection of gambling disorder because of its comorbid medical conditions and due to the trust patients have in their health service providers (HSPs). However, HSPs often lack the knowledge needed to screen for this disorder and to make appropriate referrals. This paper reports a quasi-experimental wait-list control study (experimental group n = 18; wait-list control group n = 14), with cross-over and a twelve-week follow-up which assessed whether a brief virtual gambling disorder training entitled Gambling Know More could improve gambling disorder knowledge among HSPs. Results showed workshop participation caused a significant increase in gambling disorder knowledge immediately after the workshop and twelve weeks later. Participation in Gambling Know More bodes well for increasing early detection of gambling disorder and appropriate treatment referrals among HSPs. Findings have important policy implications for the training of HSPs.

Self-Practice/Self-Reflection (SP/SR) is an aspect of therapist training and professional development aimed at enhancing therapy skills, empathy, wellbeing, and resilience in the ultimate furtherance of client outcomes. For many decades, intensive SP/SR has been a required part of therapist training in many countries but relatively little is known about the effect of SP/SR. Studies have found cognitive-behavior therapy (CBT) therapists trained under a Beckian CBT paradigm benefitted from more time limited Beckian SP/SR. Mindfulness-based CBT is a more recent third-wave CBT paradigm with psychological process aims similar to those of SP/SR. While training in mindfulness-based CBT often has prominent SP/SR aspects, and mindfulness practice has been shown to benefit health care providers personally and professionally, to date no evaluations have been reported specifically of effects of participation of CBT trainees in stand-alone mindfulness-based SP/SR that meets regulatory requirements for more intensive SP/SR. A study on SP/SR training meeting German requirements is reported here. Post-graduate CBT trainees ( N = 95) were assigned to delayed or immediate SP/SR with those in the delayed SP/SR condition crossing-over into SP/SR training after two baseline evaluations on a variety of reflective skill, wellbeing, and resilience measures spaced six to 9 months apart before participating in 120–150 hours of stand-alone mindfulness-based SP/SR followed by a third reevaluation on all study measures. Participants assigned to the immediate SP/SR condition underwent identical SP/SR training with pre/post assessments. Results indicate participation in intensive stand-alone mindfulness-based SP/SR resulted in favorable changes in measures operationalizing all variables. Findings are discussed in terms of their implications for training and professional development of CBT therapists.