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Integrating Idiographic and Nomothetic Data in Forensic Risk Assessment: A Case Illustration

Integrating Idiographic and Nomothetic Data in Forensic Risk Assessment: A Case Illustration David Joubert, Ph.D . University of Ottawa. Conceptual framework. Determination of future dangerosity is a significant component of clinical practice.

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Integrating Idiographic and Nomothetic Data in Forensic Risk Assessment: A Case Illustration

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  1. Integrating Idiographic and Nomothetic Data in Forensic Risk Assessment: A Case Illustration David Joubert, Ph.D. University of Ottawa

  2. Conceptualframework • Determination of future dangerosityis a significant component of clinical practice. • Avent of statistically-basedprediction. • However, heavycriticisms of the actuarialapproachon several fronts.

  3. Development of « hybrid » schemesincorporatingstatic and clinical (dynamic) vaeiables. • Communication of risk: Fromprobabilities to probabilisticstatements. • Concernsremain, however, regarding the reductionistic nature of riskassessment. • How do weintegrateidiographic information ?

  4. Principles for integratingidiographicassessment data • Idiographic: Individual cognitive, affective, motivationalcharacteristicswhichinteract to produce a particularresponse in a givencontext. • In order to uncoversuchcharacteristics, itisnecessary to vary the degree of structure and ambiguitywithin the assessment.

  5. Relevant questions • Whatinternalresources are available ? • Which motivations, anxieties, values are predominant ? • Whatis the individual’sexperience of self in relation to the other (Object), and how are relationshipsdeveloped and maintained ?

  6. Case study

  7. Background information • DC is a 52 y.o. African-American male • Found NGRI due to severepsychoticsymptoms • Index offense involved possession of illegal substance, resistingarrest.

  8. Developmental background: Minordelinquency, drug use. • Known to love music and « flirt with girls ». Current substance use in thiscontext. • Issues of markedjealousy and insecurity. • Unstableworkhistory, due to substance use.

  9. Several admissions intocorrectional or psychiatricfacilities, most of themdrug-related. • Currentpsychoticepisoderesolvedafterapprox. 2 years in the institution. However, heisexhibitingmarkedpreoccupationwith skin infestation. • Presents as quiet, reclusive, passivelycompliant.

  10. Behavioral observations • Cooperative but interpersonally flat, nonreactive. • Somepeculiarthought content or behaviorsat times. • Uncomfortablewithless-structuredtasks.

  11. Riskassessmentschemes • PCL score: 15 (T=41) • VRAG score: -6 (4th bin out of 9) • HCR-20: 12/40 (Low) • Riskfactors: Substance use; Criminal Hx; personalitydisorder; Lack of motivation.

  12. MCMI-III - Clinical

  13. MCMI-III - Personality

  14. Rorschach (2002) • Attemptsatdistancing self from stimulus • De-repressedsexual content (e.g., « female body part ») • Errors in logicalthinking (« it’s about that size…) • Obsessive defenses (e.g., « bat… but I don’t know what a bat looks like ») • No whole H; NumerousHd (faces) and Sx

  15. Rorschach (2008) • Unsuccessful use of obsessionaldefenses (e.g., « I don’t know if itgoesthisway or thatway »; haphazard  rotation). • Preoccupationsre: beinguncovered, exposed, intrudedupon (« I don’twannasaytoomuch …») • Preoccupationswith self boundariesevident.

  16. Summary of psychologicalassessment • Individualorganizedat the psychoticlevel, withunderlyingparanoidprocess. • Possibility of pre-existing condition, or caused by chronic substance use. • Loosening of defensesbrings about dysphoria but alsoprovidesbetteraccess to underlingconflicts.

  17. Analysis Consideration of psychologicalassessment data allowed for a betterunderstanding of needs, potentialtargets for intervention, optimal therapeuticmodalities, and potentialmoderators of risk.

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