Browsing by Author "Giles, Charles L."
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Item An examination of the combined use of the PAI and the M-FAST in detecting malingering among inmates(Texas Tech University, 2009-08) Gaines, Michelle V.; Morgan, Robert D.; Giles, Charles L.; Garos, Sheila; Clopton, James R.Severe mental illness is at least twice as common in correctional settings as in the general population (James & Glaze, 2006); however, mental health services resources remain limited in correctional settings (James & Glaze, 2006; Teplin, 1990). Complicating the issue of limited mental health resources, offenders in jails and prisons commonly feign symptoms of mental illness in order to receive treatment-related privileges (Rogers & Vitacco, 2002). Feigning inmates use mental health resources that would otherwise be allocated to genuinely mentally ill inmates, creating a need for clinicians to find efficient means of detecting feigning. The Structured Interview of Reported Symptoms (SIRS; Rogers, Bagby, & Dickens,1992), is currently the most widely validated feigning detection instrument. However, clinician time required to administer and score the SIRS renders the instrument inefficient in settings with limited mental health resources. The current study examined the use of the Miller Forensic Assessment of Symptoms Test (M-FAST; Miller, 2001) and the Personality Assessment Inventory (PAI; Morey, 1991) for increasing the efficiency of feigning detection. Archival data were examined from a male maximum-security correctional psychiatric inpatient sample (N = 100). Logistic regression analyses were performed using a combination of the M-FAST and PAI to distinguish inmates who feigned on the SIRS from non-feigning inmates. The variance in SIRS performance accounted for by the combined M-FAST/PAI model was large (93.6%) with high rates (94.7%) of classification accuracy. In addition, the M-FAST (92%) and the PAI (94.9%) individually performed well at classifying feigners and non-feigners. Consequently, logistic regression equations are presented for use as a clinical tool for calculating the probability that an individual would be classified as feigning on the SIRS, based on M-FAST and PAI scale scores.Item Implications of long-term incarceration for persons with mental illness(2012-08) Bauer, Rebecca; Morgan, Robert D.; DeMarree, Kenneth G.; Garos, Sheila; Giles, Charles L.Currently in the United Stated, 1.6 million offenders are incarcerated within state and federal prison systems (Guerino, Harrison, & Sabol, 2011). Most recent estimates purport approximately 24 percent of the prison population presents with serious mental health problems (James & Glaze, 2006); however, there is a paucity of research examining the impact of long-term incarceration among persons with mental illness (PMI). Although research with non-disordered offenders has failed to demonstrate deleterious psychological consequences due to long-term incarceration (Bonta & Gendreau, 1990; Bukstel & Kilmann, 1980), recent investigations with PMI have suggested otherwise (Morgan et al. 2007; Yang et al., 2009). For example, Morgan et al. (2007) suggested that increased time served in prison was associated with increased psychiatric symptoms, criminal thinking, and poorer institutional behavior for female PMI incarcerated in a general population prison facility, but not necessarily with concomitant complications for male PMI incarcerated in a psychiatric inpatient prison facility. Thus, the purpose of this study was to examine the relationship between time served in prison and the mental health functioning and criminal and behavioral presentations of male PMI incarcerated in general population correctional facilities. Participants (n = 134) were sampled from three separate general population correctional facilities within a Midwestern state correctional system. The majority of participants were diagnosed with Major Depressive Disorder, sentenced to an average of 20 years in prison, and served an average of 10 years on their current sentences. Results of a repeated measures regression using multilevel modeling indicated increased time served in prison was related to increased psychiatric symptoms associated with Major Depression, as well as with other depressive syndromes and personality traits. Increases in aggressive, antisocial, and negativistic personality traits were also evidenced as a function of time. Results of a series of negative binomial regression analyses suggested time served in prison was not associated with other measures of mental health functioning (i.e., days on crisis watch, mental health sick call visits, mental health referrals and follow-ups), nor were significant associations found between time served in prison and the number of disciplinary infractions received. Further, multivariate regression analyses revealed no significant relationship between time served in prison and criminal thinking and attitudes. There was a significant underrepresentation of participants with severe mental illness, such as Schizophrenia and Bipolar Disorder. This resulted in the sample being less severely mentally ill than initially intended and perhaps limited the results. In light of this limitation, implications of findings are discussed in terms of practice and future directions for research.Item Inmate characteristics and mental health services: An examination of service utilization and treatment effects(Texas Tech University, 2008-05) Shaw, Lucas B.; Morgan, Robert D.; Garos, Sheila; Cook, Stephen W.; Giles, Charles L.Many individuals incarcerated in the prison system suffer from mental health problems. As the inmate population grows, correctional mental health professionals are being overwhelmed with a population that is more likely than the general public to experience mental health problems (Fazel & Danesh, 2002). To maximize resources, it is important that treatment be offered to inmates who will receive the most benefit (e.g., Andrews, Zinger et al., 1990). Variables that have been found to impact treatment utilization and treatment outcome include demographic variables (e.g., Kessler et al., 2005), help-seeking attitudes, and client expectations (Grencavage & Norcross, 1990). For correctional mental health treatment, risk for recidivism is another variable that is predictive of treatment outcome (Andrews, Zinger et al., 1990). This study examined these variables aiming to gather information necessary to maximize treatment effectiveness. Participants consisted of 278 incarcerated adult offenders from the Kansas Department of Corrections. Inmates who received mental health services while incarcerated and those who have not were included in the study. Variables under investigation include sociodemographic variables (e.g., race, age, educational level, institutional security level, length of prison sentence), attitudes toward help seeking, expectations about mental health treatment, and risk for recidivism. Although several studies have examined inmate characteristics that affect mental health treatment (e.g., Deane et al., 1999; Morgan et al., 2004; Morgan et al., 2007; Williams et al., 2001), the impact of these characteristics on treatment effects remained uninvestigated. The objectives of this study were to identify sociodemographic variables that affect service utilization; identify if correctional mental health treatment impacts treatment outcome variables (improves institutional behavior, reduces risk for recidivism) and identify inmate characteristics (help-seeking attitudes, treatment fears, and client expectations) that impact treatment outcome variables; and identify if inmate characteristics impact treatment satisfaction. Logistic regression analysis identified security level as the most powerful predictor of mental health service utilization. Hierarchical linear regression analyses indicated that the amount of mental health treatment an inmate received was associated with institutional behavior (number and severity of disciplinary infractions). In addition, help-seeking attitudes was associated with institutional behavior and risk for recidivism. Results of standard multiple linear regression analyses indicated that treatment satisfaction was associated with inmate characteristics (i.e., help-seeking attitudes and client expectations). These results indicated that treatment utilization is impacted by sociodemographic variables. They also showed that certain outcome variables might be affected by the amount of mental health treatment and inmate characteristics. As a result, correctional psychologists may be better able to predict which inmates are more likely to utilize mental health services and which inmates will receive the most benefit from services. Findings and conclusions are discussed in light of limitations of the study.Item The antidepressant treatment utility of two self-report depression measures(Texas Tech University, 1992-08) Giles, Charles L.Previous studies have been inconsistent in their attempts to use diagnoses or individual symptoms to successfully predict outcome for depressed inpatients. The present study tested the treatment utility of the Beck Depression Inventory (BDI) and the Fawcett-Clark Pleasure Scale (FCPS) in predicting positive treatment outcome for depressed inpatients. Sixty-five depressed inpatients were evaluated before treatment on demographic and clinical characteristics, initial levels of depression severity, and degree of anhedonia. Predictions of depression and global outcome were conducted using stepwise multiple regressions, while controlling for the possible effects of pretreatment severity. In addition, prediction of dichotomized outcome was conducted utilizing one-way analysis of variance. Lower FCPS scores (greater anhedonia) were predictive of positive depression outcome, while the BDI scores were not uniquely predictive of depression or global outcome. In addition, a lack of previous psychiatric hospitalizations and a family history of psychiatric hospitalizations were predictive of global outcome. Future research directions and implications for treatment planning were discussed.