Validity of the Symptom Assessment-45 in a group of mentally disordered offenders: Comparison with the Millon Clinical Multiaxial Inventory-III

This study examined the validity of the Symptom Assessment-45 Questionnaire (SA-45) in the Mentally Disordered Offender (MDO) population. The SA-45 is increasingly administered as a tool for screening, assessment and treatment monitoring, even though its psychometric properties have not been adequately examined. The subjects for this study were 424 MDOs admitted to the Detroit Wayne County M&barbelow;entally Ill/Substance Abuse - C&barbelow;orrections O&barbelow;utpatient I&barbelow;ntensive T&barbelow;reatment Continuum (M-COIT) Bridge program. Interscale relationships were calculated for the SA-45s of 383 male MDOs and compared to those reported in the SA-45 manual. The resulting correlations in the study sample were consistently higher than those reported in the SA-45 manual. Additionally, the shared variances for the SA-45 scales were large, with 30 correlations sharing at least 30% of the variance with another scale. The criterion validity of the SA-45 was also examined employing the Millon Clinical Multiaxial Inventory 3 rd edition (MCMI-III) as the criterion measure. Overall minimal criterion related validity was found for each of the separate subscales when measured against the MCMI-III. In light of the findings, a principal component analysis was conducted to examine the structure of the SA-45. The best solution for the SA-45's primary symptom scales was a single factor structure, which is similar to findings of the parent measure, the Symptom Checklist-90 Revised, where the single factor is thought to measure general psychiatric distress. These findings suggest that clinicians working with MDOs should exercise caution when employing the SA-45 subscales to measure ongoing dynamic factors as they may relate to predictions of impending recidivism. The subscales are not sensitive enough and do not measure the constructs purported in the SA-45 manual. However, the SA-45 in its current form may be a useful, dynamic measure of overall psychological and psychiatric distress.