Do Psych evaluations pick up BPD?

[theirdad]

Entering into a likely high-conflict custody situation.  My concern is that stbXuBPDw is emotionally harmful to our small children ages 2 and 4.  Consulted with a couple of attorneys.  One attorney, who admitted he knew "a little" about BPD suggested a psych evaluation early on.  While my stbX rages, verbally abuses in behind closed doors, she is extremely intelligent and high-functioning.  Are psych evaluations sensitive enough to really detect BPD?  I can see her "faking" her way through the whole thing.  Anyone with experience regarding this?  Thanks in advance.

[sfbayjed]

I think it is possible, although I wouldn't get my expectations up. In my case it just showed some of her traits as elevated scales on the test. It did not come back with a diagnosis.  I think my ex is a pretty serious case too, but like your ex, she can but on a good show.  It did show some important things about her personality however. 

I am not even sure they attempt to make diagnosis with these things in the context of a custody dispute.

[david]

I think psych evals can help but I would not rely on them solely. You need to make a plan that you can live with and make sure your atty understands and agrees with the plan. My first atty was horrible and I stayed too long with her. She actually had my ex on the stand ready to dysregulate and stopped before it happened. My atty didn't catch it and it was so obvious to me. Had she asked a few more questions my ex would have flipped out in front of the judge and that would have been game over. Picking the right atty is important. Also, document everything you can. Record everything. It may not be admissible in court but it may help in a custody eval, etc.

[livednlearned]

It seems to depend on the type of psych eval used. Others here say that it's important to use the MMPI-2 because it is objective and is very good at picking up when people "falsely present" (clinical term for lying). My ex is extremely high functioning and very intelligent (he is a trial lawyer and a law professor). He is getting a psych eval right now, and I'm curious if a) I will learn the results and b) what the results are.

Be prepared that if you ask for a psych eval of your ex, it's very common that the opposing party requests the same of you.

I have not taken the MMPI-2, but my son did a psych-eval that follows a similar format. You get hundreds of questions, many of them asking the same thing phrased in slightly different ways. Analysis works by looking statistically at the patterns for responses -- meaning, 97% of people who answer yes to questions 16, 25, 67, 99, 158, 229, 444 are likely to answer positively to questions 33, 57, 18, 267, 552, 412. That, combined with other patterns indicates an xyz diagnosis, or a propensity to xyz behavior. (I'm oversimplifying, but that's the basic gist.) The psych eval that my ex is going through also includes an analysis of his medical records, conversations with his T, and clinical observation/interview.

Forensic psych docs look at the statistics of how the person responded. For example, if a person answers that they never have dark thoughts, have never thought about manipulating others, then statistically they are in the minority. Answer enough of those questions falsely, and the test will return results that say "This person presented falsely."

Keep in mind that the test is just one nail in the coffin. Others here say that even if you do get an affirmative diagnosis, you may still need an expert witness to explain why BPD is so harmful to the kids. Matt often refers to the research out there about BPD and kids who grow up with BPD mothers.

[ForeverDad]

Some of our ex-spouses are professionals.  How do they manage a career or job and not behave as they do with us?  A large part of it is that they can function somewhat close to normal in scenarios that don't have emotional triggers.  However, get close such as we did by marriage and you'll find that the Mask of Seeming Normalcy can't persist for very long in private or semiprivate environments.  There's just too much emotional baggage due to our close intimate relationships for them to not misbehave.

[Matt]

Following up on LnL's thoughts... .  

I think it's super-important that the psych evals be done by a qualified professional - where I live, that means a Ph.D. psychologist - and that they be based on objective testing.  The MMPI-2 which LnL mentions I think is the most common and most respected.  ("Minnesota Multiphasic Personality Index".)

I filed a motion for a Custody Evaluation, and a psychologist was appointed by the court.  He administered the MMPI-2 to both of us.  It's just as LnL describes - about 500 questions that make you choose between two options, neither one wrong or right.  Took a couple hours for me to do.

Here's the part that directly refers to your concerns:  The MMPI-2 is scored based on a number of "scales" - as LnL describes it, several of the items are compared to get your score on each "scale".  And there are a few "scales" that evaluate your honesty in taking the test - "truth scales".  So the results clearly indicate if you took the test by giving your best answers, or by trying to fake it.  My wife's results indicated that she "presented falsely" - that is, she gave answers she thought would make her look good.

But the test was able to sort out her results anyway - scoring low on the "truth scales" does not keep the test from evaluating you accurately on other scales.  So my wife's results enabled a diagnosis of multiple psychological disorders including BPD.

I would definitely recommend that you do whatever you can to have both parties tested using the MMPI-2 or another test that is equally proven and respected.  Don't hesitate to take it yourself - your results won't be perfect - nobody's are - mine showed (to my surprise) a somewhat high risk for substance abuse.  But if you handle it well - when you get your results, look to what you can do to move forward and address any issues that show up - don't be defensive - accept the results and take positive action - it will work in your favor.  People with BPD usually don't do that - my wife denied the results, and even after the court ordered her to get psychotherapy, she refused.  (I consulted with the psychologist, who said I should keep doing what I was doing - not drinking or using any drugs - and that's what I did.)

The results are one link in a chain of logic:  "Ms. Dad has been diagnosed with such-and-such."  Could be BPD and/or something else - don't assume anything - just make sure you will get the results and they won't be hidden from you.

The second link in the chain of logic is to show that being raised by someone with BPD (or another psychological disorder) puts the kids at higher risk.  There is a ton of research on this subject - you can start with "Understanding The Borderline Mother" by Christine Lawson - showing that kids who are raised mostly by someone with a psych disorder are at higher risk for substance abuse, depression, suicide, and pretty much every other psychological and social problem you can name, by the time they become adults.

To get that information into evidence, you may need to call an expert witness who can testify to it.  There may be someone where you live, or you may have to pay for someone to travel there.  It's probably best to research that now, so when you have the diagnoses you will be prepared with all three of these elements:  the diagnosis, research, and the expert witness.

Very few here (and unfortunately not me!) have put together all those elements.  It's why most of us don't get the custody results that would be best for the kids - we don't assemble this kind of bulletproof case.  You need to make it impossible for the court to ignore the fact that being raised by a parent with a psych disorder is not in the kids interests - get the discussion out of "fair to both parents" or "neither parent has hurt the kids so they both must be OK parents" and into "the kids should be in the lowest-risk home most of the time".

[livednlearned]

Matt gave me good advice about requesting the MMPI-2, and unfortunately things moved very quickly with the Ls and I was not able to have the motion specifically request MMPI-2. In my motion, I believe it just says I requested that the plaintiff undergo a psychiatric examination by a medical doctor.

Find out from your L exactly how they do it where you live. What tests do they use? What kind of forensic psychiatrist (or psychologist) will the court appoint? Does the examination involve interviews and medical records in addition to an objective test? If you specifically want the MMPI-2, at what point can you make that request in writing?

You may also want to arrange it so that your ex will experience consequences if she does not have the psych eval. In my situation, I had leverage because N/BPDx really lost his head this summer and it's all documented. He dug a hole and needs the psych eval to help him get out so he can spend overnights with S11. But the typical BPD high-conflict divorce tactic is to stall and stall some more.

One last thought: if your L is saying he knows a little about BPD, assume he knows nothing. It's safer that way. Ask him if he has had any other high-conflict cases and how he handled them. My L said the same thing (she has BPD in her family), but for the most part, I had to constantly point out holes in her strategy (especially how things were phrased). You'll get a lot of good ideas from people here who have been through it. I didn't have bpdfamily.com when I started and wish I did. My interactions with L are much better now because I learned from others what was important, and then asked my L to follow through.

[scraps66]

You need a forensic psychologist that, 1) does court-ordered work, 2) has a history of doing MMPI-II psychological evaluations, 3) is at least respected by the court system and by that I mean don't use a Dr. that has a lot fo bad press, 4) Don't count on teh court to provide thed Dr., if you can stipulate the Dr. you want to use based on research or input from your attorney.  In my courthouse the psychologist are known to be second rate hacks who don't do a lot.  Alone an MMPI-II may not be able to diagnose PBD, but can provide the court with concrete information about the litigants, like does one lie or "present falsely."  Mkae sure you stipulate that both parties use the same well respected PhD so there are no questions and you get the best chance of comparing apples to apples.  You should also write in the Order what tests are to be done and stipulate that a written report will be provided to both attorneys.  I took an MMPI-II but alsot ook three other tests along with the MMPI-II to substantiate the MMPI-II results.  A good psych eval will cost, mine was $1900 and would now be $2100 two years later.  All of this should be spelled out in the Order issues - make sure it is, if not tell your attorney it needs to be redone.  The error in my case was that my contempt hearing discussed using Dr. X, but when the Order came out it did not require a partiuclar Dr and my ex went and used some local hack that issued a bogus report. 

I say all of this becasue it wasn't done in my case and I am now - two years later - going back to court to have my xuBPDw properly evaluated by the same Dr I used. 

One thing is for sure, a psych eval alone will not be used to determine or change custody.  You would have to go a step further and have a full custody evalaution done which would include the MMPI-II, but also a full review of your living arrangements, interviews with both parties, interviews with collateral witnesses, etc.

[scraps66]

Forgot something, if ex has any issues, like taking medication or other diagnosis, the evaluating Dr. should know those becasue they can determine waht tests are appropriate.  My ex is diangosed ADHD, funny how that was not mentioned in the bogus report.  She doesn't admit it or she had forgotten that she ever admitted being diagnosed a long time ago.  My Dr. told me if he was in fact doing the evaluation he would have administered tests that would determine if her ADHD was affecting her parenting or not.  So this should get in the Order if possible.  Otherwise she could just lie like mine did.

[david]

What I notice here and with my owm situation is that neither atty was on top of things. Why didn't the atty know about what tests and who to use. Mine was the same way.

[Matt]

Matt gave me good advice about requesting the MMPI-2, and unfortunately things moved very quickly with the Ls and I was not able to have the motion specifically request MMPI-2. In my motion, I believe it just says I requested that the plaintiff undergo a psychiatric examination by a medical doctor.

My concern about that approach is that psychiatrists (medical doctors) don't focus on psychological disorders.  They focus on things that can be fixed with drugs.  And they rarely do talk-therapy;  it's likely that a psychiatrist might have a single half-hour meeting with someone, and then either prescribe something or say "She seems OK to me."

Psychologists look more about psychological problems.  I'm not a professional in this field - just sharing how it seems to me.  I think psychological disorders are like your computer's software;  a personality disorder like BPD is like a problem with the operating system - a huge, fundamental problem, but a software problem not a hardware problem.  Psychologists deal with these "software" issues that are treated mostly with talk-therapy, to un-twist the disordered person's twisted thinking.

Psychiatrists deal more with the "hardware" problems that can be treated with drugs, like schizophrenia.

So if the diagnosis is left to a "medical doctor" (probably a psychiatrist), and if there isn't an objective instrument like the MMPI-2, it's likely the diagnosis will be "She doesn't seem to have a psychiatric (physical or chemical problem)."  The psychiatrist may completely overlook psychological problems because they're not in his field.