DQ Interpretation

A Defendant Questionnaire (DQ) report is available via link to augment this discussion of DQ Scale Interpretation.  To go to this example report, click on this DQ Example Report link. There are several levels of DQ interpretation ranging from viewing the DQ as a self-report to interpreting scale elevations and scale interrelationships.The following table is a starting point for interpreting DQ scale scores.

A problem is not identified until a scale score is at the 70^th percentile or higher. Elevated scale scores refer to percentile scores that are at or above the 70^th percentile. Severe problems are identified by scale scores at or above the 90^th percentile. Severe problems represent the highest 11 percent of defendants evaluated with the DQ. The DQ has been normed on thousands of defendants. And, this normative sample continues to expand with each DQ test that is administered.

1. Truthfulness Scale: Measures how truthful the defendant was while completing the test. It identifies guarded and defensive defendants who attempt to fake good. Scores at or below the 89^th percentile mean that all DQ scales are accurate. Scale scores in the 70^th to 89^th percentile range are accurate because they have been Truth-Corrected. Truthfulness Scale scores at or above the 90^th percentile mean that all DQ scales are inaccurate (invalid) because the defendant was overly guarded, read things into test items that aren’t there, was minimizing problems, or was caught faking answers. Defendants with reading impairments might also score in this 90^th to 100^th percentile scoring range. If not consciously deceptive, defendants with elevated Truthfulness Scale scores are uncooperative, fail to understand test items or have a need to appear in a good light. The Truthfulness Scale score is important because it shows whether or not the defendant answered DQ test items honestly. Truthfulness Scale scores at or below the 89^th percentile indicate that all other DQ scale scores are accurate. One of the first things to check when reviewing a DQ report is the Truthfulness Scale score.

2. Violence (Lethality) Scale: Identifies defendants that are dangerous to themselves and others. "Violence" is defined as "the expression of rage and hostility through physical force." Violence is aggression in its most extreme and unacceptable form. Elevated scorers can be demanding, sensitive to perceived criticism and are insightless about how they express their anger/hostility. Severe Problem scorers should not be ignored as they are threatening and very dangerous. A particularly unstable and perilous situation involves an elevated Violence Scale with an elevated Antisocial, Alcohol or Drugs Scale score. Substance (alcohol or other drugs) abuse and antisocial attitudes can contribute to dangerousness. The more of these scales that are elevated with the Violence Scale, the worse the prognosis. An elevated Stress Coping Abilities Scale with an elevated Violence Scale score provides insight regarding co-determinants and possible treatment recommendations. A Severe Problem Violence Scale score is a malignant sign with or without other scale elevations and describes a dangerous person. The Violence Scale score can be interpreted independently or in combination with other DQ scales.

3. Antisocial Scale: Measures antisocial attitudes and behavior. "Antisocial" is defined as "opposed to society or existing social organization and moral codes." Antisocial behavior refers to aggressive, impulsive and sometimes violent actions that flout social and ethical codes, such as laws, property rights, etc. This behavior pattern often begins with a conduct disorder involving lying, stealing, fighting, cruelty, truancy, vandalism, theft and substance abuse. Elevated Antisocial Scale scores are often associated with non-internalization of recognized conventions. Many high scorers manifest a seeming inability to profit from experience. An elevated Antisocial Scale score in conjunction with an elevated Alcohol Scale, Drugs Scale or Violence Scale score would be a malignant sign prognostically. A Severe Problem Stress Coping Ability Scale score with an elevated Severe Problem Antisocial Scale suggests the possibility of a suspicious/paranoid mental health problem. The Antisocial Scale can be interpreted independently or in combination with other DQ scales.

4. Alcohol Scale: Measures alcohol use and the severity of abuse. "Alcohol" refers to beer, wine and other liquor. It is a licit substance. An elevated (70^th to 89^th percentile) Alcohol Scale score is indicative of an emerging drinking problem. An Alcohol Scale score in the Severe Problem (90^th to 100^th percentile) range identifies serious drinking problems.Since a history of alcohol problems could result in an abstainer (current non-drinker) attaining a Low to Medium Risk score, precautions have been built into the DQ to correctly identify "recovering alcoholics."

Several DQ items are printed in the "Significant Items" section of the report and again in the "Structured Interview" section (pages 3 and 4) for quick reference. Alcohol admission items include: #44 (in last year), #49 (has drinking problem), #55 (serious drinking problem), #153 (describes own drinking), #154 (motivation for alcohol treatment), etc. There are two alcohol recovering items: #34 (I am a recovering alcoholic) and #156 (I am a recovering alcoholic). In addition, the elevated Alcohol Scale score paragraphs clearly caution that the defendant may be "recovering."

In intervention and/or treatment settings, the defendant’s Alcohol Scale score helps staff work through defendant denial. Most defendants accept the objective and standardized Alcohol Scale scores as accurate and relevant. This is especially true when it is explained that elevated scores don’t occur by chance. The defendant must answer a definite pattern of alcohol-related admissions for elevated scores to occur. And, Alcohol Scale scores are based on thousands of defendants who have completed the DQ. An elevated Alcohol Scale score in conjunction with other elevated scores magnifies the severity of the other elevated scores when the defendant drinks. For example, if you have a defendant with an elevated Violence Scale who also has an elevated Alcohol Scale score, that defendant is even more dangerous when drinking.When both Alcohol and Drugs Scales are elevated, the higher score represents the defendant’s substance of choice. When both are in the Severe Problem range, explore polysubstance abuse. The Alcohol Scale can also be interpreted independently.

5. Drugs Scale: Measures drug use and the severity of abuse. "Drugs" refers to marijuana, cocaine, crack, ice, amphetamines, barbiturates and heroin. These are illicit substances. An elevated (70^th to 89^th percentile) Drugs Scale score is indicative of an emerging drug problem. A Drugs Scale score in the Severe Problem (90^th to 100^th percentile) range identifies serious illicit drug abusers.Similar to the Alcohol Scale, a history of drug-related problems could result in an abstainer (drug history, but not presently using or abusing drugs) attaining a Low to Medium Risk score. Precautions have been built into the DQ to correctly identify "recovering" drug abusers.Several DQ items are printed in the "Significant Items" and "Structured Interview" sections  (pages 3 and 4) of the DQ report for quick reference. Drug admission items include: #72 (in last year), #78 (direct admission), #83 (in drug treatment), #100 (admits drug dependent), #157 (describes own drug use) and #159 (motivation for drug treatment). Recovering drug abuser items include: #89 (I am recovering) and #156 (I am a recovering drug abuser). In addition, the Drugs Scale score paragraphs clearly caution that the defendant may be "recovering."In intervention and treatment settings, the defendant’s Drugs Scale score helps staff work through defendant denial in a similar way as explained earlier for the Alcohol Scale. And, an elevated Drugs Scale score in conjunction with other elevated scale scores magnifies the severity of the other elevated scores when the defendant uses drugs. For example, an elevated Violence Scale in conjunction with an elevated Drugs Scale score increases the severity and risk associated with the Violence Scale when the defendant uses drugs.When both the Drugs and Alcohol Scales are elevated, the higher score represents the defendant’s substance of choice. When both are in the Severe Problem range, explore polysubstance abuse. The Drugs Scale can also be interpreted independently.

6. Substance Abuse/Dependency Scale: Classifies defendants as substance abusers, substance dependents or non-pathological substance users in accordance with the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria.The DQ Substance Abuse/Dependency Scale is entirely based on DSM-IV classification criteria for substance abuse and dependency. When a defendant admits to one of the four DSM-IV abuse symptoms (criteria), that defendant is classified in the substance abuse category. When a defendant admits to three of the seven DSM-IV dependency symptoms (criteria), that defendant is classified in the substance dependency category. When a defendant does not meet DSM-IV criteria for abuse or dependency, they are non-pathological substance users (if they use drugs).There is an important difference between the DQ Substance Abuse/Dependency Scale and the Alcohol and Drugs Scales. The Substance Abuse/Dependency Scale classifies people as abusers, dependent or non-pathological substance users (if they use drugs). The Alcohol Scale and Drugs Scale measure the severity of alcohol and drug use or abuse.The American Society of Addiction Medicine (ASAM) states there can be exceptions to DSM-IV classification, and these exceptions are made according to the severity of a person’s substance abuse. The severity of a person’s substance abuse determines their recommended level of intervention and/or treatment.In summary, the Alcohol and Drugs Scales measure severity of substance (alcohol and other drugs) abuse; whereas, the Substance Abuse/Dependency Scale classifies people as substance abusers or substance dependents. The Substance Abuse/Dependency Scale can be interpreted independently or in combination with DQ Alcohol and Drugs Scales.

7. Stress Coping Abilities Scale: Measures how well the defendant copes with stress. It is now accepted that stress exacerbates symptoms of mental and/or emotional problems. Thus, an elevated Stress Coping Abilities Scale score in conjunction with other elevated DQ scales helps explain the defendant’s situation. When a defendant doesn’t handle stress well, other existing problems are often exacerbated. Such problem augmentation applies to substance (alcohol and other drugs) abuse, attitudinal problems and acting-out behavior.

An elevated Stress Coping Abilities Scale score can also exacerbate emotional and mental health symptomatology. When a Stress Coping Abilities Scale score is in the Severe Problem (90^th to 100^th percentile) range, it is likely that the defendant has a diagnosable mental health problem. In these instances, referral to a certified/licensed mental health professional might be considered for a diagnosis and treatment plan. Lower elevated scores suggest possible referral alternatives like stress management counseling. The Stress Coping Abilities Scale score can be interpreted independently or in combination with other DQ scales.

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In conclusion, it was noted that there are several "levels" of DQ interpretation ranging from viewing the DQ as a self-report to interpreting scale elevations and interrelationships. Staff can then put DQ test report findings within the context of the defendant’s life and court situation.