psychopathology final

gender dysphoria

Dissatisfaction or discomfort with one's secondary sex characteristics (e.g. chest hair, vagina) because of a mismatch between them and one's gender identity

common therapeutic treatments for gender dysphoria

• Gender affirmation surgery: surgical

changes to the body (e.g. to enlarge

breasts of a trans woman) to improve

self-comfort

• Hormone replacement therapy:

medication to improve self-comfort

with body (e.g. a trans man taking

testosterone to stimulate beard

growth)

gender dysphoria commonly occurs for

• Trans individuals

• Agender individuals

• Children who begin puberty early

• Girls ages ~8 - 14

Gender Dysphoria Diagnosis controversy

Arguments in Favor

• Diagnosis allows trans Americans to use insurance

to cover costs of gender confirmation

• Many trans people do feel real anxiety and discomfort

with bodies

Arguments Against

• Over-emphasizes bodies as source of gender rather than

gender identity

• Pathologizes trans identity

• Some women (trans and cis) are fine with having beards

trans are at increased risk for

• Depression and anxiety

• Most forms of mental illness

• Self-injury

•Reflects the impact of

discrimination

sexual dysfunctions

•Cluster of disorders around

• Not being able to have as

much sexual intercourse as

client wants

and/or

• Distress over lack of interest in

sexual intercourse or lack of

sexual attraction

not the same as asexuality

sexual dysfunction causes

Embarrassment and shame

• Women especially taught sexual desire is disgusting or harmful

• Can be a barrier to seeking or enjoying intercourse

Medical problems

• Many conditions cause difficulty with sexuality

• ex: low blood pressure, depression, endometriosis,

Performance anxiety

• When aware of being watched, most people become less skilled at complex tasks

Spectator role

• Greater concern with one's performance than one's or

one's partner's enjoyment

Sexual Dysfunction Diagnosis controversy

Arguments in Favor

• Lack of sexual intercourse is

considered deviant in U.S.

• Lack of romance is potential

source of dysfunction

• Many people experience

distress over sexuality

Arguments Against

• Sexualities are already over-

medicalized, esp. if queer

• Lack of romance/sex

shouldn't be deviant or

dysfunctional

• Humans don't need sexual

intercourse to be happy or

healthy

sex therapy

•Educating clients (usually a couple) about

how to have intercourse in relaxed and

mutually pleasurable way

•Providing mindfulness training, ways to

reduce stress, ways to focus on pleasure

•Increasing healthy communication about

intercourse

•Resolving physical and medical problems

sexual surrogacy

Mental health treatment that involves (legally) having sexual intercourse with a paid professional

•Helps clients become more relaxed

•Shows benefits of physical touch

•Improves overall sexual functioning

Paraphilic Disorder

•Sexual attraction to objects or situations that are inappropriate to act on

•Can include

• Sexual attraction to others' clothes

• Sexual attraction to strangers'

shocked or unpleasant reactions

• Sexual attraction to children or

animals

Fetishistic Disorders

•Sexual attraction that is outside the

norm in ways potentially harmful to

client or others

deviant by definition

fetishistic disorder can include

• Exhibitionist Disorder

• Interest in exposing other people to

one's sexual behavior without their

consent

• Voyeuristic Disorder

• Interest in viewing other people's

sexual behavior without their consent

• Sexual Sadism Disorder

• Interest in sex that causes harm to one's partner

• Sexual Masochism Disorder

• Interest in sex that causes harm to oneself

• Frotteuristic Disorder

• Interest in grabbing or rubbing against the body

of a non consenting stranger

fetishistic vs kink

• Kink

• Sexual behaviors outside the norm of one's culture

• Safe, sane, and consensual

• All involved agree upon a form of intercourse, when

it will end, how it will go

• Goal is mutual enjoyment

• Fetishistic disorders

• Sexual behaviors that put others at risk

• Also outside the norm of one's culture

• May occur without consent or safety of all parties

• May involve interests where full consent is impossible

fetishistic disorders culturally bound

For mainstream US culture certain groups get stereotyped as "hypersexual"

Mainstream pop culture has weirdly indirect approach to sexuality

How socially acceptable is it considered to be sexually aggressive/assaultive behaviours → More diagnosed fetishistic disorders

aversion therapy

• Seeks to use classical conditioning to prevent further

sexual attraction to inappropriate targets

• Client is exposed to target of interest

• Client experiences negative stimulus (e.g. electric

shock, nausea)

-or-

• Client imagines negative stimulus (e.g. spiders, blood)

• Over time, can result in more negative or neutral

feelings toward target of interest

Seems to be helpful for

• Individuals with sexual attraction to children

• Individuals who experience severe distress over own sexual urges

aversion therapy controversy

Conversion therapy uses classical conditioning: Tries to link same-sex attraction with pain or disgust to "retrain" orientation.

Its like conversion therapy: Treats identity as a problem, using harmful methods like shocks or emetic drugs.

Tries to change who people are: Targets core identity traits instead of supporting healthy self-acceptance.

Deviance isn't always bad: Not all nonconformity is harmful — it can reflect diversity, creativity, or resistance to injustice.

Emotions are neutral; actions matter: Feeling something isn't wrong — harm comes from unethical behavior, not natural emotions.

limits to diagnosis

• Drug advertising

-> happy white women

• Overprescription

-> one drug fits all

• Sigmund Freud

• Hysteria

schizophrenia

Mental illness characterized by

• Psychosis (hallucinations and delusions)

• Overall poor functioning

schizophrenia is sometimes referred to as

the "paradigm" mental illness

• Paradigm = defining or central example of a

broader idea

Schizophrenia Patterns

• Late onset

• Most clients develop symptoms in 20s

or early 30s

• Sudden onset

• Most clients go from high functioning to

extremely poor functioning in a matter

of weeks

• Permanent onset

• Can be treated with drug and talk

therapies, but no long-term cure has

ever been developed

•Usually triggered by a severe stressor

•Older term: to "lose one's mind"

schizophrenia 4ds diagnosis

• Extremely high dysfunction

• Inability to form relationships or maintain a

routine is main diagnostic criterion

• High deviance

• Behavior usually departs from norms to

such a degree that working becomes

impossible

• Moderate danger, moderate distress

• Both depend on the individual and the

nature of the psychosis (hallucinations and

delusions)

Schizophrenia Spectrum Disorders

•Post-Partum Psychosis

• Occurs in the weeks after giving birth

• Probably triggered by

• Hormonal changes

• Stress of caring for an infant

• Loneliness of mothers in nuclear families

• Lack of sleep

• Pressure to be "perfect" mother

•Shared symptoms

•Possibly many causes

• Severe depression

• Severe anxiety

• Dissociation and/or PTSD

Schizophrenia Symptoms

Negative symptoms

• Loss of normal abilities, loss of volition

SUBTRACTION of something

Positive symptoms

• Psychosis, speech disorder

ADDITION of something

Psychomotor symptoms

• Unusual patterns of movement

negative symptoms of schiz

•Poverty of speech

• Tendency to have very short utterances, many of

which are difficult to understand

• Some clients show little internal "voice"

• Some think fluidly, but cannot express that

•Flat affect

• Affect = emotional expression

(different from emotion itself)

• Person will have neutral facial

expression and level voice

regardless of their actual

emotions

• May be tied to avoilition

•Avolition

• Volition = willpower, energy and drive to do things

and pursue goals

• Person has little or no energy, struggles to engage

in actions, cannot pursue goals

• May feel neutral or ambivalent (conflicted) about

almost all decisions and subjects

•Social withdrawal

• Lack of connection to others

• Loss of basic social skills (e.g. how to converse,

how to sit in public)

• Inability to communicate, often due to differing

perceptions

positive symptoms of shiz

•Psychosis

• Umbrella term for perception that does not

align to reality

• Includes hallucinations and delusions

psychosis

•Delusions

• Deeply held beliefs that do not

align to others' perception of

reality

•Hallucinations

• Sensory experiences that occur

in the absence of any external

stimuli

hallucinations

•Auditory Hallucinations

• By far the most common type

•Can affect other senses as well

• Tactile hallucinations (touch)

• Gustatory hallucinations (taste)

• Olfactory hallucinations (smell)

• Visual hallucinations (seeing)

delusions

•Believed to be way of explaining

discrepancy between own perceptions and

those of other people

•Can reflect real discrimination

types of delusion

•Delusion of Persecution

• Belief one is being spied on, stalked, plotted

against, or followed by malicious actors

•Delusion of Reference

• Belief in coded messages being sent to the

person through the environment

•Delusion of Grandeur

• Belief one is a savior, superhero, or other

important figure

•Delusion of Control

• Belief one's thoughts or actions are being

caused by other people or external forces

Psychomotor Symptoms

•Believed to be earliest signal of risk for

schizophrenia: unusual or jerky patterns of

movement

•Can include catatonia = Near total absence of movement for several minutes; can last for many hours at a time

How do these symptoms together form a

constellation (connected syndrome)?

Symptoms cause/worsen each other

causes of schiz

a) Genetic risk

b) Severe life stress

Dopamine Hypothesis

Theory that schizophrenia caused by dopamine dis-regulation

During increases (floods of dopamine)

- Thoughts interpreted as sensory experiences

- Senses heightened until hallucinations occur

- Movement and through become rapid and erratic

During depletion (drought) of dopamine

- Thoughts are slow of disorganized

- Senses are dulled

- Movements and mutation decrease or disappear

too much connectivity in the brain

- no synaptic pruning

Diathesis-stress model

Diathesis = vulnerability to negative impacts

as a result of life changes

Orchids are very sensitive to any change - very difficult to grow, need exact right conditions

Dandelions are so insensitive to environmental changes (grow out of concrete)

so even if in stressful context, if dandelion, does not show psychopathology

factors that increase diathesis

• Poverty and discrimination

• In vitro exposure to viruses

• Highly reactive HPA Axis

• Poor training in social skills

schiz treatment

- state hospitals

- lobotomy

Patient would become subdued, withdrawn,

calm, and lacking volition

• Could also cause paralysis, seizures, flat affect

- was developed to deal with overcrowding

- Lobotomizing some patients made them manageable enough that all could benefit

Antipsychotic Drugs

•Drugs that reduce or eliminate positive

symptoms of schizophrenia

• Less effective at treating negative symptoms

first antipsychotic

Thorazine

antipsychotic drug side effects

PARKINSONIAN SYMPTOM

- tremors

Neuroleptic Malignant Syndrome

- Patient experiences rigid muscles, fever,

severe stiffness

Tardive Dyskinesia

- late appearing movement disorder

- usually permanent

issues with shiz treatment

•Medication adherence rates extremely low

•Functioning very low without medication

personality disorders

All characterized by rigidity in behaviors and

thought patterns across situations

• Long-lasting pattern of rigid

behavior

• Extreme views or thought

distortions

• Impaired ability to socialize

• Problems with functioning

when are personality disorders usually diagnosed?

Usually diagnosed in adolescence or early

adulthood, but usually have patterns of

behavior going back to early childhood

Personality Disorders and Diagnostic Criteria

•Distress

• Usually low

• "I'm not the problem; other people are"

•Dysfunction

• Often fairly high

• Poor ability to form or keep relationships

• High risk of job loss

• Impaired friendships

•Deviance

• Usually very high

• All are associated with poor social

functioning

•Danger

• Varies from disorder to disorder

• Borderline PD: high risk of self-harm

• Antisocial PD: predicts reckless behavior

• Schizoid PD: very low danger

insight

Ability to recognize that one's behavior or experience is abnormalor dysfunctional

personality disorder all are uniquely hard to treat effectively, why?

All are associated with low insight

Not tied to specific events

Trying to change clients entire worldview

Start or maintain treatment if they don't see themselves as problem but other people

Cluster A B and C

A: odd or eccentric behavior

• paranoid

• shizoid

• shizotypal

B: dramatic or impulsive behavior

• Histrionic Personality Disorder

• Borderline Personality Disorder

• Antisocial Personality Disorder

• Narcissistic Personality Disorder

C: anxiety in social relationships

• Obsessive-Compulsive Personality Disorder

• Avoidant Personality Disorder

• Dependent Personality Disorder

cluster A

•Personality disorders characterized by

• Unusual thought patterns

• Social withdrawal

•Includes

• Paranoid Personality Disorder

• Schizoid Personality Disorder

• Schizotypal Personality Disorder

paranoid personality disorder symptoms

•Symptoms

• Belief that one is constantly being

tricked, manipulated, or mocked

• Tendency to see hidden (hostile)

meanings in all communication

• Intolerance for mistakes or

uncertainty in others

• Inability to see own mistakes or

tolerate criticism

• Few/no close relationships

paranoid personality disorder causes

•Causes

• Illogical beliefs that most people are "out to

get you", "only in it for themselves", etc.

• High trait anxiety, blamed on others

Schizoid Personality Disorder symptoms

• Indifference to other people and

to social relationships

• Few or no strong emotions

• Preference to be alone

• Few/no close relationships

• Apathy to praise and criticism

Schizoid Personality Disorder causes

• Lack of strong emotions or normal affect

• Inability to pick up emotional cues in others

• Few rewards in socialization

Schizotypal Personality Disorder symptoms

• Anxiety about socializing, with intense loneliness

• Inability to sustain attention during conversation:

rambling/disorganized speech

• Repeated unusual behaviors (e.g. re-re-reorganizing

objects)

delusional social thinking

• Distortions in beliefs about relations to others

• Can include

• Belief random events are coded messages

• Perception they control others with their mind

• Communication with intangible "force"

Schizotypal Personality Disorder causes

• Inability to sustain attention

• Leads to inability to converse with others

• Poor detection of meaning (or lack thereof)

difference between shizoid and shizotypal

Schizoid PD

• Few close relationships

• Preference to be alone

• Apathy toward others

• Low distress

• Few continuous thought patterns

Schizotypal PD

• Few close relationships

• Desire not to be alone

• Fear of others

• High distress

• Delusional thought patterns, especially about socialization

schizoid - generally happy with life, just uninterested in other people

Schizotpyal - desire to build social connections but unable

cluster C

•Personality disorders characterized by

• Inhibition

• Fear and anxiety

•Includes

• Obsessive-Compulsive Personality Disorder

• Avoidant Personality Disorder

• Dependent Personality Disorder

Obsessive-CompulsivePersonality Disorde Symptoms

• Rigid adherence to rules, order, and perfection

• Expectation that no one should ever make

mistakes, that all errors are catastrophic

• Stubbornness and perfectionism

•Dysfunction

• Difficulty beginning tasks due to perfectionism

• Inability to prioritize due to focus on details

• Dissatisfaction with self and others

Obsessive-CompulsivePersonality Disorde causes

• Inflexible black-and-white thinking

• "Either it's perfect, or it's worthless"

• Distorted perceptions

• "If people actually cared about their job, they

would never make typos"

compare OCD and OCPD

Obsessive-Compulsive Personality Disorder

• Repeated behavior patterns

• Concern with cleanliness and order

• Rigidity and obsession with rules

• Low insight

• Major social deficits

Obsessive-Compulsive

Disorder

• Repeated behavior patterns

• Concern with cleanliness and order

• Use of rituals to stave off intrusive thoughts

• High insight

• Few social deficits

Dependent Personality Disorder Symptoms

• Relying heavily on other person(s) to

make decisions

• Low trust in self, and fear of making

wrong choices due to lack of

confidence

• Clinging to close others and obeying

them at all times

• Deep fear of rejection

Dependent Personality Disorder causes

• Parents who punished independent behavior and

rewarded relying on them

• Black-and-white thinking

• "I must find someone who can tell me what to do"

• "To be independent is to be alone"

• Experiences with rejection meaning abandonment

Avoidant Personality Disorder Symptoms

• Extreme fear of negative evaluation

• Withdrawal from social situations so

that no one has a chance to reject

them

• Refusal to take risks socially

• Loneliness and low self-worth

• Few or no close relationships

Avoidant Personality Disorder causes

• Experience with harsh criticism and rejection

• History of close relationships ending badly

• Lack of social skills

compare dependent DP and avoidant DP

Dependent PD

• Difficulty in existing relationships

• Fear of rejection

• Low self-worth

• "Clingy" attachment style, over-reliance on others

• Fear of being alone

Avoidant PD

• Difficulty forming relationships

• Fear of rejection

• Low self-worth

• "Aloof" attachment style, under-reliance on others

• Fear of being betrayed

Cluster B

•Personality disorders characterized by

• Extreme self-focus

• Poor understanding that others' emotions differ

•Includes

• Histrionic Personality Disorder

• Borderline Personality Disorder

• Antisocial Personality Disorder

• Narcissistic Personality Disorder

Gender and cluster B

•Narcissistic PD and Antisocial PD

• Characterized by excessive anger

• Driven by fear of others' mockery or dismissal

• More common in men

"respect me"

•Borderline PD and Histrionic PD

• Characterized by excessive attention-seeking

• Driven by fear of others' rejection or dismissal

• More common in women

" have compassion for me"

Comorbidity

•State of having multiple mental illness

diagnoses

•Extremely common with personality disorders

Histrionic Personality Disorder Symptoms

• Exaggerated emotional expression

• Shouting, crying, laughing loudly at

minor changes in environment

• Obsession with approval

• Will change behaviors, attitudes, identity

to try and please others

• Need for attention

• Self-centered thought patterns, low

tolerance for others having attention

•Relationship patterns

• Tendency to exaggerate closeness to others

• Extreme concern with winning approval

• Reliance on others to tell them what to do

Borderline Personality Disorder Symptoms

• Strong fast-changing emotions

• High risk of self-injury

• Major shifts in identity, goals, and

interests

• Impulsivity and sensation-seeking

• Chronic feelings of "emptiness"

• Splitting

splitting

• Also called black-and-white thinking

• Common thought pattern in Borderline PD

i RLLY trust you

i want NOTHING to do with you

Borderline Personality Disorder causes

• Poor understanding of own and

others' emotions

• Social and cognitive upheaval

• Experiences with

abusive/neglectful relationships

• Being a woman who lives in one

of many sexist societies

Antisocial Personality Disorder Symptoms

• Impulsivity

• Poor ability to control behavior, or to respect

others' attempts to control behavior

• Lack of fear

• Little concern for own safety or that of others

• Inability to consider consequences of actions

• Aggression

• Quick to anger, quick to start fights

• Poor social functioning from temper

--> higher risk of criminal behaviour

compare antisocial PD and borderline PD

Antisocial PD

• Feelings of emptiness

• Sensation-seeking

• Poor understanding of others' emotions

• Externalizing symptoms

• Risk of harming others

Borderline PD

• Feelings of emptiness

• Sensation-seeking

• Poor understanding of others' emotions

• Internalizing symptoms

• Risk of harming self

what is a strong situation

1. Clear behavioural expectations

2. Incentives for compliance (or threats for non-compliance)

3. Individual ability to meet the demands of the situation

•Most modern children spend most of their

time in strong situations

• Examples

• Classroom

• School bus

• Dinner table

• Team sports

• Extracurricular activities

childhood disorders

Disorders reacting against control

• Conduct Disorder

• Oppositional Defiant Disorder

• Attention-Deficit Hyperactivity Disorder

Disorders of failure to succeed in school

• Autism Spectrum Disorder

• Intellectual Disability

childhood risks

•Lack of personal freedom is a major factor in modern children's well-being

•Some actions are illegal because one

is a kid (no other reason)

• Absence from school

• Driving a car

• Drinking alcohol or smoking

• Having a job

• Making major purchases

•Children are at risk of abuse by parents and

caregivers, given few options to escape

selective mutism symptoms

• Inability to speak due to anxiety, to

point of dysfunction in school or

relationships

• Child is physically capable of speech

• May speak in situations where anxiety

is low (e.g. at home, among friends)

• Lack of speech persists for at least a

month

selective mutism causes

• Specific childhood form of Social

Anxiety Disorder

• Fear of saying "the wrong thing"

• Giving incorrect answers in front

of peers

• Making social mistakes

behavioural disorders

•Oppositional Defiant Disorder and Conduct

Disorder

• Closely related, with Conduct considered more

serious than ODD

•Attention-Deficit Hyperactivity Disorder and

Autism Spectrum Disorder

• Related as well, with distinction between

internalizing and externalizing symptoms

Oppositional Defiant Disorder symptoms + causes

Symptoms

Constant arguments with parents teachers other adults

Severe negative reactions to being told what to do

Difficulty regulating anger and frustration

Causes

Externalizing symptoms

Negative emotions expressed as anger / aggression

Extreme form of externalizing

Conduct Disorder symptoms

• Repeated physical aggression against peers,

adults, or animals

• Deliberate law-breaking such as theft,

vandalism, and arson

• Frequent absences or disappearances

• Running away from home for multiple days

• Missing major parts of school year

• Staying out past curfew more nights than not

Conduct Disorder causes

• Genetic factors- MAOA gene predisposes

being active and reactive

• Environmental factors- child abuse,

permissive parenting, school-home mismatch

treatment for Oppositional Defiant and Conduct Disorders

Parent Management Training

Parent Management Training

•Teaches parents

• How to resolve conflict without

shouting, hitting, or harsh punishment

• Importance of not giving in when kids

display strong emotion

• Consistency and structure in home life

• Communication with kids about why

rules exist

Attention-Deficit Hyperactivity Disorder (ADHD) symptoms + causes

symptoms

• Impulsivity and reactive behavior

• Inability to maintain focus

• Overactivity, inability to sit still

• Sensitivity to distractions

• Difficulty controlling emotions

causes

• Gene-environment interaction

• Genetic predisposition to excel in fast-changing

variable environments and seek novel stimuli

+

• Environment that requires sitting still and taking

in information through uniform modalities for

several hours a day

ADHD diagnostic controversy

• Over-diagnosed in white kids

• Behaviors such as ordinary school difficulty or

anxiety are characterized as ADHD

White kid acts out

• "Oh no, he needs help to succeed in

school. Will ADHD medication do

the trick?"

• Under-diagnosed in kids of color

• Teachers are more likely to attribute behaviors to

problems at home, low IQ, low suitability to

school, or being a "bad kid"•

•Black kid acts out

• "Darn, he's not very good at school,

and should probably focus on sports

instead."

Autism Spectrum Disorder symptoms

• Repetitive motions or interests,

continuous fixation and distress if

deviating from routine

• Sensory processing issues, including

sensitivities and distress

• Deficits in socialization and

communication

Autism Spectrum Disorder causes

• Lack of understanding of social cues

• Attentional problems — fixation on

one subject, inability to shift fluidly

• Theory of Mind deficits

• Inability to understand the

differences between one's own

perspective and that of others

autism in recent years

• Used to be under-diagnosed in girls

• Used to be under-diagnosed in kids of color

• Focus on cerebellum alone has broadened

• Older parents have more Autistic children,

and average parental age has increased

• Destigmatization

• Less resistance to diagnosis as famous people

openly discuss their own Autism

Autism Spectrum Disorder Diagnosis Controversy

Controversy: The 2013 DSM-5 merged separate diagnoses (e.g., Asperger's, PDD-NOS) into a single ASD category.

Concern: This may overgeneralize diverse experiences, leading to misdiagnosis or loss of identity for those previously diagnosed with subtypes.

or an intellectual disability

down syndrome symptoms

• Difficulty in problem-solving, abstract

reasoning, or deeper learning

• Less ability to succeed in everyday

tasks (e.g. communication, self-care,

literacy) than peers of the same age

• Begins in early childhood

• Skill at socialization, and affection with

many different individuals

down syndrome causes

• Greater maternal age

• Exposure to toxins, prenatally or postnatally

• Extra chromosomes (proximal cause)

down syndrome tend to have good functioning if there is...

community support

• Highly structured jobs

• Peers with similar disabilities

• Help with activities of daily

living

intellectual disability controversy

• Usually diagnosed with IQ tests

• Broad measures of ability to acquire and use new

abstract material (e.g. puzzles, new words)

• Known to be less accurate for children of color than

white children

profiling

eyewitness stuff before this but you know it from social psych

•Process of examining evidence from

a crime to arrive at conclusions

about the perpetrator

•Includes

• Demographics: age, gender, etc.

• Psychopathology, if any

• Motive for crime

• Pattern of criminality

criminal commitment

•Process of deciding that a person should

receive treatment for psychopathology after

being accused of a crime

•Major types

• Not Guilty by Reason of Insanity

• Mentally Incompetent

• Guilty but Mentally Ill

insanity

•Legal term for a state of being

• Unaware actions are wrong

• Unable to prevent actions

• Mentally unable to obey law

and/or

• Unaware of one's actions

mental incompetence

•U.S. law states that a person cannot be tried

in absentia — defendant must be present

•Psychologists sometimes determine person

is not mentally present enough for trial

•Lawyers must prove defendant has:

• "Rational as well as factual understanding of

the proceedings"

• Otherwise, trial cannot occur

issue with mental incompetence

issues when using an IQ test to decide this

- say 65 is competent but someone gets a 64

- are you really gonna say they are incompetent?

•If defendant is found mentally incompetent,

will be treated until competence restored

• Can result in very long institutionalizations,

including of innocent defendants

Not Guilty by Reason of Insanity (NGRI)

•Verdict (result of legal proceeding) where

jury finds that the defendant

• committed the crime

• was insane at the time

• needs psychiatric treatment

•Most common standards for determining

• M'Naghten Test

• Irresistible Impulse Test

•Defendant is assessed by psychologists to

determine ability to plan and think ahead