Forensic Psych Exam 2

Competency Definition

whether an individual has sufficient present ability to perform necessary personal or legal functions

Adjudicative Competence:
What case is this linked to?

(Bonnie, 1993)
Refers to a defendant's psychological state at the time of trial, broken down into two main components:
1. Foundational Competence (Understanding)
2. Applying these understandings in the court room. Other Legal Competencies: Individuals must also be competent to waive Miranda rights, confess, make treatment decisions, execute a will or contract, or take care of themselves and their finances.

Dusky v. United States (1960):

Established the foundational "Dusky Standard" addressing a defendant's psychological state at the time of trial.

- Milton Dusky (33) mentally ill. Charged with kidnapping and transporting from Missouri to KS 15 yr old Alison McQuery across state lines.
- Alison thought was getting ride to friends house. Two boys who were friends with his son came with as well. Two boys raped her.
-Had schizophrenia. found at CST evaluation
-He was found competent, guilty, and sentenced to 45 yrs in prison.
-appealed his case to supreme court, who found him incompetent

United State v. Wilson (1968):

Established that competency is a flexible standard.

Burden of Proof & Standard:

Preponderance of evidence - civil
Beyond a reasonable doubt - criminal

In Medina v. California (1992), the burden of proof was placed on the defense.
In Cooper v. Oklahoma (1996), the Preponderance of the Evidence (POE) standard was mandated for determining CST.

Pleading Guilty & Waiving Counsel:
Johnson v. Zerbst (1938)

A guilty plea must be knowing, voluntary, and intelligent.

Pleading Guilty & Waiving Counsel:
Godinez v. Moran (1993):

Separate competencies to waive an attorney or plead guilty are not automatically required once a defendant is found CST.

Pleading Guilty & Waiving Counsel:
Indiana v. Edwards (2008):

Set a higher standard for severely mentally ill defendants seeking to waive counsel.

Execution Competency:
Ford v. Wainwright (1986):

Ruled that executing an incompetent inmate does not violate the Eighth Amendment.

Execution Competency:
Panetti v. Quarterman (2007):

Clarified the legal standard for competency to be executed, though it did not fully explain what constitutes a "rational understanding" of the State's reason for execution.

Restoration of Competency & Treatment
Statistics & Characteristics:

Around 60,000 defendants are referred for CST yearly, with roughly 25% found Incompetent to Stand Trial (ICT). ICT defendants frequently show a history of mental illness, drug abuse, criminal behavior, and psychological problems that impair their ability to interact with counsel.

Restoration of Competency & Treatment
Jackson v. Indiana (1972):

Limited the confinement period of incompetent defendants to the time necessary to determine if they can return to competence in the foreseeable future.

Adolescent Competence
Juvenile Transfers:

The 1990s saw a substantial increase in juveniles transferred to adult court for serious offenses. Current research indicates these transfers are generally ineffective at reducing future crimes.

Adolescent Competence
Developmental Deficits:

Younger adolescents (especially 11- to 13-year-olds) show higher rates of CST deficits, are more apt to confess, and are more likely to accept plea bargains compared to older peers due to immaturity, poor judgment, and poor decision-making.

CST Evaluation Methods
Forensic Assessment Instruments (FAIs) began in...
some examples include...

began being used in 1971.
Examples include:
MacArthur Structured Assessment of the Competencies of Criminal Defendants (MacSAC-CD)
Fitness Interview Test-Revised (FIT-R)
Evaluation of Competency to Stand Trial Instrument-Revised (ECST-R)
Computer-Assisted Determination of Competence to Proceed (CADCOMP)
Competency Screening Test (CAST-MR)

The Insanity Defense (Not Guilty by Reason of Insanity - NGRI) definition:

Insanity refers strictly to a defendant's state of mind at the time of the crime. It is a legal concept, not a clinical diagnosis.

Mental Illness vs. Insanity:

Mental illness does not automatically equal legal insanity. Clinicians provide evidence and testimony, but the legal system ultimately determines insanity.

Major Cases & Post-Hinckley Changes

United States v. Hinckley (1982):
The first application of the ALI standard.
Resulted in a Not Guilty by Reason of Insanity (NGRI) verdict.
Notable for being one of the first examples of neurolaw expert testimony (using brain imaging/PET scans).
Led to a shift placing the burden of proof heavily on the prosecution in federal court.

Insanity Defense Reform Act (IDRA) of 1984:

A law passed by Congress that is designed to make it more difficult for defendants using the insanity defense in the federal courts to be acquitted

Narrowed the federal insanity standard.
Shifted the burden of proof to the defense.
Placed strict restrictions on expert "ultimate-opinion" testimony.

Guilts But Mentally Ill (GBMI):

Created as an alternative verdict in about 20 states alongside guilty, not guilty, and NGRI.

Misconceptions of NGRI

The insanity defense is widely overused and acts as a low-risk strategy to avoid guilt.

Realities of NGRI

Used in less than 1% of all felony cases, and less than one-third of those involve a victim's death.
The defense fails roughly 70% of the time.
NGRI defendants often spend slightly longer periods in custody/treatment facilities than defendants convicted of the same crimes.

Evaluation Challenges & Characteristics
Clinical Agreement/Disagreement:

Evaluators agree most often when the defendant has a documented history of a psychotic disorder and prior psychiatric hospitalizations. They disagree most frequently when the crime was committed under the influence of a substance.

Typical NGRI Defendant Profile:

Male, no previous violent crime, no prior criminal history, but possesses a history of hospitalization for severe mental illness, psychosis, mood disorders, or intellectual disability.

Assessment Challenges:

Evaluating insanity is difficult because it is strictly retrospective, legal criteria vary widely across states, and there is no single "gold standard" assessment.

Malingering definition:

The deliberate feigning or gross exaggeration of physical, cognitive, and/or psychological symptoms to obtain secondary gain (an external incentive, such as money, drugs, avoiding prison, or settling a lawsuit). Symptom production is conscious.

Factitious Disorder (Munchausen):

A disorder in which the patient consciously creates the signs/ symptoms of an illness and misrepresents the history to assume the patient role and get medical attention (primary gain- internal)

Patient is aware that their behavior is intentional (mechanism for the symptoms is clear/conscious) but the motivation behind the symptoms is unclear/ unconscious.

may be for itself or by proxy
may show physical or psychological symptoms or both

Feigning or exaggerating disability to obtain primary gain (internal psychological needs, such as maintaining the sick role) for oneself or someone else. Symptom production is conscious.

Somatic Symptom-Related Disorders

Involves real physical symptoms driven by unconscious psychological needs or emotional stress, with unconscious symptom production.

Common Malingering

Competency to stand trial
personal injury
disability
criminal forensics
TBI
chronic pain/Neurotoxic exposure

Methods of Detection & Indicators
Stand-Alone Measures / Symptom Validity Tests (SVT):

Made solely to detect invalid performance; often use a forced-choice recognition format (e.g., Portland Digit Recognition Test, Test of Memory Malingering) where anyone with valid effort easily passes.

Methods of Detection & Indicators
Embedded Indicators:

Derived from standard clinical tests rather than independent measures. They are less transparent, less susceptible to coaching, and increase diagnostic power.

Criteria for Malingered Neurocognitive Dysfunction (MND)

Criterion A (External Incentive):

The "gatekeeper" criterion requiring a clear, substantial external incentive (e.g., jury award, disability pension, avoiding prosecution, military release, narcotics access, avoiding the death penalty). The incentive must be present, though it does not need to be definitively proven as the sole motivator.

Criteria for Malingered Neurocognitive Dysfunction (MND)

Criterion B (Test-Centered Evidence):

Poor performance on specialized validity tests, or major discrepancies between test data and known brain functioning, behavioral observations, collateral info, or post-incident history.

Criteria for Malingered Neurocognitive Dysfunction (MND)

Criterion C (Self-Report Centered Evidence):

Discrepancies between self-reported history/symptoms and documented history, brain functioning, behavioral observations, or collateral informants, alongside evidence of fabricated psychological dysfunction.

Criteria for Malingered Neurocognitive Dysfunction (MND)

Criterion D (Exclusionary Rules):

Criteria for Malingered Neurocognitive Dysfunction (MND)

Criterion D (Exclusionary Rules):

Malingering cannot be diagnosed if positive B or C criteria are fully accounted for by a genuine neurological or psychological disturbance rather than external incentives (e.g., a death-candidate with mild retardation who scores below chance on purpose on a forced-choice test can still be labeled MND because intellectual disability cannot explain choosing wrong answers over correct ones).