forensic psych final

respondent

juvenile equivalent of a defendant

adjudicated hearing

juvenile equivalent of a trial, where the hearing occurs and the court determines whether the juvenile committed the charges

disposition

juvenile equivalent of sentencing, the court’s decision after adjudication

intake

initial processing after arrest at the juvenile justice center where a decision is made about next steps:
- dismiss the case

- informal supervision: non-judicial supervision, diversion, counseling

- file a petition: formally start juvenile court proceedings

petition

a formal charging document filed in juvenile court asking the court to adjudicate the juvenile

NCR for juveniles

Most juveniles don’t meet the criteria for NCR & NO insanity plea in Maryland for juveniles

waiver

procedure to move a juvenile case from juvenile court to adult (circuit) court

reverse waiver

process to move a case back to juvenile court from adult court

types of dispositions

1. probation: supervised/undersupervised community protection

2. house arrest/electronic monitoring

3. community service

4. commitment to juvenile detention center

5. foster placement or sheltered care: if detention is inappropriate, but a custodial setting needed for welfare needs

house arrest/electronic monitoring

secure custody at home

detention hearings/review hearings

while detained, juveniles have periodic hearings, once per week, to decide continued detention

rights that juveniles retain

• right to counsel (an attorney)

• right to an adjudicative hearing (trial)

  • right to enter a plea

discretionary waiver

waiver transferring jurisdiction to circuit (adult) court
- prosecutor/judge has discretion to seek/approve transfer

presumptive waiver

the juvenile is presumptively to be transferred unless they can rebut the presumption

mandatory waiver

automatic transfer to adult court for specific offenses (felonies) or when statutory criteria are met

reverse waiver considerations

1. amenability to treatment: are they going to benefit from juvenile programs?

2. public safety risk: would keeping them in juvenile court endanger the public?

3. emotional and physical maturity: developmental maturity, impulse control, capacity to understand consequences

4. age: closer to 14 are a stronger juvenile claim

5. nature of the offense: violent/serious crimes weigh agains a reverse waiver

circuit court jurisdiction

when waived, juvenile cases are heard in the circuit (adult) court

custody/detention determinations for juveniles

both parents are examined in custody cases, evaluated, and interviewed

psychosexual

bi-directional influence between a person’s sexual behavior and their psychological functioning developed by:
- developmental factors (childhood experiences, attachment, trauma)

- cognitive factors (beliefs, thinking patterns)

- affective factors (emotion regulation, impulses, fantasies)

- interpersonal factors (relationship styles, social functioning)

assessment of sexual risk evaluations

1. foundational aspects of psychological functioning and manifested sexual behavior

   1. medical history, criminal history, existing/past sexual behaviors

   2. personality disorders, mood disorders, cognitive abilities

   3. collateral interviews of whether the sexual behavior indicates danger

      1. interview with offender & victim & family

      2. observe body language, eye contact, grooming, defensiveness

2. risk of recidivism (likelihood of reoffending)

3. interventions/treatment to reduce risk

   1. treatment recommendations, supervision strategies, risk management plans

MMPI-2, PCL-R

assessing personality disorders and psychopathology, risk of reoffending

SORAD

specialized sexual offender risk assessment tool, less malingering because offenders are less aware of how to “fake” good

identifying deviant sexual interests

1. sexually deviant targets (children, non-consenting adults)

2. sexually deviant behaviors (coercion, rape, child pornography, fetish behaviors)

abel assessment

measures sexual interest, patterns of arousal, deviant attention tendencies

violence risk assessment

1. forecasting an individual’s risk of future violence

2. developing interventions or recommendations to reduce that risk

dangerousness

risk of being violent right now

4 factors to dangerousness

1. psychiatric stability: delusions, hallucinations, paranoia

2. behavioral stability: getting into fights, threatening others, aggressive behavior

3. personality disorders + lack of control: antisocial, borderline, narcissistic

   1. impulsivity/control: poor impulse control has an increased risk, substance use worsens impulsivity

weather analogy

Forecasting the risk to a reasonable degree of clinical certainty

1. past weather events: historical factors (static)

2. current climate patterns: current mental state & behaviors that is the best predictor for short term violence (clinical/dynamic factors)

3. favorable conditions: treatment, support system that reduce risk

Historical Factors

Predicts long-term risk, scored with the HCR-20

• previous violence, age at first violent incident, relationship instability, employment instability, substance abuse history, history of major mental illness, psychopathy, school problems, personality characteristics, failed prior supervision

clinical dynamic factors (current conditions)

best predictor of short-term violence because they represent person’s current mental state

• lack of insight, neg attitudes toward violence, hostility toward treatment or justice system, active psychiatric symptoms, active substance use, interpersonal conflicts, cognitive distortions, impulsivity, unresponsiveness to treatment

cognitive insight

a person’s ability to understand their mental illness, how their symptoms caused past violence, what they need to stay stable, prevent future violence

VRAG: Violence Risk Appraisal Guide

12 item test of historical/static (psychopathy, school problems, past violence) and used with adult offenders & psychiatric patients, used to predict recidivism % over 7-10 years

HCR-20: Historical, Clinical, Risk Management

20-item test studying all historical (static), clinical (dynamic), risk-management (future plan) used to assess general violence risk and examines psychopathy, attitude toward treatment, impulsivity, violence history, access to weapons; scored as 0,1,2

PCL-R: Hare Psychopathy Checklist-Revised

Measures psychopathy with 20 items, scores each item as 0-2, score above 30 is considered psychopathic; psychopathy is one of the strongest predictors of violence and recidivism

malingering

intentional production or exaggeration of physical or psychological symptoms, motivated by external incentives such as avoiding work, military duty, gaining financial compensation, evading prosecution, obtaining drugs

factitious disorder

intentional production of symptoms motivated by a psychological need to assume the sick role, without external gain

dissimulation

concealing, minimizing, or denying symptoms

pure malingering

complete fabrication of symptoms that do not exist

partial malingering

exaggeration of symptoms that are actually present

how to look for malingering

1. presence of medical-legal context, such as disability evaluations or criminal proceedings

2. marked discrepancy between reported symptoms and objective findings

3. poor cooperation with evaluation or treatment

   1. diagnosis of antisocial personality disorder

purposes of malingering

2. avoiding responsibility or punishment

3. obtaining financial gain or compensation

   1. acquiring prescription medications

rate of malingering

10-20% in forensic settings, higher in felony cases than misdemeanors; 67% inmates reported malingering to avoid general population

What to rule out from malingering

• factitious disorder: a serious mental health condition where a person deliberately fakes, exaggerates, or causes physical/psychological symptoms in themselves (or others, in a related form) to assume a "sick role" for attention and sympathy

• somatoform disorders: unexplained physical symptoms

• true amnesia

• memory impairment stress, PTSD, complex trauma

• self-deception

• atypical but legit psychiatric presentations from schizophrenia, delusional disorder

  • culturally specific syndrome

interviewing techniques for malingering

• conduct longitudinal, comprehensive assessments over multiple sessions

• observe behavior across different settings and obtain collateral info

  • neutral, detailed, non-leading questionsp

patterns among malingerers

• vague, inconsistent descriptions

• overly dramatic presentation, theatrical pauses

• repeatedly redirecting conversation back to symptoms

• absence of subtle symptoms, such as negative symptoms

VICA

Vagueness, Inconsistency, Contradiction, Avoidance

Hallucination Malinger symptoms

• continuous with no fluctuation or variability

• vague, dramatic, or implausible descriptions

• no coping strategies (I listen to all voices constantly)

• claims of obeying all command hallucinations

• highly unusual or bizarre visual hallcuinations

delusions malingering

• sudden, abrupt onset

• overly eager or excited to discuss delusions

• behavior is inconsistent with claimed beliefs

  • delusions that come and go

schizophrenia malingering

very hard to malinger thought disorder (incoherent thinking), neologism (incomprehensible words and thoughts), negative symptoms (lack of motivation, reduced speech, inability to feel pleasure, restricted emotional expression)

amnesia malingering

forgetting highly stable personal information (name, DOB, family) which true amnesic patients retain, inability to maintain performance over time

cognitive symptoms malingering

frequent “I don’t know", illogical mixtures of cognitive deficits, patterns inconsistent, approximate answers phenomenon (answering 3 when asked 2+2)

SIMS (structured Inventory of Malingered Symptomatology)

75 item screening tool testing for psychosis, low intelligence, neurologic impairment, affective disorders, amnestic disorders; score above 14 consists of malingering

SIRS-2 (Structured Interview of Reported Symptoms-2)

Gold-standard tool for being used in court; high sensitivity & specificity; scales for rare symptoms, combinations, improbable symptoms, blatant symptoms

TOMM (test of memory malingering)

visual recognition memory test, trials of learning 1, learning 2, retention; looks for below-chance performance which strongly indicates malingering

VIP (validity indicator profile)

forced-choice task assessing verbal vs nonverbal abilities, detecting non-credible cognitive effort

MFAST/MPS

brief screening measures for feigned (fabrication, exaggeration) symptoms

insanity defense

idea that most people are capable of choosing the law, but 0.01% of the population have a mental disease or defect that renders them incapable of understanding or controlling their actions

as such, punishment is ineffective, treatment

m’naughten test

defendant is not criminally responsible if at the time of the act, they:

1. did not understand the nature of the act, OR

2. did not understand that it was wrong

irresistible impulse test

knew the act was wrong but were unable to control their behavior

police-at-elbow test

would the defendant have committed the act even if a police officer were standing next to them?

durham test

defendant is not criminally responsible if the unlawful act was the product of a mental disease or defect

not widely adopted in the US because individuals with mental illnesses do not commit crimes

ALI/Model Penal Code Test

Defendant is not criminally responsible if they lacked substantial capacity to appreciate the wrongfulness/criminality of the act (cognitive), OR conform conduct to the law (volitional, impulse control), included irresistible impulses

Insanity Defense Reform Act of 1984

Recognized that severe mental illness can make a defendant NCR; eliminated irresistible impulse (volitional), defendant must be unable to appreciate right vs wrong

Guilty but Mentally ill (GBMI)

defendant is convicted and sentenced normally, undergoes psychiatric evaluation, if treatment is needed gets hospitalized and returns to prison after stabilization

Burden of Proof

defendant must prove insanity with a high degree of certainty; NCR and NGRI are protected under the disability law

This illness is not considered for NCR

antisocial personality disorder, does not qualify as mental illness

competency to stand trial

current mental state; ability to understand proceedings and assist counselc

criminal responsibility

mental state at the time of the offense, cognitive or volitional (choice) incapacity

mental disorder/retardation

behavioral or emotional illness arising from psychiatric or neurological condition

IQ70

NCR may be granted for intellectual disability for this IQ number

Possible Pleas

1. Guilty: no trial; full sentence or plea bargain

2. Not guilty: trial

3. NCR: defendant must declare and prove

requirements must be in writing, demonstrate competency to enter in plea, and cannot be entered against the defendant’s objection

process after pleading NCR

court orders DHMH to evaluate NCR:

1. Clinical interview

2. competency evaluation

3. criminal responsibility evaluation: events leading to crime, memory of events, mental state & rationale at the time, behavior during arrest, post-crime behavior, toxicology (substance use), collateral interviews (family, friends, witnesses), medication adherence, full records (hospital, employment, financial), victim interviews, recent function, diagnostic conclusions

Outcomes: (within 60 days)

• not NCR → Guilty

  • NCR → Commitment to DHMH for treatment or release (with/without conditions) if not dangerous

Not dangerous standard

must prove by a preponderance of evidence that they are not dangerous

NCR hearing

NCR hearing on release eligibility every 50 days with an exam + report

request for release time

no sooner than 1 year after initial eligibility hearing

hawken v state

conditional release does not require zero risk, conditions must mitigate potential danger

return from condition release (release before full sentence to reintegrate into life)

hearing occurs within 10 days, and state must show the violation.

notification requirements for victim

• evaluation or commitment is ordered

• hearings are scheduled

• defendant applies for release

• hospital recommends discharge

• defendant escapes (elopement)

process for determining competency

1. Arrest

2. Hospital (optional)

• If the person is severely ill, they may first go to a hospital.

3. Intake at county detention center

4. Charges issued

• The state’s attorney reviews police information and decides if there is probable cause to charge.

5. Status hearing where formal charges are presented

• More charges can be added later (e.g., if a victim dies after the crime).

6. Defendant meets with attorney

7. At a later status hearing, competency is questioned (usually by a public defender)

8. A written court order is issued for a competency evaluation

9. Order goes to a “screener”

• The screener decides:

  • Does this person need a full forensic evaluation?

  • Should they be seen by a forensic psychologist?

10. Competency evaluation occurs

who can raise concerns about competency

judge, defense attorney, prosecutor, defendant, jail staff/mental health professionals

important because people’s mental states can change (medication changes, psychosis returns). A person who was once competent can become incompetent later

dusky standard (legal rule)

a defendant is competent if they have:

1. ability to understand the charges, court process, roles of the judge, jury, prosecutor, and defense

2. ability to assist and communicate with their attorney, make decisions about their case, participate in their defense

included in a competency evaluation

1. Clinical interview: informed consent to agree/refuse treatment, personal, psychiatric history, MSE

2. Competency Interview: do they know their charges, explain court procedures, work with their attorney, make rational decisions

3. Psychological testing: MMSE (measure cognitive impairment), cognitive tests, symptom validity tests if malingering suspected

   1. collateral information (medical records, jail observations, family interviews, police reports)

issues that affect competency (specific)

1. cultural barriers: language, immigration fears, cultural beliefs

2. developmental disabilities: low IQ, autism, learning disorders can interfere with competency

3. physical illness: traumatic brain injury, seizures, UTIs causing delirium, neurological diseases

4. malingering

Mental status exam

Tests current mental functioning. Includes:

• General appearance

• Orientation (person, place, time, situation)

• Mood & affect

• Sleep & appetite

• Cognitive abilities (memory, attention)

• Speech

• Thought process & content

• Hallucinations

• Suicidal/homicidal thoughts

Evaluator possible conclusions for competency

1. competent to stand trial

2. not competent to stand trial

3. Dangerous, Restorable, commit to hospital?

Clinical Review Panel

when patient refuses medication but need to restore them to competency:

• people participating are the patient, treating doctor, 3 clinical specialists (social worker, psychiatrist, psychologist), rights advisor

Outcomes:

• medication can be approved or rejected, and often rejected if the crime is minor (misdemeanor)

criteria for medication approval in involuntary medication

1. without medication, they remain dangerous or cannot be restored

2. unlikely to be restored to competency without medication

   1. needs to be reviewed every 90 days

time limits for crimes

felonies are 5 years (used to be 10 years)

• after 5 years, charges may be dismissed or re-filed

misdemeanors: cannot be held longer than max sentence

• ex include trespassing (cannot be held over 90 days for restoration)

five general principles (APA ethics code)

1. Beneficence and Nonmaleficence
   Do good, avoid harm.

2. Fidelity and Responsibility
   Maintain trust, uphold professional standards, clarify roles.

3. Integrity
   Be honest, accurate, and truthful; avoid deception unless justified.

4. Justice
   Ensure fairness and equal access to services; avoid bias.

5. Respect for People’s Rights and Dignity
   Respect privacy, autonomy, and cultural differences.

seven specialty guidelines for psychologists working in legal contexts

1. Responsibility
   Understand differences between legal and clinical roles; clarify limits.

2. Competence
   Stay within areas of expertise, maintain training in law and psychology.

3. Diligence
   Be thorough, timely, and prepared; avoid negligence.

4. Relationships
   Avoid multiple relationships, dual roles, and conflicts of interest.

5. Confidentiality
   Understand limited confidentiality in forensic work; communicate limits clearly.

6. Fees
   Avoid contingency fees; clarify fee structure and who pays.

7. Methods and Procedures
   Use reliable, scientifically supported methods that fit the legal question.

forensic psychologist methods and procedures

1. Use standardized, validated assessment tools.

2. Use procedures that are relevant to the legal question (competency, risk assessment, etc.).

3. Explain methods clearly in reports (tests used, limitations, reasoning).

4. Base opinions on sufficient information (no “hired gun” biases).

forensic practice characteristics

1. Objective, neutral, and unbiased (not an advocate for either side).

2. Evaluative rather than therapeutic.

3. Limited confidentiality (information often goes to courts/lawyers).

4. Focus on legal standards, not mental health treatment goals.

5. Role clarity (evaluator vs. treating clinician must be separated).

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informed consent

Person agrees voluntarily to the evaluation after being informed of risks/benefits.

disclosure

1. Person is told the nature and purpose of the evaluation, who will receive the results, and limits of confidentiality.

2. The person does not need to agree to be evaluated in many forensic settings.

forensic testing requirements

1. Disclosure is required.

2. Informed consent may not be required if the court orders the evaluation.

forensic psychologist communication allowed to

• Court

• Retaining attorney

• Opposing attorney (when required)

• Relevant professionals involved in the case
  
  They should not discuss case details with:

• The public

• The media

• Uninvolved professionals

• Friends or family

responding with questions forensic psychologist must:

• Maintain objectivity.

• Avoid giving opinions about guilt/innocence unless directly required by the legal question.

• Keep statements brief, factual, and non-speculative.

• Protect confidentiality to the extent possible.

forensic psychologist client

one who hires or appoints the psychologist, NOT the person being evaluated

examples include the court, attorney, government agency

sixth amendment

• Right to a speedy and public trial

• Right to an impartial jury

• Right to be informed of charges

• Right to confront witnesses

• Right to compulsory process (subpoena witnesses)

• Right to an attorney

options if forensic psychologist has personal relationshp with defendant, attorney, etc.

• Disclose the relationship

• Withdraw from the case

• Avoid any dual relationship or conflict of interest