Competency Restoration: An Examination of the Differences Between Defendants Predicted Restorable and Not Restorable to Competency

According to the U.S. Supreme Court's decision in Jackson v. Indiana (1972), examiners must determine if a defendant has substantial probability of regaining competency through treatment in the foreseeable future. Previous research has indicated that, given the low base rate of defendants unable to be restored to competency, examiners are relatively poor at predicting which defendants will regain competency. Determining the characteristics of not restorable incompetent defendants and restorable incompetent defendants is a necessary first step toward improving examiners' ability to predict a defendant's likelihood of regaining competency. This study examined the competency evaluation reports of 468 defendants evaluated for competency to stand trial. Incompetent defendants significantly differed from competent defendants with regard to age, employment status, ethnicity, criminal charges, and psychiatric diagnosis. Few significant differences existed between defendants predicted restorable and those predicted not restorable by mental health examiners—the differences that did exist were related mainly to nonpsychiatric variables.     

Developmental incompetence to stand trial in juvenile courts

Juveniles' competency to participate in delinquency proceedings has received increased attention in recent years. Developmental incompetence, whereby juveniles' incompetency is based upon their immaturity, as opposed to a mental disorder or developmental disability, is an evolving and important aspect of this area of law. The following paper reviews theories used to support the notion of developmental incompetence, as well as the extant empirical research on juveniles' competency-related abilities. Using a LexisNexis search, statutory and case laws pertaining to juvenile competency were identified across the 50 states and the District of Columbia. Only six states clearly allow developmental incompetence, whereas 17 have laws that do not include developmental immaturity as an acceptable basis of incompetence in juvenile courts. Developmental incompetence is likely to affect a relatively small proportion of juvenile cases, but has important implications for juvenile forensic practice. Recommendations are offered for forensic practitioners conducting this type of evaluation.     

精神病人受审能力评定标准的制订

目的制订符合中国刑事法律体系的精神病违法者受审能力评定标准。方法根据自己的法医精神病学实践,结合国外已有的标准和中国刑事法律,研究者首先创建了称为“受审能力评定表”的评定工具,然后在实践中运用该工具;最后通过诊断性实验,对该工具的信度、效度及实用性进行了检验。结果该工具的分半信度和同质性信度分别为0.9366和0.9213,工具评定与专家评定的一致性为0.704,除了敏感性为0.6097,其他所有的诊断性指标均大于0.80。结论受审能力评定表具有较好的实用性。     

Predictor Variables in Competency to Stand Trial Decisions

Clinicians possess significant discretion in competency to stand trial assessment. Therefore, it is paramount to explore the contribution of individual variables to ensure that the decision-making process is devoid of bias and solely relates to the legal criterion. To test for the possibility of bias in clinical decision-making, we examined the predictive efficiency of clinical, criminological, and sociodemographic variables in a sample of 468 criminal defendants referred for competency evaluations. Only clinical diagnostic variables and employment status were significant predictors. This finding supports the idea that examiner decisions of competency appear to be unbiased and relate primarily to a defendant's functional ability.     

An Examination of the Relationship Between Competency to Stand Trial,Competency to Waive Interrogation Rights,and Psychopathology

This study compared the legal abilities of defendants (N = 212) with current primary psychotic disorders (n = 44), affective disorders (n = 42), substance abuse disorders (n = 54), and no diagnosed major mental illness (n = 72). Defendants with primary psychotic disorders demonstrated more impairment than did other defendants in their understanding of interrogation rights, the nature and object of the proceedings, the possible consequences of proceedings, and their ability to communicate with counsel. Psychosis was of limited value as a predictor however, and high rates of legal impairment were found even in defendants with no diagnosed major mental illness. Sources of within-group variance were examined to further explain this finding. Policy and clinical implications of these results are discussed.     

受审能力探析

受审能力是被告人接受法庭审判的能力。我国对受审能力的研究还处于起步阶段,立法上还有许多空白之处。本文从评定标准、提起、确认与法律后果等方面对受审能力进行了探讨。     

Forensic Applications of the Miller Forensic Assessment of Symptoms Test (MFAST): Screening for Feigned Disorders in Competency to Stand Trial Evaluations

Forensic evaluations must systematically assess malingering and related response styles. In the criminal forensic domain, competency to stand trial evaluations are the most common referrals. Effective screens for feigned incompetency would be valuable assets for forensic evaluations. This study evaluates the effectiveness of the Miller Forensic Assessment of Symptoms Test (MFAST) as a screen for feigned incompetency. Using a simulation design, the MFAST was tested on jail and competency-restoration samples. Most notably, recommended MFAST cut score (6) was useful for the identification of feigning cases in competency evaluations. Recommendations for forensic practice, including the advantages and disadvantages of systematic screens, are discussed.     

论受审能力的恢复

受审能力评定越来越引起重视的情况下,对于无受审能力者,受审能力的恢复也是一项值得大家关注的问题,受审能力恢复的培训程序包括相关精神障碍治疗、法律知识培训、综合住院治疗;而个别程序的专门培训可能是受审能力最大程度恢复的必要措施。受审能力恢复评定的标准更多的参照于经典的Bennett标准。虽然有关受审能力恢复的研究还存在一些挑战,但为我国相关受审能力恢复的研究指明了道路,提供了很好的参考依据和措施。     

The Effect of Competency Restoration Training on Defendants with Mental Retardation Found Not Competent to Proceed

The present investigation focused on the reevaluations of competency to stand trial (CST) of 75 criminal defendants with mental retardation (MR) who were originally found incompetent and who were referred for treatment. The effect of competency restoration training was examined. Site of training was also investigated. Because habilitation facilities are specially designed to help individuals with MR, it was suspected that training at habilitation centers would have a greater effect on restoration of defendants with MR than the training at state hospitals. Results showed that significantly more defendants did not gain competency following training than those who did. Analysis revealed that (a) higher IQ and (b) being African American rather than Caucasian American were predictive of restoration. When discriminating factors were held constant, site of training did not significantly affect competency restoration. Possible explanations for this finding were discussed.     

精神病人受审能力影响因素研究

目的探究精神病人受审能力的影响因素。方法对在四川大学华西基础医学与法医学院法医精神病学教研室进行法医精神病学鉴定的170名被鉴定人进行受审能力评定,评定研究对象的受审能力、精神症状,收集其人口学资料、犯罪学资料,采用统计描述、t检验、χ2检验、秩和检验和logistic回归分析等方法研究精神病人受审能力的影响因素。结果BPRS的思维障碍因子、激活性因子、PANSS的P分对受审能力具有显著影响;无受审能力组病理性和不明作案动机比例较高,且与有受审能力组相比差别具有统计学意义;无受审能力组言语智商低于有受审能力组,差别具有统计学意义;无受审能力组精神分裂症比例较高,差别具有统计学意义。结论BPRS的思维障碍因子、激活性因子、PANSS的P分、言语智商、精神疾病诊断、作案动机对精神病人受审能力具有一定影响。     

The Fitness to stand trial Interview Test: how four professions rate videotaped fitness interviews

The results of this study provide some preliminary support for the use of the FIT as a method for providing structure to interviewers. The FIT may be particularly useful as a guide for making initial decisions about fitness. It was suggested that a screening evaluation based on the FIT could be completed by any properly trained individual with some professional background. The more difficult cases can be referred for lengthier evaluations. Of course, further research on the use of the FIT with actual defendants in real assessments will need to occur before such a procedure can be used as a matter of routine. Finally, the FIT promises to be an effective research tool for isolating professional group differences in definitions of fitness and the importance of different aspects of it, from both a legal and a mental health perspective.     

精神障碍者受审能力评定量表的编制

目的研制符合中国法律体系的精神障碍者受审能力评定量表。方法从法学要件着手,提取出15个条目,编制出初步的精神障碍者受审能力评定量表,从决断值、条目与总分相关、校正条目与总分相关、条目删除后的α值、条目共同性、因素负荷量6个方面对量表进行条目分析,并以Logistic回归方程与ROC曲线划定界值两种方式进行诊断效能的判断。结果各条目极端组的决断值18.390~46.763,各条目与总分相关系数0.639~0.952,校正条目与总分相关系数0.582~0.944,条目共同性0.377~0.916,因素负荷量0.614~0.957。共7个条目进入回归方程,总样本的回判正确率为96.0%。ROC拟合曲线分析出宜以33分作为量表划界分,与专家鉴定意见的重叠率为95.8%,敏感性为0.938,特异性为0.966,阳性似然比为27.67,阴性似然比为0.06。结论量表编制合理,各条目符合同质性检验要求,诊断性评价指标较好。     

受审能力的法律辨析

目前司法领域对受审能力缺乏明确的立法规定，实践中也没有统一标准。本文就受审能力的适用于诉讼的范围、受审能力的二分法、评定程序等问题，从法律而非医学的角度来进行分析。以纠正目前对受审能力的部分错误认识。     

An Investigation of the Construct of Competence: A Comparison of the FIT,the MacCAT-CA,and the MacCAT-T

The 1990s witnessed Supreme Court decisions in both Canada and the United States on issues of competence that went against longstanding case law, psychological research, and common sense. These decisions held that there is to be one standard for all types of criminal competencies. The present research attempts to investigate whether this is an appropriate assumption and thus tests whether there are one or more constructs that underlie different types of competence. Two divergent types of competence were examined, competence to stand trial (both Canadian and American conceptualizations) and competence to consent to treatment, to determine if these different types of competence share a common underlying construct. Confirmatory factor analysis was used to test this question and results indicate that there is a common construct that underlies different types of competence.     

An Evaluation of Malingering Screens with Competency to Stand Trial Patients: A Known-Groups Comparison

The assessment of malingering is a fundamental component of forensic evaluations that should be considered with each referral. In systematizing the evaluation of malingering, one option is the standardized administration of screens as an initial step. The current study assessed the effectiveness of three common screening measures: the Miller Forensic Assessment of Symptoms Test (M-FAST; Miller, 2001), the Structured Inventory of Malingered Symptomatology (SIMS; Widows & Smith, 2004), and the Evaluation of Competency to Stand Trial-Revised Atypical Presentation Scale (ECST-R ATP; Rogers, Tillbrook, & Sewell, 2004). Using the Structured Interview of Reported Symptoms (SIRS) as the external criterion, 100 patients involved in competency to stand trial evaluations were categorized as either probable malingerers (n=21) or nonmalingerers (n=79). Each malingering scale produced robust effect sizes in this known-groups comparison. Results are discussed in relation to the comprehensive assessment of malingering within a forensic context.     

Interventions with women offenders: a systematic review and meta-analysis of mental health gain

Currently, a conjunction of policy, legislative change in health and social care and the criminal justice system, combined with funding for innovative services make it opportune to assess the evidence base for interventions with women offenders. Women offenders have a distinctive criminological, health and social profile and a gender specific approach to their difficulties is advocated. This systematic review and meta-analysis focus on mental health gain in adult women offenders in forensic health settings, criminal justice institutions and in the community, following therapeutic interventions. Interventions were assessed in terms of specific outcome measures of depression, trauma symptomatology and global mental health status. Comprehensive search strategies yielded 3018 articles, from which we obtained 199 full text articles. Seventeen articles were included in the final review, of which six were excluded from the meta-analysis as there was no comparator group. There is a modest, but increasing, body of evidence for the utility of some interventions, notably those addressing the consequences of earlier trauma, including interventions which also address comorbid substance misuse. This does not amount, to date, to a robust evidence base. Limitations of these studies are discussed and include small sample sizes, their restriction mainly to prison populations and that they were substantially undertaken in the US. Variations in outcome measures follow-up and the difficulties inherent in measuring change in this complex population are also detailed. However, the review delineates definite avenues for further work. To achieve this, those responsible for policy, practice and purchase of services should both be mindful of existing evidence and promote additional, high quality research into interventions which are designed around a coherent, theoretical approach.     

Police crackdowns on illegal gun carrying: a systematic review of their impact on gun crime

This paper presents a systematic review of the impact of police strategies to reduce illegal possession and carrying of firearms on gun crime, including directed patrols, monitoring of probationers and parolees, weapon reporting hotlines, and others. Four studies met the inclusion criteria, reporting a total of seven nonrandomized tests of directed patrols focused on gun carrying in three American cities (five tests) and two Colombian cities (two tests). Six of the seven tests (not all of which were independent) suggest that directed patrols reduced gun crime in high-crime places at high-risk times. However, conclusions and generalizations must be qualified based on the small number of studies, variability in study design and analytic strategy across the studies, preintervention differences between intervention and comparison areas, and limited data regarding factors such as implementation, crime displacement, and long-term impact.Although the protocol for this review was registered and approved by the Campbell Collaboration Crime and Justice Group (), this paper represents an independent effort of the authors and has not been reviewed by the Campbell Collaboration. Evan Mayo-Wilson conducted research for this project while he was Coordinator of the Campbell Crime and Justice Group at the University of Pennsylvania's Jerry Lee Center of Criminology and a student at the Fels Institute of Government.