Feigning incompetency to stand trial

The vulnerability of competency to stand trial instruments to malingering was previously unexamined. In this study, the Georgia Court Competency Test (GCCT) was administered to offenders asked to feign incompetency; their results were compared to controls and pretrial defendants (both competent and incompetent). Offenders appeared to be able to simulate incompetency and tended to score lower on the GCCT than their truly incompetent counterparts. For the detection of simulators, a newly developed Atypical Presentation scale for the GCCT showed promise. In addition, several strategies were explored that included simulators' failure of very simple items (i.e., floor effect) and variable success on items of increasing difficulty (i.e., performance curve). Optimal cutting scores are presented for forensic clinicians to screen defendants for feigned incompetency.     

Vaginal fluid zinc concentration as a marker for intercourse

Zinc is present in high concentration in semen, but in low concentration in vaginal fluid. We evaluated vaginal zinc levels as a marker for intercourse by measuring precoital (greater than 11 h after intercourse) or postcoital (less than 5 h after intercourse) zinc and acid phosphatase levels in 26 specimens of vaginal fluid from 18 women. The approximate 95% reference range for zinc in precoital vaginal fluid was 1.2 to 15 micrograms/mL (mean 4.5), and in postcoital vaginal fluid 4.0 to 135 micrograms/mL (mean 24). There is an overlap between the precoital and postcoital reference ranges. Provided that the vaginal fluid zinc level is less than approximately 4.0 micrograms/mL or greater than approximately 15 micrograms/mL, vaginal fluid zinc concentration may be useful as an indicator of intercourse.     

Development of a new classificatory model of malingering

Inclusion criteria for the classification of malingering are shaped and largely predetermined by our explanatory theories. Current theories have postulated the motivation to malinger is either the product of underlying psychopathology (pathogenic model) or criminal backgrounds (DSM III-R model). I have proposed a third model that malingering is typically an adaptive response to adverse circumstances which may best be understood in the context of decision theory. Based on this approach I have argued that indices of malingering should be empirically derived and focused on clinical presentation. Finally, I have proposed a preliminary model for the classification of malingerers which combines clinical data with corroborative evidence.     

Oregon's Psychiatric Security Review Board: a comprehensive system for managing insanity acquittees

The insanity defense is a particularly controversial aspect of the interaction between law and mental health. During the past decade, many states have revised or abolished their insanity defenses. Oregon, however, chose in 1974 to retain its existing defense and create a new, unique system for the post-adjudication management of insanity acquitees. Oregon's legislature established the Psychiatric Security Review Board (PSRB), which is composed of five part-time members drawn from different disciplines, to conduct periodic hearings to determine the placement and supervision of defendants who successfully raise the insanity defense and remain mentally ill and dangerous. The PSRB has received national attention as a promising approach to managing mentally ill offenders. The authors first describe the structure and operation of the Oregon system. Then they summarize the empirical studies they have conducted of the PSRB in action.