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Mental Illness and Legal Fitness (Competence) to Stand Trial in New York State: Expert Opinion and Criminal Defendants' Psychiatric Symptoms,
Authors:Eugene Lee MD  Richard Rosner MD  Ronnie Harmon PhD
Institution:1. University of Arkansas School of Law & University of Arkansas for Medical Sciences, , Fayetteville, AR, 72701;2. Department of Psychiatry, New York University School of Medicine, Suite 6‐A, , New York, NY, 10028;3. Forensic Consultant, , Tampa, FL, 33635
Abstract:Fitness to Stand Trial is a critical concept in the adjudication of justice‐involved persons. A retrospective study was conducted to examine criminal defendants' specific psychiatric symptoms and those symptoms' associations with expert opinions on Competence to Stand Trial. One hundred charts were reviewed: 50 Cases (opined as Not Fit) were compared against 50 Controls (opined as Fit) with respect to ratings on the Brief Psychiatric Rating Scale (BPRS). A significance level of 0.001 was selected a priori. Statistically significant differences were found in seven of the eighteen BPRS symptom constructs (with the highest differences in Conceptual Disorganization and Unusual Thought Content) and two of the four BPRS higher‐order syndrome factors (Thinking Disorder and Hostile‐Suspiciousness). Consistent with previous reports, psychotic symptoms are found in this study to be inversely associated with Fitness. Validity, reliability, and limitations of this study, as well as directions for future research, are discussed herein.
Keywords:forensic science  psychiatry  psychology  behavioral science  Brief Psychiatric Rating Scale  psychosis  psychotic disorders  Schizophrenia  Schizophreniform Disorder  Brief Psychotic Disorder  Schizoaffective Disorder  Delusional Disorder  Psychotic Disorder Not Otherwise Specified  Schizophrenia Spectrum and Other Psychotic Disorders  expert opinion  expert witness  mental disease  mental defect  mental disease or defect  Fitness to Stand Trial  Competence to Stand Trial  criminal justice  criminal law  justice‐involved persons
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