AAPL practice guideline for forensic psychiatric evaluation of defendants raising the insanity defense. American Academy of Psychiatry and the Law

The journal of the American Academy of Psychiatry and the Law (Impact Factor: 0.93). 02/2002; 30(2 Suppl):S3-40.
Source: PubMed


The insanity defense is a legal construct that excuses certain mentally ill defendants from legal responsibility for criminal behavior. This practice guideline has delineated the forensic psychiatric evaluation of defendants raising the insanity defense. The document describes acceptable forensic psychiatric practices. Where possible, standards of practice and ethical guidelines have been specified. And where appropriate, the practice guideline has emphasized the importance of analyzing the individual case, the jurisdictional case law and the state (or federal) statute. This practice guideline is limited by the evolving case law, statutory language and legal literature. The authors have emphasized the statutory language of current legal standards, as well as the state or federal courts' interpretation of those standards because the same statutory language has been interpreted differently in different jurisdictions. Similarly, this practice guideline has reviewed the state and federal trends that determine which diagnoses meet the criteria for mental disease or defect. These trends yield to jurisdictional court interpretations. Finally, the authors hope this practice guideline has begun the dialogue about formulating a forensic psychiatric opinion by surveying the various approaches used to analyze case data. The forensic psychiatrist's opinion in each case requires an understanding of the current jurisdictional legal standard and its application, as well as a thorough analysis of the individual case. The psychiatrist's analysis and opinion should be clearly stated in the forensic psychiatric report. It should be noted that the role of a psychiatric expert witness in the criminal justice system is predicated on the law's interest in individualizing the criteria of mitigation and exculpation. Forensic psychiatric analyses and formulations of opinions are, therefore, subject to change as the legal guidance changes.

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    • "The following items are mandated: a description of the examination, diagnosis of the defendant, an opinion as to whether the defendant had the capacity to appreciate the wrongfulness of conduct or conform behavior to the requirements of law, an opinion as to the defendant's capacity to embody a particular state of mind required to establish elements of the legal charge (when specifically ordered by court), and a statement that the opinion was arrived at independently from other examiners. Hawaii courts routinely mandate CST and criminal responsibility opinions in the same court order, especially in the initial evaluation of the defendant (Giorgi-Guarnieri et al., 2002; Gowensmith, personal communication, April 24, 2011). This study is the third in a series of forensic report quality studies. "
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    ABSTRACT: This paper is the third in a series of research reports on quality of forensic mental health evaluations submitted to the Hawaii judiciary. Previous studies examined quality of reports assessing competency to stand trial (CST) and post-acquittal conditional release, in felony defendants undergoing court-ordered examinations. Utilizing a 44-item quality coding instrument, this study examined quality of criminal responsibility reports in a sample of 150 forensic mental health evaluations conducted between 2006 and 2010 by court-appointed panels. Raters attained high levels of agreement in training and quality coding. Similar to the previous studies, overall quality of reports was mediocre, falling below the .80 quality criterion score for report elements, regardless of evaluator professional identification or employment status. Level of agreement between evaluators and judicial sanity determinations was "fair" using Cicchetti's (1994) standards for interpretation of intra-class correlations. Level of agreement was lower than previously published findings for CST reports and better than conditional release reports. Reasons for mediocre report quality and "fair" inter-rater agreement are discussed, including the fact that criminal responsibility evaluations are complex, retrospective in nature, and involve significant degrees of inference. In contrast to CST evaluations, assessment of criminal responsibility involves a mental state at the time of the offense evaluation. Threats to reliability in forensic reports are discussed. Suggestions for improvement of report quality are proffered, including standardization of procedures and report format and use of forensic assessment instruments.
    Full-text · Article · Dec 2013 · International Journal of Law and Psychiatry
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    • "1995]). Although there also have been attempts to operationalize the legal construct of volitional impairment (Hall, 1985; Giorgi-Guarnieri et al., 2002) and even specifi c guidelines developed for assessing control in the insanity context (Rogers & Shuman, 2000), there tends to be no coherent account of how one might differentiate an actor who has veritably lost control from one who has decidedly abandoned control. Moreover, it is uncertain whether these guidelines or operationalizations are in fact consistent with how the Supreme Court is conceptualized control in Hendricks and Crane. "
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    ABSTRACT: The Kansas v. Hendricks (1997) decision, in which the Supreme Court authorized post-sentence civil commitment for certain sex offenders, appeared to be constitutionally legitimized by limiting the class of offenders eligible for this special form of civil commitment to those who are "unable to control" their dangerousness. Nowhere in the available record, however, did the Court elucidate what they meant by this notion of volitional impairment. This study sought to examine factors that legal professionals (n=43), psychologists (n=40), and mock jurors (n=76) deem most relevant to a determination of sex offender volitional impairment. Participants, who were randomly assigned to a sexual predator commitment or an insanity hearing context, read a series of 16 vignettes that described a pedophilic offender and included combinations of variables hypothesized to be related to judgments of volitional impairment. Results suggested that participants, who as a group made remarkably high estimates of likelihood of future sexual violence, considered verbalization of control, history of sexual violence, and the context of the hearing as highly relevant to determinations of volitional impairment. Implications for policy and practice are explored.
    Full-text · Article · Nov 2006 · Law and Human Behavior
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    ABSTRACT: This chapter discusses how clinicians who conduct criminal responsibility evaluations should use a framework that is legally informed, ethically, and empirically guided, especially when conducting evaluations concerning mentally insane criminals. The underlying principle establishing the need for an insanity defense is that individuals who commit crime for irrational reasons or because they were unable to control their behavior should not be convicted and punished. Such individuals may be considered in need of treatment in a forensic facility rather than confinement in a prison. Psychotic disorders are widely accepted as a basis for an insanity defense Mental retardation, organic disorders, and affective disorders are relatively common among insanity defense cases, reflecting approximately 5, 7, and 10 percent, respectively. In order to facilitate the validity of an assessment, it is argued that psychologists have an ethical responsibility to always assess for response biases. Many common self-report measures, such as the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), contain scales that measure exaggeration of psychopathology, minimization of psychopathology, and inconsistent responding.
    No preview · Chapter · Dec 2004
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