This study evaluated the influence of psychiatric symptoms (psychoticism, withdrawal, depression, hostility) and cognitive abilities (executive functioning, working memory, attention, processing speed) on competence-related abilities (understanding, reasoning, appreciation). Seventy-seven male forensic patients were administered the MacCAT-CA, the BPRS, and several cognitive measures. Results revealed that, when considered as a group, the cognitive abilities accounted for more variance in the scores for all three competence-related abilities than did the psychiatric symptoms although there was an additive effect when these groups of variables were considered collectively. Both the psychiatric symptoms and cognitive abilities accounted for a substantial portion of the variance in understanding and reasoning scores, but less so for appreciation. Psychoticism and attention were important factors across all aspects of competence, while working memory was associated with understanding and reasoning, but not appreciation. The presence of symptoms of psychosis had a moderating effect on all four cognitive variables with regard to reasoning, but not understanding or appreciation. The knowledge gained from these results can be used by practitioners to help improve the consistency and accuracy of competency evaluations.
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