Competence to stand trial is the most requested forensic evaluation in the United States, with a minimum of 60,000 assessments conducted per year. In the U.S., once found incompetent, restoration typically is provided by the mental health system, generally via an inpatient admission. There has been a nationwide surge in referrals for competence to stand trial evaluations, with a corresponding increase in defendants court-ordered for restoration. When jurisdictions require inpatient treatment for this restoration process, defendants often wait in jail for a hospital bed. As more states face litigation because of these waiting times, strategies to improve the efficiency of systems charged with restoration is imperative. Our study examined the utility of an admission screening process to achieve this goal. Eight hundred and thirty seven patients were admitted as incompetent to stand trial during the study period, 486 of whom had adequate data for analysis. Our results indicated that this screening process was useful in identifying individuals who may need a comprehensive assessment of feigning. Our data confirm that the assessment of response style is a critical component of a forensic evaluation. If this assessment is not performed pretrial, there is benefit to conducting the assessment on admission for restoration.
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References
1.
American Psychiatric Association. (2013) Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Publishing.
2.
ArdolfB. R.DenneyR. L.HoustonC. M. (2007). Base rates of negative response bias and malingered neurocognitive dysfunction among criminal defendants referred for neuropsychological evaluation. The Clinical Neuropsychologist, 21, 899–916. https://doi.org/10.1080/13825580600966391
3.
BianchiniK. J.GreveK. W.Gary GlynnG. (2005). On the diagnosis of malingered pain-related disability: Lessons from cognitive malingering research. The Spine Journal, 5, 404–417.
4.
BonnieR. J.GrissoT. (2000). Adjudicative competency and youthful offenders. In GrissoT.SchwartzR. G. (Eds.), Youth on Trial: A developmental perspective of juvenile justice (pp. 73–103). Chicago, IL: University of Chicago Press.
5.
ColwellL. H.GianesiniJ. (2011). Demographic, criminologic, and psychiatric factors that predict competency restoration. Journal of the American Academy of Psychiatry and the Law, 39, 297–306.
6.
CooperD.GrissoT. (1997). Five-year research update (1991–1995): Evaluations for competence to stand trial. Behavioral Sciences and the Law, 15, 347–364. https://doi.org/10.1002/(SICI)1099-0798(199722/06)15:3<347::AID-BSL270>3.0.CO;2-K
7.
CornellD. G.HawkG. L. (1989). Clinical presentation of malingerers diagnosed by experienced forensic psychologists. Law and Human Behavior, 13, 375–383. https://doi.org/10.1007/BF01056409
8.
Dusky v.United States. (1960). 362 U.S. 402.
9.
EdensJ. F.BuffingtonJ. K.TomicicT. L. (2000). An investigation of the relationship between psychopathic traits and malingering on the psychopathic personality inventory. Assessment, 7, 281–296. https://doi.org/10.1177/107319110000700307
10.
FrederickR. I. (2012). Malingering/cooperation/effort. In FaustD. (Ed.), Coping with psychiatric and psychological testimony (6th ed., pp. 229–247). New York: Oxford University Press.
11.
FogelM. H.SchiffmanW.MumleyD.TillbrookC.GrissoT. (2013). Ten year research update (2001–2010): Evaluations for competence to stand trial (adjudicative competence). Behavioral Sciences and the Law, 31, 165–191. https://doi.org/10.1002/bsl.2051
12.
GothardS.RogersR.SewellK. W. (1995). Feigning incompetency to stand trial. Law and Human Behavior, 19, 363–373. https://doi.org/10.1007/BF01499137
13.
GothardS.ViglioneD. J.MeloyJ. R.ShermanM. (1995). Detection of malingering in competency to stand trial evaluations. Law and Human Behavior, 19, 493–505. https://doi.org/10.1007/BF01499340
14.
GottfriedE.GlassmireD. (2015). The relationship between psychiatric and cognitive feigning among forensic inpatients adjudicated incompetent to stand trial. Assessment, 23, 672–682. https://doi.org/10.1177/107319115599640
15.
GottfriedE. D.VitaccoM. J.SteadhamJ. A. (2017). The relationship between feigned psychiatric symptoms and feigned lack of legal knowledge among a multi-site sample of forensic inpatients. International Journal of Forensic Mental HealthAdvance online publication. https://doi.org/10.1080/14999013.2017.1288667
16.
GowensmithW. N.MurrieD. C.BoccacciniM. T. (2012). Field reliability of competence to stand trial opinions: How often do evaluators agree, and what do judges decide when evaluators disagree?Law and Human Behavior, 36, 130–139. https://doi.org/10.1037/h0093958
17.
GowensmithW. N.PinalsD. A.KarasA. (2015). States' standards for training and certifying evaluators of competency to stand trial. Journal of Forensic Psychology Practice, 15, 295–317. https://doi.org/10.1080/15228932.2015.1046798
18.
GowensmithW. N.FrostL. E.SpeelmanD. W.ThersonD. E. (2016). Lookin’ for beds in all the wrong places: Outpatient competency restoration as a promising approach to modern challenges. Psychology, Public Policy and Law, 22, 292–305. https://doi.org/10.1037/law0000088293
19.
GrissoT. (1992). Five-year research update (1986–1990): Evaluations for competence to stand trial. Behavioral Sciences and the Law, 10, 353–369. https://doi.org/10.1002/bsl.2370100306
20.
HeilbrunK.CollinsS. (1995). Evaluations of trial competency and mental state at the time of the offense: Report characteristics. Professional Psychology: Research and Practice, 26, 61–67. https://doi.org/10.1037/0735-7028.26.1.61
21.
HeinzeM. C.PurischA. D. (2001). Beneath the mask: Use of psychological tests to detect and subtype malingering in criminal defendants. Journal of Forensic Psychology Practice, 1, 23–52. https://doi.org/10.1300/J158v01n04_02
22.
HeinzeM. C.VessJ. (2005). The relationship among malingering, psychopathy, and the MMPI-2 validity scales in maximum security forensic psychiatric inpatients. Journal of Forensic Psychology Practice, 5, 35–53. https://doi.org/10.1300/J158v05n03_02
23.
HomsyS. E., McDermottB. E., & WoofterC. (March). Competence to Stand Trial Evaluations: Does Quality Matter?Paper presented at the meeting of the American Psychology and Law Society, Seattle, WA.
24.
JohnsonW. G.MullettN. (1987). Georgia court competency test - R. In HersenM.BellackA. S. (Eds.), Dictionary of behavioral assessment techniques. New York: Pergamon Press.
25.
KatzM. H. (2016). Examination of increase in mental competency cases. Los Angeles, CA: LA County Health Agency.
26.
KucharskiL. T.DuncanS.EganS. S.FalkenbachD. M. (2006). Psychopathy and malingering of psychiatric disorder in criminal defendants. Behavioral Sciences and the Law, 24, 633–644. https://doi.org/10.1002/bsl.733
27.
LambH. R.WeinbergerL. E. (2005). The shift of psychiatric inpatient care from hospitals to jails and prisons. Journal of the American Academy of Psychiatry and the Law, 33, 529–534.
28.
McLaughlinJ. L.KanL. Y. (2014). Test usage in four common types of forensic mental health assessment. Professional Psychology: Research and Practice, 45, 128–135. https://doi.org/10.1037/a0036318
29.
MeltonG. B.PetrilaJ.PoythressN. G.SloboginC. (2007). Psychological evaluation for the courts: A handbook for mental health professionals (3rd ed.). New York: Guilford.
30.
MillerH. A. (2001). Miller-Forensic Assessment of Symptoms Test (M-FAST): Professional manual. Odessa, FL: Psychological Assessment Resources.
31.
MillerR. D. (2003). Hospitalization of criminal defendants for evaluation of competence to stand trial or for restoration of competence: Clinical and legal issues. Behavioral Sciences and the Law, 21, 369–391. https://doi.org/10.1002/bsl.546
32.
MittenbergW.PattonC.CanyockE. M.ConditD. C. (2002). Base rates of malingering and symptom exaggeration. Journal of Clinical and Experimental Neuropsychology, 24, 1094–1102. https://doi.org/10.1076/jcen.24.8.1094.8379
33.
MonahanJ.SteadmanH. J.AppelbaumP. S. (2005). Classification of Violence Risk (COVR). Lutz, Fla: Psychological Assessment Resources.
34.
MonahanJSteadmanH. J.SilverE. (2001). Rethinking risk assessment: The MacArthur study of mental disorder and violence. New York: Oxford University Press.
35.
MorrisD. R.ParkerG. F. (2008). Jackson's Indiana: State hospital competence restoration in Indiana. Journal of the American Academy of Psychiatry and the Law, 36, 522–534.
36.
MossmanD.NoffsingerS. G.AshP.FriersonR. L.GerbasiJ.HackettM.ZonanaH. V. (2007). AAPL practice guideline for the forensic psychiatric evaluation of competence to stand trial. The Journal of the American Academy of Psychiatry and the Law, 35(Suppl.), S3–S72.
37.
MumleyD. L.TillbrookC. E.GrissoT. (2003). Five year research update (1996–2000): Evaluations for competence to stand trial (adjudicative competence). Behavioral Sciences & the Law, 21, 329–350. https://doi.org/10.1002/bsl.534
38.
MusickJ. F., & OttoR. K. (2010). Inventory of Legal Knowledge (ILK) [Assessment instrument].Lutz, FL: PAR.
NussbaumD., HancockM., TurnerI., ArrowoodJ. & MelodickS. (2008). Fitness/Competency to stand trial: A conceptual overview, review of existing instruments, and cross-validation of the Nussbaum Fitness Questionnaire. Brief Treatment and Crisis Intervention, 8, 43–72. http://dx.doi.org/10.1093/brief-treatment/mhm026
41.
OverallJ. E.GorhamD. R. (1962). The brief psychiatric rating scale. Psychological Reports, 10, 799–812. https://doi.org/10.2466/pr0.1962.10.3.799
42.
PalermoG. B. (2004). Editorial: A look at malingering. International Journal of Offender Therapy and Comparative Criminology, 48, 265–267. https://doi.org/10.1177/0306624X04263993
43.
PiersonA. M.RosenfeldB.GreenD.BelfiB. (2011). Investigating the relationship between antisocial personality disorder and malingering. Criminal Justice and Behavior, 38, 146–156. https://doi.org/10.1177/0093854810389292
44.
PirelliG.GottdienerW. H.ZapfP. A. (2011). A meta-analytic review of competency to stand trial research. Psychology, Public Policy, and Law, 17, 1–53. https://doi.org/10.1037/a0021713
45.
PoythressN. G.EdensJ. F.WatkinsM. M. (2001). The relationship between psychopathic personality features and malingering symptoms of major mental illness. Law and Human Behavior, 25, 567–582. https://doi.org/10.1023/A:1012702223004
46.
RobinsonR.AcklinM. W. (2010). Fitness in paradise: Quality of forensic reports submitted to the Hawaii judiciary. International Journal of Law and Psychiatry, 33, 131–137. https://doi.org/10.1016/j.ijlp.2010.03.001
47.
RogersR.BagbyR.DickensS. (1992). Structured interview of reported symptoms: Professional manual. Odessa, FL: Psychological Assessment Resources.
48.
RogersR.SalekinR. T.SewellK. W.GoldsteinA.LeonardK. (1998). A comparison of forensic and nonforensic malingerers: A prototypical analysis of explanatory models. Law and Human Behavior, 22, 353–367. https://doi.org/10.1023/A:1025714808591
49.
RogersR.VitaccoM. J. (2002). Forensic assessment of malingering and related response styles. In Van DorstenB. (Ed.), Forensic psychology: From classroom to courtroom (pp. 83–104). New York, NY: Kulwer Academic Press.
SlickD. J.ShermanE. M. S.IversonG. L. (1999). Diagnostic criteria for malingered neurocognitive dysfunction: Proposed standards for clinical practice and research. Clinical Neuropsychologist, 13, 545–561. https://doi.org/10.1076/1385-4046(199911)13:04;1-Y;FT545
52.
SolimanS.ResnickP. J. (2010). Feigning in adjudicative competence evaluations. Behavioral Sciences and the Law, 28, 614–629. https://doi.org/10.1002/bsl.950
53.
StaffordK. P.SellbomM. O. (2012). Assessment of competence to stand trial. In WeinerI. B.OttoR. K. (Eds.), Handbook of psychology, Vol 11 forensic psychology (2nd ed., pp. 412–439). Hoboken, NJ: John Wiley and Sons, Inc.
54.
TombaughT. N. (1996). Test of Memory Malingering (TOMM). New York: Multi-Health Systems.
Trueblood v. (2015). State of Washington Department of Social and Health Services, No. C14-1178-MJP, WA Western District Court.
57.
Trueblood v. (2016). Washington State Department of Social and Health Services, No. 15–35462, United States Court of Appeals, Ninth Circuit.).
58.
VitaccoM. J.RogersR.GabelJ. (2009). An investigation of the ECST-R in male pretrial patients: Evaluating the effects of feigning on competency evaluations. Assessment, 16, 249–257. https://doi.org/10.1177/1073191108325057
59.
VitaccoM. J.RogersR.GabelJ.MunizzaJ. (2007). An evaluation of malingering screens with competency to stand trial patients: A known-groups comparison. Law and Human Behavior, 31, 249–260. https://doi.org/10.1007/s10979-006-9062-8
60.
WarrenJ. I.MurrieD. C.StejskalW.ColwellL. H.MorrisJ.ChauhanP.DietzP. (2006). Opinion formation in evaluating the adjudicative competence and restorability of criminal defendants: A review of 8,000 evaluations. Behavioral Sciences and the Law, 24, 113–132. https://doi.org/10.1002/bsl.699
61.
WygantD. B.SellbomM.Ben-PorathY. S.StaffordK. P.FreemanD. B.HeilbronnerR. L. (2007). The relation between symptom validity testing and MMPI-2 scores as a function of forensic evaluation context. Archives of Clinical Neuropsychology, 22, 489–499. https://doi.org/10.1016/j.acn.2007.01.027
62.
ZapfP. A.RoeschR. (2009). Evaluation of competence to stand trial. New York, NY: Oxford University Press.
