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Persons with neuropsychiatric disorders present specific and unique challenges for forensic experts and defense attorneys in the criminal justice system. This article reviews two potential criminal defenses: legal insanity and the various legal standards or tests of criminal responsibility that are used in jurisdictions throughout the United States (i.e., the M'Naghten standard and the American Law Institute's Model Penal Code), and the partial legal defense of diminished capacity (lacking the mental state necessary to be found guilty of a specific intent crime). The process of evaluating criminal responsibility or diminished capacity is also presented with a specific emphasis on common issues that arise in evaluating defendants with Intellectual Developmental Disorder (Intellectual Disability), Parasomnias, Seizure Disorders, and Neurocognitive Disorders. [ABSTRACT FROM AUTHOR]

Insanity evaluations are often criticized for their—alleged—lack of objectivity, reliability and transparency. Structured tools to guide and support forensic evaluators during these evaluations have been developed—but they are rarely employed in forensic practice. In the present article, we consider the value of these tools for forensic practice in terms of opportunities and limitations. First, we briefly describe different insanity criteria used in Western countries. Next, we will review five structured instruments to guide insanity assessment together with their performance measures. Finally, we draw conclusions on the value of such instruments for forensic practice. [ABSTRACT FROM AUTHOR]

The present investigation was designed to systematically examine the insanity defense typology proposed by Brown (2018) using a large sample of cases wherein there was support for the insanity defense. A total of 187 court‐ordered cases in which an insanity defense was supported were categorized based on the typology. The sample comprised of mostly single, middle‐aged males who had been charged with a felony and diagnosed with a psychotic disorder. About half the sample was ultimately adjudicated not guilty by reason of insanity by the court. About two‐thirds of the cases were categorized into one of the seven insanity defense subtypes using a coding scheme developed by the author of the typology. Inter‐rater agreement occurred 82% of the time. The most frequent subtype was Paranoid Self‐Defense, followed by "But It's Mine" and Paranoid Protection of Others. There were few differences among these subtypes based on demographic, clinical, offense, and outcome variables, except for presence of a primary psychotic disorder and offense type. Implications and ideas for future research are discussed. [ABSTRACT FROM AUTHOR]

Voluntary, or intentional, acute intoxication does not qualify for an insanity defense. However, in many jurisdictions, voluntary intoxication can create a diminished capacity to form a specific intent necessary for a criminal offense. This is a type of mens rea defense. Homicide provides a clear example where the absence of a required specific intent can lead to a lesser included crime that does not require that specific intent. Thereby, a mens rea defense may lessen a first-degree murder charge to a lesser degree or even manslaughter, depending on the jurisdiction. After reviewing the history of mens rea defenses and voluntary intoxication, we performed a search of LexisNexis for state statutes and case law regulating the use of voluntary intoxication in mens rea defenses, focusing on homicide-related offenses. In this article, we compare the different approaches that have developed to address this complex issue. We discuss why knowledge of these different approaches is essential to the practicing forensic examiner in relevant jurisdictions and explore developing issues in the area. [ABSTRACT FROM AUTHOR]

The standard of practice for forensic interviews in criminal and delinquency cases, other than those conducted as part of brief preliminary screening evaluations or in emergency situations, should include a digital recording requirement. This standard should be adopted because of the greater availability of, and familiarity with, recording technology on the part of mental health professionals, the greater use and proven effectiveness of recording in other contexts of the criminal justice system, and the improvement in court presentation and accuracy of judicial determinations involving forensic assessments that recording will provide. The experience of practitioners with recording since professional associations last studied the issue should be taken into account, as informal data suggest it has been positive. Unfortunately, the legal system is unlikely to prompt this advance without its reconsideration by the forensic mental health professions, because current constitutional jurisprudence does not require recording and effectively makes it contingent upon request by examiners. Forensic evaluators thus have a valuable opportunity to educate the legal system on the utility and importance of this key reform, and so should adopt it as a best practice. [ABSTRACT FROM AUTHOR]

Much has been written about how to conduct insanity defense evaluations, as well as how to operationalize the legal definitions of insanity. However, the insanity defense has never been categorized by a typology. This article describes a typology of six subtypes of the insanity defense: paranoid self-defense, "but it's mine," erotomanic stalking, deific decree, disorganized, and false report. Knowledge of these subtypes, while not all inclusive, can inform insanity defense evaluations, guide training, and potentially increase the reliability of forensic evaluators' opinions. In addition, such subtypes can generate future research regarding prevalence, interrater reliability, and associated features of the different subtypes. [ABSTRACT FROM AUTHOR]

This study used a mixed quantitative-qualitative methodology to examine whether mock jurors considered a defendant's meta-responsibility - specifically, the defendant's medication noncompliance and degree of insight into his/her schizophrenia - when determining the person's criminal responsibility. The degree of expert witness explanation regarding these factors was also varied. Participants (n = 173) were grouped into 30 juries, randomized across five conditions, and shown mock testimony and attorney arguments based on a real not guilty by reason of insanity court case. Linear mixed-modeling analysis showed that manipulations of medication compliance, insight, and expert testimony elaboration did not predict differential verdict and meta-responsibility outcomes. Nevertheless, qualitative exploration of focus groups from five juries (n = 29) indicated that participants across groups strongly considered meta-responsibility, but did so in a way that, along with a host of other considerations, suggested mock jurors were unable and/or unwilling to follow their duties as the triers of fact. Implications for legal participants, expert witnesses, and researchers are discussed. [ABSTRACT FROM AUTHOR]

The role of experts and their presentation of testimony in insanity cases remain controversial. In order to decrease possible expert bias associated with this testimony, a number of different alternatives to adversarial presentation have been suggested. Two such alternatives are the use of court-appointed experts and the use of concurrent testimony (or "hot-tubbing"), in which opposing experts provide testimony concurrently and converse with each other directly. An experiment using a sample of venire jurors (n = 150) tested the effect of these alternatives. Results indicate that participants' pre-existing attitudes towards the insanity defense had significant effects on their comprehension of expert testimony, their evaluations of the two opposing experts, and their eventual verdicts, over and above the presentation format (i.e., concurrent vs. traditional testimony) or the use of court-appointed experts (vs. traditional adversarial experts). When concurrent testimony was presented, defense-favoring experts were perceived by jurors as more credible than their traditional counterparts, though comprehension of the testimony did not increase; nor did the presentation format or the affiliation of the experts affect verdicts. The legal and policy implications of the incorporation of the hot-tubbing procedure to US courts are discussed. [ABSTRACT FROM AUTHOR]

While some correlates of criminal responsibility (CR) outcomes are consistent, others are not. Study-level characteristics, such as sample selection, variability in the operational definition of insanity, or other unknown influences may explain discrepant findings. It is critical to systematically consolidate and assess the literature in order to guide future work. We conducted the first meta-analysis and study space analysis (see Malpass et al., ) in this area. 15 studies met inclusion criteria for the meta-analysis, which encompassed 19,500 cases. Summary effects for psycholegal cases indicated that older age, female sex, educational attainment, and unemployment were associated with insanity. Those classified insane more often had psychiatric histories and psychotic disorders. Finally, individuals opined or found insane were less likely to have criminal histories but more likely to have been opined incompetent to stand trial in the past. Importantly, virtually all summary effects were impacted by study design. Study space analyses (N = 7) revealed a dearth of literature that thoroughly addressed theoretically important variables. Taken together, the project provides a comprehensive, empirical analysis of CR correlates and a systematic call for future research. [ABSTRACT FROM AUTHOR]

Evaluations of legal sanity are some of the most complex and consequential mental health evaluations that forensic clinicians perform for the courts. Thus, there is strong reason to monitor the wide-scale process and conclusions of sanity evaluations. In this study, we review 1,111 court-ordered sanity evaluation reports submitted by 74 evaluators in Virginia from the first year after the state initiated an oversight system that allowed for such comprehensive review. Overall, the base rate of insanity findings was 16.9%, although base rates of insanity findings among individual evaluators varied from 0% to 50%. Similarly, most evaluators cited the cognitive (rather than volitional) criteria of the insanity defense as the basis for their insanity findings, although evaluators varied in their patterns of citing these underlying insanity criteria. Our review revealed other trends in practice, such as the rarity of psychological testing (2% of cases) and the frequency of conveying conclusions in "ultimate issue" format (76%). Overall, findings reveal that a majority of reports seem reasonably consistent with practice guidelines, but also reveal some idiosyncratic practices or patterns that suggest there is opportunity for improvement. [ABSTRACT FROM AUTHOR]

This project began as an attempt to develop systematic, measurable indicators of bias in written forensic mental health evaluations focused on the issue of insanity. Although forensic clinicians observed in this study did vary systematically in their report-writing behaviors on several of the indicators of interest, the data are most useful in demonstrating how and why bias is hard to ferret out. Naturalistic data were used in this project (i.e., 122 real forensic insanity reports), which in some ways is a strength. However, given the nature of bias and the problem of inferring whether a particular judgment is biased, naturalistic data also made arriving at conclusions about bias difficult. This paper describes the nature of bias - including why it is a special problem in insanity evaluations - and why it is hard to study and document. It details the efforts made in an attempt to find systematic indicators of potential bias, and how this effort was successful in part, but also how and why it failed. The lessons these efforts yield for future research are described. We close with a discussion of the limitations of this study and future directions for work in this area. [ABSTRACT FROM AUTHOR]

An introduction is presented to the journal on topics including insanity defense, implementation of insanity defense doctrine by courts and forensic evaluators in the U.S.; and take of criminal justice system on the same.

In the Canadian forensic mental health system, a person found Not Criminally Responsible on account of Mental Disorder (NCRMD) and given a conditional discharge returns to the community while remaining under the jurisdiction of a provincial/territorial Review Board. However, the individual can be re-hospitalized while on conditional discharge, for reasons such as substance use, violation of conditions, or violence. We investigated whether being re-hospitalized has an impact on the factors associated with the subsequent Review Board disposition. Persons found NCRMD from the three largest Canadian provinces who were conditionally discharged at least once during the observation period were included in the sample (N = 1,367). These individuals were involved in 2,920 disposition hearings; nearly one-third of patients (30%) were re-hospitalized after having been conditionally discharged by the Review Board. The factors examined included the scales of the Historical Clinical Risk Management-20 and salient behavior that occurred since the previous hearing, such as substance use or violence. The greater presence of clinical items resulted in a greater likelihood of a hospital detention decision at the next hearing. The effect was larger for the re-hospitalized group than for the group who successfully remained in the community since the last hearing. The results suggest that dynamic factors, specifically indicators of mental health, are heavily weighted by the Review Boards, consistent with the literature on imminent risk and in line with the NCRMD legislation. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

For over 30 years now the movement and status of insanity acquittees in Connecticut has been supervised by the Psychiatric Security Review Board (PSRB). During this time, 365 acquittees have been committed to the jurisdiction of the PSRB, 177 individuals have achieved conditional release (CR) and 215 acquittees have been discharged from PSRB jurisdiction. This article examines revocation of CR by the PSRB, arrests of acquittees on CR, and provides the first report of arrests following discharge from the PSRB's jurisdiction. The literature on relevant aspects of recidivism is reviewed and compared with findings in Connecticut. There is little available literature about recidivism of insanity acquittees following release from supervision. In the present sample of individuals discharged from the PSRB, 16% were rearrested, a rate that compares favorably with other discharged populations of offenders. For discharged acquittees, community supervision on CR prior to discharge from the PSRB had a statistically significant effect on decreasing the risk of subsequent rearrest, as did both the length of stay in the hospital and the duration of commitment to the PSRB. This article presents descriptive information about revocations, arrests on CR, and arrests following discharge. These data are consistent with criminal justice studies demonstrating the value of community supervision in lowering recidivism. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The objectives of this study were to describe the disposition and housing trajectories of individuals found Not Criminally Responsible on account of Mental Disorder (NCRMD), and the factors that predict different trajectories. To do so, disposition and housing status were coded for 934 NCRMD patients over a 36-month follow-up period. Sequential data analysis resulted in four distinct trajectories: detention in hospital, conditional discharge in supportive housing, conditional discharge in independent housing, and absolute discharge to unknown housing. The likelihood of a placement in supportive housing compared with detention significantly decreased for individuals with a higher index offense severity. Less restrictive trajectories were significantly predicted by clinical factors. The results revealed little change in the disposition and housing trajectories of NCRMD patients. Furthermore, decisions about disposition and housing placement reflect a knowledge-practice gap between risk factors known to be predictive of community resources use in the forensic population. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The Forensic Monitoring System (FMS) of the Missouri Department of Mental Health considers and approves consumers committed under not guilty by reason of insanity (NGRI) status for release. The system extends to the outpatient sector to ensure that such persons maintain their mental stability and do not pose a danger to the community. The process of conditional release and the organization of the FMS are outlined, reasons for the low recidivism rate are discussed, and paternalism in requiring treatment compliance as a condition of individual liberty is explored. Case examples illustrate the success, in terms of revocation and rearrest rates, of the Missouri system, which typically sees an annual return to inpatient custody of only 7%, and a still lower rate of criminal recidivism. Cost-effectiveness is discussed in terms of resources spent so that recovered persons with dangerous mental illnesses may live in safety outside of an institution. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

With the advent of psychotropic medications and with the deinstitutionalization of psychiatry starting in 1968, patients were prematurely discharged from forensic state hospitals. Due to lack of resources, psychiatric forensic patients ended up in the correctional system or homeless with the reduction of psychiatric beds in forensic and civil state hospitals. Lacking proper training and medication management, the recidivism rate of this population was close to 10% for rearrest and about 35% for revocation of conditional release (CR; Manguno-Mire et al., ). A new treatment modality was created to successfully transition patients from the forensic state hospital system to the community. This article describes and analyzes the principles and constructs of Passageway, a model residential program for patients found not guilty by reason of insanity or those incompetent to proceed to CR. The CR allows for a program like Passageway to be successful in transitioning patients back into the community. This is accomplished with minimal government funding, and since 1982 has resulted in a 0% recidivism rate, for any known arrests or convictions and for recommittal of a felony, defined in the state of Florida as, "any criminal offense that is punishable under the laws of this state, or that would be punishable, if committed in this state, by death or imprisonment in a state penitentiary. " (Fla. Stat. § 775.08). Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

In Foucha v. Louisiana (1992), the United States Supreme Court ruled that individuals adjudicated not guilty by reason of insanity (NGRI) could not remain in a forensic hospital if they were no longer mentally ill and dangerous. Since this decision, a variety of important questions have arisen related to the insanity defense and what should happen to insanity acquittees post-adjudication. This article provides an analysis of clinical issues confronting forensic examiners when psychosis as a result of substance abuse is the underlying condition supporting an insanity defense. To accomplish this analysis, this article provides the reader with a review of literature showing the complex relationship between psychosis and substance abuse. Second, this article investigates how substance-induced psychosis may impact both insanity opinions and subsequent conditional release decisions. Third, the article aims to provide research-driven information to assist clinicians in conducting conditional release evaluations. Finally, this paper provides a model for evaluating dangerousness in the context of conditional release evaluations. Given the substantial comorbidity between substance abuse and psychosis, it is critical for researchers and clinicians to consider potential effects of substance abuse when evaluating insanity acquittees for conditional release, especially as substance use relates to future dangerousness. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

There is relatively little research in the literature on insanity acquittees as compared with the large number of studies focused on the supervision and treatment of probationers and parolees with mental illness. Ideally, the latter literature could be successfully applied to insanity acquittees discharged from an inpatient hospital on "conditional release." This article describes the challenges faced by persons on conditional release as well as the gaps in extant conditional release literature. Then, five evidence-based models for the supervision and/or treatment of probationers and parolees with mental illness are applied to a theoretical conditionally released population (mental health courts, forensic assertive community treatment teams, the risk-need-responsivity model, informed supervision practices, and HOPE probation). Benefits and limitations are noted, and recommendations for such crossover are given. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Originally a hedge against the death penalty, the insanity defense came to offer hospitalization as an alternative to imprisonment. In the late 19th century Italy opened inpatient services first for mentally ill prisoners and then for offenders found not guilty by reason of insanity. Within the past decade, a series of decrees has resulted in transferring the responsibility for treating NGRI acquittees and "dangerous" mentally ill prisoners from the Department of Justice to the Department of Health, and their treatment from Italy's high security forensic psychiatric hospitals (OPGs) to community regional facilities (REMSs, Residences for the Execution of Security Measures), community mental health facilities, one of which is located in each region of Italy. Today community REMSs provide the treatment and management of socially dangerous offenders. The dynamic evolution of Italy's progressive mental health system for insanity acquittees, to our knowledge the most libertarian, community oriented approach of any country, is retraced. Discussion includes cautionary concerns as well as potential opportunities for improvements in mental health services. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

A large number of individuals are acquitted of criminal charges after being found 'not guilty by reason of insanity.' Most of these individuals are hospitalized and later seek hospital discharge under a court-ordered provision called conditional release ('CR'). Courts rely on opinions from forensic evaluators to determine acquittees' readiness for CR. However, how evaluators make these decisions are unknown. Eighty-nine CR readiness evaluators from nine states were surveyed to understand which factors evaluators prioritize and to understand evaluators' assessment methodologies and their beliefs about the CR process itself. Little uniformity was found among evaluators on any aspect of the decision-making process. Evaluators utilized a wide variety of methodologies when making their decisions on readiness for CR. Moreover, evaluators' conceptualizations of the CR process itself varied widely. The results highlight the difficulty and confusion evaluators face when conducting CR readiness evaluations, and demonstrate the need for enhanced training, statutory guidance, and standardized evaluation protocols for these evaluations. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The majority of individuals found not criminally responsible on account of mental disorder (NCRMD) in Canada spend some time in hospital before they are conditionally or absolutely (no conditions) discharged to the community by a legally mandated review board. By law, the decision to conditionally discharge an individual found NCRMD should be guided by the need to protect the public, the mental condition of the accused, and the other needs of the accused, especially regarding his/her community reintegration. At the time of this study, Canadian legislation and case law required that the review board disposition should be the 'least onerous and least restrictive' possible for the accused. This means that, if there is no evidence that the person poses a significant risk to public safety, he/she must be released. However, the Canadian Criminal Code does not specify the criteria that must be considered when making this risk assessment. This leads to two questions. (1) What predicts review board dispositions? (2) To what extent do disposition determinations reflect evidence-based practices? The present study examined dynamic and static predictors of detention in custody, conditional discharge (CD), and absolute discharge (AD) dispositions among persons found NCRMD across the three largest provinces in Canada. The National Trajectory Project (NTP) examined men and women found NCRMD in British Columbia (BC), Québec (QC), and Ontario (ON) between May 2000 and April 2005, followed until December 2008. For the purposes of this study, individuals who had at least one hearing with a review board were extracted from the NTP dataset ( N = 1794: QC = 1089, ON = 483, BC = 222). Over the course of the study, 6743 review board hearings were examined (QC = 3505, ON = 2185, BC = 1053). Despite advances in the risk assessment field, presentation of a comprehensive structured risk assessment to the review board was not the norm. Yet our findings suggest that review boards were taking into account a combination of empirically validated static and dynamic risk factors, as represented by the items of the HCR-20 risk assessment scheme. Particular attention was being paid to the behavior of the patient between hearings (e.g., violent acts, compliance with conditions). Severity of index offense was associated with review board decisions; though index severity is not related to recidivism, it is an important consideration in terms of public perceptions of the justice system and can be related to better established risk factors (i.e., criminal history and prior violence). Historical factors had more influence on the decision to detain someone, while clinical factors were more influential on an AD decision. Disposition stability was the most common trajectory, meaning that a patient with a prior CD disposition was most likely to receive another CD disposition at the next hearing. Static and dynamic risk factors found in the HCR-20 influenced review board determinations, although presentation of a complete structured risk assessment is the exception, not the norm. Results suggest that clinicians recommending less restrictive dispositions are more likely to include a comprehensive risk assessment with their recommendation. An alternative explanation is that, when there is no comprehensive assessment of risk, the review board tends to be more cautious and apply more restrictive dispositions. The practice seems to be contrary to the legislation at the time of the study, given that there should be a presumption that the patient is not a significant threat. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Research has examined differences between psychologists and psychiatrists in opinions on trial competency and criminal responsibility, but there is little research on such differences in risk assessment. This study examined the impact of disciplinary affiliation on opinions regarding whether new insanity acquittees should be hospitalized or released, and the risk factors given the most weight by each discipline. There was no significant difference between disciplines in the frequency of recommendations for hospitalization versus release. However, the concordance rate at the individual case level was only moderate when controlling for chance, which raises questions about the reliability and validity of forensic risk assessments in real-world settings. A number of variables emerged as significant in the decision-making of each discipline, with some differences noted. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The introduction of neuroscientific evidence in criminal trials has given rise to fears that neuroimagery presented by an expert witness might inordinately influence jurors' evaluations of the defendant. In this experiment, a diverse sample of 1,170 community members from throughout the U.S. evaluated a written mock trial in which psychological, neuropsychological, neuroscientific, and neuroimage-based expert evidence was presented in support of a not guilty by reason of insanity (NGRI) defense. No evidence of an independent influence of neuroimagery was found. Overall, neuroscience-based evidence was found to be more persuasive than psychological and anecdotal family history evidence. These effects were consistent across different insanity standards. Despite the non-influence of neuroimagery, however, jurors who were not provided with a neuroimage indicated that they believed neuroimagery would have been the most helpful kind of evidence in their evaluations of the defendant. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Given the influence of social conformity and prejudice, defendants pleading not guilty by reason of insanity face the significant challenges of securing fair and impartial juries. Attitudes and knowledge of the insanity defense are factors that may influence levels of impartiality. In the light of this, we set out to develop a scale to examine knowledge levels of the insanity defense and their influence on decision-making. Two studies were conducted to construct a scale designed to assess laypersons' knowledge of the insanity defense. Items measuring knowledge of the insanity defense were based on Perlin's (1995) insanity defense myths. The first study identified particular items in need of revision and subscales that required the development of additional items in order to improve reliability and construct validity in the second study. The second study used the revised scale, demonstrating improved validity and reliability. The scale also had acceptable predictive validity with reference to insanity defense verdicts. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

In the U.S. the decision to impose criminal responsibility rests on an assumption about the defendant's decision to engage in proscribed conduct. We punish only those who we believe had the capacity to make a choice. In an increasingly violent world, the criminal law and the assumptions upon which it rests are relentlessly tested. A new generation of neuro-imaging technologies offers to provide insights into structural and functional abnormalities in the brain that may limit the autonomy of many dangerous offenders and unravel the fabric of the criminal justice system. How will the results of these technologies be received by the courts—are they relevant to existing formulations of the prima facie case, the insanity defense, or mitigation of sentence; will changes in the science or the law be required to accommodate this knowledge? The new generation of technologies may appropriately play a role in assessing culpable mental states only if they are also reliable. This short article takes on these and a host of other related questions at the intersection between science, law, and science fiction. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Although neurological evidence is used with increasing frequency in criminal trials, there is limited research examining the effects that this evidence has on juror decision-making in insanity trials. Participants (396) were presented with a case summary and psychological testimony and asked to render either a verdict of guilty or not guilty by reason of insanity in a 2 (psychosis or psychopathy) × (presence or absence of an MRI indicating a brain lesion) × (presence or absence of testimony describing a car accident that caused injury to the brain) factorial design. Defendants diagnosed with a psychotic disorder, defendants who could demonstrate the existence of a brain lesion via MRI, and defendants who had a history of brain injury were more likely to be found not guilty by reason of insanity than those defendants who did not present any neurological testimony. Participants who reported they were more influenced by the psychological and neurological testimony were almost six times more likely to render a verdict of NGRI than those participants who reported that the psychological and neurological testimony and evidence did not influence their decision regarding verdict. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Research consistently indicates that jurors' intuitive prototypes of insanity and case-relevant attitudes shape their verdicts more strongly than legal definitions of insanity. Based on a sample of 113 prospective jurors, this study was designed to (a) assess the extent to which three prototypes of insanity held by jurors in a past study generalize to a sample of jurors in another state and (b) determine the relative influence of attitudes toward the insanity defense and prototypes of insanity on jurors' case judgments across four insanity case vignettes. Results suggest that jurors' attitudes toward the insanity defense affected case judgments so strongly (r = .41–.61) that they swamped efforts to assess jurors' prototypes of insanity. Further, jurors' prototypes of insanity offered little incremental utility beyond that of insanity defense attitudes. Implications for identifying biased jurors and potential interventions for bringing jurors' decisions into greater accord with the law are discussed. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

We conducted a retrospective review of factors involved in clinical recommendations for release of patients adjudicated not guilty by reason of insanity (NGRI). Medical records from 91 patients in a maximum security forensic hospital who participated in a formal hearing process to determine suitability for release were reviewed. The purpose of the study was twofold: (1) to examine the process involved in day to day clinical decision-making regarding release from a maximum security forensic hospital and (2) to determine what factors in a patient's clinical and legal history were related to recommendation decisions. Multivariate statistical methods revealed that among the clinical, demographic, and legal information available to clinicians at the time a formal release recommendation was made two factors emerged that were significantly related to release recommendations: PCL-R score and the age at which the patient committed his first criminal offense. Patients with high levels of psychopathy and those who engaged in criminal behavior at a younger age were less likely to be recommended for release from a maximum security forensic hospital. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Scholars have carefully considered all aspects of the incompetency to stand trial process, questions involving incompetency to confess, questions involving incompetency to be executed, and, to a lesser extent, questions related to incompetency to plead guilty or to waive counsel, but little attention has been paid to the relationship between incompetency and the full range of other criminal procedure issues: sentencing, appeals, consent to searches, and others. This article discusses this range of issues, assesses the factors relied upon by courts in deciding these cases and attempts to offer an agenda for future scholarly developments in this area. [ABSTRACT FROM AUTHOR]

This study analyzed data from 1710 criminal defendants referred by federal courts throughout the United States. We examined 12 categories of criminal charges with respect to diagnosed psychopathology and opinions related to competence to stand trial (CST) and criminal responsibility (CR) at the time of the alleged offense. Overall, 18% of the present sample were found to be incompetent to stand trial, while 12% were found to be not criminally responsible or 'insane.' In this study, crimes were associated with rates of psychopathology and rates of opinions regarding CST and CR. The findings of this study suggest that individuals who are charged with different crimes have different mental states and psychopathology and are therefore found to have differential rates of competence and sanity. [ABSTRACT FROM AUTHOR]

The public expects central government to have immediate knowledge of the condition and circumstances of certain vulnerable or dangerous individuals such as insanity acquittees, and to take action in individual cases to protect the individual and the public. Therefore, such persons conditionally released to community settings require an unusual degree of close monitoring and management. Being immediately aware of the condition and circumstances of its assignees, together with other duties of a board or commission responsible for that monitoring and management, is largely an information management function. The Psychiatric Security Review Board in Oregon is used to illustrate this unique mission, operations, and information management. In this paper, the Psychiatric Security Review Board is described in terms of its core and secondary businesses, together with a model information system that is based on information and information management processes actually employed by the Board. [ABSTRACT FROM AUTHOR]

This paper reviews the law related to voluntary intoxication and criminal responsibility in the 50 United States, the District of Columbia, the US Virgin islands, and Puerto Rico. Statutory and case law citations are provided which govern the use of intoxication evidence in each jurisdiction to negate mens rea (i.e., to establish diminished capacity), to support an insanity defense, and to mitigate criminal sentencing. Factors that courts typically focus on when deciding whether to admit this evidence in a particular case are discussed, and these factors are related to clinically relevant criteria. [ABSTRACT FROM AUTHOR]

The insanity defense is perhaps the most vigorously debated topic at the interface of the legal and mental health systems. This article addresses the need for empirical evidence by providing data on insanity acquittees and their later outcomes in Oklahoma, a jurisdiction not previously studied. Information was obtained on the demographic, legal, psychiatric, hospitalization, and post-hospitalization characteristics of all 61 defendants acquitted not guilty by reason of insanity (NGRI) and treated on the state forensic unit during a 5-year period. Insanity acquittees had few resources, significant psychopathology, and extensive involvement with the legal and mental health systems prior to the NGRI offense. Follow-up of three groups of discharged patients--those released at an initial court review, those who completed the NGRI treatment program, and those who absconded from the forensic unit--revealed that those who escaped from the unit had significantly more arrests and subsequent legal charges than regularly discharged patients. [ABSTRACT FROM AUTHOR]