Psychiatric predictions and the death penalty: An unconstitutional sword for the prosecution but a constitutional shield for the defense

The Supreme Court continues to permit psychiatrists and other mental health professionals to testify regarding capital defendants' propensity to future dangerousness. Virtually all scientific evidence indicates that these predictions are unreliable. However, capital juries are particularly likely to rely heavily on such testimony. The admission of this evidence violates the safeguards mandated by the Supreme Court's own case law demanding that a capital jury's discretion be guided. The Court must consider the reliability of evidence of future dangerousness, deny its admissibility on behalf of the prosecution, but structure a rule that does not infringe on capital defendants' right to present evidence in mitigation that may implicate future dangerousness.     

Amicus Curiae Brief for the United States Supreme Court on Mental Health Issues Associated With “Physician‐Assisted Suicide”

After providing background material related to the Supreme Court cases on “physician‐assisted suicide” (Washington v. Glucksberg, 1997, and Vacco v. Quill, 1997), this article presents the amicus curiae brief that was submitted to the United States Supreme Court by 2 national mental health organizations, a state psychological association, and an ad hoc coalition of mental health professionals. The document focuses on the role mental health professionals can play in discussions about hastened death. In particular, it is asserted that mental health professionals can assess capacity the decision‐making process, and the role of coercion in such decisions. The effect of the brief on the Supreme Court and within the organizations involved is also discussed.     

Étude de la concordance des diagnostics psychiatriques et psychologiques dans un échantillon de 505 criminels

Our focus is to study how frequently psychologists and psychiatrists make diagnoses in forensic reports, whether structural or nosographic, in relation to judicial expertise. Our goal is thus to assess the conformability ratio between psychologists and psychiatrists for both diagnoses. To do so, we studied the level of inter-observer agreement for the diagnoses of 505 male criminals made in France by expert psychologists and psychiatrists between 1990 and 2003. The measurement of agreement was done with the Kappa coefficient. The inter-observer agreement (psychiatrics versus psychologists) shows a 0.55 to 0.71 variation for the structural diagnoses and 0.51 to 0.89 for the nosographic diagnoses.Furthermore, the results also show a high level of agreement between the psychiatrists and psychologists for not making diagnoses, whether structural (k = 0.66) or nosographic (k = 0.73). Hence, we provide specific advice to improve the consistency of expert diagnoses for criminals in France.     

A frequent misunderstanding associated with point biserial and phi coefficients

The label "Pearson r" is legitimately used both for the standard Pearson r calculated on continuous variables and for its other varieties in the form of the point biserial or the phi coefficient. This fact is often ignored by psychologists and psychiatrists.     

Comment on “The Self‐Care of Psychologists and Mental Health Professionals” (Dattilio, 2015)

Professor Frank Dattilio's article “The Self‐care of Psychologists and Mental Health Professionals” provides an overview of stress and related mental health problems among psychologists, and a proposition that psychologists are not vigilant in regard to self‐care. Dattilio offers a range of self‐care strategies and recommendations, and highlights self‐care practices within various psychology frameworks, and concludes with some “healthy tips” for managing stress. In my commentary I underscore Dattilio's message that self‐care is of critical importance in psychology practice, given the responsibility of caring for others inherent in the work psychologists undertake. However, I raise additional points of consideration and suggest an alternative approach to addressing the self‐care needs of the profession. My commentary makes the following points: (a) the need to distinguish between psychology trainees and practising qualified psychologists when addressing stress and self‐care requirements in the profession; (b) the importance of developing a culture of self‐care among psychologists by providing self‐care instruction during training; (c) the need to temper research findings on stress and mental health among psychologists by the methodological weakness of the studies in this area; (d) adhering to the recent call from colleagues to shift from a focus on pathology and punishment to a positive acceptance, mindfulness, and values‐based approach for encouraging self‐care among psychologists; (e) the use of a systematic framework for organising the presentation of self‐care strategies that makes them more accessible; and (f) an appeal to professional bodies to take their responsibility in promoting self‐care in the profession.     

The professionalization of psychologists as court personnel: Consequences of the first institutional commitment law for the “feebleminded”

The first law providing for the permanent, involuntary institutionalization of “feeble‐minded” individuals was passed in Illinois in 1915. This bill represented the first eugenic commitment law in the United States. Focusing on the consequences of this 1915 commitment law within the context of intelligence testing, eugenics, and the progressive movement, this paper will argue that the then newly devised Binet–Simon intelligence test facilitated the definition and classification of feeble‐mindedness that validated feeble‐mindedness theory, enabled the state to legitimize the eugenic diagnosis and institutionalization of feeble‐minded individuals, and especially empowered psychologists to carve out a niche for themselves in the courtroom as “experts” when testifying as to the feeble‐mindedness of individuals.     

Ethics in Psychology and Law: An International Perspective

Some psychologists working in the psychology and law (psycholegal) field feel that the profession does not provide them with adequate ethical guidance even though the field is arguably one of the oldest and best established applied fields of psychology. The uncertainty psychologists experience most likely stems from working with colleagues whose professional ethics differs from their own while providing services to demanding people and the many moral questions associated with the administration of law. I believe psychology’s ethics does, however, provide adequate moral guidance. It has a sound historical basis, has face validity and emphasizes those social moral principles that allow psychologists to best serve individuals and society. Psychologists may nevertheless be confronted with conflicting demands because there are other norm systems that also regulate their behavior as researchers and practitioners, and they, like all people, are influenced by their conscience. Ultimately, psychologists working in the psycholegal field will be best served if they have good knowledge of, and have internalized, the ethical principles of psychology.     

"Enhanced" interrogation of detainees: do psychologists and psychiatrists participate?

After revelations of participation by psychiatrists and psychologists in interrogation of prisoners at Guantánamo Bay and Central Intelligence Agency secret detention centers, the American Psychiatric Association and the American Psychological Association adopted Position Statements absolutely prohibiting their members from participating in torture under any and all circumstances, and, to a limited degree, forbidding involvement in interrogations. Some interrogations utilize very aggressive techniques determined to be torture by many nations and organizations throughout the world. This paper explains why psychiatrists and psychologists involved in coercive interrogations violate the Geneva Conventions and the laws of the United States. Whether done with ignorance of professional ethical obligations or not, these psychiatrists and psychologists have crossed an ethical barrier that may best be averted from re-occurring by teaching medical students and residents in all medical specialties about the ethics principles stemming from the 1946–1947 Nuremberg trials and the Geneva Conventions, together with the Ethics Codes of the World Medical Association and the American Medical Association; and, with regard to psychiatric residents and psychological trainees, by the teaching about The Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry and the Ethical Principles of Psychologists and Code of Conduct, respectively. In this way, all physicians and psychologists will clearly understand that they have an absolute moral obligation to "First, do no harm" to the human beings they professionally encounter.     

Parent Alienation Syndrome: A Two Step Approach Toward a Solution

This paper deals with the steps involved in mediation before or while legal action and the courts intervene to force a solution by law to often tragic, acrimonious human interaction between former partners. Professionals such as qualified psychologists or psychiatrists should be able to offer a full course of mediation before partners begin divorce proceedings or decisions regarding the placement of children with one party or the other. A 10-year study involving 16 cases provides evidence that the initial use of mediation may well be superior to the initial use of the adversarial system on its own.     

The age of androgyny: The new views of psychotherapists

Male therapists no longer engage in sexual stereotyping in their views of mentally healthy men and women as 15 previous studies had shown. Both male and female therapists, both psychiatrists and psychologists, held a single androgynous standard of mental health for both men and women. Psychologists scored higher on this androgyny factor than psychiatrists. Therapists with many women patients scored higher on this androgyny factor than therapists with few women patients.     

Jurors' Views on the Value and Objectivity of Mental Health Experts Testifying in Sexually Violent Predator Trials

Although psychologists and psychiatrists often testify in court, we know relatively little about the extent to which jurors value the testimony they hear from these experts. We surveyed 161 jurors who rendered opinions in 14 sex offender civil commitment trials after hearing testimony from psychologists and psychiatrists serving as expert witnesses. Most jurors reported that the experts they heard testify were honest, and they tended to attribute disagreements among experts to case complexity, as opposed to adversarial allegiance or bias. Most reported that hearing from the experts helped them make better decisions and that experts using risk assessment instruments could make more accurate predictions than those who did not. Jurors were, however, more skeptical about the ability of experts to accurately predict recidivism when they heard testimony from both prosecution and defense experts. Findings suggest that jurors value risk assessment testimony from experts, but that experts must think carefully about how to best make risk assessment instrument results accessible to jurors. Copyright © 2014 John Wiley & Sons, Ltd.     

Predicting the present: expert testimony and civil commitment

This article uses the Supreme Court's decision in Daubert as an opportunity to address a chronic concern regarding the disparity between mental health law as officially enunciated and the practical application of that law. After Daubert, admissibility of expert evidence under the federal rules requires a qualified expert, a reliable basis for the testimony, and relevance to the legal issue. Ongoing psychological research pursues empirical data that expands the scope of psychological expertise and clarifies its limits. This article addresses the requirement of relevance by examining the logical relationship between the psychologist's actuarial and clinical expertise and the legal issues addressed by the court in civil commitment proceedings. Ideally, Daubert might stimulate a process of cooperative analysis in which psychologists and lawyers clarify the proper roles of psychological experts and of the courts with which those experts interact. This article begins that project by clarifying the legal determination required in civil commitment proceedings and by explicating the relationship between the responsibilities of experts and those of courts.     

Problematic,absent and stigmatizing diagnoses in current mental disorders classifications: Results from the WHO-WPA and WHO-IUPsyS Global Surveys

This study examined English- and Spanish-speaking psychologists’ and psychiatrists’ opinions regarding problematic, absent and stigmatizing diagnoses in current mental disorders classifications (ICD-10 and DSM-IV), and their perceived need for a national classification of mental disorders. Answers to open-ended questions included in WHO-WPA and WHO-IUPsyS surveys were examined using an inductive content-analysis method. A total of 3,222 participants from 35 countries were included. The most problematic diagnostic group was personality disorders, especially among psychiatrists, because of poor validity and lack of specificity. Complex posttraumatic stress disorder was the most frequent diagnosis suggested for inclusion, mainly by psychologists, to better account for the distinct processes and consequences of complex trauma. Schizophrenia was the diagnosis most frequently identified as stigmatizing, particularly by psychiatrists, due to lack of public understanding or knowledge about the diagnosis. Of the 14.4% of participants who perceived a need for a national classification system, two-thirds were from Africa or Latin America. The rationales provided were that mental disorders classifications should consider cultural and socio-historical diversity in the expression of psychopathology, differences in the perception of what is and is not pathological in different nations, and the existence of culture-bound syndromes. Implications for ICD-11 development and dissemination are discussed.     

An experimental analysis of the civil commitment recommendations of psychologists and psychiatrists

Legal and nonlegal factors influencing the civil commitment recommendations of psychologists and psychiatrists separately and as a whole were investigated using an experimental design. One hundred and seventy-six psychologists and psychiatrists made recommendations for or against commitment for a series of clinical vignettes wherein the five facets of commitment criterion, legal committability, clinical treatability, alternative resources and presence of psychosis were systematically varied. Results revealed that all facets contributed independently and in combination to the commitment decisions of participants as a whole. It was concluded that mental health professionals may utilize a variety of types of information, beyond the relevant legal criteria, in making actual decisions to initiate civil commitments.     

“The tempest in my mind”: Cultural interfaces between psychiatry and literature, 1844–1900

The professional literature of the first generation of American psychiatrists is replete with poetical passages drawn from the imaginative works of such English authors as Shakespeare, Byron, and Scott as well as the writings of residents of the asylums they tended. A close reading of such passages in the American Journal of Insanity (AJI), the central medium through which members of this nascent profession attempted to “popularize the study of insanity,” suggests they were not simply textual ornaments or signs of the underdeveloped state of American psychiatry in the mid-nineteenth century. Indeed, literary manifestations of the imaginative minds of patients and renowned writers were scrutinized by psychiatrists seeking to advance their understanding of mental disease. Moreover, the English authors were often elevated to the status of medical experts and their poetry and prose were commended to fellow medical practitioners as sources of psychological insight. Toward the turn of the century psychiatrists' engagement with these literary forms was less pronounced in the AJI, due in large part to the impact of rising asylum populations and the coming of a culture of positivist medicine. Yet literary influences on psychiatric writing are still evident in this period, indicating the complexity of the cultural interfaces between psychiatry and literature and the importance of examining the historical processes that have served to define and distinguish the enterprise of the psychiatrist from that of the poet.     

Opinion formation in evaluating the adjudicative competence and restorability of criminal defendants: a review of 8,000 evaluations

Evaluations of competence to stand trial (CST) are the most common type of criminal forensic evaluation conducted, and courts tend to defer to clinician opinions regarding a defendant's competence. Thus, it is important to study the ways in which clinicians arrive at opinions regarding adjudicative competence and the data they consider in forming their opinions. We reviewed 8,416 evaluations conducted by forensic evaluators in Virginia over a 12 year period, and examined (a) the clinical, demographic, and criminal characteristics of a defendant as related to opinions regarding competence, predicted restorability, and impairment on "prongs" of the Dusky standard, (b) process and outcome differences in evaluations conducted by psychiatrists versus psychologists and inpatient versus outpatient evaluators, and (c) the consistency of incompetence base rates over a 10 year period. Overall, clinicians opined that 19% of defendants were incompetent and considered 23% of these unlikely to be restored to competence. Not surprisingly, psychotic and organic/intellectual disorders were most strongly associated with findings of incompetence. However, there were some notable differences between evaluations by psychologists versus psychiatrists and between evaluations conducted in inpatient versus outpatient settings.     

“Shalom” Means Peace

ABSTRACT: This paper is based on firsthand information learned through observation-participation and speaking with individuals directly involved with postwar activities in Israel. Contacts with psychologists, social workers, and military personnel involved in postwar activities were the sources for much of the information. My personal experiences in Israel during the last 5 years (1969–1974) were the basis for my speculations.     

Evaluation Study of Lawyers' Satisfaction with Expert Witness Reports

This study attempted to evaluate the satisfaction of personal injury lawyers with expert witness reports from psychologists and psychiatrists. A questionnaire was sent to 514 civil litigation lawyers and 79 (15.4%) were completed. It was found that most lawyers were satisfied with reports and that there was no difference between the standard and quality of expert reports of psychologists and psychiatrists. Criticisms were limited and focussed on the cost, length and lack of clarity of some of the reports. These criticisms are discussed within the context of the reforms within the legal aid system and it is concluded that expert reports are perceived by lawyers as being reasonably good value for money.