Use of the insanity defense: A survey of attorneys in wyoming

Attorneys in the State of Wyoming were surveyed to determine their reported use of the insanity defense during the preceding 5 years. They were asked about the success, defined as “benefit to the defendant,” of the insanity defense at various stages that occur before trial. The attorneys reported that the insanity defense is used throughout the various stages preceding trial, with more use and benefit to the defendant being reported than previously suggested. This was particularly true for the earlier stages in the criminal justice process. The attorneys were also asked various attitude questions related to the insanity defense. Defense lawyers were more in from of the insanity defense and expressed attitudes that supported the insanity defense while prosecuting attorneys were relatively more opposed to the insanity defense and expressed attitudes consistent with this view.     

Constructing insanity: jurors' prototypes, attitudes, and legal decision-making

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.     

Measuring knowledge of the insanity defense: scale construction and validation

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.     

NGRI Revisited: Venirepersons' Attitudes Toward the Insanity Defense1

Three hundred venirepersons from the 12^th Judicial Circuit in Sarasota, Florida completed the following booklet of stimulus materials: one question measuring participants' level of support for insanity defense; a 16‐item measure assessing participants' attitudes toward the myths associated with the insanity defense, the legal definitions of insanity, and mental illness; a case scenario; verdict preference; and standard demographic questions. Level of support for the insanity defense was significantly related to participants' attitudes toward legal standards of insanity, mental illness, and the myths associated with the insanity defense. In addition, results indicated that level of support for the insanity defense, age, educational level, occupation, type of prior jury service, and political views were significantly related to verdict preference. Notably, three factors that have been found to impact verdict preference in previous research failed to do so in the current study: participants' experience with psychological disorders; participants' exposure to psychotropic medications; and participants' experience with psychologists or psychiatrists. The findings both replicate and extend earlier findings by suggesting that attitudes toward the insanity defense are more complex than previously imagined.     

Characteristics and outcomes of insanity acquittees in Oklahoma

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.     

Pathological gambling as an insanity defense

Recognition of pathological gambling as a diagnostic and clinical entity has been paralleled by its use as an insanity defense by gamblers engaged in criminal behavior. The societal ramifications of exculpation for crimes committed by volitionally impaired defendants require a critical analysis of the relationship between mental illness and criminal acts. Following a summary of current knowledge about pathological gambling as a clinical disorder, case law relevant to its use as an insanity defense is reviewed. It is argued that pathological gambling is not a serious mental illness for the purposes of the criminal law and that it bears no causal relationship to criminal activity. Legal and societal interests dictate that pathological gambling be excluded as a potential insanity defense.     

The mental illness defense in the capital penalty hearing

Several defense strategies are available to the capital defendant who is arguing for life in the penalty phase, including a mental illness (MI) defense. An MI defense presents psychiatric testimony to the effect that the defendant was mentally disturbed at the time of the offense and, therefore, should not be held completely responsible. The few studies available suggest that an MI defense will be ineffective because (1) death-qualified jurors do not respond favorably to purely psychological explanations of criminal behavior and (2) an MI defense may erroneously mislead the jury regarding the defendant's unpredictability and dangerousness. Analagous studies of insanity acquittals suggest certain factors that may be associated with a succesful MI defense.     

Insanity defense research and treatment of insanity acquittees

This article is a comprehensive review of issues relevant to the insanity defense and the disposition of insanity acquittees. The characteristics of persons found Not Guilty by Reason of Insanity (NGRI) are described. Although the locus of treatment of the NGRI acquittee varies by jurisdiction, at this time, care and detention of insanity acquittees fall mainly to state mental health agencies. Recent reforms, as they relate to locus of treatment, are reviewed and public policy issues are discussed. The author concludes that more clinical research on the insanity acquittee is necessary for the development of more informed public policy on the insanity defense.     

The competency of criminal defendants to refuse,for delusional reasons,a viable insanity defense recommended by counsel

This article addresses the issues of whether mentally ill defendants charged with serious crimes who refuse to plead a viable and counsel-recommended insanity defense for delusional reasons (but who are otherwise competent to stand trial) should be considered to be competent, or incompetent, to stand trial; whether such defendants should be allowed to represent themselves with a delusional defense; and whether an insanity defense may properly be imposed upon such defendants. Based on an analysis of relevant Supreme Court decisions and other relevant cases, it is concluded that such defendants should not be allowed to go forward with a delusional defense (at least until reasonable efforts to treat the defendants' delusions are made). It is also argued, however, that unless an insanity defense would be viable (as well as recommended by counsel) delusional defendants who are otherwise competent to stand trial should be permitted to go forward, and represent themselves, with the defense of their choosing.     

Neuroscience, Ethics and Legal Responsibility: The Problem of the Insanity Defense

The insanity defense presents many difficult questions for the legal system. It attracts attention beyond its practical significance (it is seldom used successfully) because it goes to the heart of the concept of legal responsibility. ??Not guilty by reason of insanity?? generally requires that as a result of mental illness the defendant was unable to distinguish right from wrong at the time of the crime. The many difficult and complex questions presented by the insanity defense have led some in the legal community to hope that neuroscience might help resolve some of these problems, but that hope is not likely to be realized.     

Homicide and the insanity defense: A comparison of sane and insane murderers

A sample of 50 homicide defendants acquitted by reason of insanity (NGRI) was compared with a group of 50 defendants who were evaluated for insanity and found to be criminally responsible (CR). Significant differences were found between the two groups in terms of prior psychiatric and criminal histories and nature of the homicide (i.e., relationship to victim). The dispositions of those found NGRI were also examined on the above variables.     

��A Hideous Torture on Himself��: Madness and Self-Mutilation in Victorian Literature

This paper suggests that late nineteenth-century definitions of self-mutilation, a new category of psychiatric symptomatology, were heavily influenced by the use of self-injury as a rhetorical device in the novel, for the literary text held a high status in Victorian psychology. In exploring Dimmesdale's "self-mutilation" in The Scarlet Letter in conjunction with psychiatric case histories, the paper indicates a number of common techniques and themes in literary and psychiatric texts. As well as illuminating key elements of nineteenth-century conceptions of the self, and the relation of mind and body through ideas of madness, this exploration also serves to highlight the social commentary implicit in many Victorian medical texts. Late nineteenth-century England, like mid-century New England, required the individual to help himself and, simultaneously, others; personal charity and individual philanthropy were encouraged, while state intervention was often presented as dubious. In both novel and psychiatric text, self-mutilation is thus presented as the ultimate act of selfish preoccupation, particularly in cases on the "borderlands" of insanity.     

Insanity and responsibility

This paper attempts to set forth, in the context of Anglo‐U.S. criminal law, the meaning of the concept of insanity, its necessary relation to absence of responsibility, and its bearing on some relevant psychiatric concepts and legal controversies. Irrationality is a distinctive and necessary (but not sufficient) condition for insanity. Irrationality consists in failure even to grasp the relevance of what is ‘essentially’ relevant. To that extent there obviously can be no responsibility. A mental makeup which renders one (who would not normally be so) substantially incapable of rational conduct constitutes insanity, and in that respect renders the person non‐responsible. Much more broadly and roughly speaking, the mind that is ill is the mind that is irrational (and hence in that respect non‐responsible).     

The Feeling-Tone Questionnaire: Reliability and Validity of a Direct Patient Assessment Screening Instrument for the Detection of Depressive Symptoms in Cases of Dementia

The purpose of this study was to develop a reliable and valid measure of affective disorder in elderly demented patients. The field lacks instruments which are sensitive to detecting depressive signs in severely as well as mildly and moderately demented subjects. Two samples of subjects were chosen for study. The first sample consisted of subjects from six institutions, which were chosen for study from a probability sample of 25 long-term care institutions in New York City. This sample was part of the Cross-National Institutional Study conducted in New York and London (Gurland et al., 1979; Mann et al., 1984). Thirty patients were selected at random within each institution. The second sample consisted of 52 inpatients at Willard Psychiatric Center, a traditional state psychiatric hospital in upstate New York. All subjects had a chart diagnosis of dementia and were 60 years old or older. The mean age of the sample was 82 years and 56% of the subjects were female. The Feeling-Tone Questionnaire, which was developed for these analyses, consists of 16 dichotomous items and 16 5-point Likert ratings of affect. The reliability of this scale using Cronbach's alpha is .91 for the long-term care institutional sample and .90 for the psychiatric hospital sample. Interrater reliability for two raters on ten cases is .99. Test–retest reliability on ten cases with a 1-day to 2-day interval between trials is .81. A short mood scale was developed from the observational data as a validity measure for the Feeling-Tone Questionnaire. Evidence for the validity of the Feeling-Tone Questionnaire is provided.     

Fewer reasons for staying alive when you are thinking of killing yourself: The brief reasons for living inventory

The Linehan Reasons for Living Inventory is a 48-item scale on which respondents rate how important each item would be for living if suicide were contemplated. The inventory possesses good psychometric properties and can distinguish suicidal from nonsuicidal people among shoppers, psychiatric inpatients, college students, and adolescents. As its length limits its utility in many institutional and screening settings, the purpose of this study was (1) to develop a brief form of the Reasons for Living Inventory appropriate for clinical use and (2) to examine the predictive validity of this brief measure, named the Brief Reasons for Living Inventory (BRFL), to distinguish suicidal from nonsuicidal prison inmates. Results indicate that the brief form was as good as either the Beck Depression Inventory or the Beck Hopelessness Scale at predicting suicidality in this population. Further study is needed to validate the BRFL with different institutionalized and other populations as well as to assess its ability to discriminate suicide ideators from those engaging in overt suicidal behavior.Support for this project was provided in part by the New York State Office of Mental Health Bureau of Forensic Services and the New York State Department of Correctional Services.     

The medical student experience with disasters and disaster response

Medical students from New York City were integrally involved in the response by health professionals to aid the families of victims of the September 11, 2001, attacks on the World Trade Center. The present study was performed to investigate the emotional impact of this involvement on medical students from the Mount Sinai School of Medicine in New York City. One hundred fifty-seven students responded to a mail survey that explored their personal and professional involvement in the disaster as well as their psychiatric symptoms in the week after the event and at the time of the survey (3.5 months after the event). Findings suggested a differential emotional impact on female students and on students involved in less supervised and more emotionally intense activities. However, involvement in the relief effort, per se, did not contribute to psychiatric symptomatology. It may have been associated with enhanced professional self-esteem among the students. These findings have implications for future planning of psychiatric response to disasters.     

The insanity defense: Historical development and present status

This article provides an overview of the historical development of the insanity defense, including a discussion of the standards which have been used to excuse someone from criminal responsibility. The legal issues raised pre-trial and at trial are presented, along with a discussion of current proposals to modify or abolish the insanity defense. The article also focuses on the disposition of insanity acquittees, including both the case and statutory law in this area. Constitutional bases for challenges to differential procedures for insanity acquittees, along with proposals to change the law relating to them are included.     

Perceptions of insanity based on occupation of defendant and seriousness of crime

The purpose was to estimate the relationship between a defendant's stated intelligence on perceptions of his sanity and responsibility. This analog study was a 2 (occupation of defendant) x 2 (seriousness of outcome) between-subjects design. A scenario involving an insanity defense was read by 190 college students who then answered a 12-item questionnaire. The hypothesis that participants would attribute less responsibility to less intelligent defendants than to more intelligent ones was partially supported. Belief in a Just World moderated these evaluations. Seriousness of outcome influenced men's perceptions of the defendant's insanity, responsibility, and sentence, but not women's. Participants seemed to be more willing to accept the possibility that the defendant was insane if the outcome of his crime was not serious.     

Mock Juror Attribution of Criminal Responsibility: Effects of Race and the Guilty But Mentally III (GBMI) Verdict Option1

The present study examined three questions relevant to the insanity defense: Does the availability of the alternative verdict “Guilty But Mentally III” affect juror assessment of criminal responsibility? Does race of defendant significantly affect juror decision-making about who should be acquitted under the insanity defense? And does race of victim significantly influence how jurors decide their final insanity defense verdicts? Race of defendant (black or white), race of victim (black or white), and verdict choice set [(Not Guilty by Reason of Insanity (NGRI), Guilty, and Not Guilty) vs. (Guilty but Mentally III (GBMI), NGRI, Guilty, and Not Guilty)] were systematically varied. The mock-trial was presented to 197 college student subjects by means of an audiotape and slide show. Following the re-enacted trial, subjects answered a series of questions regarding the case. The main dependent variable was the rendered verdict. Both χ²loglinear analyses revealed a significant relationship between race of defendant and verdict such that the defendant, when presented as black, was acquitted NGRI significantly more often than when the defendant was presented as white. No significant effects were found for race of victim. The availability of the GBMI verdict option resulted in a twofold effect: There was a two-thirds reduction in both NGRI and straight guilty verdicts when the GBMI verdict option was made available. The implications for legal policy and future research are discussed.     

The insanity defense: Legal standards and clinical assessment

Although the insanity defense is used infrequently, it has received significant attention from legal and mental health professionals. In this article, we review the historical development of insanity defense standards and describe the standards currently employed in the United States. We present a model for evaluating a defendant's mental nonresponsibility, and we briefly discuss the legal standards and procedures for the assessment of insanity acquittees for release. Throughout the article, we discuss some scientific, ethical, and jurisprudential issues associated with the insanity defense and nonresponsibility evaluations.