The practice of forensic psychology. A look toward the future in light of the past

Income, Demographics, and Life Experiences of Clinical-Forensic Psychologists in the United States

We provide aggregate data about income, demographics, and life experiences of women and men practicing clinical-forensic psychology primarily in the United States (N = 376). We examine how these variables relate to one another, as well as how gender demographics of the field have changed over time. The average hourly rate charged by psychologists for forensic work, aggregated across all types of referral questions, regions, and employment settings is $280.23 (US Dollars; SD = $108.12; median and mode = $250). Total median annual income is = $125,000 - $149,999 and mode is = $100,000 - $124,999. Men’s annual income (median = $175,000 - $199,000) is significantly higher than women’s (median = $100,000 - $124,999) even while controlling for years of experience and number of hours worked per week. Women forensic psychologists earn $0.83 for every $1.00 men make. Having a Ph.D. is disproportionately associated with men and PsyD with women; however, the difference is not significant once controlling for years of experience. Employment type related to pay, such that people in private practice make significantly more than those who work in institutions (e.g., prisons, hospitals) or universities. Year of highest degree associated with employment type, such that people in practice longer are more likely to be in private practice. Although we expected caretaking responsibilities and children would relate to gender and pay, no differences emerged in this sample. Women are more likely than men to have completed a formal postdoctoral fellowship in forensic psychology, even when controlling for year of highest degree. Regarding the gender composition of the field over time, we calculated the Index of Dissimilarity for each five year increment spanning 1965-2019. Before the late 1990s, proportionally more men entered the field; after the late 1990s, proportionally more women entered. We discuss the promising and less promising implications of these findings for gender equity and work-life management in forensic psychology, as well as how professionals in the field and students might make use of these data.

Use of assessment instruments in forensic evaluations of criminal responsibility in Norway

OBJECTIVES

Assessment instruments are often used to enhance quality and objectivity in therapeutic and legal settings. We aimed to explore the use of instruments in Norwegian reports of forensic evaluations of criminal responsibility; specifically, whether this use was associated with diagnostic and forensic conclusions.

METHODS

Our study has an exploratory cross-sectional design. We examined 500 reports filed with the Norwegian Board of Forensic Medicine in 2009-2018 regarding defendants indicted for the most serious violent crimes. The first author coded data from all reports according to a registration form developed for this study. Two co-authors then coded a random sample of 50 reports, and inter-rater reliability measures were calculated. The first author coded 41 reports for calculation of intra-rater reliability. Descriptive statistics are presented for the use of assessment instruments, and a generalized linear mixed model (GLMM) was used to estimate associations between the use of instruments and diagnostic and forensic conclusions.

RESULTS

Instruments were used in 50.0% of reports. The Wechler's Adult Intelligence Scale (WAIS), Historical Clinical Risk-20 (HCR-20), and the Structured Clinical Interview for DSM disorders (SCID I), were used in 15.8, 13.8, and 9.0% of reports, respectively. The use of instruments increased from 36% in 2009 to 58% in 2015; then decreased to 49% in 2018. Teams of two experts wrote 98.0% of reports, and 43.4% of these teams comprised two psychiatrists. In 20.0% of reports, the diagnostic conclusion was schizophrenia, and in 8.8% it was other psychotic disorders. A conclusion of criminal irresponsibility was given in 25.8% of reports. Instruments were more often used in reports written by teams that comprised both a psychiatrist and a psychologist, compared to reports by two psychiatrists. The use of instruments was strongly associated with both diagnostic and forensic conclusions.

CONCLUSION

Instruments were used in 50% of reports on forensic evaluations of criminal responsibility in Norway, and their use increased during the study period. Use of instruments was associated with diagnostic and forensic conclusions.

Personality Assessment in Legal Contexts: Introduction to the Special Issue

This special issue addresses a major gap in the literature by providing comprehensive, credible reviews of the psychometric evidence for and legal status of some of the most commonly-used psychological and personality assessment measures used in forensic evaluations. It responds to Neal and colleagues' (2019) call for research to improve the state of and access to knowledge about psychological assessments in legal contexts, and encourages critical thinking about forensic assessment in the spirit of improvement. These articles offer clarity about the strengths and weaknesses of a number of assessment instruments to inform psychologists' preparation for expert testimony, lawyers' preparation for direct and cross-examination, judges' evidence admissibility determinations, and scholars' future research. We assembled teams of authors with different perspectives and areas of expertise to review each tool fairly, including several adversarial collaborations. Articles on the Rorschach and R-PAS, MMPI-3, PCL-R, MCMI-IV and MACI-II, PAI and PAI-A, SIRS-2, HCR-20^V3, TSI and TSI-2, and the MacCAT-CA, ECST-R, and CAST*MR are included. To increase visibility, accessibility, and impact, this issue is published as free access, meaning the articles are available to download without charge. We anticipate these articles will be widely read and useful to scholars and practitioners in both psychology and law.

The Personality Assessment Inventory in U.S. Case Law: A Survey and Examination of Relevance to Legal Proceedings

The Personality Assessment Inventory (PAI), a popular measure of personality, psychopathology, and interpersonal functioning, has demonstrated utility to address various psycholegal questions. This case law review examines a large sample of randomly selected published U.S. case law decisions to ascertain how the PAI has been applied and considered by legal decision makers. The review indicates the instrument is popular in criminal and civil legal settings, particularly in preadjudication forensic mental health evaluations (e.g., competency to proceed) and cases considering social security disability benefits. Forensic evaluators and legal actors primarily consider the results of the PAI as indicators of examinee impression management, psychopathology, and interpersonal functioning, although this varied by psycholegal context. The admissibility of the instrument was rarely challenged, although some challenges to the forensic evaluator's interpretation and conclusions emerged. Despite the PAI's popularity, the utility of the instrument is determined by specific, empirically supported, contexts. As such, forensic evaluators must consider how the PAI may inform decision making given examinee characteristics and the psycholegal question.

Forensic assessment may be based on common sense assumptions rather than science

Forensic assessments must be scientifically founded, because courts should obtain expert evidence with acceptable evidential value. In Slovenia, professional guidelines of forensic personality assessment are too general and not always in line with international professional recommendations. Thus, experts have no strict guidelines which would lead them to scientifically grounded expert opinions. The aim of the research was to establish which tests are employed in forensic assessment in Slovenia and to what extent the professional guidelines for expert opinions are followed. A total of 166 forensic personality assessments were reviewed, representing the majority of expert opinions issued in the period 2003-2018. The results of the analysis revealed that questionable projective tests are most commonly used. Typically, an expert opinion was rendered based on two tests, at least one of which was projective. What is more, expert opinions did not include hypotheses, in-text citations, reference lists, or proof of the expert witness's competence. The tests and their results were mentioned briefly and inadequately, without mention of their reliability and validity. Possible malingering of the person being evaluated was not detected. Professional guidelines were not followed and non-standardized tests without normative values and of questionable scientific merit were predominantly used, despite lack of proof that they truly measure what they claim to be measuring. These findings significantly differ from the results of similar research, raising serious concerns over the credibility of expert opinions in Slovenia.

Psychological Assessments in Legal Contexts: Are Courts Keeping “Junk Science” Out of the Courtroom?

In this article, we report the results of a two-part investigation of psychological assessments by psychologists in legal contexts. The first part involves a systematic review of the 364 psychological assessment tools psychologists report having used in legal cases across 22 surveys of experienced forensic mental health practitioners, focusing on legal standards and scientific and psychometric theory. The second part is a legal analysis of admissibility challenges with regard to psychological assessments. Results from the first part reveal that, consistent with their roots in psychological science, nearly all of the assessment tools used by psychologists and offered as expert evidence in legal settings have been subjected to empirical testing (90%). However, we were able to clearly identify only about 67% as generally accepted in the field and only about 40% have generally favorable reviews of their psychometric and technical properties in authorities such as the Mental Measurements Yearbook. Furthermore, there is a weak relationship between general acceptance and favorability of tools’ psychometric properties. Results from the second part show that legal challenges to the admission of this evidence are infrequent: Legal challenges to the assessment evidence for any reason occurred in only 5.1% of cases in the sample (a little more than half of these involved challenges to validity). When challenges were raised, they succeeded only about a third of the time. Challenges to the most scientifically suspect tools are almost nonexistent. Attorneys rarely challenge psychological expert assessment evidence, and when they do, judges often fail to exercise the scrutiny required by law.

Neuroscience and mental state issues in forensic assessment

Neuroscience has already changed how the law understands an individual's cognitive processes, how those processes shape behavior, and how bio-psychosocial history and neurodevelopmental approaches provide information, which is critical to understanding mental states underlying behavior, including criminal behavior. In this paper, we briefly review the state of forensic assessment of mental conditions in the relative culpability of criminal defendants, focused primarily on the weaknesses of current approaches. We then turn to focus on neuroscience approaches and how they have the potential to improve assessment, but with significant risks and limitations.

Detecting malingering mental illness in forensics: Known-Group Comparison and Simulation Design with MMPI-2, SIMS and NIM

BACKGROUND

Criminal defendants may often exaggerate psychiatric symptoms either to appear non-accountable for their actions or to mitigate their imprisonment. Several psychometric tests have been proposed to detect malingering. These instruments are often validated by Simulation Design (SD) protocols, where normal participants are explicitly requested to either simulate a mental disorder or respond honestly. However, the real scenarios (clinical or forensic) are often very challenging because of the presence of genuine patients, so that tests accuracy frequently differs from that one obtained in well-controlled experimental settings. Here we assessed the effectiveness in criminal defendants of three well-known malingering-detecting tests (MMPI-2, SIMS and NIM) by using both Known-Group Comparison (KGC) and Simulation Design (SD) protocols.

METHODS

The study involved 151 male inmates. Participants to the KGC protocol were all characterized by a positive psychiatric history. They were considered as genuine patients (KGC_Controls) if they had some psychiatric disorders already before imprisonment and scored above the cutoff of SCL-90-R, a commonly used test for mental illness, and as suspected malingerers (KGC_SM) if they were diagnosed as psychiatric patients only after imprisonment and scored below the SCL-90-R cutoff. Participants to SD protocol had no history of psychiatric disease and scored below the SCL-90-R cutoff. They were randomly assigned to either group: Controls (requested to answer honestly, SD_Controls) and simulated malingerers (requested to feign a psychiatric disease, SD_SM). All participants were then submitted to MMPI-2, NIM and SIMS.

RESULTS

Results showed that while MMPI-2, SIMS and NIM were all effective in discriminating malingerers in the SD, SIMS only significantly discriminated between KGC_Controls and KGC_SM in the Known-Group Comparison. Receiver Operating Characteristic (ROC) curves analysis confirmed the better sensitivity of SIMS with respect to the other tests but raised some issues on SIMS specificity.

DISCUSSION

Results support the sensitivity of SIMS for the detection of malingering in forensic populations. However, some specificity issues emerged suggesting that further research and a good forensic practice should keep into account multiple measures of malingering, including psychometric data, clinical and social history and current clinical situation. These methodological constraints must be kept in mind during detection of malingering in criminal defendants reporting psychiatric symptoms.

The developing significance of context and function: Neuroscience and law

Neuroscience has already changed the understanding of how intent forms and is acted upon, how an individual's cognitive processes shape behavior, and how bio-psychosocial history and neurodevelopmental approaches provide information that has been largely missing from the assessment of intent. In this paper, we first review the state of forensic assessment of mental condition and intent, focused primarily on the weaknesses of the current approach. In Section 2, we discuss neurobehavioral forensic assessment, which is a neuroscience-based approach. Section 3 focuses on the changing understanding of mental illness and how neuroscience is pushing law towards a functional capacity-and-ability model and away from a diagnostic cut-off model. Finally, in Sections 4 and 5, we turn to the role of social and environmental context in shaping behavior and propose a model of behavioral intent in line with the scientific evidence.

The Utility of Psychological Testing in Assessing Emotional Damages in Personal Injury Litigation

Psychological testing and assessment instruments frequently play a small but important role when psychologists assist the courts as emotional damage experts in personal injury matters. However, examiners frequently, if sometimes inadvertently, mislead the court with test interpretations that are based on clinical rather than forensic populations and that fail to appreciate the lack of robustness of clinical measures in this forensic context. Whereas published computerized interpretations repeatedly remind experts that personality test results should only be used as a method to generate hypotheses about the examinee that are to be subjected to further investigation and consideration, experts all too often inform the courts of test interpretations as if the test results were measures of clinical constructs rather than plaintiffs’ self-reports of symptoms.

Thinking Outside the Box: Developing Dynamic Data Visualizations for Psychology with Shiny

The study of human perception has helped psychologists effectively communicate data rich stories by converting numbers into graphical illustrations and data visualization remains a powerful means for psychology to discover, understand, and present results to others. However, despite an exponential rise in computing power, the World Wide Web, and ever more complex data sets, psychologists often limit themselves to static visualizations. While these are often adequate, their application across professional psychology remains limited. This is surprising as it is now possible to build dynamic representations based around simple or complex psychological data sets. Previously, knowledge of HTML, CSS, or Java was essential, but here we develop several interactive visualizations using a simple web application framework that runs under the R statistical platform: Shiny. Shiny can help researchers quickly produce interactive data visualizations that will supplement and support current and future publications. This has clear benefits for researchers, the wider academic community, students, practitioners, and interested members of the public.

The Clinical Assessment in the Legal Field: An Empirical Study of Bias and Limitations in Forensic Expertise

According to the literature, psychological assessment in forensic contexts is one of the most controversial application areas for clinical psychology. This paper presents a review of systematic judgment errors in the forensic field. Forty-six psychological reports written by psychologists, court consultants, have been analyzed with content analysis to identify typical judgment errors related to the following areas: (a) distortions in the attribution of causality, (b) inferential errors, and (c) epistemological inconsistencies. Results indicated that systematic errors of judgment, usually referred also as "the man in the street," are widely present in the forensic evaluations of specialist consultants. Clinical and practical implications are taken into account. This article could lead to significant benefits for clinical psychologists who want to deal with this sensitive issue and are interested in improving the quality of their contribution to the justice system.

Identifying Examiner-Related Threats to Validity in the Forensic Assessment of Disability

As the number of disability claims increases, so does the demand for forensic disability evaluations. However, an examiner's lack of knowledge and understanding of the nature and nuances of disability evaluations can threaten the validity of these evaluations. Although many threats to validity are outside the control of the examiner, this article identifies eight examiner-related threats to validity in terms of conceptual errors, errors in data collection, and inferential errors. Following this, six suggestions for reducing such threats are presented.

Quality of criminal responsibility reports submitted to the Hawaii judiciary

This paper is the third in a series of research reports on quality of forensic mental health evaluations submitted to the Hawaii judiciary. Previous studies examined quality of reports assessing competency to stand trial (CST) and post-acquittal conditional release, in felony defendants undergoing court-ordered examinations. Utilizing a 44-item quality coding instrument, this study examined quality of criminal responsibility reports in a sample of 150 forensic mental health evaluations conducted between 2006 and 2010 by court-appointed panels. Raters attained high levels of agreement in training and quality coding. Similar to the previous studies, overall quality of reports was mediocre, falling below the .80 quality criterion score for report elements, regardless of evaluator professional identification or employment status. Level of agreement between evaluators and judicial sanity determinations was "fair" using Cicchetti's (1994) standards for interpretation of intra-class correlations. Level of agreement was lower than previously published findings for CST reports and better than conditional release reports. Reasons for mediocre report quality and "fair" inter-rater agreement are discussed, including the fact that criminal responsibility evaluations are complex, retrospective in nature, and involve significant degrees of inference. In contrast to CST evaluations, assessment of criminal responsibility involves a mental state at the time of the offense evaluation. Threats to reliability in forensic reports are discussed. Suggestions for improvement of report quality are proffered, including standardization of procedures and report format and use of forensic assessment instruments.

The role of university-based forensic clinics

As forensic psychiatry and forensic psychology have grown and matured, the range of specialized services provided by each has expanded. In addition to traditional services such as forensic mental health assessments in criminal, family, and civil contexts, forensic specialists are now involved in delivering services in the community that include (in the criminal justice context) assessment for diversion into specialized probation or problem-solving courts, rehabilitation needs upon reentry (including specialized parole), and risk assessment for particular populations such as sexual offenders. Specialized forensic treatment services include those provided to clients under the jurisdiction of problem-solving courts or parole/probation. Similar specialized assessment and treatment services may be provided for juveniles. The nature of such service needs underscores the importance of the university-based forensic clinic as one source of specialized forensic services in the community. Such clinics are based in universities, directed by supervising faculty, and offer services provided in part by forensic trainees (psychiatric residents and forensic fellows; psychology doctoral students, interns, and post-doctoral fellows). The structure and operations of such clinics are described, with different models provided. Implications for specialized training, forensic practice, and research are discussed.

Formal training in forensic mental health: psychiatry and psychology

The field of forensic mental health has grown exponentially in the past decades to include forensic psychiatrists and psychologists serving as the primary experts to the court systems. However, many colleagues have chosen to pursue the avenue of serving as forensic experts without obtaining formal training and experience. This article discusses the importance of formal education, training and experience for psychiatrists and psychologists working in forensic settings and the ethical implications that befall those who fail to obtain such credentials. Specific aspects of training and supervised experience are discussed in detail.

Interrater reliability of Risk Matrix 2000/s

Actuarial risk assessment instruments for sexual offenders are often used in high-stakes decision making and therefore should be subject to stringent reliability and validity testing. Furthermore, those involved in the risk assessment of sexual offenders should be aware of the factors that may affect the reliability of these instruments. The present study examined the interrater reliability of the Risk Matrix 2000/s between one field rater and one independent rater with a sample of more than 100 sexual offenders. The results indicated good interrater reliability of the tool, although reliability varies from item to item. A number of factors were identified that seem to reduce the reliability of scoring. The present findings are strengthened by examining interrater reliability of the tool in the usual practitioner context and by calculating a range of reliability statistics. Strategies are suggested to increase reliability in the use of actuarial tools in routine practice.

Freedom in paradise: quality of conditional release reports submitted to the Hawaii judiciary

Annually thousands of insanity acquitees are released from mental hospitals when they are no longer determined to be dangerous. This research examined quality of post-acquittal Conditional Release (CR) reports submitted to the Hawaii Judiciary. Hawaii utilizes a "three panel" system for assessing trial felony competency, criminal responsibility, and conditional release, where typically two psychologists (one Department of Health and one community-based) and one community-based psychiatrist submit independent reports to the Court. One hundred fifty CR reports were rated using a 44-item report quality measure. Interrater reliability trials indicated good to excellent agreement between quality ratings. Overall level of report quality was poor regardless of examiners' professional discipline, employer, or board certification status. Concordance rates for CR opinions were poor. Level of agreement between the judicial determination and majority recommendations was also poor. Reasons for the poor quality and level of agreement are discussed with recommendations for report quality improvement, including standardization of procedures and use of forensic risk assessment instruments.

Fitness in paradise: quality of forensic reports submitted to the Hawaii judiciary

This paper examined quality of forensic reports submitted to the Hawaii Judiciary. Hawaii utilizes a three panel system for assessing fitness to proceed, where two psychologists and one psychiatrist submit independent reports to the Court. Utilizing a survey instrument based on previous research and nationally-derived quality standards, 150 competency to stand trial (CST) reports were examined. Reports demonstrated pervasive mediocrity with respect to quality (Mean QC=68.95, SD=15.21). One quarter (N=38) of the reports scored at or above 80% of the maximum possible score. Levels of CST agreement between evaluators and evaluators and judges were high. Report quality did not differ as a function of evaluator professional identity. Full-time employed evaluators submitted a greater number of reports above the quality criterion. For those evaluators who attended the March training, reports demonstrated significantly improved quality. Suggestions for enhancing report quality are offered with a special attention to inclusion of report elements, focus on inclusion of historical elements, and clearly described rationales supporting forensic opinions. (7664 words. Competency to stand trial, inter-rater agreement).

Assessing violence risk and psychopathy in juvenile and adult offenders: a survey of clinical practices

This study surveyed 199 forensic clinicians about the practices that they use in assessing violence risk in juvenile and adult offenders. Results indicated that the use of risk assessment and psychopathy tools was common. Although clinicians reported more routine use of psychopathy measures in adult risk assessments compared with juvenile risks assessments, 79% of clinicians reported using psychopathy measures at least once in a while in juvenile risk assessments. Extremely few clinicians, however, believe that juveniles should be labeled or referred to as psychopaths. Juvenile risk reports were more likely than adult reports to routinely discuss treatment and protective factors, and provide recommendations to reevaluate risk. The implications of these findings are discussed.

Does interrater (dis)agreement on Psychopathy Checklist scores in sexually violent predator trials suggest partisan allegiance in forensic evaluations?

Many studies reveal strong interrater agreement for Hare's Psychopathy Checklist-Revised (PCL-R) when used by trained raters in research contexts. However, no systematic research has examined agreement between PCL-R scores from independent clinicians who are retained by opposing sides in adversarial legal proceedings. We reviewed all 43 sexual-offender civil-commitment trials in one state and identified 23 cases in which opposing evaluators reported PCL-R total scores for the same individual. Differences between scores from opposing evaluators were usually in a direction that supported the party who retained their services. These score differences were greater in size than would be expected based on the instrument's standard error of measurement or the rater agreement values reported in previous PCL-R research. The intraclass correlation for absolute agreement for the PCL-R Total score from a single rater (ICC 1,A = .39) was well below levels of agreement observed for the PCL-R in research contexts, and below published test-retest values for the PCL-R. Results raise concerns about the potential for a forensic evaluator's "partisan allegiance" to influence PCL-R scores in adversarial proceedings.

A case law survey of the Personality Assessment Inventory: examining its role in civil and criminal trials

Although professional surveys suggest that the Personality Assessment Inventory (PAI; Morey, 1991) is a popular instrument among forensic and correctional psychologists, relatively little is known about the specific types of legal cases in which it is applied, the particular types of questions it is used to address, or the extent to which its admissibility has been at issue in court cases. Using a comprehensive legal database, we surveyed all published U.S., Canadian, European, and Australian criminal and civil cases in which the PAI was administered. The PAI appears to be introduced by examiners in a wide variety of civil (e.g., child custody, personal injury) and criminal (e.g., insanity, competence) cases to aid in the assessment of a broad range of psychopathology. Additionally, the PAI seems to be used frequently to assess questions concerning potential dissimulation and response styles. Surprisingly, the admissibility of the PAI into evidence was never at issue in any of the cases reviewed.

Detection of Malingering in Psychiatric Unit and General Population Prison Inmates: A Comparison of the PAI, SIMS, and SIRS

In this study, we compared the utility of three instruments, the Personality Assessment Inventory (PAI; Morey, 1991), the Structured Inventory of Malingered Symptomatology (Smith & Burger, 1997), and the Structured Interview of Reported Symptoms (SIRS; Rogers, Bagby, & Dickens, 1992) to detect malingering among prisoners. We examined 4 inmate samples: (a) prisoners instructed to malinger, (b) "suspected malingerers" identified by psychiatric staff, (c) general population control inmates, and (d) psychiatric patients. Intercorrelations among the measures for the total sample (N = 115) were quite high, and receiver operating characteristic analyses suggested similar rates of overall predictive accuracy across the measures. Despite this, commonly recommended cut scores for these measures resulted in widely differing rates of sensitivity and specificity across the subsamples. Moreover, although all instruments performed well in the nonpsychiatric samples (i.e., simulators and controls), classification accuracy was noticeably poorer when attempting to differentiate between psychiatric patients and suspected malingerers, with only 2 PAI indicators significantly discriminating between them.

Diagnostic labeling in juvenile court: how do descriptions of psychopathy and conduct disorder influence judges?

This study examined the influence of diagnostic criteria and diagnostic labels for psychopathy or conduct disorder on judicial decisions. A national sample of judges (N = 326) rendered hypothetical dispositions based on 1 of 12 mock psychological evaluations. The evaluations varied the presence of 2 sets of diagnostic criteria (antisocial behavioral history and psychopathic personality traits) and 3 diagnostic labels (conduct disorder, psychopathy, no diagnosis) to distinguish diagnostic criterion effects from diagnostic labeling effects. Results revealed substantial effects (Cohen's d = .33- 1.27 on 6 of 9 variables) for a history of antisocial behavior. Psychopathic personality features also appeared influential, albeit on fewer variables. There were no negative effects associated with conduct disorder or psychopathy labels. Results suggest that the criteria underlying labels, more than labels themselves, exert influence in juvenile justice contexts.

A National Survey of State Legislation defining mental retardation: implications for policy and practice after Atkins

In Atkins v. Virginia 2002, the U.S. Supreme Court held that the Eighth Amendment prohibits executing offenders who are mentally retarded. Rather than adopting a uniform definition of mental retardation, the court charged each state with defining mental retardation in a manner that enforces the constitutional restriction. An unanswered question is how states define mental retardation after Atkins, which has implications for capital defendants and forensic evaluators who conduct capital mitigation evaluations. This project identified the statutory definitions of mental retardation in each state, and grouped the definitions based on consistency with accepted clinical criteria for mental retardation. Results show that definitions of mental retardation vary considerably by state. The large majority of states, both overall and specifically among death penalty states, use criteria for mental retardation that are not entirely consistent with accepted clinical standards. As such, it is not clear whether the majority of states are effectuating the intent of Atkins. The implications of these findings for both policy and practice are discussed.

A Survey of Psychological Test Use Patterns Among Forensic Psychologists

Clinical psychologists are frequently called on to testify in court regarding mental health issues in civil or criminal cases. One of the legal criteria by which admissibility of testimony is determined includes whether the testimony is based on methods that have gained "general acceptance" in their field. In this study, we sought to evaluate the psychological tests used in forensic assessments by members of the American Psychology-Law Society Division of the American Psychological Association, and by diplomates in the American Board of Forensic Psychology. We present test results from this survey, based on 152 respondents, for forensic evaluations conducted with adults using multiscale inventories, single-scale tests, unstructured personality tests, cognitive and/or intellectual tests, neuropsychological tests, risk assessment and psychopathy instruments, sex offender risk assessment instruments, competency or sanity-related instruments, and instruments used to evaluate malingering. In addition, we provide findings for psychological testing involving child-related forensic issues.

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.

Psychopathy, conduct disorder, and stigma: does diagnostic labeling influence juvenile probation officer recommendations?

This study investigated the potential influence of labeling a juvenile as psychopathic. Juvenile probation officers (JPOs; N = 260) rendered hypothetical recommendations based on eight mock psychological evaluations. The evaluations varied the presence of two diagnostic criteria (antisocial behavioral history and psychopathic personality traits) and diagnostic labels (psychopathy, conduct disorder, no diagnosis) in order to distinguish criterion effects from labeling effects. The diagnostic criteria of antisocial behavior had a substantial effect on JPO recommendations (effect sizes .50-.79), while the diagnostic criteria of psychopathic personality traits had a more limited effect. Surprisingly, diagnostic labels had little effect, and there were no appreciable differences between conduct disorder and psychopathy diagnoses. These findings illustrate the importance of distinguishing diagnostic criterion effects from diagnostic labeling effects.

A History of Clinical Psychology as a Profession in America (and a Glimpse at Its Future)

Clinical psychology emerged as a profession in the United States in the 1890s with studies conducted by psychologists with patients in the mental asylums of that time, and with the founding of Witmer's psychological clinic, where he treated children with learning and behavioral problems. This chapter traces the history of clinical psychology as a profession, from the focus on assessment at the turn of the twentieth century to the provision of psychotherapy that would come to dominate the field after World War II. It concludes with a discussion of some of the contemporary concerns in the profession and how those might impact the future practice of clinical psychologists.

The problem behavior model: the development of a stalkers clinic and a threateners clinic

Traditionally, forensic mental health services have focused on the assessment and treatment of offenders with serious mental disorders. In recent years, there has been growing recognition that forensic clinicians have an important role to play for those offenders who engage in criminal acts driven by psychological or/and social problems, which may, or may not, occur in conjunction with a major mental disorder. This is especially true for specific offenses such as stalking and threatening. This article describes the innovation of the problem behavior model. This model uses a reductionist approach and the nexus between psychiatry and psychology to address the complex phenomena associated with specific problem behaviors that often culminate in offenses. The model is illustrated by describing the development of specialist clinics for the problem behaviors of stalking and threatening.

The impact of mental health evidence on support for capital punishment: are defendants labeled psychopathic considered more deserving of death?

Controversy surrounds the use of the Hare Psychopathy Checklist--Revised (Hare, 1991, 2003) in capital murder cases, where it has been introduced to support prosecution claims that a defendant represents a "continuing threat to society". Although widely presumed to have a prejudicial impact (e.g., American Psychological Association, 2004), little is known about how the lay public reacts to data derived from ostensibly stigmatizing assessment instruments such as the PCL-R. The present study examined the effect of psychopathy data on layperson attitudes by having 203 undergraduates review a capital murder case where the results of the defendant's psychological evaluation were experimentally manipulated. When expert testimony described the defendant as psychopathic, a much larger percentage of participants supported a death sentence (60%) than when testimony indicated that he was psychotic (30%) or not mentally disordered (38%). Interestingly, participant ratings of how psychopathic they perceived the defendant to be--regardless of the testimony condition to which they had been assigned--also predicted support for a death sentence. Given the limited probative value of the PCL-R in capital cases and the prejudicial nature of the effects noted in this study, we recommend that forensic examiners avoid using it in these trials.

Family psychology and family law: introduction to the special issue

As part of a multilevel systemic approach, the authors appearing in this journal suggest implications for social policy and legislation extrapolated from the individual, family, legal, and larger sociocultural systems discussed. The field of family psychology can play a significant leadership role in advocating policies and legislation relevant to the emerging family types and legal dilemmas based on empirical findings.

Views of the downward extension: comparing the Youth Version of the Psychopathy Checklist with the Youth Psychopathic traits Inventory

Increasing interest in "juvenile psychopathy" has been met with scholarly debate about the validity of directly extending the adult construct of psychopathic personality disorder to youth. To inform this debate, this study of 160 serious adolescent offenders compared two alternative, adult-based conceptualizations of juvenile psychopathy: that of the Psychopathy Checklist: Youth Version (PCL:YV) and the self-report Youth Psychopathic traits Inventory (YPI). The results indicate that these two conceptualizations overlap only partially, with the YPI focusing more tightly on core interpersonal and affective features than the PCL:YV. Each conceptualization is reliable and predicts different forms of short-term institutional misbehavior. However, only the YPI possesses a theoretically coherent, inverse association with anxiety. Despite this promise, these conceptualizations of psychopathy are less strongly associated with one another than they are with psychosocial markers of developmental maturity. This raises questions about their divergent validity and ability to identify a disorder that will remain stable during the transition from adolescence into adulthood. Implications for future longitudinal research on the validity, manifestations, and course of juvenile psychopathy are discussed.