Ten year research update (2001-2010): evaluations for competence to stand trial (adjudicative competence).

This article reviews and evaluates publications during 2001-2010 with relevance for assessments of competence to stand trial, referred to in this article as adjudicative competence. The review focuses specifically on articles that provide new concepts or data supported by research or case analyses. The studies are reviewed under the following headings: (i) systemic issues, (ii) conceptual guidelines for AC evaluations, (iii) AC assessment methods, (iv) empirical correlates of AC judgments and psycholegal abilities, (v) quality of AC evaluations and reports, (vi) interpretive issues, (vii) special populations (defendants who are elderly, defendants with intellectual disabilities), (viii) AC evaluations of juveniles, and (ix) treatment of incompetent defendants. Suggestions are offered for further research to advance the quality of clinical evaluations of adjudicative competence.

Practical application of the MacArthur competence assessment tool-criminal adjudication (MacCAT-CA) in a public sector forensic setting.

Several instruments have been developed to assess defendants' competence to stand trial (CST). These instruments have become increasingly sophisticated mainstays of CST evaluation research. Less is known, however, about their clinical utility. Continuous quality-improvement (CQI) efforts within forensic practice are one means of helping ascertain the effectiveness and efficiency of the use of these measures, especially in public sector settings. In this article, the authors describe a CQI project examining the use of the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA) on an inpatient forensic evaluation service. Results of a small, local CQI project cannot be generalized to all settings. However, from this CQI experience, the authors found the MacCAT-CA to be advantageous in assessing CST in certain defendants. Given some limitations of its practical utility, including its use with defendants putting forth poor effort, those with significant cognitive impairments, and those from various cultural backgrounds, the authors did not find that it would be an efficient practice to utilize the instrument in all CST assessments within a busy, public sector, inpatient forensic evaluation service. Having the instrument available for use as an adjunct to a clinical interview in particular cases may offer the most advantage. In addition, it is a useful tool for educating trainees about complex CST domains. This case-based CQI project reveals some basic strengths and weaknesses of the instrument and offers direction for further exploration in a systematic research study.

Assessing dimensions of competency to stand trial: construct validation of the ECST-R.

Four decades of forensic research have left unanswered a fundamental issue regarding the best conceptualization of competency to stand trial vis-à-vis the Dusky standard. The current study investigated three competing models (discrete abilities, domains, and cognitive complexity) on combined data (N = 411) from six forensic and correctional samples. Using the Evaluation of Competency to Stand Trial-Revised (ECST-R), items representative of the Dusky prongs were used to test the three models via maximum-likelihood confirmatory factor analyses (CFA). Of the three, only the discrete abilities model evidenced a good fit, indicating that competency to stand trial should consider separately each defendant's factual understanding of the proceedings, rational understanding of the proceedings, and ability to consult with counsel. ECST-R competency scales, based on the current CFA, have excellent alphas (.83 to .89) and interrater reliabilities (.97 to .98).

Teaching adolescents and adults about adjudicative proceedings: a comparison of pre- and post-teaching scores on the MacCAT-CA.

The current study investigated whether teaching was associated with improved legal understanding among adolescents and adults. Participants included 927 youth and 466 young adults, who completed the MacArthur Competence Assessment Tool-Criminal Adjudication, the Massachusetts Youth Screening Instrument-Second Version, and the Wechsler Abbreviated Scale of Intelligence. Adolescents aged 13 and younger were less likely than older individuals to improve with teaching. IQ score was positively associated with improvements following teaching, and individuals from ethnic minority groups showed greater improvements following teaching than non-Hispanic Caucasians. The implications of these findings are discussed.

Five year research update (1996-2000): evaluations for competence to stand trial (adjudicative competence).

This article reviews and evaluates publications during 1996-2000 with relevance for assessments of competence to stand trial (also known as adjudicative competence). The review focuses specifically on articles that provide new concepts or data supported by research or case analyses. The studies are reviewed under the following headings: (i) the systemic context of evaluations of adjudicative competence (AC); (ii) conceptual guidelines for AC evaluations; (iii) research on AC assessment methods; (iv) empirical correlates of AC judgments and psycholegal abilities; (v) quality of AC evaluations and reports; (vi) interpretation of AC evaluation data; (vii) issues in AC assessment of special populations (e.g., juveniles, persons with mental retardation, and women); and (viii) treatment to restore competence. Suggestions are offered for further research to advance the quality of clinical evaluations of adjudicative competence.