Confirmatory information seeking is robust in psychologists' diagnostic reasoning.

OBJECTIVE: Across two experiments, we examined three cognitive biases (order effects, context effects, confirmatory bias) in licensed psychologists' diagnostic reasoning. HYPOTHESES: Our main prediction was that psychologist-participants would seek confirming versus disconfirming information after forming an initial diagnostic hypothesis, even given multiple opportunities to seek new information in the same case. We also expected that individual differences would affect diagnostic reasoning, such that psychologists with lower (vs. higher) cognitive reflection tendencies and larger (vs. smaller) bias blind spots would be more likely to demonstrate confirmatory bias. METHOD: In Study 1, we recruited 149 licensed psychologists (M = 18 years of experience; 44% women; 71% White) and exposed them to one of four randomly assigned vignettes that varied order effects (one set of symptoms in reversed orders) and context effects (court referral vs. employer referral). They rank ordered a list of four possible initial diagnostic hypotheses and received a piped follow-up choice of which of two pieces of information (confirmatory or disconfirmatory) they wanted to test their initial hypothesis. Study 2 (n = 131; M = 21 years of experience; 53% men; 68% White) replicated and extended Study 1, following the same procedure except offering three sequential choice opportunities. RESULTS: Both studies found robust confirmatory information seeking: 92% sought confirmatory information in Study 1, and confirmation persisted across three opportunities in Study 2 (90%, 84%, 77%), although it lowered with each opportunity (generalized logistic mixed regression model), F(2, 378) = 3.85, p = .02, ηp² = .02. CONCLUSION: These findings expand a growing body of research on bias in expert judgment. Specifically, psychologists may engage in robust confirmation bias in the process of forming diagnoses. Although further research is needed on bias and its impact on accuracy, psychologists may need to take steps to reduce confirmatory reasoning processes, such as documenting evidence for and against each decision element. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Do risk measure scores and diagnoses predict evaluator opinions in sexually violent predator cases? It depends on the evaluator.

OBJECTIVE: Field research increasingly reveals that forensic evaluators are not interchangeable. Instead, they tend to differ in their patterns of forensic opinions, in ways that likely reflect something about themselves, not just the persons evaluated. This study used data from sexually violent predator (SVP) evaluations to examine whether evaluator differences in making intermediate decisions (e.g., instrument scoring, assigning diagnoses) might explain their different patterns of final opinions. HYPOTHESES: Although this study was generally exploratory and not strongly hypothesis driven, we expected that there might be evidence for a simple form of bias in which some evaluators would be more likely than others to consistently "find" indications of SVP status (i.e., consistently assigning higher risk scores and more SVP-relevant diagnoses) and, therefore, be more likely to find behavioral abnormality, the legal construct qualifying someone for commitment as an SVP. METHOD: The study used data from 745 SVP evaluations conducted by 10 different evaluators who were assigned cases from the same referral stream. Potential evaluator difference variables included behavioral abnormality opinions, paraphilia and antisocial personality disorder diagnoses, and Psychopathy Checklist-Revised and Static-99 scores. RESULTS: Evaluator differences explained a statistically significant (p < .001) amount of variance in behavioral abnormality opinions (17%), paraphilia diagnoses (7%), and Psychopathy Checklist-Revised scores (16%). Contrary to our expectation of a simple tendency for some evaluators to find all indicators of SVP status more often than others, evaluators differed in the ways that underlying diagnoses and scores corresponded with their conclusions. The overall pattern was one in which different evaluators appeared to base their final opinions on different factors. CONCLUSIONS: Findings reveal further evidence of substantial forensic evaluator differences in patterns of assigning instrument scores and reaching forensic conclusions. But these findings are the first to also reveal wide variability in their patterns of reaching forensic conclusions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Evaluations of competence to stand trial are evolving amid a national "competency crisis".

Across the United States, court orders for competence to stand trial (CST) evaluations and competence restoration services have been increasing much more rapidly than states can provide these services, prompting what has been called a national "competency crisis." The challenge in providing timely competence restoration services has, in several jurisdictions, prompted a change in competence evaluations. Evaluators are more often required to address broader clinical issues-such as recommending placement or addressing the urgency of hospitalization-rather than addressing only CST. This marks an evolving practice in forensic evaluation, which moves evaluators beyond the very narrow forensic question of competence and into more traditionally clinical recommendations. We describe several state examples of changing practice in order to highlight the initial barriers, and potential benefits, to addressing additional clinical issues in competence evaluations, amid a national competence crisis.

Evaluator empathy in risk assessment interviews.

OBJECTIVE: Should forensic evaluators convey empathy during forensic assessments? Opponents contend that empathy causes harm by leading evaluees to disclose potentially incriminating information, but proponents hold that empathy is crucial for establishing rapport and conveying respect. This study provides a comprehensive examination of experienced forensic evaluators' use of empathy in forensic assessment. HYPOTHESES: The study was exploratory and not hypothesis-driven, but we expected to find identifiable subgroups of evaluators who differed in their use of empathy in the context of a risk assessment interview. We also expected that evaluator subgroups would differ in their attitudes and practices regarding empathy and that higher levels of empathy may be associated with more favorable views of evaluees. METHOD: Experienced forensic evaluators (N = 200) assumed the role of interviewer in a written parole risk assessment interview and chose questions (high or low empathy) they would ask the evaluee if they were conducting the interview. Evaluators also provided ratings of their perceptions of the evaluee and responded to questions regarding their attitudes toward, and use of, empathy in forensic assessment. RESULTS: Latent class analysis results indicated that most evaluators fell into low- (46.0%) or moderate- (43.0%) empathy subgroups, with few falling into a high-empathy subgroup (11.0%). Higher levels of empathy in the interview were associated with attitudes and practices supporting empathy use and higher self-reported understanding of the evaluee, but not with opinions of the evaluee's risk or suitability for parole. CONCLUSIONS: These findings of clear differences in evaluator empathy add to the growing body of research documenting the extent to which forensic evaluators differ in their evaluation styles and tendencies. Although there was support for both very low and very high levels of empathy, support for very high levels of empathy was uncommon. Most evaluators opted for low to moderate empathy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Estimating the Size of the Los Angeles County Jail Mental Health Population Appropriate for Release into Community Services.

In 2015, the Office of Diversion and Reentry Division (ODR), an internal department of the Los Angeles County Department of Health Services, was created to redirect individuals with serious mental illness from the criminal justice system. Part of ODR's mission is to identify individuals currently incarcerated in a Los Angeles County jail who are experiencing a serious mental health disorder and, to the extent practical, provide them with appropriate community-based care with the goals of reducing recidivism and improving health outcomes. Such redirection from the traditional criminal justice process is often characterized as diversion. To better build and scale efforts to support this work, in 2018, the Los Angeles County's Board of Supervisors asked for a study of the existing county jail mental health population to identify those who would likely be eligible for diversion based on legal and clinical factors. Researchers found that an estimated 61 percent of the jail mental health population were likely appropriate candidates for diversion; 7 percent were potentially appropriate; and 32 percent were likely not appropriate candidates for diversion. These findings will help the county determine how it would need to scale community-based treatment programs to accommodate these individuals. The authors also provide recommendations for future programming and research. This study will be of interest to state and county governments as well as other organizations serving criminal justice-involved populations with serious mental illness.

Field validity of Static-99R and STABLE-2007 with 4,433 men serving sentences for sexual offences in British Columbia: New findings and meta-analysis.

Many forensic assessment measures are developed and validated under research conditions but applied in the field, where professionals or paraprofessionals have varied training, unknown fidelity to administration procedures, and contextual pressures related to their institutions or legal system. Yet few studies examine the generalizability of psychometric properties of these scales as actually applied in field settings. This study examined 4,433 individuals assessed by probation officers on the Static-99R or STABLE-2007 sexual recidivism risk scales in British Columbia, Canada. Sexual, violent, and any recidivism were examined. Static-99R and STABLE-2007 had moderate accuracy in discriminating recidivists from non-recidivists, and both scales added incrementally in predicting all three outcomes (with Static-99R demonstrating higher accuracy). Organizing the items into constructs, sexual criminality, general criminality, and youthful stranger aggression incrementally predicted all three outcomes. For violent and any recidivism, the incremental effect of sexual criminality was in the negative direction (i.e., high sexual criminality was associated with relatively lower rates of violent and any recidivism). Calibration analyses indicated that recidivism rates were lower than what would be predicted by the norms for the scales. The current study also presented a meta-analysis of 15 field validity studies of Static-99R and 4 field validity studies of STABLE-2007. Results of the current study and meta-analysis support the field application of Static-99R and STABLE-2007, while emphasizing the importance of training and proper implementation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The impact of misdemeanor arrests on forensic mental health services: A state-wide review of Virginia sanity evaluations.

OBJECTIVE: We examined the prevalence of criminal defendants facing only misdemeanor charges and referred for forensic mental health evaluations of legal sanity (criminal responsibility) in a state-wide sample of sanity reports. We sought to describe this population of defendants, particularly as compared to defendants facing felony charges and referred for evaluation of legal sanity. HYPOTHESES: We hypothesized that, among those referred for sanity evaluations, defendants facing only misdemeanor charges would have higher rates of serious mental illness than would defendants charged with felonies, as evidenced by their mental status during the evaluation and at the time of alleged offenses. We also hypothesized that defendants charged with only misdemeanors would be more often opined insane, as compared to those charged with felonies. METHOD: We reviewed a statewide sample of 926 court-ordered sanity evaluation reports in Virginia and coded numerous variables describing the defendants, sanity evaluation process, resulting reports, and legal opinions offered within the reports. RESULTS: Approximately 22.3% of sanity evaluations involved defendants charged only with misdemeanor offenses. Defendants facing only misdemeanor charges were 1.82 times more likely to be opined insane than were defendants facing only felony charges, primarily due to their increased likelihood of experiencing psychotic symptoms at the time of the offense (1.83 times more likely than defendants facing felony charges). CONCLUSIONS: The merits of pursuing the insanity defense in response to misdemeanor charges are questionable given the cost- and resource-intensive outcomes associated with insanity acquittals. Diversion strategies may be a more efficient response to those defendants with serious mental illness facing only misdemeanor charges. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

How do latent print examiners perceive proficiency testing? An analysis of examiner perceptions, performance, and print quality.

Proficiency testing has the potential to serve several important purposes for crime laboratories and forensic science disciplines. Scholars and other stakeholders, however, have criticized standard proficiency testing procedures since their implementation in laboratories across the United States. Specifically, many experts label current proficiency tests as non-representative of actual casework, at least in part because they are not sufficiently challenging (e.g., [1-4]. In the current study, we surveyed latent print examiners (n = 322) after they completed a Collaborative Testing Services proficiency test about their perceptions of test items. We also evaluated respondents' test performance and used a quality metric algorithm (LQMetrics) to obtain objective indicators of print quality on the test. Results were generally consistent with experts' concerns about proficiency testing. The low observed error rate, examiner perceptions of relative ease, and high objective print quality metrics together suggest that latent print proficiency testing is not especially challenging. Further, examiners indicated that the test items that most closely resembled real-world casework were also the most difficult and contained prints of the lowest quality. Study findings suggest that including prints of lower quality may increase both the difficulty and representativeness of proficiency testing in latent print examination.

Competency to stand trial evaluations: A state-wide review of court-ordered reports.

Competence to stand trial (CST) evaluations are a critical part of certain criminal proceedings, and competence-related evaluation and treatment are an increasing part of public mental health services. Whereas more research describes the defendants undergoing competence evaluations, less research has examined the actual reports detailing those competence evaluations. This study reviewed 3,644 court-ordered CST evaluation reports submitted by 126 evaluators in Virginia since Virginia initiated an oversight system allowing for comprehensive review. The base rate of incompetence opinions was 38.8%, but these rates varied significantly across evaluation type (initial versus post-restoration efforts) and evaluators (ranging from 9.1% to 76.8% incompetence rate). Results suggest generally strong compliance with state statutes guiding CST evaluations, but also highlight marked variability in forensic conclusions and reveal a few areas in which some reports fell short of statutory requirements and practice guidelines.

Rater experience and the predictive validity of Psychopathy Checklist: Youth Version scores.

We compared the predictive validity of Psychopathy Checklist: Youth Version (PCL:YV) scores assigned by a licensed clinician to scores assigned by a graduate student across a sample of 82 juvenile offenders. Although both raters completed in-depth training and practice scoring cases, the graduate student had no prior clinical experience. The raters showed a high level of agreement in their scoring for 11 reliability check cases (intraclass correlation coefficient, ICCA,1 = .90 for PCL:YV Total score), but the scores assigned by the licensed clinician were better predictors of post-release recidivism (area under the curve, AUC = .77) than those assigned by the graduate student (AUC = .45). There was more variability in the scores assigned by the licensed clinician than those assigned by the graduate student, suggesting that more experienced clinicians' willingness to assign both high and low scores may help explain rater differences in predictive validity.

What do forensic analysts consider relevant to their decision making?

In response to research demonstrating that irrelevant contextual information can bias forensic science analyses, authorities have increasingly urged laboratories to limit analysts' access to irrelevant and potentially biasing information (Dror and Cole (2010) [3]; National Academy of Sciences (2009) [18]; President's Council of Advisors on Science and Technology (2016) [22]; UK Forensic Science Regulator (2015) [26]). However, a great challenge in implementing this reform is determining which information is task-relevant and which is task-irrelevant. In the current study, we surveyed 183 forensic analysts to examine what they consider relevant versus irrelevant in their forensic analyses. Results revealed that analysts generally do not regard information regarding the suspect or victim as essential to their analytic tasks. However, there was significant variability among analysts within and between disciplines. Findings suggest that forensic science disciplines need to agree on what they regard as task-relevant before context management procedures can be properly implemented. The lack of consensus about what is relevant information not only leaves room for biasing information, but also reveals foundational gaps in what analysts consider crucial in forensic decision making.

Perceptions and estimates of error rates in forensic science: A survey of forensic analysts.

Every scientific technique features some error, and legal standards for the admissibility of scientific evidence (e.g., Daubert v. Merrill Dow Pharmaceuticals, Inc., 1993; Kumho Tire Co v. Carmichael, 1999) guide trial courts to consider known error rates. However, recent reviews of forensic science conclude that error rates for some common techniques are not well-documented or even established (e.g., NAS, 2009; PCAST, 2016). Furthermore, many forensic analysts have historically denied the presence of error in their field. Therefore, it is important to establish what forensic scientists actually know or believe about errors rates in their disciplines. We surveyed 183 practicing forensic analysts to examine what they think and estimate about error rates in their various disciplines. Results revealed that analysts perceive all types of errors to be rare, with false positive errors even more rare than false negatives. Likewise, analysts typically reported that they prefer to minimize the risk of false positives over false negatives. Most analysts could not specify where error rates for their discipline were documented or published. Their estimates of error in their fields were widely divergent - with some estimates unrealistically low.

Do evidence submission forms expose latent print examiners to task-irrelevant information?

Emerging research documents the ways in which task-irrelevant contextual information may influence the opinions and decisions that forensic analysts reach regarding evidence (e.g., Dror and Cole, 2010; National Academy of Sciences, 2009; President's Council of Advisors on Science and Technology, 2016). Consequently, authorities have called for forensic analysts to rely solely on task-relevant information-and to actively avoid task-irrelevant information-when conducting analyses (National Commission on Forensic Science, 2015). In this study, we examined 97 evidence submission forms, used by 148 accredited crime laboratories across the United States, to determine what types of information laboratories solicit when performing latent print analyses. Results indicate that many laboratories request information with no direct relevance to the specific task of latent print comparison. More concerning, approximately one in six forms (16.5%) request information that appears to have a high potential for bias without any discernible relevance to latent print comparison. Solicitations for task-irrelevant information may carry meaningful consequences and current findings inform strategies to reduce the potential for cognitive bias.

How does evaluator empathy impact a forensic interview?

We used an experimental design to test the key concern that expressive empathy from evaluators during forensic interviews leads to more disclosure of misbehavior (e.g., stealing, breaking the law, manipulating others) from evaluees. In the context of a psychopathy assessment interview, evaluees (N = 94, 100% male, 57.4% Caucasian) interviewed by an evaluator using expressive empathy techniques were no more likely than those interviewed by an evaluator avoiding expressive empathy techniques to admit to past instances of misbehavior (d = .17, 95% CI [-.24, .57]). Instead, the use of expressive empathy techniques seemed to influence evaluator perceptions of the evaluees. Evaluators using expressive empathy rated evaluees as less psychopathic (d = -.52, 95% CI [-.93, -.11]), more conscientious (d = .72, 95% CI [.30, 1.13]), and as having engaged in less impression management (d = -.54, 95% CI [-.95, -.13]) than evaluators avoiding the use of expressive empathy. Put simply, when evaluators expressed empathy, it influenced the evaluator, not the evaluee. These findings suggest the need to expand professional discourse and research on empathy in forensic evaluations to better understand the possible effects of evaluator empathy on both evaluators and evaluees. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Resolving latent conflict: What happens when latent print examiners enter the cage?

Latent print examination traditionally follows the ACE-V process, in which latent prints are first analyzed to determine whether they are suitable for comparison, and then compared to an exemplar and evaluated for similarities and differences. Despite standard operating procedures and quality controls designed, in part, to mitigate differences between examiners, latent print processing and review are inherently subjective. The ACE-V process addresses subjectivity, and the possibility of error, in the verification stage in which a second examiner repeats the analysis, comparison, and evaluation steps in a given case. Other procedures outside the ACE-V framework, such as consultation and conflict resolution, provide further opportunity to understand how differences between latent print examiners emerge. Despite the growing body of research on latent print examination, questions have emerged about how these procedures work in practice. This study reviews case processing data for two years of casework at the Houston Forensic Science Center (HFSC). We describe these data as cases proceed through each step of the ACE-V process, with a particular focus on verification, consultation, and conflict resolution. We discuss trends in these processes regarding modal types of disagreements, modal outcomes, and roles of the examiners involved. Results reveal implications for improving the practice of latent print examination.

Insanity findings and evaluation practices: A state-wide review of court-ordered reports.

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.

Field validity of Static-99/R scores in a statewide sample of 34,687 convicted sexual offenders.

The Static-99 (and revision, the Static-99R) reflect the most researched and widely used approach to sex offender risk assessment. Because the measure is so widely applied in jurisdictions beyond those on which it was developed, it becomes crucial to examine its field validity and the degree to which published norms and recidivism rates apply to other jurisdictions. We present a new and greatly expanded field study of the predictive validity (M = 5.23 years follow-up) of the Static-99 as applied system-wide in Texas (N = 34,687). Results revealed stronger predictive validity than a prior Texas field study, especially among offenders scored after the release of an updated scoring manual in 2003 (AUC = .66 to .67, d = .65 to .69), when field reliability was also stronger. But calibration analyses revealed that the Static-99R routine sample norms led to a significant overestimation of risk in Texas, especially for offenders with scores ranging from 1 to 5. We used logistic regression to develop local Texas recidivism norms (with confidence intervals) for Static-99R scores. Overall, findings highlight the importance of revisiting and updating field study findings, and the potential benefits of using statewide data to develop local norms. (PsycINFO Database Record

Field reliability influences field validity: Risk assessments of individuals found not guilty by reason of insanity.

Individuals acquitted as not guilty by reason of insanity (NGRI) are usually committed to psychiatric hospitals for treatment until they are considered suitable for conditional release back to the community. The clinical evaluations that inform conditional release decisions have rarely been studied but provide an ideal opportunity to examine the reliability and validity of complex evaluations in the field. For example, to what extent do forensic evaluators agree about an acquittee's readiness for conditional release? And how accurate are their opinions? We reviewed 175 evaluation reports across 62 cases from Hawaii, which requires 3 separate evaluations from independent clinicians for each felony NGRI acquittee referred for conditional release evaluation. Evaluators agreed about an NGRI acquittee's readiness for conditional release in only 53.2% of evaluations (κ = .35). Courts followed the majority evaluator opinion in 79.3% of all cases but ruled in an opposite direction from the majority evaluator opinion in more than a third of cases in which evaluators disagreed. Evaluators accurately differentiated those conditionally released acquittees who remained in the community from those who were rehospitalized in 62.4% of cases. Among the 43 insanity acquittees who were ultimately released, evaluator agreement was significantly associated with rehospitalization within 3 years. When the evaluators unanimously agreed that conditional release was appropriate, only 34.5% were rehospitalized. When the evaluators disagreed, 71.4% were rehospitalized. Overall, results reveal poor agreement among independent evaluators in routine practice but suggest that opinions may be more accurate when evaluators agree than when they disagree. (PsycINFO Database Record

Field reliability of competency and sanity opinions: A systematic review and meta-analysis.

We know surprisingly little about the interrater reliability of forensic psychological opinions, even though courts and other authorities have long called for known error rates for scientific procedures admitted as courtroom testimony. This is particularly true for opinions produced during routine practice in the field, even for some of the most common types of forensic evaluations-evaluations of adjudicative competency and legal sanity. To address this gap, we used meta-analytic procedures and study space methodology to systematically review studies that examined the interrater reliability-particularly the field reliability-of competency and sanity opinions. Of 59 identified studies, 9 addressed the field reliability of competency opinions and 8 addressed the field reliability of sanity opinions. These studies presented a wide range of reliability estimates; pairwise percentage agreements ranged from 57% to 100% and kappas ranged from .28 to 1.0. Meta-analytic combinations of reliability estimates obtained by independent evaluators returned estimates of κ = .49 (95% CI: .40-.58) for competency opinions and κ = .41 (95% CI: .29-.53) for sanity opinions. This wide range of reliability estimates underscores the extent to which different evaluation contexts tend to produce different reliability rates. Unfortunately, our study space analysis illustrates that available field reliability studies typically provide little information about contextual variables crucial to understanding their findings. Given these concerns, we offer suggestions for improving research on the field reliability of competency and sanity opinions, as well as suggestions for improving reliability rates themselves. (PsycINFO Database Record