Forensic assessment instruments: Their reliability and applicability to criminal forensic issues.

Forensic evaluations have advanced considerably with the development of specialized measures validated on forensic and correctional samples. Prior to this progress, such evaluations relied heavily on extrapolations from general psychological tests to crucial, legally relevant questions. Since then, decades of empirical work have produced forensic assessment instruments (FAIs) addressing psycholegal standards in addition to forensically relevant instruments (FRIs) examining issues central to forensic practice (e.g., malingering) but not the standards themselves. This article provides a critical examination of the development, validation, and modern applications of six published FAIs that each address one of three broad criminal forensic issues (i.e., insanity, competency to stand trial, and Miranda abilities and waivers). Evaluations of the measures' reliability and validity particularly in forensic samples are highlighted. To complement FAIs, FRIs related to response styles are briefly explored. As a primary goal, forensic practitioners are provided with the knowledge and background about FAIs to enhance their criminal forensic practices.

Comparability and Validity of the Online and In-Person Administrations of the Inventory of Problems-29.

While the psychometric equivalence of computerized versus paper-and-pencil administration formats has been documented for some tests, so far very few studies have focused on the comparability and validity of test scores obtained via in-person versus remote administrations, and none of them have researched a symptom validity test (SVT). To contribute to fill this gap in the literature, we investigated the scores of the Inventory of Problems-29 (IOP-29) generated by various administration formats. More specifically, Study 1 evaluated the equivalence of scores from nonclinical individuals administered the IOP-29 remotely (n = 146) versus in-person via computer (n = 140) versus in-person via paper-and-pencil format (n = 140). Study 2 reviewed published IOP-29 studies conducted using remote/online versus in-person, paper-and-pencil test administrations to determine if remote testing could adversely influence the validity of IOP-29 test results. Taken together, our findings suggest that the effectiveness of the IOP-29 is preserved when alternating between face-to-face and online/remote formats.

Acquisition and Interpretation of Digital Information in Forensic Assessments.

ABSTRACT: Despite the now ubiquitous presence of technology in everyday life, there is little written on the subject of personal digital data as it pertains to forensic mental health evaluations. Ethical concerns and limited consensus guidance on this issue have previously made it challenging to use this information in a responsible way. This Perspectives article elaborates on the different types of personal data that exist and the practical aspects of acquiring such information, including data location and legal considerations. Incorporation of personal digital information into the forensic assessment as a form of collateral information is discussed, along with the current state of the literature on technology use and its relationship to psychopathology and risk. Given the important role of technology in the life of the modern individual, deeper research into this topic will be necessary in the immediate future to establish practice standards for the safe and ethical use of digital information in both forensic and non-forensic mental health assessments.

Mental health, mental capacity, ethics, and the law in the context of COVID-19 (coronavirus).

The emergence of the COVID-19 (coronavirus) pandemic in late 2019 and early 2020 presented new and urgent challenges to mental health services and legislators around the world. This special issue of the International Journal of Law and Psychiatry explores mental health law, mental capacity law, and medical and legal ethics in the context of COVID-19. Papers are drawn from India, Australia, the United Kingdom, Ireland, Germany, Portugal, and the United States. Together, these articles demonstrate the complexity of psychiatric and legal issues prompted by COVID-19 in terms of providing mental health care, protecting rights, exercising decision-making capacity, and a range of other topics. While further work is needed in many of these areas, these papers provide a strong framework for addressing key issues and meeting the challenges that COVID-19 and, possibly, other outbreaks are likely to present in the future.

Forensic mental telehealth assessment (FMTA) in the context of COVID-19.

Due to the present COVID-19 pandemic, forensic mental telehealth assessment (FMTA) is an increasingly utilized means of conducting court-sanctioned psychiatric and psychological evaluations. FMTA is not a novel development, and studies have been published during the past two decades that opine on the positive and negative implications of conducting testing and interview procedures online, in forensic and traditionally clinical matters alike. The present article examines prospects for eventual legal challenges to FMTA, describes considerations for conducting FMTA in both institutional and residential settings, and concludes that FMTA is now-due to predicted accommodations on the part of courts, attorneys, institutions, and professional guilds-a permanent part of the forensic evaluation landscape, even once the present COVID-19 pandemic has subsided.

Capital juror questionnaires in death-penalty cases: A study of attitudes, denials, and deceptions.

The Sixth Amendment right to an "impartial jury" should guarantee fundamental fairness that in capital cases may literally be a matter of life and death. For ecological validity, the current study focuses on capital jury questionnaires (CJQs) employed in actual death-penalty cases. Study I examined 248 undergraduates and their responses to death-penalty relevant questions. As an MTurk investigation, Study II consisted of 259 community members potentially eligible for capital trial jury trials. Misrepresentations were operationalized as either denials (concealing their true views) or outright deceptions (dissembling the opposite viewpoint). Both studies found that CJQ items were very susceptible to both types of misrepresentation, irrespective of support-life or support-death views. Nearly 30% of undergraduates openly acknowledged that they would misrepresent close to half their CJQ responses. Overall, community members were much more willing to engage in denials and outright deceptions. The discussion focuses on how CJQs could be improved to promote candor about death-penalty views.

Effectiveness of the Miranda Acquiescence Questionnaire for Investigating Impaired Miranda Reasoning.

The capacity of arrestees to comprehend their Miranda rights adequately and to waive them intelligently remains largely unexamined by most defense attorneys and forensic practitioners. Although much is now known about Miranda comprehension, only recently has forensic research emerged on Miranda reasoning. This archival study utilizes an extensive dataset of 847 pretrial detainees who were administered the Standardized Assessment of Miranda Abilities. This study focuses on how forensic practitioners can evaluate Miranda misperceptions that may have contributed to highly consequential decisions to cooperate with law enforcement without seeking legal counsel. Specific items from the Miranda Acquiescence Questionnaire of the Standardized Assessment of Miranda Abilities clearly identified detainees with impaired Miranda reasoning. Two important patterns of Miranda misperceptions were observed: adversarial perspective on arrest and trusting law enforcement. For instance, more than 20 percent of detainees with impaired reasoning wrongly believed that cooperating with police could only have positive outcomes. Even more troubling, more than one fourth of detainees erroneously believed that they must always comply with police requests, which obviously could entail self-incrimination. These findings are then placed in a broader context when examining the professional roles of forensic practitioners in recognizing, understanding, and evaluating for impaired Miranda abilities.

Treatment Delayed is Treatment Denied.

The past few decades have witnessed the steady development of a mental health jurisprudence dedicated to the preservation of human rights. Self-determination and personal autonomy are critical aspects of this perspective, pervading every facet of institutional psychiatric care. Of considerable concern, however, are those cases in which rote procedural approaches produce unintended consequences for the very persons such maneuvers were designed to protect. Delays-inherent in court-based procedures-may ironically lead to an acute illness becoming chronic, and to a single bout of inpatient services being transformed into a lifetime of revolving-door psychiatric admissions. This discussion is not about lawyers or lawyering; rather, it is about the proposition that a better system can and should be devised for advocates who must make do with the options they are dealt. A particularly problematic example is the "Rogers Guardianship" model currently prevalent in Massachusetts. Laws that effectively place on counsel and courts the challenge of second-guessing medical treatment decisions-with minimal latitude for counsel to exercise measured professional judgment-will inevitably generate, and empirically do generate, a degree of delay that ironically deprives patients of the liberation from illness that is the common goal of all stakeholders. Possible solutions to these difficulties are also suggested.

Missing out on Miranda: Investigating Miranda comprehension and waiver decisions in adult inpatients.

Internationally, millions of arrests occur each year, but very little is known about how suspects are informed regarding their rights as the accused and whether these rights are accurately understood. Concerns regarding accurate comprehension are further heightened for suspects with severe mental disorders (SMDs). In the United States alone, it is estimated ≥300,000 mentally disordered suspects are arrested annually and Mirandized (i.e., given American warnings regarding the rights of the accused). Despite this widespread prevalence, only two published studies have specifically targeted impaired Miranda comprehension for persons with SMDs, and none has focused directly on Miranda reasoning and waiver decisions. The current study examined both Miranda comprehension and reasoning for 85 adult inpatients recruited from a private psychiatric hospital with three major findings. First, inpatients extremely poor Miranda recall, averaging only 21.3% of the total warning. Second, none appeared to exhibit adequate abilities for Miranda reasoning. Third, an initial waiver of rights always led to a confession within several minutes of questioning. These findings and methodological issues are discussed for the United States as well as other countries.

Evaluating juvenile detainees' Miranda misconceptions: The discriminant validity of the Juvenile Miranda Quiz.

Most juvenile arrestees in custodial settings waive their Miranda rights almost immediately, and many then provide incriminating statements, if not outright confessions. Forensic practitioners are then asked to provide retrospective determinations regarding whether these waivers were effectuated knowingly, voluntarily, and intelligently. At present, the forensic assessment instrument for juvenile Miranda issues consists of the Miranda Rights Comprehension Instruments (MRCI)-which as its name implies-focuses mostly on Miranda comprehension with a de-emphasis of Miranda reasoning. In partially addressing this gap, the current study investigated the clinical utility of the Juvenile Miranda Quiz (JMQ) for evaluating key Miranda misconceptions, a critically important component of Miranda reasoning. Using data from 201 juvenile detainees, we evaluated the JMQ's discriminability with regards to cognitive variables and MRCI scales. Many moderate effect sizes in the predicted direction were found for the JMQ Primary Total and Juvenile Total scores. Finally, these detainees were tested using a mock crime scenario with a representative Miranda warning plus a brief interrogation to evaluate whether they would waive their rights, and if so, whether they would confess. Using Miranda measures to predict problematic outcomes (i.e., impaired waivers followed by confessions), the JMQ Juvenile Total proved the most successful. These findings are discussed within the context of the "intelligent" prong of Miranda waivers. (PsycINFO Database Record

Mobile Mental Health: Navigating New Rules and Regulations for Digital Tools.

Mobile health (mHealth) apps are becoming much more widely available. As more patients learn about and download apps, clinicians are sure to face more questions about the role these apps can play in treatment. Clinicians thus need to familiarize themselves with the clinical and legal risks that apps may introduce. Regulatory rules and organizations that oversee the safety and efficacy of mHealth apps are currently fragmentary in nature and clinicians should pay special attention to categories of apps which are currently exempt from significant regulation. Uniform HIPAA protection does not apply to personal health data that are shared with apps in many contexts which creates a number of clinically relevant privacy and security concerns. Clinicians should also consider several relatively novel potential adverse clinical outcomes and liability concerns that may be relevant to specific categories of apps, including apps that target (i) medication adherence, (ii) collection of self-reported data, (iii) collection of passive data, and (iv) generation of treatment recommendations for psychotherapeutic and behavioral interventions. Considering these potential pitfalls (and disclosing them to patients as a part of obtaining informed consent) is necessary as clinicians consider incorporating apps into treatment.

An Examination of Juveniles' Miranda Abilities: Investigating Differences in Miranda Recall and Reasoning.

Juvenile suspects are routinely expected to possess an accurate recall of written or oral Miranda warnings. This study addresses the Miranda-related comprehension recall and reasoning of legally involved juveniles. It is the first juvenile research to compare systematically two levels of complexity for Miranda warnings with the three modalities (oral, written, or combined) of administration. Unexpectedly, easily read written warnings marginally outperformed the combined modality. In order to examine Miranda reasoning, three juvenile groups were operationalized: impaired, questionable, and likely adequate. Predictably, the impaired and questionable groups possessed significantly lower verbal abilities than the likely-adequate reasoning group. In addition, the likely-adequate group exhibited the strongest appreciation of the adversarial context in which Miranda waiver decisions are rendered. The discussion addresses the marked disparities in Miranda recall from a total recall versus component-by-component understanding of Miranda rights. It also considers more generally how crucially important Miranda misconceptions might be remedied. Copyright © 2016 John Wiley & Sons, Ltd.

One American Perspective on the Rights of Accused: An Initial Survey of Miranda Rights in a Broader Context.

In the wake of countless police dramas, commonly held misperceptions endure that the American public knows both Miranda warnings and concomitant rights. Past research has tested public knowledge of Miranda per se, without evaluating additional misconceptions. The current investigation utilizes the European Union's much more all-encompassing safeguards, as delineated in the EU's 2012 Directive and Letter of Rights. Besides knowledge of Miranda, the advisability of these enhanced rights and protections was also assessed. In order to obtain a cross-section of the community, 619 participants were recruited from actual jury pools. Interestingly, they believed that Miranda afforded arrestees many more protections than it actually does. In general, nearly all (>90%) agreed that the accused should be given accurate information (e.g., charges and alleged criminal acts) coupled with an absence of police deception. The potential implications of these findings are discussed as they relate to police practices and due process. Copyright © 2016 John Wiley & Sons, Ltd.

Assessing Adaptive Functioning in Death Penalty Cases after Hall and DSM-5.

DSM-5 and Hall v. Florida (2014) have dramatically refocused attention on the assessment of adaptive functioning in death penalty cases. In this article, we address strategies for assessing the adaptive functioning of defendants who seek exemption from capital punishment pursuant to Atkins v. Virginia (2002). In particular, we assert that evaluations of adaptive functioning should address assets as well as deficits; seek to identify credible and reliable evidence concerning the developmental period and across the lifespan; distinguish incapacity from the mere absence of adaptive behavior; adhere faithfully to test manual instructions for using standardized measures of adaptive functioning; and account for potential bias on the part of informants. We conclude with brief caveats regarding the standard error of measurement (SEM) in light of Hall, with reference to examples of ordinary life activities that directly illuminate adaptive functioning relevant to capital cases.

Mired in Miranda misconceptions: a study of legally involved juveniles at different levels of psychosocial maturity.

The Supreme Court of the United States has long recognized that the vulnerabilities of juvenile offenders merit special protections due to deficits in experience and maturity. Appellate courts assume that Miranda warnings will inform juvenile suspects of their Miranda rights, and allow them to render knowing and intelligent waivers. This study examines Miranda misconceptions of legally involved juveniles (i.e., juvenile detainees and youth mandated to juvenile justice alternative education) at different levels of psychosocial maturity. These juveniles manifested an unexpectedly large frequency of erroneous Miranda beliefs; each group (low, middle, and high maturity) averaged a dozen or more misconceptions, thus overshadowing substantive differences between maturity groups. However, maturity played an important role in the immediate recall of a Miranda advisement. Alarmingly, both low- and middle-maturity groups displayed less than one-third immediate recall. The high-maturity group performed better, but still failed to recall almost half of the Miranda concepts. The overall findings are discussed with respect to juvenile Miranda comprehension and reasoning.

Psychiatric disorders in people with intellectual disability (intellectual developmental disorder): forensic aspects.

PURPOSE OF THE REVIEW: Persons with intellectual disability come into frequent and underreported contact with the legal system. Advances in forensic psychiatry help better identify persons with intellectual disability in forensic contexts, inform evaluation and treatment, and elucidate unique characteristics of this population. With the release of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), forensic psychiatrists must adjust to changes in the diagnostic process. RECENT FINDINGS: This review examines the past year's contributions to the literature, including predictors among offenders with intellectual disability, concurrent diagnoses, efficacy of competence restoration, means of studying individuals with intellectual disability, and impact of DSM-5. SUMMARY: Impoverished personal relationships are found to be an important predictor of offense among persons with intellectual disability. A Personality Disorder Characteristics Checklist allows screening for personality disorders (indicative of increased risk of violence) among intellectual disability offenders. Referrals to specialists for treatment more often occur for violent and sexual offenses than for other offenses. Competence restoration is historically low among those with intellectual disability, specially compared with those referred for substance abuse and personality disorders. However, the Slater Method results in higher rates of restoration than traditional training methods. DSM-5 alters the definition of intellectual disability, moving from an IQ-oriented diagnosis system to a multifaceted approach, introducing more flexibility and nuance.

Investigating the effects of repeated Miranda warnings: do they perform a curative function on common Miranda misconceptions?

In Miranda v. Arizona (1966), the Supreme Court of the United States required that custodial suspects be apprised of their Constitutional rights against self-incrimination. The Court could not have anticipated the rampant popularization of Miranda warnings in subsequent movies and television dramas. Influenced by public media, many arrestees assume that they already "know" their rights, with no awareness of their misconceptions. The current investigation examines whether repeated exposures to Miranda warnings performs any "curative" function (i.e., dispelling common Miranda misconceptions held by pretrial defendants). The accumulative effects of five different Miranda warnings were tested over a several-hour period on 260 detainees. For the nearly half (113 or 43.5%) with three or more misconceptions, improvement (i.e., ≥2 fewer misconceptions) occurred for only 35 defendants. Predictably, this improved group also tended to display a better understanding of Miranda-relevant vocabulary words and a better recall of the administered Miranda warnings than their unimproved counterparts. On average, the improved group also performed better on general measures of intelligence, and listening and reading comprehension, while still evidencing substantial cognitive deficits. The curative function of Miranda advisements is considered in light of these findings.

Do forensic practitioners distinguish between testifying and consulting experts? A pilot study.

Forensic mental health professionals (n=44) reviewed a series of statements that an attorney might make to a consulting or testifying expert. Each statement was rated for its degree of appropriateness to either the consulting or the testifying role. In light of increasing attention paid to this topic in the forensic practice literature, as well as long-standing distinctions recognized by the legal profession, it was originally hypothesized that participants would differentiate clearly between these roles; however, results of this pilot study indicate that forensic practitioners do not possess a consistent sense of which activities rest most comfortably within testimonial as opposed to consulting duties.

"Certainty" and expert mental health opinions in legal proceedings.

This pilot study addresses the legal and scientific ramifications of the "certainty" expressed by mental health professionals when functioning as expert witnesses in criminal and civil proceedings. The sporadic attention paid to "certainty" in the professional literature has typically taken the form of general policy oriented analyses as opposed to empirical, data-driven investigations. In the current study, 25 doctoral and master's level mental health professionals were provided with 53 different statements. Some statements addressed "certainty" itself in the typical fashion (e.g., "Reasonable Degree of Scientific Certainty," "Reasonable Degree of Medical Certainty," and "Reasonable Degree of Psychological Certainty"). Other statements were confined to specifically legal standards of proof (e.g., "Beyond a Reasonable Doubt," "Preponderance of the Evidence," and "Clear and Convincing"). Additional statements included those that bore at least some direct forensic relevance (e.g., "Based upon All the Data at My Disposal," "In My Medical Opinion," and "In My Clinical Judgment"), as well as those of a non-forensic nature (e.g., "I Would Bet My Life Savings," "On My Word of Honor," and "I Am Personally Convinced"). Ratings were provided on one form as if the participant had uttered the statement, and on another form as if another expert witness had uttered the statement. Overall, participants did not tend to identify traditional legal terms as expressing the highest level of "certainty," and respondents tended to ascribe more "certainty" to the same terms when uttered by themselves as opposed to when uttered by other expert witnesses. Those providing forensic testimony will do well to accommodate the court's traditional requirements while developing and preparing to justify their own notions of just what "certainty" denotes in this context.