Forensic psychiatry: diagnosis and criminal responsibility.

An examination of the primary and secondary diagnoses of 1195 defendants admitted to an urban forensic service was carried out. This indicated that personality disorders dominated the referral patterns from the court. Of those conditions which could produce thought disorders, schizophrenia dominated. An analysis of the prevalence of schizophrenia among defendants charged with homicide in St. Louis revealed a rate of schizophrenia similar to that found in the general population. Organic brain syndromes resulted in a large proportion of assaultive behavior, and these cases also involved a large number of secondary diagnoses. Alcohol and drug abuse were the most common secondary diagnoses. In general, no correlation between psychiatric diagnosis and types of criminal activity was found.     

A questionnaire survey on judgment of criminal responsibility]

The authors conducted questionnaire surveys utilizing model cases with the aim of investigating the current views of psychiatrists regarding criminal responsibility judgments in forensic psychiatric evaluations. Six model cases-injury by a person with acute schizophrenia, indecent assault by a person with chronic schizophrenia, attempted murder by a woman with depression, arson by an alcohol abuser, burglary by an amphetamine abuser, rape and indecent assault by a person with personality disorder-were presented to 345 psychiatrists, who were asked about criminal responsibility and appropriate treatment for each of the cases. One hundred eighty-five of the psychiatrists responded. In the case of acute schizophrenia with hallucination and delusion, the case of severe depression, and the personality disorder case, there was a high level of agreement between the evaluations of criminal responsibility made by the different respondents, but in the case of chronic schizophrenia, the case of alcohol-induced psychotic disorder, and the case of amphetamine abuse, there were variations in the evaluation of criminal responsibility, with many respondents emphasizing the patient's symptoms and condition at the time of the offense, and relatively few emphasizing whether the disorder was endogenous. Regarding the form of treatment, many of the respondents recommended compulsory hospitalization for the case of acute schizophrenia with hallucination and delusion, while at the same time recommending treatment in a prison environment for the personality disorder case. In contrast, for the case of chronic schizophrenia and the case of alcohol-induced psychotic disorder, opinion was divided as to whether the subject should be handled with a medical or a judicial approach. Regarding treatment for the case of alcohol-induced psychotic disorder and the case of amphetamine abuse, there was a tendency to make a judgment based on the subject's condition at the point of psychiatric evaluation, which was not necessarily linked to the criminal responsibility.     

Isaac ray at 200: phrenology and expert testimony

In honor of Isaac Ray's 200th birthday, the author examines his early career for an example of critical thinking about expert testimony. Ray, a scientist from the outset, expressed interest in phrenology, a contemporary science of the mind. This paper explores a criminal case from Maine in which phrenological testimony was proffered and which Ray critiqued. The author then examines Ray's standards of practice in relation to present concepts of admissibility of expert testimony. He concludes that Ray's quality standards remain evident in contemporary efforts to apply evidence-based science to legal matters.     

Psychiatric aspects of criminal responsibility: insanity and mitigation

Forensic psychiatry expertise may be useful to criminal courts in several ways, including evaluating competence (e.g., to stand trial, waive Miranda rights, confess, plead, represent oneself, or be sentenced), assessing responsibility for alleged criminal behavior, and clarifying mental or psychosocial factors that may mitigate criminal charges or the form and severity of punishment. This column focuses on psychiatric/psychological aspects of mitigation in criminal matters.     

The problem of evasive testimony: the expert "waffle"

Confronted with a difficult, unexpected, or confrontational question, an expert witness may answer by attempting to overwhelm the questioner with words, sometimes highly evasive ones, that avoid, rather than actually address, the question asked. Such a discursive response is sometimes called a "waffle," as in "The expert's answer was a waffle." This review notes some examples of this phenomenon and attempts to categorize them in a meaningful way. An ancillary goal of this discussion may be to aid experts in focusing their answers.     

Rethinking adult attachment: a study of expert consensus

Self-report questionnaires designed to assess attachment in adulthood potentially confound global valence of relationships (e.g., liking and disliking) with attachment. The authors surveyed an international panel of experts to develop items for a new measure of attachment that systematically distinguishes between attachment and non-attachment aspects of relationships. The survey yielded a large set of items on which there is consensus in five domains: secure attachment, dismissing attachment, preoccupied attachment, positive non-attachment, and negative non-attachment. This report presents a content analysis of the core themes in each of these five domains and discusses implications of these results for conceptualizing and researching adult attachment.     

Assassination of Henri IV, mental disorders and criminal responsibility

On 14th May 1610, Fran?ois Ravaillac, a delusional mystic, assassinated King Henri IV. Under the Ancien Regime, regicide was considered as a supreme act of patricide and received the ultimate punishment even if the perpetrator showed obvious signs of insanity. What would the situation be today? A study of this notorious historical episode provides a reflection on the way dangerousness linked to mental disorders has been viewed and treated over the last four centuries.     

Commentary: expert testimony as a potential asset in defense of capital sentencing cases

Montgomery et al. have documented the extent to which jurors apparently do and do not rely on expert testimony regarding dangerousness and mental illness. This article reviews some of the methodological issues raised by their findings and argues that their results have potential value for appellate defense counsel in appealing death sentences in which trial counsel failed to introduce expert testimony on mental illness.