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However, consistent with the functional approach to competency assessments, the scale scores are not summed to total one final score for the ECST-R, and no cut-offs are used to determine whether a defendant is competent or incompetent. The ECST-R demonstrates high internal consistency, with alpha coefficients for the competency scales ranging from.
Each of these three sections provides clinicians with specific questions that tap into different areas involved in competency. Each item is rated on a 3-point scale ranging from no impairment to definite or serious impairment. The Interdisciplinary Fitness Interview IFI was designed to assess both the legal and psychopathological aspects of competency Golding et al. The original IFI comprised three major sections assessing legal issues, psychopathological issues, and an overall evaluation of competency.
The IFI was revised Golding, and in its current form, the Interdisciplinary Fitness Interview-Revised taps 31 relatively specific psycholegal abilities organized into 11 global domains, addressing issues such as the iatrogenic effects of psychotropic medications Riggins v. The original IFI collected data from defendants interviewed by a two-person team, composed of a lawyer and either a psychologist or a social worker, and found high agreement about their final opinions of competency Golding et al.
Some items require the defendant to visually identify the location of certain participants in the courtroom i. Each defendant is asked about the nature of the charges that he or she is facing, how the defendant would assist his or her lawyer, the nature of his or her relationship with the lawyer, and the consequences of a guilty verdict. The CAST-MR comprises 50 verbally administered questions that assess basic legal concepts, skills to assist defense, and understanding of case events. Items are scored based on the ability of the individual to relate information about his or her case in an accurate and understandable manner.
The CST has 22 item stems that ask defendants to complete sentences. Although the CST appears to be a reliable instrument Nicholson et al. Prior to Jackson v. Indiana , incompetent defendants would automatically be sent to a treatment facility for an indefinite period of time until competency was restored. This practice was challenged in Jackson. Theon Jackson, who was deaf and mute and could not read or write, was charged with two robberies and found incompetent due primarily to his inability to communicate and also his intellectual deficits. Treatment staff reported that his condition precluded his understanding the nature of charges against him and participating in his defense, and stated that there was no treatment that could help Jackson learn minimal communication skills.
Although the Court did not indicate how a reasonable period of time should be defined or progress toward regaining competency could be assessed, the decision made clear that if these two conditions were not met, the defendant would have to be released unless civil commitment was an appropriate alternative. The duration of confinement varied from state to state, with some states providing maximum time limits e.
The Jackson decision raises the issue of whether it is possible to predict which incompetent defendants are unlikely to be restored. Mossman gives an example of a line of research that addresses this issue. He examined a sample of incompetent defendants in a restoration program and found that a number of factors were associated with a low probability of restoration, including a longstanding psychotic disorder, a diagnosis of mental retardation, and older age.
However, the limited research has produced mixed results. Incompetent defendants are typically sent to residential forensic facilities, although outpatient treatment is an option Miller, Almost all incompetent defendants are returned to court within a year, with only a small percentage found to be unresponsive to treatment and thus not restorable.
Because many defendants are found incompetent due to a psychosis, psychotropic medication is the most frequent type of treatment. The use of medication raises the question of whether an incompetent defendant can refuse to consent to being medicated. The issue reached the U. Supreme Court in the case of Sell v. Charles Sell was a dentist who was charged with fraud and attempted murder. He had a history of mental illness and although initially found competent, he later deteriorated and was found to be incompetent.
He refused to consent to treatment, and the treatment facility attempted to force medication involuntarily. Sell appealed and the appellate court held that medication was necessary because he was dangerous to himself or others and medication was likely to restore competence. The use of psychotropic medication has been shown to be effective in restoring competence, as evidenced by the high rate of restoration noted. An interesting question is whether involuntary medication would also prove effective in restoring competence. One concern about restoring competence through medication is that defendants who are found competent and are proceeding with their criminal cases may discontinue taking medications.
This was the case in Miles v. Stainer , in which a defendant was considered competent but only if he continued to take antipsychotic medication. The Appeals Court held that the trial court erred because it was not aware that jail records indicated that the defendant had stopped taking his medication two weeks before entering a plea. Less intrusive forms of treatment include legal rights education, deficit-focused remediation programs, and standard hospital treatment programs Bertman et al.
Unfortunately, there is little research on the effectiveness of various treatment approaches. One of the first to examine an education-focused approach, Siegel and Elwork found that incompetent defendants randomly assigned to an educational program that provided information on the legal process as well as problem-solving training showed significantly greater improvement on competency assessment instrument scores compared to a control group. Incompetent defendants with intellectual deficits fare more poorly in restoration programs. Competency to participate fully in the defense of his or her criminal case is an essential right of a defendant to ensure a fair trial.
The vast majority of defendants are competent to understand the charges against them, appreciate the legal consequences, make decisions about how to proceed with their cases, and able to communicate rationally with their attorneys. It is important, however, that mental health professionals are able to reliably and validly inform the court about the competency of defendants whose competence has been questioned by their lawyers, the prosecution, or the court.
This article has provided an overview of forensic assessment instruments that have been developed to guide this process. For defendants found incompetent, treatment is usually successful in restoring competence and allowing them to return to court and proceed with the resolution of their cases.
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A meta-analytic review of competency to stand trial research. Psychology, Public Policy and Law , 17 , 1— Competency to stand trial: A historical review and some new data. Journal of Psychiatry and Law , 8 , — The Competence Screening Test: A replication and extension. Criminal Justice and Behavior , 8 , — Nevada , U. Social worker assessments of competency to stand trial. Journal of Forensic Social Work , 5 , — Competency to stand trial. University of Illinois Press. A structured interview for assessing competency to stand trial. Defining and assessing competency to stand trial.
Recent interview-based measures of competence to stand trial: A critical review augmented with research data. The detection of feigned mental disorders on specific competency measures. Psychological Assessment , 14 , — Evaluation of Competency to Stand Trial-Revised professional manual. Competence to stand trial: Clinical reliability and the role of offense severity. Journal of Forensic Sciences , 43 , — Psychopathology and competence to stand trial.
Criminal Justice and Behavior , 25 , — Assessment of maturity in juvenile competency to stand trial evaluations: Journal of Forensic Psychology Practice , 3 , 23— Participants obtaining IQ scores below 60 were excluded from the present sample due to inadequate norms for these participants on one of the study's dependent measures MacCAT-CA. Participants provided demographic information regarding age, gender, ethnicity, and socioeconomic status. The MacCAT-CA is a item measure administered in a semistructured interview format that provides three subscale scores: The reasoning subscale most closely reflects Bonnie's concept of decisional competence.
Each of the 22 items is scored on a scale of 0 to 2, resulting in subscale scores ranging from 0 to 16 understanding and reasoning and 0 to 12 appreciation. A hypothetical vignette about an individual charged with assault provides the context for items loading on the understanding and reasoning subscales, while items loading on the appreciation subscale are based on the circumstances of the defendant's specific case. The Judgment in Legal Contexts JILC instrument 21 was designed to assess youth and adult decision-making in the context of the legal circumstances that frequently face defendants.
In addition to assessing the examinees' choices in three legal decision contexts commonly facing defendants, the JILC assessment was designed to identify and evaluate examinees' explanations for their choices. These explanations are coded to provide the present study's measure of future orientation. Previous studies utilizing the JILC formerly called the MacArthur Judgment Evaluation to measure future orientation have found age-related increases in this dimension of psychosocial maturity such that older adolescents identify more long-range consequences on the JILC than do younger adolescents.
The first of the three vignettes involves a police interrogation in which officers, seeking to obtain a statement, request that the suspect waive his rights to silence and counsel. The suspect is described as having been a lookout for others engaged in a crime, and the examinee is asked to advise the suspect regarding how to handle the situation.
Through a set of structured interview questions, the examinee is asked to provide possible ways that the suspect could respond, eliciting a best choice and worst choice from these options, eliciting explanations for why these choices are best and worst, ranking the importance and impact of the consequences provided for the best and worst choices, and identifying what the examinee believes he would actually do in this situation.
The second vignette plea agreement focuses on a defendant's decision in response to an agreement in which pleading guilty will result in the offer of a lesser penalty than the prospective outcome of pleading not guilty. The series of structured interview questions following the presentation of this vignette mirrors those outlined in the police interrogation vignette.
Finally, the third vignette consulting attorney involves responses to the defendant's attorney who is requesting information to prepare a defense. Follow-up questions are abbreviated versions of those accompanying the police interrogation and plea agreement vignettes, as the consulting attorney vignette does not include follow-up questions assessing the dimension of future time perspective. After they have reviewed these vignettes, participants are asked to list potential positive and negative consequences for the choices previously identified as best and worst.
Future time perspective includes the variable of future recognition F-Rec , which reflects the total number of long-term consequences provided from this inquiry and was operationalized by Woolard and colleagues 21 as consequences that occur within several days after the decision was made. The variable F-Rec reflects the total number of consequences, both positive and negative, that are coded as long-term.
The Wechsler Abbreviated Scale of Intelligence WASI 41 is a standardized measure of intellectual functioning and provides both a four- and two-subtest form. The two-subtest form, used in the present study, is composed of a vocabulary section, which is a measure of individuals' expressive vocabulary and verbal knowledge; and a matrix reasoning section, which is a measure of nonverbal fluid reasoning and general intellectual ability. The MAYSI-2 was created as a screening instrument for youths entering juvenile detention facilities and is composed of six scales representing common psychiatric conditions among youth entering the juvenile justice system that potentially warrant clinical attention: Models testing direct and indirect effects and tests of invariance were estimated using AMOS Moderation analyses used a multiple group model approach 47 in which the hypothesized moderator was dichotomized by a median split procedure.
After an adequate fit of the model was established without the imposition of equality constraints, a series of increasingly restrictive constraints were placed on the model. In addition, z -scores were utilized to examine pairwise parameter comparisons in order to determine the relative magnitude of multiple paths. The means, correlations, and standard deviations of all observed study variables are presented in Table 1 and mean performances by age and sample are presented in Table 2.
As seen in Table 1 , competency-related abilities were strongly positively associated with age and with WASI vocabulary scores, with slightly weaker associations between competency-related abilities and WASI matrix reasoning scores. In contrast, MAYSI-2 measures of psychopathology showed only minimal correlation with competency-related abilities. Also, the JILC measure of future orientation F-Rec showed significant positive associations with competency-related abilities. As a result, all subsequent analyses combined the detention and community samples.
It was hypothesized that future orientation would partially explain the association between age and reasoning, but not between age and understanding or age and appreciation. Consistent with the causal-steps strategy advocated by Baron and Kenny, 51 Sobel's test 52 of indirect effects was used to evaluate the mediated paths. To evaluate mediation, this strategy examines the ratio of the product term ab standardized regression path from age to competence multiplied by the standardized regression path from future orientation to competence, with adjustment for age to its estimated standard error.
This ratio yields a z -statistic that is compared with the standard normal distribution to test for indirect effects. As seen in Figure 1 , the path from age to future orientation as well as the paths from future orientation to competence, with adjustment for age, were all significant.
That is, consistent with the stated hypothesis, future orientation partially mediated the relation between age and reasoning and, unexpectedly, between age and appreciation. Test of indirect effects of age on competence through future orientation. We also hypothesized that the competence of adolescents who were less future oriented would be more vulnerable to the effects of cognitive impairment and psychiatric symptomatology. First examining the potential moderating role of future orientation on the intellectual ability-competence link, we estimated a model in which intellectual ability and psychiatric symptomatology were simultaneously entered to predict understanding, reasoning, and appreciation, and age was entered as a covariate Fig.
Based on the recommendation of Byrne, 50 two groups i. Then, an initial model was run to establish an adequate baseline fit of the model to the data with no equality constraints imposed. Next, increasingly restrictive constraints were placed on the model, beginning with constraining all factor loadings on the latent variable of intellectual ability to be invariant across groups to evaluate whether the WASI factor structure was equivalent across groups. After placing these constraints on the model, chi-square tests for difference were used to evaluate whether constraining these factor loadings to be invariant across groups resulted in a significant decrement in the model chi-square.
Baseline model for tests of invariance across levels of future orientation. As shown in Table 3 , a series of stepwise analyses revealed that future orientation moderated the association between intellectual ability and appreciation.
Canadian Journal of Psychiatry , 46 , — The IFI was revised Golding, and in its current form, the Interdisciplinary Fitness Interview-Revised taps 31 relatively specific psycholegal abilities organized into 11 global domains, addressing issues such as the iatrogenic effects of psychotropic medications Riggins v. Law and Psychology Review , 28 , — Law and Human Behavior , 36 , — Guilford Press , Show more Regular Article. Google Preview WorldCat Pate v.
Using the same model in Figure 2 , the potential moderating role of future orientation on the psychiatric symptomatology-competence link was examined. In sum, findings suggest that future orientation partially mediates the relationship between age and reasoning and also between age and appreciation. Further, future orientation was found to moderate the relationship between intellectual ability and appreciation, indicating that the relationship between intelligence and this aspect of adjudicative competence varies depending on a youth's level of psychosocial maturity.
The present study first examined the direct effects of age, intellectual ability, psychiatric symptomatology, and future orientation on adolescents' competency-related abilities. Congruent with previous research, age and intellectual ability were both positively related to competence. Further, the development of an orientation to the future was found to be significantly positively related to an adolescent's competence. In contrast to previous research in adult populations that shows a strong negative association between psychiatric symptomatology and competence, 13 only small effects were detected in the present study linking psychiatric symptomatology and competence.
Expanding on previous research which has consistently documented a positive association between age and competence, the present study found that this association is partially explained by the development of an orientation to the future. In addition, while future orientation was found to moderate the association between intellectual ability and competence, it did not influence the modest relation between psychiatric symptomatology and competence. In demonstrating that the development of an orientation to the future partially mediates the relationship between age and competence, the present findings shed an explanatory light on this relationship that forensic evaluators might consider when assessing juvenile competence to stand trial.
Within the framework of the conceptual model of Grisso, 20 the evaluation of an adolescent's future orientation may represent a causal factor contributing to deficits in the adolescent's psycholegal abilities, thereby informing the evaluator's prognosis for competency restoration. In addition, the present findings support the expansion of the predicate conditions often necessary, either implicitly or explicitly, for adult defendants that narrowly focus on cognitive deficits or severe psychopathology.
Further, in finding that future orientation moderated the relationship between intellectual ability and competence, the present findings carry important implications for immature youth entering the justice system.
Not only do these cognitive limitations exert a substantial effect on the competency-related abilities of these youth, but combined with the effects of immaturity these factors appear to be particularly detrimental to these youths' capacity to proceed. For the forensic evaluator, these finding suggest caution is warranted in interpreting how a particular score on an intelligence measure might translate into competency-related abilities.
Specifically, these findings suggest that evaluators are likely to reach the most accurate conclusions concerning the role of intelligence when it is considered in the context of an adolescent's psychosocial maturity. From a treatment perspective, restoration programs attempting to compensate for these pervasive cognitive limitations would do well to use concrete learning strategies tailored to individuals with cognitive limitations to bring these defendants up to speed legally.
While the present findings regarding the role of future orientation on juvenile competence to stand trial begin to delineate the mechanisms responsible for the well-documented association between age and competence, they are not without several limitations.
First, given that detained adolescents evincing acute psychological distress were screened out of the present study, the weak findings linking psychiatric symptomatology and competence should be interpreted cautiously. That is, because of the artificially circumscribed range of psychiatric symptomatology, it would be premature to draw firm conclusions regarding the influence of psychiatric symptomatology on juvenile competence. That said, given that severe psychiatric disorders typically do not manifest until late adolescence or early adulthood, it is also possible that youthful defendants simply do not tend to experience psychiatric symptoms of the severity that often result in findings of incompetence for adult defendants e.
Second, it should be noted that future orientation is but one of many aspects of psychosocial maturity. While an underdeveloped ability to consider future consequences has been shown to be related to antisocial decision-making, 14 the present findings are the first to demonstrate the role of future orientation on adolescent defendants' decision-making in the context of competency to stand trial.
Future research should continue to examine how other aspects of psychosocial maturity, such as risk orientation and resistance to peer influence, may influence juveniles' decision-making in legal contexts. Despite these limitations, the present findings provide support for the consideration of psychosocial maturity in evaluating juveniles' adjudicative competence. While several states e. Under the adult standard emphasizing mental disease or defect, a defendant who is free of severe psychiatric symptomatology and not cognitively deficient is generally presumed to be competent.
As the present findings suggest, however, this does not appear to be adequate for youthful defendants given that normal immaturity alone can exert a significant impact on competency-related abilities. As the juvenile justice system continues to shift toward a more punitive approach to youthful offenders and the state is given greater leeway to pursue harsher sanctions, it becomes the responsibility of researchers to expose the impact of these changes to the light of scientific scrutiny and to continue to inform the legal system of the empirical basis surrounding the prosecution of youthful offenders.
We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Skip to main content. Research Article Regular Article. Kivisto , Todd M. Moore , Paula A. Fite and Bruce G. Abstract The current study examined the direct, indirect, and interactive effects of age, intellectual ability, psychiatric symptomatology, and future orientation on juvenile adjudicative competence utilizing a secondary sample of youth from the MacArthur Juvenile Adjudicative Competence Study.
Juvenile Adjudicative Competence In the first published study of juvenile adjudicative competence, Savitsky and Karras 8 found that age was significantly associated with performance on a brief competency screening measure, with results indicating that year-olds were, as a group, not competent to stand trial, and that to year-olds were found to be less competent trial defendants than adults. Development and Decisional Competence While Bonnie's 19 emphasis on decisional competence was not intended explicitly for juvenile defendants, this construct is increasingly being recognized as essential to the evaluation of juveniles' adjudicative competence.
The Present Study While early research examining the competence of juvenile defendants has consistently pointed to a positive association between age and competency-related abilities, 12 , 29 , 30 the mechanisms accounting for this relationship have only recently begun to be explored. Methods The present sample was collected as a secondary sample from the MacArthur Juvenile Adjudicative Competence Study with permission from the original authors, 29 and use of this data was approved by the institutional review board IRB at the University of Tennessee.
Participants and Sites Participants included detained youth and youth recruited from the community. Measures Participants provided demographic information regarding age, gender, ethnicity, and socioeconomic status. Measure of Future Orientation The Judgment in Legal Contexts JILC instrument 21 was designed to assess youth and adult decision-making in the context of the legal circumstances that frequently face defendants.
Results Preliminary Results The means, correlations, and standard deviations of all observed study variables are presented in Table 1 and mean performances by age and sample are presented in Table 2. View inline View popup. Indirect Effects of Age on Competence It was hypothesized that future orientation would partially explain the association between age and reasoning, but not between age and understanding or age and appreciation.
The Fragility of Competence We also hypothesized that the competence of adolescents who were less future oriented would be more vulnerable to the effects of cognitive impairment and psychiatric symptomatology. Discussion The present study first examined the direct effects of age, intellectual ability, psychiatric symptomatology, and future orientation on adolescents' competency-related abilities. Limitations, Strengths, and Conclusions While the present findings regarding the role of future orientation on juvenile competence to stand trial begin to delineate the mechanisms responsible for the well-documented association between age and competence, they are not without several limitations.
Footnotes Disclosures of financial or other potential conflicts of interest: Forensic Evaluation of Juveniles. Professional Resource Press , Psychological Evaluations for the Courts: Guilford Press , United States, U. In re Gault, U. In re Causey, So. Savitsky JC , Karras D: Competency to stand trial among adolescents. Cowden V , McKee G: Competency to stand trial in juvenile delinquency proceedings: J Fam Law Competency to stand trial in preadjudicatory juveniles and adults.
J Am Acad Psychiatry Law The competence of adolescents as trial defendants. Psychol Public Policy Law 3: