David DeMatteo

The role and relevance of the Psychopathy Checklist-Revised in court: A case law survey of U.S. courts (1991-2004).

The Psychopathy Checklist–Revised (PCL–R; R. D. Hare, 1991, 2003) is the most empirically validated instrument for measuring psychopathy in correctional and forensic psychiatric populations. The PCL–R’s predictive utility with criminal justice populations has led to its frequent use by clinicians conducting forensic assessments in criminal and sexually violent predator (SVP) cases. Despite its apparent wide acceptance in U.S. courts, little is known about how often the PCL–R is being introduced, the types of cases in which it is being used, and whether claims made in court regarding psychopathy are empirically defensible and/or relevant to the question at hand. This project documents some uses of the PCL–R in U.S. courts from 1991 through 2004 by year, jurisdiction, type of evaluation, and party. The results suggest that the PCL–R is being used by expert witnesses with increasing regularity across U.S. jurisdictions, primarily to assess risk of future violence. A review of 3 recent cases is also provided that illustrates concerns about the validity of the PCL–R for certain types of legal questions that may arise in criminal and SVP trials.

Predicting Juvenile Recidivism with the PCL:YV, MAYSI, and YLS/CMI

The primary purpose of this study was to investigate juvenile recidivism prediction as a function of the static and dynamic risk factors identified in the literature on juvenile recidivism by integrating the Psychopathy Checklist-Youth Version (PCL:YV), the Massachusetts Youth Screening Instrument (MAYSI), and the Youth Level of Service/Case Management Inventory (YLS/CMI) into a prediction model. The results suggested a predictive relationship between a 9-factor model consisting of MAYSI subscale scores and recidivism. The accuracy of the model improved with the addition of the Prior and Current Offenses/Dispositions subscale of the YLS/CMI. These findings suggest that emotional distress, offense history, and current criminal involvement may be important factors to consider when addressing recidivism potential.

How “Specific” Are Gender-Specific Rehabilitation Needs? An Empirical Analysis

There has been relatively little empirical research on the distinctive characteristics and needs of female offenders that could help guide rehabilitative approaches that are gender specific. This study considered a sample of female offenders (N = 886) and male offenders (N = 1,435) who had been released from incarceration and provided with assessment services as part of the community reentry process. Comparisons were conducted using the employment, companions, and financial domains of the Level of Service Inventory (LSI-R and LS-CMI). Female offenders received significantly higher ratings in companion and financial deficits, consistent with some prior research suggesting that social and financial risk factors for offending may be more substantial in women. Implications for research and the practice of gender-specific rehabilitation approaches are discussed.

THE LSI-R AND THE COMPAS Validation Data on Two Risk-Needs Tools

Over the past two decades, the role of risk-needs assessment in the criminal justice system has increased substantially. This study provides validation data on the Level of Service Inventory—Revised (LSI-R) and the Correctional Offender Management Profiling for Alternative Sanctions (COMPAS) using a large male cohort ( N = 975) with a substantial proportion of ethnic minority offenders. In comparing the predictive validity of these tools, the authors employed a retrospective, archival, known-groups design to study outcomes of offenders released into the community from New Jersey prisons between 1999 and 2002, with a postrelease outcome period of 12 months. The results indicate that both the LSI-R composite score and the COMPAS recidivism score have inconsistent validity when tested on different ethnic/racial populations. Furthermore, the results suggest that different ethnic/racial groups have varying risk and needs factors that predict recidivism.

Principles of Forensic Mental Health Assessment: Implications for Neuropsychological Assessment in Forensic Contexts

Forensic mental health assessment (FMHA) is a form of evaluation performed by a mental health professional to provide relevant clinical and scientific data to a legal decision maker or the litigants involved in civil or criminal proceedings. SuchFMHAevaluations can be further specialized when the clinical and scientific data are primarily neuropsychological. This paper provides an adaptation of 29 recently derived principles of FMHA (Heilbrun, 2001) that have been described in two forms: general guidelines for application in FMHA, and guidelines for application to neuropsychological assessment in forensic contexts. Each principle is described, and the general guideline is compared with the highly specialized neuropsychological guideline. In this way, the applicability of such FMHA principles to forensic neuropsychological assessment is described.

Secondary Prevention Services for Clients Who Are Low Risk in Drug Court: A Conceptual Model

The drug court model assumes that most drug offenders are addicts, and that drug use fuels other criminal activity. As a result, drug court clients must satisfy an intensive regimen of treatment and supervisory obligations. However, research suggests that roughly one third of drug court clients do not have a clinically significant substance use disorder. For these clients, standard drug court services may be ineffective or even contraindicated. Instead, these clients may be best suited for a secondary prevention approach directed at interrupting the acquisition of addictive behaviors. Unfortunately, there are no established secondary prevention packages for adults in criminal justice settings. This article presents a conceptual framework for developing and administering secondary prevention services in drug courts and proposes a platform of prevention techniques that can be tailored in a clinically relevant manner for the sizeable population of drug court clients who are low risk.

OUTCOME TRAJECTORIES IN DRUG COURT Do All Participants Have Serious Drug Problems

Graduation rates in drug courts average 50% to 70%, but it is unclear what proportion of graduates responded to the drug court services and what proportion might not have had serious drug problems on entry. This study cluster analyzes urine drug screen results during the first 14 weeks of treatment on 284 participants from three misdemeanor drug courts. A four-cluster solution (R 2 > .75) produced distinct subgroups characterized by (a) consistently drug-negative urine specimens (34% of the sample), (b) consistently drug-positive specimens (21%), (c) consistently missed urine specimens (26%), and (d) urine specimens that began as drug positive but became progressively drug negative over time (19%). These data suggest that approximately one third of the participants might not have had serious drug problems on entry. Approximately one fifth appeared to respond to drug court services, and nearly one half continued to exhibit problems after 14 weeks. Implications for adaptive programming in drug courts are discussed.

The Role and Reliability of the Psychopathy Checklist—Revised in U.S. Sexually Violent Predator Evaluations: A Case Law Survey

The civil commitment of offenders as sexually violent predators (SVPs) is a highly contentious area of U.S. mental health law. The Psychopathy Checklist-Revised (PCL-R) is frequently used in mental health evaluations in these cases to aid legal decision making. Although generally perceived to be a useful assessment tool in applied settings, recent research has raised questions about the reliability of PCL-R scores in SVP cases. In this report, we review the use of the PCL-R in SVP trials identified as part of a larger project investigating its role in U.S. case law. After presenting data on how the PCL-R is used in SVP cases, we examine the reliability of scores reported in these cases. We located 214 cases involving the PCL-R, 88 of which included an actual score and 29 of which included multiple scores. In the 29 cases with multiple scores, the intraclass correlation coefficient for a single evaluator for the PCL-R scores was only .58, and only 41.4% of the difference scores were within 1 standard error of measurement unit. The average score reported by prosecution experts was significantly higher than the average score reported by defense-retained experts, and prosecution experts reported PCL-R scores of 30 or above in nearly 50% of the cases, compared with less than 10% of the cases for defense witnesses (κ = .29). In conjunction with other recently published findings demonstrating the unreliability of PCL-R scores in applied settings, our results raise questions as to whether this instrument should be admitted into SVP proceedings.

Standards of practice and care in forensic mental health assessment: Legal, professional, and principles-based consideration.

The specialization of forensic mental health assessment (FMHA) has incorporated important advances during the last two decades. As scientific advances, specialized tools, and relevant ethical guidelines have become core elements of FMHA, however, the question of how to regulate poor practice has assumed increasing importance. One such means of regulation that has been rarely applied to FMHA thus far is malpractice litigation using a clearly defined standard of care. This article focuses on the relationship between standard of practice and standard of care in FMHA. The authors discuss the current absence of a standard of care in FMHA, describing the historical, regulatory, and legal influences that have helped to shape the current state of practice in this specialty area and their relevance to operationalizing a standard of care. The authors address the various sources of authority that the law might consider in defining a standard of care and specify circumstances under which legal regulation using a standard of care would be more useful than would ethical/ professional regulation using a standard of practice. Finally, the authors describe the advantages of developing a clearer standard of practice in FMHA, which can then inform the operationalization of a standard of care.

Community-based alternatives for justice-involved individuals with severe mental illness: review of the relevant research

Community-based alternatives to conviction and imprisonment for adult offenders with severe mental illness are receiving increasing attention from researchers and policy makers. After discussing the justifications that have been offered in support of community-based alternatives, this article reviews the current empirical evidence relevant to such alternatives. The authors use the sequential intercept model as a guide and summarize the existing research at several points along the criminal justice continuum. They conclude by highlighting the gaps in existing research and discussing the need for further research in several key areas.