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Psychological Assessment Lecture 6

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Psychological Assessment Lecture 6 Powered By Docstoc
					Dr Louise Phillips
Psychological Assessment.




              Psychological Assessment
                      Lecture 6:
              Forensic and legal aspects                   Legal issues

                    Dr Louise Phillips            Psychologists as expert witnesses




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         Issues psychologists might address
     •   Competency to stand trial
     •   Reasons for criminal behaviour
     •   Prediction of violence                     Competency to stand trial
     •   Personal injury
     •   Assessment of capacity




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Dr Louise Phillips
Psychological Assessment.




             Competency to stand trial
     • 3 components:
       – Understanding of criminal process
       – Ability to consult with defence lawyer         Reasons for criminal behaviour
       – Capacity to understand court proceedings
     • Possible reasons for lack of competence to
       stand trial:
       – Low IQ
       – Very poor memory
       – Major mental illness
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               Reasons for behaviour
     • Control of actions at time of crime
       – Understanding of actions
       – Insanity at time of the offence                   Prediction of reoffending
          • M’Naughten Rule from England 1843.
          • Not guilty by reason of insanity.
     • Reliability of confessions
     • Likelihood of committing crime


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Dr Louise Phillips
Psychological Assessment.




          Prediction of future behaviour
     • What is likelihood of reoffending?
     • Important in:
       – Determining sentence and parole                       Personal injury claims
     • But:
       – Very poor ability to predict
       – High false positive rate



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                    Personal injury
     • Common after road accident
     • Issues may need to address:
       – Evidence of psychological dysfunction?           Assessing capacity and incapacity
       – Is this attributable to accident/injury?
       – Brain injury or ‘psychological’ disorder?
       – Is it treatable?
       – Prognosis for future career/care needs?


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Dr Louise Phillips
Psychological Assessment.




               Assessment of capacity                                           Domains in determining capacity
     • Capacity to:                                                          • BPS report 2006
       – Make a will, give gift                                              • Areas to be assessed might include:
       – Manage property/finances                                              – General intellectual ability;
     • Assessing capacity                                                      – Memory and ability to learn;
       – Medical evidence                                                      – Attention and concentration;
       – Psychometric tests                                                    – Verbal comprehension and expression;
       – Assessing understanding of legal issues                               – Reasoning;
          • ‘Ability to understand nature and effects of a                     – Information processing;
            decision or transaction’
                                                                               – Executive functioning.
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        Adults with Incapacity (Scotland) Act 2000                                   Assessment of capacity
            http://www.scotland.gov.uk/about/JD/CL/00016360/home.aspx


     “The Act changes the system for managing                                • Study in Grampian NHS
       the finances, property and welfare of                                   – Whyte et al. (2003)
       adults who lack the capacity to take some                               – Doctors, MMSE, take average of 24 minutes
       decisions for themselves.”                                              – Psychologists, broad battery – 83 minutes
     • But how is ‘capacity’ to be assessed?                                   – Executive function key difference between
     • Who assesses capacity?                                                    doctor and psychologist assessments




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Dr Louise Phillips
Psychological Assessment.




                                                                     Critique of Pinochet's UK psychological assessment
                                                                                   filed in court, 13 Jul 2000.
                                                                               Http://www.torturecare.org.uk/articles/news/231

                                                                    • No specific tests of malingering were
                                                                      carried out.
                          Malingering                                 – A memory test sensitive to malingering was
                                                                        started but abandoned
                                                                    • Long testing session for 84 year old man
               Faking of test performance?
                                                                      – No mention in report on effects of fatigue
                                                                    • Did not use standard tests for older adults
                                                                      – May have compared his performance to
                                                                        means of much younger adults
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                                                                       Structured interview of reported symptoms
       Detecting faking of performance
                                                                                 (Rogers et al., 1992).
     • Presence of external incentive
     • Clinical judgement
                                                                    • Interview assessing 8 primary scales
        – Attitude of patient & inconsistencies
                                                                      – Rare symptoms
        – Self-report v other evidence                                – Strange combinations
     • Patterns of performance                                        – Improbable symptoms
        – E.g. below chance scores
                                                                      – Blatant symptoms
                                                                      – Subtle symptoms
     • Specific tests sensitive to faking, e.g.:
        – Memory tests designed to be easier than they look.
                                                                      – Severity
        – Structured interview of reported symptoms                   – Selectivity
                                                                      – Reported versus observed symptoms
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Dr Louise Phillips
Psychological Assessment.




                            Summary                                                      Exam tips 1
     • Legal issues commonly addressed by                            • Work to understand the material
       psychologists:                                                  – If you don’t understand something do some
                                                                         research to find out the answer
        – Competency during crime and trial
                                                                       – Be active in your revision
        – Disability caused by personal injury
                                                                       – Rewrite lecture notes
        – Capacity to make decisions
                                                                       – Practice summarising each lecture
     • Possibility of malingering                                    • In relation to studies/evidence:
        – Clinical judgement                                           – Learn what the key findings are
        – Pattern of test performance                                  – More important than remembering date

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                          Exam tips 2                                                    Exam tips 3
     • If you want to pass                                           • Do not be too selective in what you revise
        – Show us you know key points from the lectures                – It is risky to learn prepared answers
                                                                     • In the exam…
     • If you want to get a 2.1                                        –   Read the question carefully
        – Address the question,                                        –   Don’t write pages of introduction
        – Provide evidence that you have learnt substantially          –   Provide a conclusion which sums up your argument
          from the course                                              –   Don’t spend too much time planning
     • If you want to get first class marks                          • Past papers
                                                                       – Provide useful practice at answering questions,
        – Integrate material from reading                                particularly under exam conditions
        – Don’t just follow the lecture structure                      – Don’t use them to second guess which questions will
                                                                         appear this year
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