Graduate Department of Clinical Psychology.
Montana VA Healthcare System.
Law Hum Behav. 2020 Dec;44(6):449-460. doi: 10.1037/lhb0000398.
To develop a typology of criminal defendants found incompetent to stand trial using data-driven classification techniques and validate it against forensically relevant outcomes.
We hypothesized that discrete groups of defendants determined to be incompetent exist that can be identified in the structure of observed clinical, demographic, and criminological data. We also expected that class membership would be differentially associated with competency restoration.
We coded hospital records for 492 consecutive male criminal defendants committed to a secure hospital for competency restoration between 2013 and 2017 (mean [M] age = 38.7 years, standard deviation [SD] = 14.2; 61.0% White, 34.2% Black, 2.6% Hispanic, 2.2% "Other"). Clinical, demographic, and criminological data were analyzed using latent class analysis. Validation analyses modeled competency restoration outcomes as a function of class membership.
An 8-class solution best fit the data and included 3 discrete classes of patients with psychotic disorders (Class 2, n = 74; Class 3, n = 78; Class 6, n = 68), as well as classes characterized by intellectual limitations without comorbid psychosis (Class 4, n = 54), comorbid psychosis and intellectual limitations (Class 1, n = 41), mood disorders (Class 5, n = 80), older adults with neurocognitive disorders (Class 8, n = 59), and chronic instability (Class 7, n = 38). The restoration rate in the overall sample was 87.8%, and Classes 1-7 showed restoration rates similar to the overall sample, ranging from 82.9% to 100%. The restoration rate of Class 8 was 66.1%, and this was the only class to show significantly lower odds (odds ratio [OR] = 0.181, 95% confidence interval [CI: 0.093, 0.353], p < .001) and hazards (hazard ratio [HR] = 0.511, 95% CI [0.361, 0.724], p < .001) of restoration.
Older adults with neurocognitive disorders admitted for competency restoration are at increased risk of failed restoration. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
使用数据驱动的分类技术为被判定无能力接受审判的刑事被告建立一种类型学，并根据法医相关结果对其进行验证。
我们假设存在可以在观察到的临床、人口统计学和犯罪学数据结构中识别出的、确定为无能力的被告离散群体。我们还预计，类别成员资格将与能力恢复相关。
我们对 2013 年至 2017 年间因能力恢复而被送入安全医院的 492 名连续男性刑事被告的住院记录进行了编码（平均[M]年龄=38.7 岁，标准差[SD]=14.2；61.0%为白人，34.2%为黑人，2.6%为西班牙裔，2.2%为“其他”）。使用潜在类别分析对临床、人口统计学和犯罪学数据进行了分析。验证分析将能力恢复结果建模为类别成员的函数。
8 类解决方案最适合数据，包括 3 个具有精神病障碍的离散患者类别（第 2 类，n=74；第 3 类，n=78；第 6 类，n=68），以及以无共病精神病的智力限制为特征的类别（第 4 类，n=54）、共病精神病和智力限制（第 1 类，n=41）、心境障碍（第 5 类，n=80）、有神经认知障碍的老年人（第 8 类，n=59）和慢性不稳定（第 7 类，n=38）。总体样本的恢复率为 87.8%，而第 1-7 类的恢复率与总体样本相似，范围为 82.9%-100%。第 8 类的恢复率为 66.1%，这是唯一显示恢复几率（比值比[OR] = 0.181，95%置信区间[CI：0.093，0.353]，p<.001）和恢复风险（风险比[HR] = 0.511，95% CI [0.361，0.724]，p<.001）显著降低的类别。
因能力恢复而入院的有神经认知障碍的老年人恢复失败的风险增加。
