Effects of advanced age and dementia on restoration of competence to stand trial

Morris, Douglas R.; Parker, Gavin

doi:10.1016/j.ijlp.2009.02.009

Cited by 22 publications

(17 citation statements)

References 12 publications

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“…Despite the relative dearth of research in this area, research links age and gender to competency restoration outcomes. Specifically, older age (i.e., defendants over the age of 65) is associated with a lower rate of competency restoration (Colwell & Gianesini, 2011;Morris & Parker, 2008, 2009Mossman, 2007). In regard to gender, female defendants have a greater likelihood of restoration compared to their male counterparts (Morris & Parker, 2008).…”

Section: Factors Associated With Competency Restorationmentioning

confidence: 99%

“…Based on previous research (Advokat et al, 2012;Colwell & Gianesini, 2011;Cooper & Zapf, 2003;Hubbard et al, 2003;Jacobs, Ryba, & Zapf, 2008;Morris & DeYoung, 2012;Morris & Parker, 2008, 2009Mossman, 2007;Warren et al, 2013), we propose the following hypotheses: (1) A greater number of psychotic (e.g., delusions, paranoia, derailment, constricted affect, auditory hallucinations, and visual hallucinations) and neuropsychological (e.g., perseveration, impaired orientation, impaired executive functioning, stroke, memory problems, stereotyped movements, impaired attention, seizures, aphasia, echolalia, apraxia, and agnosia) symptoms will predict both IST and competency non-restoration; (2) severe cognitive symptoms (e.g., lack of orientation, executive functioning deficits, derailment) will be associated with initial IST opinions and non-restoration; (3) depressive (e.g., indecisiveness, fatigue, hopelessness, decrease/increase in appetite, depressed mood, impaired hygiene, suicidal ideation, decrease/increase in sleep, guilt, and motor retardation), anxiety (e.g., avoidance, increased heart rate, chest discomfort, dizziness, repetitive behaviour, sweating, fear of going crazy, worry, fear, shaking, hypervigilance, fear of social situations, fear of dying, shortness of breath, nausea, chills, and repetitive mental acts), manic (e.g., tangential speech, motor hyperactivity, flight of ideas, pressured speech, distractibility, irritability, and grandiosity), and/or Cluster B personality disorder symptoms (e.g., manipulative, lacks remorse, malingering, uncooperative, entitled, seductive, grandiose) will not be related to IST or nonrestoration; and (4) older age will predict IST and non-restoration.…”

Section: Current Studymentioning

confidence: 99%

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Mental health symptoms predict competency to stand trial and competency restoration success

Vitacco

Ragatz

2017

Legal Criminol Psychol

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Purpose Although several studies have examined demographic and clinical variables associated with findings of incompetency to stand trial (IST), few studies have examined factors influencing competency restoration success. This study is among the first to longitudinally examine demographic variables and mental health symptoms’ impact on both IST and competency non‐restoration. This study fills a gap in the competency to stand trial literature by utilizing the same defendants to examine progression through initial competency decisions to their eventual restoration outcomes. Methods This study examined demographic variables and mental health symptoms differentiating defendants deemed competent to stand trial, not competent and restored, and not competent and not restored. We coded and analysed 237 competency evaluations consecutively conducted over a 3‐year period. Results Specific psychotic (e.g., thought derailment, delusions, auditory/visual hallucinations) and neuropsychological symptoms (e.g., impaired executive functioning, impaired mental status) were independently associated with findings of IST and non‐restoration. Additional analyses revealed an intellectual disability diagnosis and a greater number of psychotic and manic symptoms predicted a decreased likelihood of competency restoration. Conclusions These findings suggest more severe symptom combinations (e.g., psychotic and manic symptoms) are predictors of both initial findings of incompetency and non‐restorability.

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Section: Factors Associated With Competency Restorationmentioning

confidence: 99%

Section: Current Studymentioning

confidence: 99%

Mental health symptoms predict competency to stand trial and competency restoration success

Vitacco

Ragatz

2017

Legal Criminol Psychol

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“…Heck and Herrick () also discussed evaluation and restoration of geriatric defendants, recommending that evaluators be familiar with geropsychiatric issues, consult with individuals from related disciplines (e.g., neurology, psychiatry, psychology, social work), and rule out all possible causes of treatable cognitive impairment before rendering an opinion. Finally, Morris and Parker () conducted one of the first studies specifically addressing the effects of advanced age and dementia on restoration of competence. Older non‐demented defendants, as well as defendants with a dementia diagnosis, were significantly less likely to be restored to competence than other defendants.…”

Section: Special Populationsmentioning

confidence: 99%

Ten Year Research Update (2001–2010): Evaluations for Competence to Stand Trial (Adjudicative Competence)

Fogel

Schiffman

Mumley

et al. 2013

Behavioral Sci & The Law

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This article reviews and evaluates publications during 2001-2010 with relevance for assessments of competence to stand trial, referred to in this article as adjudicative competence. The review focuses specifically on articles that provide new concepts or data supported by research or case analyses. The studies are reviewed under the following headings: (i) systemic issues, (ii) conceptual guidelines for AC evaluations, (iii) AC assessment methods, (iv) empirical correlates of AC judgments and psycholegal abilities, (v) quality of AC evaluations and reports, (vi) interpretive issues, (vii) special populations (defendants who are elderly, defendants with intellectual disabilities), (viii) AC evaluations of juveniles, and (ix) treatment of incompetent defendants. Suggestions are offered for further research to advance the quality of clinical evaluations of adjudicative competence.

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“…Consistent with the literature, patients evidencing the longest time to restore were those with schizophrenicspectrum and cognitive disorders. 33,[36][37][38][39] In addition, the majority of patients who could not be restored were those with a schizophrenic-spectrum diagnosis (70%), followed closely by individuals with a cognitive disorder diagnosis (18.3%), indicating that almost 90% of patients determined to be nonrestorable fell under those two diagnostic categories. Furthermore, close to half (42.6%) of admissions with a cognitive disorder diagnosis were ultimately deemed unrestorable.…”

Section: Discussionmentioning

confidence: 99%

“…33 Research has shown that cognitive disability and psychotic symptomology are not just associated with findings of incompetency, but also with restorability and a prolonged length of stay. [36][37][38][39] Using records from 351 inpatient pretrial defendants who underwent competence restoration at a state psychiatric hospital from 1995 through 1999, patients with prolonged psychotic disorders and irremediable cognitive disorders were less likely to be restored. 36 Similarly, Morris & DeYoung 39 found that among 455 male defendants admitted to a forensic treatment center for competency restoration, psychotic disorders and cognitive disability predicted unsuccessful restoration within three months of treatment.…”

Section: Characteristics Of Ist Offendersmentioning

confidence: 99%

A longitudinal description of incompetent to stand trial admissions to a state hospital

2019

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Objective.Evidence is clear that the nation is experiencing an increasing number of incompetent to stand trial (IST) admissions to state hospitals. As a result, defendants in need of treatment can wait in jail for weeks for admission for restoration. This study was conducted to better understand this growing population and to inform hospital administration about the characteristics of IST admissions.Methods.The study was conducted at the Department of State Hospitals (DSH) facility in Napa (DSH-Napa), a 1200-bed primarily forensic inpatient psychiatric facility located in northern California. The records of patients found IST and admitted to DSH-Napa for restoration of competence between the dates of 1/1/2009 and 12/31/2016 were eligible for inclusion in the study.Results.There were a total of 3158 unduplicated IST admissions available during the specified time period. Our data indicate that the number of admissions with more than 15 prior arrests increased significantly, from 17.7% in 2009 to 46.4% in 2016. In contrast, the percent of patients reporting prior inpatient psychiatric hospitalization evidenced a consistent decrease over time from over 76% in 2009 to less than 50% in 2016.Conclusion.Our data add to the body of literature on the potential causes of the nationwide increase in competency referrals. The literature is clear that jails and prisons are now the primary provider of the nation’s mental health care. Our data suggest that another system has assumed this role: state hospitals and other providers charged with restoring individuals to competence.

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Effects of advanced age and dementia on restoration of competence to stand trial

Cited by 22 publications

References 12 publications

Mental health symptoms predict competency to stand trial and competency restoration success

Mental health symptoms predict competency to stand trial and competency restoration success

Ten Year Research Update (2001–2010): Evaluations for Competence to Stand Trial (Adjudicative Competence)

A longitudinal description of incompetent to stand trial admissions to a state hospital

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