Competency to Stand Trial and Cognitive Functioning

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0 height="100%"><tr> <td valign="top" width=160 BGCOLOR="#333333" TEXT="#F7F7FF" background="03cdedc2ddualp.png"> <div> <A HREF="index.htm" TARGET="_top" TITLE="Dr. Wade Silverman, Ph.D"><U><B>Dr. Wade Silverman, Ph.D</B></U></A></div> <bR> <div> <A HREF="id8.htm" TARGET="_top" TITLE="Contact Us"><U><B>Contact Us</B></U></A></div> <bR> <div> <A HREF="id147.htm" TARGET="_top" TITLE="FAQs"><U><B>FAQs</B></U></A></div> <bR> <div> <A HREF="id16.htm" TARGET="_top" TITLE="About Dr. Silverman"><U><B>About Dr. Silverman</B></U></A></div> <bR> <div> <A HREF="id146.htm" TARGET="_top" TITLE="Great links"><U><B>Great links</B></U></A></div> <bR> <div> <A HREF="id3.htm" TARGET="_top" TITLE="The Mind Reader© archive"><U><B>The Mind Reader© archive</B></U></A></div> </td> <td valign="top" BGCOLOR="#FFFFFF" TEXT="#080000" background="03d64643.png"> <div> <FONT SIZE="5" COLOR="#666633" FACE="Times New Roman" ><B>Dr. Wade Silverman, Ph.D</B></FONT>    |     <FONT SIZE="2" COLOR="#0000BF" FACE="Times New Roman" ><A HREF="index.htm" TARGET="_top" TITLE="Dr. Wade Silverman, Ph.D"><U>home</U></A></FONT></div> <div>                                                   </div> <div> Competency to Stand Trial and Cognitive Functioning</div> <div>   </div> <div> There are about 25,000 competence to stand trial evaluations (CST) performed each year. </div> <bR> <bR> <div> In Dade County these evaluations are carried out by psychologists and psychiatrists broadly using </div> <bR> <bR> <div> the Dusky standard. We are to examine the defendant taking into account following seven </div> <bR> <bR> <div> factors: 1. Appreciation of the charges against the defendant. 2. Appreciation of the range and </div> <bR> <bR> <div> nature of the possible penalties. 3. Understanding of the adversarial nature of the legal process. 4. </div> <bR> <bR> <div> The capacity to disclose to attorney facts pertinent to the proceedings. 5. Ability to manifest </div> <bR> <bR> <div> appropriate courtroom behavior. 6. Capacity to testify relevantly. 7. Any other factors deemed </div> <bR> <bR> <div> relevant. </div> <bR> <bR> <div> The most frequently used assessments include a mental status exam and some form of </div> <bR> <bR> <div> psychological testing such as the Minnesota Multi phasic Inventory, the Symptomatic Checklist-</div> <bR> <bR> <div> 90-R, or the Mac Arthur Competency Assessment Tool. Since professional and financial </div> <bR> <bR> <div> resources are scarce in Dade county, we all try to do our best within a narrow time frame.</div> <bR> <bR> <div> This presents even more difficulty than first imagined because of the ever increasing complexity </div> <bR> <bR> <div> of the task. Previously, mental health professionals usually base their evaluations on the notion </div> <bR> <bR> <div> that mental illness or psychosis to an assessment of incompetency. </div> <bR> <div> Recent findings by Nestor, Daggett, Haycock, and Price in<U> Law and Human Behavior</U> </div> <bR> <bR> <div> Volume 23 1999 calls into question our present form of assessment. They indicate that a  </div> <bR> <bR> <div> different set of psychological measures are also extremely important in this evaluation, mainly </div> <bR> <bR> <div> cognitive tests. They examined retrospectively 309 patients over an 8 year period. From this </div> <bR> <bR> <div> sample they identified 181 patients who had undergone CST evaluations. They compared </div> <bR> <bR> <div> neurological test scores on those recommended as competent versus those recommended as </div> <bR> <bR> <div> incompetent. Salient variables were indexes of intelligence, memory, attention, and </div> <bR> <bR> <div> concentration. The most predictive of these tests were those of memory, particularly verbal </div> <bR> <bR> <div> memory. There were no differences on standardized tests of academic skills or executive </div> <bR> <bR> <div> functions.</div> <bR> </td> </tr></table></body>