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Response style evaluation is a fundamental component of forensic examinations. This retrospective study aims to evaluate how measures of feigning performed with individuals with intellectual disabilities (ID) who were undergoing competency to proceed to trial evaluations.

Using a known-groups design (ID vs non-ID) with 145 individuals, 37 individuals met diagnostic criteria for ID. The individuals were administered the Miller Forensic Assessment of Symptoms Test (M-FAST; Miller, 2001), the Inventory Legal Knowledge (ILK; Musick and Otto, 2010), the Evaluation Competency to Stand Trial-Revised, atypical presentation scale (ATP; Rogers et al., 2004b) and the Competence Assessment for Standing Trial-Mental Retardation (Everington and Luckasson, 1992).

The total ILK demonstrated differences between groups with a large effect size (Cohen’s d = 1.02). Six items on the ILK had over a 30% difference as a function of group. However, two revised scales from the ILK, the R-ILK-90 and the R-ILK-95 (Rogers et al., 2017), did not demonstrate differences as a function of group membership with small effect sizes (Cohen’s ds = 0.02 and 0.29). The M-FAST total score and ATP scales were not different between groups, although results demonstrated that individuals with ID would be potentially more at risk to for misclassification as feigning on the M-FAST.

This study has several limitations. It is a retrospective study with a relatively small sample size so additional research is needed to substantiate the results. However, this study highlights the potential for individuals with intellectual disabilities to be disadvantaged when undergoing competency to stand trial evaluations.

This manuscript shows that individuals with ID are at-risk for being mislabeled as feigning when employing standard measures of response style testing if appropriate cautions are not used. However, revised measures that take into account baseline information of legal knowledge offer a way forward that may prevent false positives with individuals with ID.

The mislabeling of individuals with ID could lead to significant problems, including harsh sentences and unnecessary incarcerations. This manuscript provides real-world data and encourages clinicians to be mindful when evaluation individuals with ID for court-ordered evaluations.

This manuscript is critical, as it shows that caution is needed when using instruments of feigning with individuals with ID who are undergoing competency evaluations. This has value for clinicians who are tasked with completing these evaluations for the courts.

Adults with intellectual disabilities (ID) entering the legal system in the USA are at heightened risk of being incorrectly labeled as malingering. The Inventory of Legal Knowledge (ILK) was recently developed to assess response style of individuals undergoing competency to stand trial (CST) evaluations. The purpose of this paper is to present preliminary data on the utility of the ILK with adults with ID.

In total, 32 adults were recruited from an American day program for adults with ID. Using a simulation design, the first 24 participants were assigned to the honest responding group and the remaining eight were assigned to the fake bad group. The normative performance of the honest responding group was compared to established norms for adults without ID, the most efficient ILK cut-off score was examined, and convergent validity of the ILK and other malingering measures tested.

Compared to the established mean score, the recommended cut-off score, and two independent published samples of non-ID adults, the normative performance of the honest responding ID group was significantly lower. Analyses of area under the curve revealed that the ILK lacked sufficient ability to discriminate adults with ID instructed to respond honestly from those instructed to feign incompetence, and correlational analyses failed to support the convergent validity of the ILK in this sample.

The present findings do not support the use of the ILK with adults with ID, even with adjusted cut scores. The development of novel malingering measures that can be used in the context of CST evaluations with adults with ID is needed.

The present study is the first to examine the psychometric properties of the ILK with adults diagnosed with ID and without concomitant psychiatric symptomatology.

The concept of unfitness to plead is central to conduct of a fair trial for someone accused of a crime. The historical origins go back several centuries, developing through a number of legislative changes. The modern concept of unfitness to plead arose from a number of legal cases in the 19th century. The Criminal Procedure (Insanity and Unfitness to Plead) Act 1991 followed a number of concerns over existing legislation. More recently, there have been a number of amendments made through the Domestic Violence, Crime and Victims Act 2004. This paper reviews the history and changes in legislation to the present day, and provides an example of the practical application of fitness to plead in practice. It also reviews relevant research and attempts to consider the future of this important medico‐legal term.

People with intellectual disabilities commonly come into contact with the criminal justice system as victims, witnesses or suspects. Their intellectual disabilities may make them disadvantaged in relation to all components of the criminal justice system, including police interviews, fitness to plead and stand trial, capacity to give evidence in court, and issues to do with criminal responsibility and sentencing. The focus in this paper is on police interviews and the capacity of adults with intellectual disabilities to give evidence in Court. Research into the types of vulnerability seen by people interviewed by police have focused on interviewees' understanding of the Oath and their legal rights, suggestibility, acquiescence, compliance and perceptions of the consequences of making self‐incriminating admissions. The essential components of any interview and testifying in court require that the person can communicate effectively and give reliable answers and accounts of events. Research into police interviews has highlighted the importance of taking into account the interviewee's vulnerabilities and providing appropriate support, and suggests a more humane approach to interviews and when vulnerable people testify in Court.

Although cultural competence is gaining increased attention among mental health practitioners, such primarily has centered on race, religion, ethnicity, language, and nationality. Thus far, there has been relatively little recognition of specific socialized subcultures aside from the aforementioned groups, and virtually no discussion regarding those associated with various firearm-related subcultures. This topic is particularly relevant to mental health practitioners, as positions on firearm use and ownership frequently split across political party lines, and mental health professionals and academics are more likely to espouse liberal rather than conservative views. It follows that practitioners may understand little about firearms culture and, therefore, are at increased risk for biased decision making when working with clients for whom firearms have relevance. The paper aims to discuss these issues.

This paper takes a conceptual approach to reviewing potential areas of bias in both clinical and clinical-forensic practice in the US context.

The authors detail the prevalence of firearm-related issues in the USA, contextualize firearm-related issues in forensic treatment and evaluation scenarios, delineate a number of firearm subgroups, and recommend considerations for mental health professionals to develop cultural competence as it relates to firearms and associated subcultures.

This is an original conceptual study of cultural competence and various firearm-related subcultures.

Despite the existence of minimum age laws for juvenile justice jurisdiction in 18 US states, California has no explicit law that protects children (i.e. youth less than 12 years old) from being processed in the juvenile justice system. In the absence of a minimum age law, California lags behind other states and international practice and standards. The paper aims to discuss these issues.

In this policy brief, academics across the University of California campuses examine current evidence, theory, and policy related to the minimum age of juvenile justice jurisdiction.

Existing evidence suggests that children lack the cognitive maturity to comprehend or benefit from formal juvenile justice processing, and diverting children from the system altogether is likely to be more beneficial for the child and for public safety.

Based on current evidence and theory, the authors argue that minimum age legislation that protects children from contact with the juvenile justice system and treats them as children in need of services and support, rather than as delinquents or criminals, is an important policy goal for California and for other national and international jurisdictions lacking a minimum age law.

California has no law specifying a minimum age for juvenile justice jurisdiction, meaning that young children of any age can be processed in the juvenile justice system. This policy brief provides a rationale for a minimum age law in California and other states and jurisdictions without one.

The minimum age of criminal responsibility (MACR) was set at ten years old in 1963. Since then a deeper appreciation of children's rights and understanding of their unique capabilities and experiences has been gained. This paper seeks to examine the implications of these developments for our understanding of this MACR.

Research is reviewed that illuminates questions about children's culpability, their competence to participate in the criminal justice system (CJS) and the consequences of criminalising them at a young age. Recent understandings of how children's rights apply to the MACR are also summarised.

Developmental science and human rights perspectives are inconsistent with a MACR no younger than 12 years.

The paper is one of the first to extensively apply developmental science research to the MACR. The author finds that although a just and rehabilitative CJS may be achievable in the case of most adolescent defendants, this is an unrealistic goal for younger children who instead require a welfare‐based system that addresses underlying causes of antisocial behaviour, facilitates accountability and ensures child protection.

This chapter uses Goffman’s concept of total institutions in a comparative case study approach to explore the role of psychotropic drugs in the process of transinstitutionalization.

This chapter interprets psychotropic drug use across four institutionalized contexts in the United States: the active-duty U.S. military, nursing homes and long-term care facilities, state and federal prisons, and the child welfare system.

This chapter documents a major unintended consequence of transinstitutionalization – the questionable distribution of psychotropics among vulnerable populations. The patterns of psychotropic use we synthesize suggest that total institutions are engaging in ethically and medically questionable practices and that psychotropics are being used to serve the bureaucratic imperatives for social control in the era of transinstitutionalization.

Psychotropic prescribing practices require close surveillance and increased scrutiny in institutional settings in the United States. The flows of mentally ill people through a vast network of total institutions raises questions about the wisdom and unintended consequences of psychotropic distribution to vulnerable populations, despite health policy makers’ efforts regulating their distribution. Medical sociologists must examine trans-institutional power arrangements that converge around the mental health of vulnerable groups.

This is the first synthesis and interpretive review of psychotropic use patterns across institutional systems in the United States. This chapter will be of value to medical sociologists, mental health professionals and administrators, pharmacologists, health system pharmacists, and sociological theorists.

The purpose of this paper is to review the impact of a new, brief forensic rotation for general psychiatry residents on the variety of residents’ forensic exposures.

The authors surveyed residents who trained before and after the implementation of the new rotation to assess the impact of the rotation on the residents’ forensic experiences during training across a variety of domains.

Even in a highly clinical forensic setting, residents participating in the required rotation reported significantly greater variety of forensic experiences than those who had not completed the required rotation, including types of settings and assessments, Rotation completers reported greater exposure to various types of settings and assessments, and courtroom-related experiences, as well as the overall number of forensic exposures. The two groups did not differ in their forensic exposures in general psychiatry settings, civil-forensic evaluations or diverse forensic populations. Secondary analyses showed that increased exposure to court-based experiences and multiple forensic settings was associated with forensic fellowship interest.

This study demonstrates that a brief, mandatory forensic clinical rotation may increase residents’ exposure to forensic settings, assessments and courtroom-related experiences and that increased exposure to courtroom-based experiences in particular may increase interest in forensic fellowship. While not surprising, the results demonstrate that residents were not otherwise having these forensic experiences and that even time-limited forensic rotations can enhance the breadth of residents’ forensic exposures. Further, the rotation achieved these outcomes without using typical forensic sites but instead highly clinical sites, which may be particularly encouraging to residency programs without ready access to classic forensic rotation sites. This study contributes to the small but expanding body of the literature describing the value of increasing psychiatry residents’ training in clinical forensic psychiatry.