“Help! I am being held hostage in a reality show!”

The Suspicion System: How the social world shapes delusions

Not so long ago, any decent-sized psychiatric hospital had at least two or three Jesus Christs in residence, and plenty of other patients serving as conduits for the CIA or the KGB.

Nowadays, Jesus Christ is harder to find. You are far more likely to encounter reality TV stars: patients whose every move is choreographed by hidden directors, videotaped by hidden camera crews, and broadcast without consent to an audience of millions. “We see many, many young people who have had the sensation of being filmed,” a psychiatrist at a public clinic in London told the New Yorker. His estimate: One or two out of every 10 patients he sees. 

This so-called Truman Show Delusion is not so irrational in our modern surveillance state, where we (and our cars) are photographed and videotaped whenever we venture into the public space, microphones capable of recording our conversations and instantly beaming them to authorities are hidden in street lighting, and – as exposed by Edward Snowden – the NSA is intercepting vast swaths of our communications and storing them in a massive, top-secret vault in the Utah desert. Soon, our homes will afford no privacy; the CIA is cheering the advent of the “smart home” as a bonanza for clandestine eavesdropping. If you scoff at the notion that They are watching you, revisit the chilling scene in the Bourne Ultimatum (2007) in which Matt Damon tries to avoid the cameras in London’s Waterloo Station.   

The solipsist premise of Peter Weir’s 1998 Truman Show, starring Jim Carrey as an insurance adjuster who realizes that his entire life is actually a TV show, was not original. The psychiatric patient in Robert Heinlein’s 1941 short story, “They—,” was convinced that he was an actor on a stage; the troubled protagonist of Philip K. Dick’s 1959 novel, Time Out of Joint, also starred in his own self-constructed reality. But in an innocent era before the entrenchment of the panoptical gaze or reality TV – in which any random person, it seems, can wake up to find him- or herself an instant social media celebrity – these stories were fantastical, and thus incapable of producing mass contagion. 

But the cultural environment influences more than just the superficial content of persecutory or grandiose delusions. Far more profoundly, it impacts who will catch psychosis, and why. This blog’s readers may know that early use of cannabis significantly increases the risk of psychosis, as does experiencing childhood adversity such as severe abuse or parental loss. You may also be aware that merely growing up in a city puts one at heightened risk of mental breakdown; there is a near-linear correlation between population density and psychosis. But consider these further research findings:

• The greater a nation’s income inequality, the higher its per capita rate of psychosis. 

• Immigration is a major risk factor for psychosis – and not just for the immigrants themselves, but for their first-generation offspring. Nor is this risk equally distributed: It is highest for darker-skinned people relocating to whiter countries, especially if they settle outside of ethnic enclaves.

The burden of social defeat

In Suspicious Minds: How Culture Shapes Madness, psychiatrist Joel Gold and his philosopher brother Ian identify social fragmentation as the construct tying these seemingly disparate strands together. More precisely, the experience of social defeat, in which a person who is persistently demeaned, humiliated, or subordinated ultimately comes to see himself as a second-class citizen.

I have long found delusional beliefs fascinating. In particular, I enjoy talking with delusional people, and trying to understand the meaning of their beliefs. In this, I’ve gained a lot from the theories of luminaries in the field such as Brendan Maher, Richard Bentall and John Read. But Suspicious Minds is brilliant in pulling together all of the extant research to create a single unified theory, one that foregrounds and humanizes the delusional person’s experience.

The theory developed out of Joel Gold’s experiences as attending psychiatrist at New York City’s notorious Bellevue Hospital. After treating several patients with Truman Show delusions, he – in partnership with his brother Ian, a philosophy professor at McGill University in Canada – published a 2012 article on the phenomenon in Cognitive Neuropsychiatry. That, in turn, generated a deluge of emails from people all around the world who were relieved to realize they were not the only one who thought their lives were being secretly filmed and broadcast to the masses.

The Gold brothers’ theory of delusions as a social phenomenon goes against the grain in this era of pharmaceutical industry domination and biological reductionism, especially here in the United States, where the social context of mental illness has been systematically suppressed in favor of simplistic theories of genetic or chemical imbalances.

But things have a way of circling back around. Almost 50 years ago, against the backdrop of the assassination of Martin Luther King and the ensuing inner-city rebellions, African American psychiatrists William Grier and Price Cobbs dissected the psychic burden of prejudice. To survive, they wrote in their influential 1968 book Black Rage, oppressed people must maintain a delicate balancing act of being ever-vigilant and suspicious, yet without succumbing to frank paranoia:

“[S]urvival in America depends in large measure on the development of a ‘healthy’ cultural paranoia. [The black man] must maintain a high degree of suspicion toward the motives of every white man and at the same time never allow this suspicion to impair his grasp of reality. It is a demanding requirement and not everyone can manage it with grace…. Of all the varieties of functional psychosis, those that include paranoid symptoms are by far the most prevalent among black people.”

The panoptical gaze in The Bourne Ultimatum

Suspicion, then, is necessary and adaptive, especially for those most vulnerable to exploitation. But when chronic stressors overwhelm the brain’s capacity to cope, delusions are kindled. This is the essence of the Golds’ theory of delusions as the product of an overtaxed “Suspicion System.”

Drawing on recent research in neuroscience and evolutionary psychiatry, the Golds locate the Suspicion System in the amygdala – evolved to anticipate threat by interpreting ambiguous signs of potential social danger – and connected brain regions. Delusions take hold, they posit, with a breakdown in communication between this early-warning Suspicion System and the more rational, slower-thinking (“System 2” in Daniel Kahneman’s formulation) cognitive network that should be dampening the amygdala’s over-enthusiasm.

A solid theory should not only be logical, elegant, and empirically supportable, but should also explain diverse manifestations of a phenomenon. The Golds’ theory explains not just persecutory delusions, but each of the other 11 major delusional themes (e.g., grandiose, religious, erotomanic) as well. For example, grandiosity  – which we see in the Truman Delusion  – can be interpreted as a way of deflecting threat, much like a puffer fish blows itself up or a cat arches it back when faced with danger:

“Flexing your social muscles makes you less vulnerable to exploitation by others, and putting your high status front and center in a potential exploiter’s mind might make them think twice about victimizing you…. Grandiosity is thus a symptom of a Suspicion System on overdrive, a caricature of the normal adaptive strategies we employ every day…. Paranoia and grandiosity … are functionally connected: paranoia is a broken form of threat detection, and grandiosity is a broken threat response.”

With ever-growing income disparity and economic stress, social network disintegration, loss of privacy,  and social media's increasingly panoptical reach, we may expect more and more alienated people with trouble psyches to succumb to Truman Show delusions. Let us hope that, in treating them, we do not lose sight of their humanity, for they really are  not so different from us. As the Golds put it, “mental illness is just a frayed, weakened version of mental health.”

Indeed, if we listen, these frantic souls may even have something to teach.

RadioLab explores criminal culpability and the brain

Debate: Moral justice versus risk forecasting

After Kevin had brain surgery for his epilepsy, he developed an uncontrollable urge to download child pornography. If the surgery engendered Klüver-Bucy Syndrome, compromising his ability to control his impulses, should he be less morally culpable than another offender?

Blame is a fascinating episode of RadioLab that explores the debate over free will versus biology as destiny. Nita Farahany, professor of law and philosophy at Duke, is documenting an explosion in the use of brain science in court. But it's a slippery slope: Today, brain scanning technology only enables us to see the most obvious of physical defects, such as tumors. But one day, argues neuroscientist David Eagleman, we will be able to map the brain with sufficient focus to see that all behavior is a function of one perturbation or another.

Eagleman and guest Amy Phenix (of Static-99 fame) both think that instead of focusing on culpability, the criminal justice system should focus on risk of recidivism, as determined by statistical algorithms.

But hosts Jad and Robert express skepticism about this mechanistic approach to justice. They wonder whether a technocratic, risk-focused society is really one we want to live in.

The idea of turning legal decision-making over to a computer program is superficially alluring, promising to take prejudice and emotionality out of the equation. But the notion of scientific objectivity is illusory. Computer algorithms are nowhere near as value-neutral as their proponents claim. Implicit values are involved in choosing which factors to include in a model, humans introduce scoring bias (as I have reported previously in reference to the Static-99 and the PCL-R), and even supposedly neutral factors such as zip codes that are used in crime-forecasting software are coded markers of race and class. 

But that’s just on a technical level. On a more philosophical level, the notion that scores on various risk markers should determine an individual’s fate is not only unfair, punishing the person for acts not committed, but reflects a deeply pessimistic view of humanity. People are not just bundles of unthinking synapses. They are sentient beings, capable of change.

In addition, by placing the onus for future behavior entirely on the individual, the risk-factor-as-destiny approach conveniently removes society’s responsibility for mitigating the environmental causes of crime, and negates any hope of rehabilitation.

As discussed in an illuminating article on the Circles of Support and Accountability (or COSA) movement in Canada, former criminals face a catch-22 situation in which society refuses to reintegrate them, thereby elevating their risk of remaining alienated and ultimately reoffending. Yet when surrounded by friendship and support, former offenders are far less likely to reoffend, studies show.

The hour-long RadioLab episode  concludes with a segment on forgiveness, featuring the unlikely friendship that developed between an octogenarian and the criminal who sexually assaulted and strangled his daughter.

That provides a fitting ending. Because ultimately, as listener Molly G. from Maplewood, New Jersey, comments on the segment’s web page, justice is a moral and ethical construct. It’s not something that can, or should, be decided by scientists.

* * * * *

The episode is highly recommended. (Click HERE to listen online or download the podcast.)

Forensnips aplenty, forensnips galore

Everybody knows that the war is over
Everybody knows the good guys lost
Everybody knows the fight was fixed
The poor stay poor, the rich get rich
That's how it goes, Everybody knows

I can't seem to get Leonard Cohen’s haunting Everybody Knows out of my mind.

Perhaps it's because I was just down in Alabama, the belly of the beast, working on a tragic case. With the highest per capita rate of executions in the United States, the Heart of Dixie State kills people for crimes that other nations punish with probation. No exaggeration. It was jarring to drive around  Montomery and see the close proximity of historic mansions to abandoned homes and decaying housing projects. The juxtaposition is fitting, as Montgomery claims the dual distinctions of being the "cradle of the Confederacy" and the "birthplace of the Civil Rights Movement."  

Montgomery, Alabama (c) Karen Franklin 2013

Or maybe it's a flashback to Elysium, in which the one percenters have left Earth’s teeming masses to rot away while they luxuriate on an idyllic orbiting satellite. The scene in the parole office, with a robot parole agent delivering a quick risk assessment and then pushing meds, is worth the price of admission, although the film is marred by interminable hand-to-hand combat scenes and a ridiculous Hollywood ending.

David Miranda, held hostage
by British security forces

Or, it could be because I’m still riled up over the British government's abuse of David Miranda. He is the Brazilian partner of journalist Glenn Greenwald (think Edward Snowden). In what can only be called an outrageous effort to intimidate journalists, the Brits detained Miranda at Heathrow Airport for nine solid hours -- the maximum allowed under the British Terrorism Act -- before finally releasing him sans his laptop, cell phone and camera. Under the Terrorism Act, he was not entitled to counsel, nor to decline to cooperate. I sure hope it backfires and incenses journalists; it certainly fired up USA Today columnist Rem Rieder (whose column I highly recommend).

* * * * *

I feel bad about the dearth of posts recently. It's been a hectic period. I'll try to make up for my lapse by packing this post with lots of links to forensic psychology and criminology news and views from the past few weeks:

Evidence-based justice: Corrupted memory

Nature magazine's profile of Elizabeth Loftus and her decades-long crusade to expose flaws in eyewitness testimony is worth a gander.

Psychopathic criminals have empathy switch

New research published in the journal Brain indicates that psychopaths do not lack empathy, as is often claimed. Rather, they can switch it on and off at will. The study, out of the Netherlands Institute for Neuroscience, is freely available online. BBC also has coverage.  

The demographics of sexting

Sexting is becoming increasingly commonplace. But practices and meanings differ by gender, relationship and sexual identity, according to a new article, also available online, in the journal Cyberpsychology, Behavior, and Social Networking.

Brainwashed video discussion

New York Times columnist David Brooks just interviewed psychiatrist Sally Satel and psychologist Scott Lilenfield about their new book, Brainwashed, which is getting quite a bit of media buzz. The book is a workmanlike, if a bit superficial, exploration of the allure of "mindless neuroscience." If you’ve got 65 minutes, I recommend watching the video discussion.

Prison news: Hunger strike, juveniles, the elderly, women

On the prison front, a lot has been going on. California prisoners are into Day 50 or so of their hunger strike over solitary housing (a condition that the Department of Corrections denies, despite many men being kept in segregation units for years and even decades) and other cruel conditions. With prisoners' health deteriorating, a court order has been issued allowing force feeding if necessary to forestall deaths. Mainstream media reporting has been minimal, but at least Al Jazeera's got you covered.  

Even more local to me, a lawsuit has been filed over solitary confinement of juveniles in Contra Costa County. The lawsuit, filed in U.S. District Court, accuses county officials of flouting state laws mandating that juvenile detention facilities be supportive environments designed for rehabilitation.

Meanwhile, NBC news is sounding an alarm over the increasing number of elderly people in U.S. prisons. NBC sounds mostly worried about the cost to taxpayers of prisons teeming with upwards of 400,000 elderly prisoners by the year 2030. Read ithttp://usnews.nbcnews.com/_news/2013/06/29/.UeV62HppQL8.twitter, and weep. 

Piper Kerman, author of the memoir Orange Is the New Black that's become a trendy Netflix series, is also sounding an alarm. In a New York Times op-ed, she writes about a federal plan to ease overcrowding in men's prisons by shipping about 1,000 women from Connecticut down to Alabama and points beyond, where they will be even more estranged from their families. As Kerman notes: "For many families these new locations might as well be the moon." I recommend her thoughtful essay on alternatives for low-risk women prisoners. 

In a more promising development, the U.S. Justice Department has announced efforts to curtail the stiff drug sentences that have caused much of this overcrowding in the first place. The U.S. prison system is so bloated, so costly, and so irrational, that even conservatives are calling for reform. Better late than never, I suppose.

By the way, Florida has executed John Errol Ferguson, the prisoner whose controversial case I blogged about earlier this year, whose competency was contested in part because of his insistence that he was the "Prince of God." The American Bar Association had filed an amicus brief asking the U.S. Supreme Court to clarify the standard for competency for execution being applied in the case. 

Sex offender news

In yet another in a series of registry-facilitated vigilante attacks, a South Carolina man has been arrested for killing a sex offender and his wife in the mistaken belief that the man was a child molester. At the same time, there are signs that overzealous laws that contribute to such stigmatization are being scrutinized more closely. For example, a federal judge has struck down a Colorado city's ordinance restricting where registered sex offenders can live, ruling that it conflicts with a state law requiring parolees to be reintegrated into society. An appellate panel in North Carolina has also struck down a law that banned registered sex offenders from using social media sites. The state Court of Appeals agreed with the challenger that the law violated his Constitutional rights to free speech and freedom of association. 

Dispute over expert witness credentials

Finally, there's a big brouhaha in South Dakota over the credentials of a psychologist who frequently testifies as an expert witness in child custody cases. The credentials of the widely respected psychologist, Thomas Price, became an issue during a child custody dispute. It was ascertained that he had earned his PhD in behavioral medicine from an online degree mill called Greenwich University on Norfolk Island, Australia, that was subsequently shuttered by the Australian government. According to an expert on diploma mills quoted by the Sioux Falls Argus Leader, degree mills often adopt the names of respected English universities. Price's resumé says he earned a Ph.D. in behavioral medicine from Greenwich University, without noting the Norfolk Island location. "Typically," notes the article, "people don’t get caught using an unaccredited degree until they assume a high-profile position ... or they do something that causes another person to research their backgrounds…. If you stay under the radar, you can get by."

Science blogger

Finally (this time I really mean it), for those of you who are into offbeat science, I've just added a new blog, Mike the Mad Biologist, to my blog roll (which can be found a little ways down the right column of my blog site). Mike is prolific and wide-ranging in his news links, with a creative spin. 

Hat tips to Jane, Terry, Kirk and others

"America's Real Criminal Element: Lead"

There are dozens of competing theories about the causes of crime. But only one fits perfectly with the data, claims a bold new investigative report. And that is lead poisoning.

"An astonishing body of evidence" on the international, national, local and even individual levels shows that much of the rise and fall of violent crime over the past half century is attributable to atmospheric lead from leaded gasoline popular from the 1940s through 1970s, according to the report by Kevin Drum in the current issue of Mother Jones magazine.

The theory has been around for about a decade, but it has been marginalized by criminologists, according to Drum, a political blogger.

As many of you know, childhood lead exposure has been linked to a permanent loss of gray matter in the prefrontal cortex, which controls executive functioning (emotional regulation, impulse control, attention, verbal reasoning, and mental flexibility). Lead also degrades the myelin that is necessary for efficient communication among neurons. Drum calls this a "double whammy":

"[Lead] impairs specific parts of the brain responsible for executive functions and it impairs the communication channels between these parts of the brain.... Even moderately high levels of lead exposure are associated with aggressivity, impulsivity, ADHD, and lower IQ. And right there, you've practically defined the profile of a violent young offender."

Drum isn't arguing that lead exposure automatically turns youngsters into criminal automatons. Rather, he says, the neurological effects of lead pushed vulnerable youngsters who were "already on the margin" over the edge into crime.

"Once you understand that, it all becomes blindingly obvious. Of course massive lead exposure among children of the postwar era led to larger numbers of violent criminals in the '60s and beyond. And of course when that lead was removed in the '70s and '80s, the children of that generation lost those artificially heightened violent tendencies."

The leaded-gasoline hypothesis explains some other demographic features of crime, Drum asserts, such as the diminishment of urban-rural gaps in murder rates in recent decades.

Drum concludes with a spirited argument for government-funded programs to vanquish the remaining lead in soils and homes:

"We can either attack crime at its root by getting rid of the remaining lead in our environment, or we can continue our current policy of waiting 20 years and then locking up all the lead-poisoned kids who have turned into criminals. … Cleaning up the rest of the lead that remains in our environment could turn out to be the cheapest, most effective crime prevention tool we have. And we could start doing it tomorrow."

I'm not sure I'm completely sold on it, but it’s a fascinating thesis, and certainly worth reading. I’d love to hear blog readers' reactions


The piece, published today in the January/February 2013 issue of Mother Jones, is available HERE.

Blogger wins scientific achievement award

Accepting the award. Photo credit: Michael Donner

I am pleased to report that I have been awarded the 2012 Distinguished Scientific Contribution in Psychology award. It struck like a thunderbolt in a clear blue sky; I had no idea I had even been nominated for an award until I got a phone call notifying me I had won. 

It was especially meaningful to come from the California Psychology Association. The only voice for California’s 18,000 licensed psychologists, the CPA tirelessly advocates for the profession as well as for the mental health needs of the general public in California.

For those of you who only know me as a blogger and/or a forensic psychology practitioner, I conducted pioneering research in the late 1990s into the motivations of hate crime perpetrators. I later extended that work to group rape, likening both forms of violence to cultural theater in which the actors publicly demonstrate masculinity, with their victims as dramatic props. (I'm excited about a forthcoming chapter in a cutting-edge text on multiple-perpetrator rape, due out next year.) I have also conducted historical research and published on the ethics of forensic diagnosis, and especially the contested sexual paraphilia of "hebephilia." More information on my research is available on my website and on Wikipedia.

The location of the awards ceremony could not have been more idyllic -- the gorgeous Monterey coast on a balmy weekend. The 270-degree view of the Monterey Bay and the surrounding hills from the 10th floor of the Marriott Hotel was breathtaking; unfortunately, a photo just can't capture it.

CPA President Craig Lareau presents award.
Photo credit: Patricia VanWoerkom

The quality of this year's convention trainings was impressive. Perhaps because the current president, Craig Lareau, is a forensic psychologist and attorney, there was a good deal of forensic programming. Alan Goldstein presented the latest on Miranda waiver evaluations (including the new instrument), Professor Gail Goodman gave an overview of the research on child witness accuracy, and there were workshops on forensic neuropsychology.

I especially enjoyed a presentation by Keely Kolmes of San Francisco and Heather Wittenberg of Maui designed to help psychologists step up their online presence. For anyone interested, Dr. Kolmes has some nice resources (HERE) for psychologists on the ethics of social media and on managing one's online reputation.

By the way, if you practice in California and don't belong to the CPA, I encourage you to join. The reconfigured CPA has a forward-looking leadership team headed by the dynamic Jo Linder-Crow and is doing essential advocacy work on behalf of psychologists and the public. It appears to have defeated (at least for the time being) an effort to axe our regulatory agency, the Board of Psychology, which would have left psychologists at the mercy of other professions. It's working hard to promote parity for mental health consumers. And it's tangibly supporting legislators who will lobby for progressive causes, for example prisoner rehabilitation instead of endless warehousing. So do your share, whether it's just paying dues or volunteering, so that all of the heavy lifting does not fall on just a few shoulders.

Sea Otter, Monterey Bay

Whether or not you belong to the CPA, if you are in California you might also consider donating to its Political Action Committee, which funds progressive politicians and reforms. The unfortunate reality is, politics is money-driven.

And now, sadly, it's back to the grindstone.

Related news: Your blogger profiled in the 2012 edition of advanced high school textbook, Forensic Science: Advanced Investigations.

More developments on the sex offender front

Study finds problems with real-world reliability of Static-99

Evaluators differ almost half of the time in their scoring of the most widely used risk assessment instrument for sex offenders, the Static-99, according to a report in the current issue of Criminal Justice and Behavior. Even a one-point difference on the instrument can have substantial practical implications, both for individual sex offenders and for public policy. In by far the largest and most ecologically valid study of interrater agreement in Static-99 scoring, the research examined paired risk ratings for about 700 offenders in Texas and New Jersey. The findings call into question the typical practice of reporting only a single raw score, without providing confidence intervals that would take into account measurement error. The study, the latest in a line of similar research by Marcus Boccaccini, Daniel Murrie and colleagues, can be requested HERE.

California reining in SVP cowboys

Psychiatrist Allen Frances has more news coverage of a memorable state-sponsored training at which Sexually Violent Predator (SVP) evaluators were cautioned to be more prudent in their diagnostic practices. Ronald Mihordin, MD, JD, acting clinical director of the Department of Mental Health program, warned evaluators against cavalierly diagnosing men who have molested teenagers with “hebephilia” and rapists with “paraphilias not otherwise specified-nonconsent,” unofficial diagnoses not found in the current edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. California evaluators have come under fire in the past for billing upwards of $1 million per year conducting SVP evaluations of paroling prisoners. The PowerPoints of the 3-day training are now available online, at the DMH's website.

The neuroscience of sex offending

In preventive detention trials of sex offenders, forensic evaluators often testify about whether an offender lacks volitional control over his conduct. But how much do we really know about this? In the current issue of Aggression and Violent Behavior, forensic psychologist John Matthew Fabian explores the neuroscience literature on sex offending as it applies to civil commitment proceedings. The article can be viewed online, or requested from the author HERE.

Challenge to sex offender registry

Although the sex offender niche is by far the most partisan and contentious in forensic psychology, one thing that just about all informed professionals agree about is that sex offender registration laws do more harm than good. By permanently stigmatizing individuals, they hamper rehabilitation and reintegration; as Elizabeth Berenguer Megale of the Barry University School of Law explores in an essay in the Journal of Law and Social Deviance (full-text available HERE), they lead to a form of “social death.” Now, the California Coalition on Sexual Offending (CCOSO) and the Association for the Treatment of Sexual Abusers (ATSA) have filed a joint amicus brief in a challenge to California's "Jessica's Law," which bars registered sex offenders from living within 2,000 feet of any school or park. The amicus contends that the restriction is punishment without any rational purpose, in that it does not enhance public safely or deter future criminality. The challenge was brought by Steven Lloyd Mosley. After a jury found Mosley guilty of misdemeanor assault, a non-registerable offense, the sentencing judge ordered him to register anyway, ruling that the assault was sexually motivated. The 4th District Court of Appeal granted Mosley’s appeal, and the California Department of Corrections has appealed to the state's supreme court. We'll have to wait and see whether the high court will tackle the issue of registration laws directly, or will sidestep with a narrow, technical ruling.

Appellate court upholds exclusion of SPECT evidence

Yerba Buena Island, San Francisco Bay

On May 22, 2002, the body of Juliette Williamson was found washed up on Yerba Buena Island in the San Francisco Bay. Williamson and her long-time partner Bruce Brooks were well-known street performers known as the Chicago Brother and Sister Blues Band. For years, they had lived together in a purple school bus parked under a freeway.

Within days of Williamson's disappearance, Brooks gave three confessions to friends. He provided graphic details of how he bludgeoned her to death with a hammer after a drunken quarrel. He even took one friend to the location where he had tossed her body into the Bay; there, police later recovered blood samples that matched Williamson's DNA.

The couple’s 16-year relationship had always been tumultuous, but it was deteriorating in the weeks before the killing. Brooks had resumed smoking crack cocaine and had openly threatened to kill Williamson if she left him, according to trial testimony.

Bruce Brooks. Photo credit: M. Macer, S.F. Chronicle

By the time he went to trial six years later, Brooks's story had changed. He testified that Williamson attacked him and knocked him "silly." He saw a fluorescent number three in his mind; the next thing he knew he was dropping Williamson's body over the bridge to bury her at sea. He had no recollection of killing her, but figured he must have.

A defense-retained neuropsychologist, Myla Young, testified that Brooks had frontal lobe damage that might cause him to begin a repetitive act like hitting and not stop until worn out. The impairment also made him prone to amnesia, she said.

But the jury wasn't buying. After three days of deliberations, jurors convicted Brooks of second-degree murder. He was sentenced to 15 years to life.

Appeal: Unfair to exclude SPECT evidence

Brooks appealed, citing the trial judge's exclusion of Single Photon Emission Computed Tomography (SPECT) evidence. He had hoped to introduce the colorful brain scans to convince the jury he had organic brain damage that made it impossible for him to premeditate a murder, or even form a conscious intent to kill. Psychiatrist Daniel Amen was prepared to testify that Brooks' scan, which measures blood flow to certain regions of the brain, looked "very abnormal."

San Francisco trial judge Cindy Lee excluded the SPECT testimony based on concerns about both the method and the messenger.

Daniel Amen promotes his Amen Clinics

Under California's Kelly-Frye standard, for scientific evidence to be admissible in a criminal case, there must be proof that the technique is considered reliable in the scientific community and that the witness is a qualified expert who used correct scientific procedures. The party seeking to introduce the evidence has the burden of proving its admissibility by a preponderance of the evidence.

Regarding the method, the judge ruled that research has not established that SPECT scans can accurately determine cognitive impairment, much less impairment so severe as to preclude the requisite mental states for premeditated murder. While the scans were "pretty glitzy" and "high tech," their colors lacked meaning and had a high potential to confuse the jury, she said.

As to the messenger, the judge had "a 'considerable question' ... as to whether [Amen] is an independent and unbiased expert and truly represents a cross-section of the relevant scientific community," according to a just-issued appellate ruling.

The First District Court of Appeal upheld the trial judge's ruling, endorsing her concerns about both the method and the messenger.

The appellate justices were unable to find any published appellate decision on the issue of whether SPECT evidence is admissible in a criminal trial to support a theory that a defendant's ability to form a specific intent was impaired by organic brain damage. So they conducted their own independent review of the scientific status of SPECT evidence. They were ultimately under-impressed.

[W]e agree with the trial court that defendant failed to establish that SPECT was generally accepted by the scientific community as showing brain injuries that were relevant to the defense theory that he did not form the intent necessary to commit murder. Defendant did not establish a generally accepted correlation between blood flow to a particular part of the brain and any particular behavior…. [A]s the trial court correctly summarized the testimony, "[T]here’s a lack of any testimony that there’s any quantitative percentage of blood flow, specific cognitive functions or other factors that will be impaired or even affected."

Regarding the messenger, the appellate justices said it was within the trial judge's discretion to raise "serious questions about Amen’s qualifications to testify as an expert witness. The court doubted that he could be independent and unbiased in light of his long engagement in significant entrepreneurship activities regarding SPECT via the Amen Clinics and activities as a proponent of the utility of SPECT scan imaging."

Amen's methods questioned

Judge Lee and the appellate panel were not alone in viewing Amen's activities with suspicion.

Amen, a graduate of the now-defunct Oral Roberts University School of Medicine, has said he was "led by God to pursue this work." And the missionary zeal with which he promotes SPECT for everything from depression and anxiety to aggression and drug abuse has raised concerns among other medical professionals.

In 2005, Amen's unconventional treatments had caught the attention of Quackwatch, an international network dedicated to exposing medical "frauds, myths, fads, fallacies, and misconduct." Three years later, Salon ran a piece by neurologist Robert Burton, criticizing PBS for running Amen's "self-produced infomercial" touting his unproven intervention for Alzheimer's disease:

It’s hard to dismiss the religious undertones of Amen’s work…. And yet Amen’s sense of calling hasn't led him to undertake the high-quality clinical investigations that would lend scientific credence to his claims…. Amen states that he has read more than 40,000 SPECT scans and holds himself up as a world expert. But a brief quote from his TV special quickly reveals a very peculiar method of determining what constitutes a normal SPECT scan…. Using Amen’s figures from his TV program, only 3 percent of those he has studied have been interpreted by himself and his staff as being normal. Put another way, 97 percent of patients who attend Amen’s clinic can expect to be told that their SPECT brain scan is abnormal.

But the controversies surrounding neuroimaging in court go far beyond those swirling around Amen and his SPECT scans. Echoing the trial judge's concerns in the Brooks case, the UK Royal Society just this week warned that jurors may be far too impressed with brain images, not recognizing their limited applicability to real-world legal questions.

POSTSCRIPT: On Feb. 29, 2012, the California Supreme Court denied review of the case. 

Steffan's Alerts #7: Neuromaging, juveniles, and perceptions of injustice

Click on a title to read the article abstract; click on a highlighted author's name to request the full article.

Perceptions of wrongful convictions by criminal justice personnel

In a new issue of Crime and Delinquency, Brad Smith and colleagues surveyed attitudes of criminal justice participants in Michigan. According to their findings, defense attorneys perceived that wrongful convictions occur more frequently than did police, prosecutors, and judges. Of the professionals surveyed, only defense attorneys viewed this concern as warranting reforms in the justice system.

How important are graduated sanctions in reducing recidivism?

In another article in Crime and Delinquency, Kristin Johnson and coauthors indicate that incorporating graduated sanctions into predictions of recidivism diminishes the predictive utility of waiver to adult court. Their results draw attention to the role of graduated sanctions and treatment programming for juvenile offenders.

What do mock jurors make of neuroimaging evidence?

N.J. Schweitzer and colleagues presented neuroscience-based testimony and neuroimagery to jury-eligible participants in mock court experiments. As reported in a new issue of Psychology, Public Policy, and the Law, participants rendered opinions on criminal culpability and sentencing. Neuroimagery, the authors reported, affected jurors' judgments no more than verbal testimony based on neuroscience.

Is the Adam Walsh Act working with juvenile offenders?

Also in Psychology, Public Policy, and the Law, Ashley Batastini and colleagues report that the Act’s classification system failed to predict sexual or nonsexual reoffending among a small sample of juveniles who were followed over a two-year period. In addition to their exploratory study, they discuss key concerns in the application of the Act to juveniles.

Steffan's alerts are brought to you by Jarrod Steffan, Ph.D., a forensic and clinical psychologist based in Wichita, Kansas. For more information about Dr. Steffan, please visit his website.

Encephelon #86: Blogging scientific mysteries

Of Florence Nightingale, free will, psychopath-hunters and -- yes -- even octopuses

It’s my turn to host the neuroscience and psychology blog carnival, Encephalon. This month, my blogger colleagues were busy analyzing fascinating unsolved mysteries in the wide-ranging fields of brain and behavior. So all of you sleuths out there, dust off your magnifying glasses and come exploring with me....

The mystery of the bedridden activist

At Providentia, psychologist Romeo Vitelli probes the mysteries surrounding pioneering public health activist Florence Nightingale (1820-1910) in a 2-part series, "The Bedridden Activist." Dr. Vitelli (who for all of you forensic folks escaped Ontario's maximum-security Millbrook Correctional Centre after a 15-year stint) marvels at Nightingale's indefatigable crusade for the poor and downtrodden, despite a debilitating illness that rendered her unable to travel. While discussing the theories of her mysterious illness, Dr. Vitelli also corrects the historical record:

Although Florence Nightingale opposed the Contagious Diseases Act, it was not because she opposed the germ theory of disease (as some critics later argued). Even though germ theory was not taken seriously before Joseph Lister and Louis Pasteur made the theory acceptable, Nightingale actually pioneered the need for sanitation and antiseptic conditions. Her opposition to the legislation that was eventually passed stemmed from the intrusive nature of the Act (including mandatory screening of prostitutes for syphilis and detaining infected women). When the act was passed in 1864, she campaigned for its repeal. 

The mystery of free will

Should a man who takes out a murder contract on his wife and children be held responsible? For most people, the obvious answer is, “Of course!” But for pure determinists, free will is an illusion; no one is responsible for anything.

That doesn't fit well with the assumptions of our criminal and civil court systems. Or does it? As Peter reports in his post on "expertimental free will" at Conscious Entities, an odd thing happens when determinism runs up against moral values. In an experiment in which subjects were told to assume that determinism is correct (meaning people are not responsible for their actions), subjects still assigned responsibility to the man who took out a contract on his family.

The mysterious octopus

Octopuses fascinate scientists. That's partly because they are so different from mammals like us. Not only are their brain regions not arranged to correspond with bodily systems, but their individual arms can control some movement without input from their brain. Over at Cephalove, Mike Lisieski discusses a study on the unsolved mystery of exactly how an octopus’s brain uses vision to control ongoing movements. The post is, "The octopus, the maze, and why it matters: behavioral flexibility and sensory-motor integration."

The mystery of the sightless mind

While some researchers study the role of vision in the elusive octopus, others study it in humans. Janet Kwasniak at Thoughts on Thoughts reports on new research into the brains of sightless humans. In “How is the world represented without vision?,” she muses on how, given the importance of vision to our species, it is possible to produce a conscious model of the world without it. And how does the brain use the third of the cortex involved with vision when vision is idle? Attempting to solve those mysteries, the researchers used fMRI technology to compare the brains of congenitally blind people, blind people who were once sighted, and sighted and blindfolded sighted individuals.

The mystery of the calcium in the brain

Here's one that I bet few of my readers have thought much about:

Zen Faulkes at Neurodojo, a biology professor at the University of Texas-Pan American, ponders long-held assumptions about the role of calcium in neuronal functioning. How do you prove the neurons don't use calcium, he wonders? And what do they use instead? These are among the questions addressed in the post, “Neurotransmitter release without calcium.”

The mystery of the ulcer-less zebra

Daniel Lende at Neuroanthropology is highlighting the intriguing teachings of Robert Sapolsky, a MacArthur Fellow who divides his time between teaching biology and neuroscience at Stanford University and conducting stress research on baboons in Kenya. In "Robert Sapolsky and Human Behavioral Biology," Daniel provides links to an entire course of study on human behavioral biology that's available for free online at YouTube. If you’re interested in anything from memory and plasticity to schizophrenia, language, individual differences, and human sexual behavior, this 25-session course is worth checking out.


After reading Daniel’s post, I couldn't resist buying a copy of Sapolsky's latest book, Why Zebras Don't Get Ulcers, which explores stress and stress-related illness. To answer the question: Zebras don't get ulcers because they – like our ancestors – do not have to confront the chronic stresses of contemporary life, which our bodies were not designed to withstand.

The mystery of the psychopath hunter

Back to this blog’s central theme of forensic psychology I bring you (drum roll) the biggest mystery of all: What motivates US! I blogged about research into why some psychologists give higher scores than others on a measure of psychopathy. In case you haven't read the post I won't give it all away here, but the researchers found that subjects' levels of empathy and excitement-seeking affected whether they saw others as psychopathic. The post is, "Psychopathy: A Rorschach test for psychologists?"

That's it for now. Past -- and future -- issues of Encephalon are available HERE. 

Encephalon carnival 84: Psychology-neuroscience roundup

The dominant theme of this month's Encephalon blog carnival is that no matter how straightforward something may appear, it is not always that simple. Among the intriguing offerings:

• Taylor Burns at Cognoculture discusses some of the misconceptions about testosterone in a brief essay, Testosterone and human aggression. 

• Dave Deriso at The Artful Brain examines Cotard syndrome in What is Truth? And What is ‘Walking-Dead’ Syndrome?. 

• In The Mathematician in the Asylum, forensic psychologist Romeo Vitelli at Providentia explores the life of Andre Bloch, a leading French mathematician who spent 30 years in an asylum after knifing three family members to death.   

Hosting the 84^th edition of Encephalon is Janet Kwasniak, who blogs about consciousness at “Thoughts on Thoughts.” Janet is in France, but wherever you are the content is just a click away – HERE.