Spring reading recommendations -- forensic and beyond

Marauding bands of juvenile killers. Gang rapist-kidnappers. Wife beaters.

We’re talking elephants, dolphins and parrots, respectively. That's my forensic psychology angle on Animal Wise, a fascinating new book by nature journalist Virginia Morell.

Not long ago, it was taboo in science circles to claim that animal have minds. But the burgeoning field of animal cognition, having broken out of the strait jacket imposed by 20th-century behaviorism, is now mounting a full-on challenge to the notion of an evolutionary hierarchy with humans at the top. Morell, a science writer for National Geographic and Science magazines, traveled around the world interviewing animal scientists and observing their research projects on everything from architecturally minded rock ants and sniper-like archerfish to brainy birds, laughing rats, grieving elephants, scheming dolphins, loyal dogs, and quick-witted chimpanzees.

She found cutting-edge scientists who not only regard animals as sentient beings, but even refer to their study subjects as trusted colleagues. Professor Tetsuro Matsuzawa in Kyoto, for example, has set up his lab so that when the chimpanzees "come to work" each morning, they enter on elevated catwalks and sit higher than the humans, which makes them feel more comfortable. He cannot understand why humans feel so threatened by his discovery that chimpanzees are capable of holding much more information in immediate memory than can we humans.

"I really do not understand this need for us always to be superior in all domains. Or to be so separate, so unique from ever other animal. We are not. We are not plants; we are members of the animal kingdom." 

 

 

YouTube video of Alex the parrot showing his cognitive skills

Animal researchers are realizing that not only do all animals have individual personalities, but some -such as chimpanzees and dolphins - even develop cultures. This engaging and thought-provoking book can be read on many levels. It is highly informative while also being quite entertaining. But on a deeper level, it probes the moral dimensions of science.

Morell’s 2008 National Geographic article in from which the book grew is HERE. Her Slate article, "What are animals thinking?" is HERE.  My Amazon review (if you are so inclined, click on "yes," this review was helpful) is HERE.


The Signal and the Noise

If you haven't yet read Nate Silver's important The Signal and the Noise, it’s past time to grab a copy. Silver’s analytic method is central to forensic psychology. Best known for his spot-on predictions of U.S. presidential races, Silver argues that accurate predictions are possible in some (limited) contexts -- but only when one learns how to recognize the small amount of signal in an overwhelming sea of noise. And also when one approaches the prediction using Bayes's Theorem. This is one of those engrossing books that really stays with you, and has very practical applications in forensic assessments. I find it especially useful in writing reports. Plus, it helps one understand current events involving prediction, like the story of six Italian scientists being sent to prison for failing to predict a deadly earthquake. (Earthquakes are inherently unpredictable, and Silver explains why.) 

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Speaking of forensic report writing, if you want to tune up your own report writing skills, or you are teaching or supervising students, I highly recommend Michael Karson and Lavita Nadkami's book, Principles of Forensic Report Writing, due out at the end of this month. Karson and Nadkami take an innovative and thoughtful approach, helping us to think outside of the box about this essential aspect of our trade.


Other  recommendations

Beyond forensics, here a few other worthwhile books I've read recently:

If American history interests you, check out bestselling author Tony Horwitz's Midnight Rising, about John Brown's ill-fated raid on Harpers Ferry and its role in the abolitionist movement, or Tim Egan's The Big Burn, about the massive fire in the U.S. Northwest that helped change the political landscape and establish the national Forest Service. Both are engrossing and educational; I listened to the audio versions during lengthy road trips.

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If you are into dystopic fiction, I recommend Hillary Jordan's When She Woke. In the not-distant future, the government has gone broke, and can no longer afford to maintain its massive prison system. So, instead of incarceration, law-breakers -- in a modern-day riff on The Scarlet Letter -- are dyed bright colors for the length of their sentences. In a globally warmed Texas ruled by Christian fundamentalists, Hannah Payne wakes up bright red, for the crime of aborting her baby. This edge-of-your-seat tale isn't too far-fetched, given current trends, as laws are being passed in Oklahoma and elsewhere to criminalize abortion, and as the public shaming of sex offenders (who in the novel are "melachromed" blue and killed on sight by vigilantes) becomes more and more entrenched.

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Finally, I'm just launching into Gary Greenberg's hot-off-the-press book on the DSM, The Book of Woe: The DSM and the Unmaking of Psychiatry, and I can already tell it's going to be a doozy. More on that soon, time permitting....

Forensic practice: A no-compassion zone?

Murder trial prompts professional dialogue

Do empathy or compassion have a place in a forensic evaluation? Or should an evaluator turn off all feelings in order to remain neutral and unbiased?

That question is at the center of a controversy in the murder trial of Jodi Arias that I blogged about last week, with the prosecutor accusing a defense-retained psychologist of unethical conduct for giving a self-help book to the defendant.

Under heavy-artillery fire, Richard Samuels* denied prosecutor Juan Martinez's accusation of "having feelings for" the defendant, who killed her ex-boyfriend and is claiming self defense. Samuels testified he gave Arias a book because he is a "compassionate person" and thought the book would help her, but that his objectivity was never compromised. The exchange prompted a juror to ask Samuels:  "Do you believe absolutely that it is possible to remain purely unbiased in an evaluation once compassion creeps in?"

Martinez called a rebuttal witness to testify that gift-giving is a boundary violation and unethical. Newly minted psychologist Janeen DeMarte, testifying in court for only the third time, testified that a forensic evaluator should never feel compassion for a defendant, as such feelings compromise integrity (a position she modified under cross-examination).

Given these starkly divergent positions, I was curious what other forensic psychologists think. So, I initiated a conversation with a group of seasoned professionals, publishing two brief video excerpts of the relevant testimony on YouTube (click on the images below to watch the excerpts) to guide the conversation.

View the Richard Samuels excerpt (18 minutes) by clicking on the above image.

View the Janeen DeMarte excerpt (10 minutes) by clicking on the image.

Gift-giving: A bad idea

Contrary to the prosecutor’s insistence, our Code of Ethics does not prohibit gift-giving. Nor do the Forensic Psychology Specialty Guidelines (which are aspirational rather than binding). It's an ethical gray area.** As with much involving ethics, it all depends. But still, the consensus was that giving a book to a defendant is a mistake. Whether or not it affects one's objectivity, it gives the appearance of potential bias. And in forensic psychology, maintaining credibility is essential. "Gift giving," as one colleague put it, "gives the appearance of either a personal or therapeutic relationship with the defendant."

Samuels's error lay in failing to think through his action, and recognize how his blurring of boundaries could damage his credibility and thus undermine his testimony. Ultimately, by discrediting his own work, he potentially caused harm to the very client whom he was attempting to help.

The nature of the book itself further undermined the expert's credibility in this case. As another colleague pointed out, what good is a self-help book, Your Erroneous Zones: Step-by-Step Advice for Escaping the Trap of Negative Thinking and Taking Control of Your Life, going to do a woman who is in jail and facing the death penalty for stabbing and shooting someone to death?

On the other hand, although gift-giving is a slippery slope, there are times when only a curmudgeon would not give. For example, if you are conducting a lengthy evaluation and you decide to buy yourself a drink or a snack from the vending machines, do you refuse the subject a soda, for fear it would undermine objectivity or lend an appearance of bias? How rude!

Empathy: It's only human 

The general consensus was that, without some measure of empathy, one cannot hope to understand the subject or the situation. One is left with "an equally problematic perspective that dehumanizes and decontextualizes the evaluation,' in the words of another psychologist.

"There is an orientation toward forensic work that is strikingly cold," noted yet another colleague. "I have seen some highly experienced forensic examiners who use their 'objectivity' with icy precision and thereby fail to establish the kind of rapport necessary to obtain a complete account of the offense or other important information…. The absence of empathy can be just as biasing as too much of it."

Or, as Jerome Miller wrote, in one of my favorite quotes from the forensic trenches, "It takes unusual arrogance to dismiss a fellow human being’s lost journey as irrelevant."

In other words, without empathy, any claim to objectivity is illusory, because there is no true understanding. And that, too, is dangerous. DeMarte's extreme position thus errs in the opposite direction from Samuels', in advocating for forensic psychologists to be automaton-like technocrats.

Indeed, the main danger of empathy as discussed by leaders in our field, such as Gary Melton and colleagues in Psychological Evaluations for the Courts, is not that it biases the evaluator, but that it potentially seduces vulnerable subjects into revealing too much, thus unwittingly increasing their legal jeopardy. For this reason, Daniel Shuman, in a minority position in the field, argues that using clinical techniques to enhance empathy is unethical because this can -- wittingly or unwittingly -- cause harm to evaluatees. 

After all, our training as therapists makes us good at projecting understanding, and at least the illusion of compassion. Our subjects often let down their guard and experience the encounter as therapeutic, even when we clearly inform them that we are not there to help them in any way, and even when we remain vigilant to control our expressions of empathy.

"The best forensic evaluations bring all the clinical skills learned to promote self-disclosure and emotional emitting (empathy, reflective comments, attention to feelings, suspension of moral judgment, etc.)," a colleague commented. "We know how to get people to talk about things that they might otherwise wish to hide from others and themselves. Most defendants feel understood or at least feel they have been heard at the conclusion of an assessment."

Behaviors, not emotions, can be unethical

A third general consensus emerging from our professional dialogue was that feelings themselves are "almost never unethical." Which is fortunate, as we can never know for certain what another person is thinking or feeling. Rather, it is the behavior that follows that can be problematic; we must remain alert to what feelings a subject is evoking in us, lest they lead us astray. Sticking close to the data, and being transparent in our formulations, can keep us from behaving incompetently or problematically in response to our feelings, whether of empathy and compassion or -- at least as problematic -- dislike or revulsion. 

Bottom line: Do not check your empathy at the jailhouse door. You need it in order to do your job. And also to remain human.

Thanks to all of the many eloquent and insightful colleagues who contributed to this conversation.

NOTES:

*Samuels has taken down his website (svpexpertwitness.com), so I am providing a link to an old cached version.  

**Psychology ethicist Ofer Zur has written more on gift-giving in psychotherapy, with links to the gift-giving provisions of various professional ethics codes.

Diagnostic controversies: Registration open for my Hawaii workshop

A shameless plug for my upcoming training workshop in Honolulu, sponsored by the American Psychological Association. CE's in paradise; what's not to like? To register (or get more information), click HERE.

'Digital lynch mob' assaults expert witness in televised murder trial

Imagine you are testifying in a high-profile murder case being live-streamed over the Internet. Suddenly, an angry mob swarms all over you. More than 10,000 people sign an online petition urging a boycott of your lecture contracts. Your book gets a thousand negative hits on Amazon. You are stalked, and a photo of you dining with the trial attorney is posted on Facebook, implying unethical conduct. You even get death threats.

That is the social media-coordinated avalanche that hit domestic violence expert Alyce LaViolette, testifying for the defense in the capital murder trial of Jodi Arias. The unrelenting cyber assaults so rattled LaViolette that she suffered an anxiety attack that landed her in the emergency room.

But the ER visit may only encourage the cyber-stalkers, who revel online over her discomfiture and obvious emotional deterioration over the course of seven grueling days of court testimony.

This type of Internet mobbing, in which cyber-posses enforce social norms through public shaming, is becoming more and more commonplace. One of the most widely known examples of such Internet vigilanteism was the 2005 case of "Dog Poop Girl," a South Korean woman who gained infamy after she refused to clean up after her dog on a Seoul subway; the harassment eventually escalated to the point that she was forced to quit her university job. 

But what was LaViolette's crime?

The domestic violence counselor had the audacity to opine that Jodi Arias was a victim of domestic violence -- that she was dominated and abused (physically, emotionally and sexually) by the man she eventually killed. Such an opinion bolsters Arias's claim that she killed her ex-boyfriend in self defense.

Murder tragedies as entertainment

Unfortunately for LaViolette, her analysis runs counter to the dominant narrative in a gendered morality play produced by media conglomerate Turner Broadcasting and distributed through its cable channels HLN, CNN and In Session. In this good-versus-evil melodrama, Arias is a psychopathic female who killed a morally righteous man in a fit of jealous rage. Period. End of story. Airbrushed out are all the nuances, the shades of grey inevitably present in any such violent tragedy. 

The burgeoning infotainment industry has perfected a profit-making formula of sensationalized true-crime "reporting" that plays on viewers' emotions, whipping audiences into a frenzy of self-righteous indignation in which they clamor for guilty verdicts -- very often against female transgressors. Nancy Grace's shrill ranting over the Casey Anthony murder acquittal garnered HLN a record of almost three million viewers. More recently, HLN went after another woman, Elizabeth Johnson, suspected in the mysterious disappearance of her baby. 

The Arias case seems Heaven-sent for this voyeuristic style of entertainment, in which vulturous pundits mete out tantalizing morsels of crime "facts" to their addicted audience. Travis Alexander provides titillation from the grave via thousands of graphic emails, instant messages, texts and phone chats in which he degrades his paramour as a "whore," "slut," "corrupted carcass" and "three-hole wonder" whom he can sexually violate at will. For her part, Arias is a demonstrable liar. When her ex-boyfriend was found with a gunshot wound to the head, a slit throat, and more than two dozen stab wounds, she initially claimed innocence. After police demolished her alibi defense, she then claimed that two intruders broke into the home and killed Alexander, before finally admitting to the killing but claiming self defense.

Cast in the starring role of swashbuckling hero in this sordid drama is prosecutor Juan Martinez, a dapper man with a quick mind and an acerbic style, whose meteoric rise from the son of Mexican immigrants to a top government attorney is the stuff of American legend. Women line up outside the Maricopa County, Arizona courthouse, swooning at the sight of him as they jockey for photographs and autographs.

"This is murder trial as entertainment," Josh Mankiewicz, a correspondent for NBC's Dateline program (which ran two segments on the case), told reporter Michael Kiefer of the Arizona Republic. "This is not a trial like O.J. (Simpson's) that sheds new light on society. This is not about race or money. It's a perfect tabloid storm. It is occurring in the absence of any other tabloid storm."

Nancy Grace, "Dr. Drew" and the other pundits capitalizing on such trials foster a false sense of intimacy by calling everyone by first names. They encourage vicarious audience participation on Facebook, Twitter, online polls and other social media. But this is no value-neutral production. This is an archetypal trope that requires a guilty verdict; as one insightful media critic noted, acquittals do not produce the desired catharsis.

Public shaming run amok

In such an emotionally charged climate, anyone affiliated with the defense automatically becomes a villain. However, it is interesting to observe the disparate treatment of LaViolette as compared with a male expert witness, psychologist Richard Samuels. The prosecutor aggressively attacked them both. Playing not only to the jurors but to his sizeable out-of-court fan base, Martinez paced back and forth like a tiger smelling blood, demanding of his cornered prey that they give only "yes or no" answers to his myriad questions. Under his withering cross-examination, both witnesses came across as defensive and evasive. Both were vulnerable due to their confirmatory biases -- a failure to seek out evidence that might disconfirm their case theories. But, objectively, Samuels would seem to invite at least as much criticism as LaViolette, due to his bumbling style, his test scoring errors, and his questionable case formulation (he diagnosed posttraumatic stress disorder using a rating scale on which Arias endorsed a fictitious trauma, of witnessing Alexander's murder at the hands of imaginary intruders).

However, the public's palpable fury against LaViolette far outstrips that targeting Samuels. Consistent with the Turner Network's gendered narrative of criminal villainy, the cyber-posse is fueled by a potent combination of misogyny and homophobia: The expert witness in their crosshairs is "emasculating," "a bull dyke," "a man-hater," "fat," "buck-teethed," "a bitch."

The Internet fosters this culture of hate. Its cloak of anonymity is disinhibitory, emboldening people to spew bile with impunity. In The Cult of the Amateur, Andrew Keen warns that the deluge of anonymous online content is altering public debate, manipulating opinion, blurring the boundaries between experts and the uninformed and weakening the vitality of professional media -- newspapers, magazines, music and movies.

The proliferation of bottom-feeders on Twitter and YouTube is one thing. But it is quite another thing when cyber-bullying seeps into the courtroom, intimidating witnesses and threatening the presumption of innocence.

Can inundated jurors remain unbiased?

Legal experts worry that a virtual deluge of unreliable and biased information -- readily available at the click of the mouse or a TV remote -- is undermining jurors' neutrality. In their off hours, curious jurors in the Arias case can tune in not only to the cable TV and social media debacle, but can watch the defendant's entire videotaped police interrogation -- including excised portions -- as well as a police interview with Arias's parents, in which they speak of her mental problems. Pro- and anti-Arias websites have sprung up. And it's not just outsiders who are furiously Tweeting, texting and blogging about the case.  Witnesses are watching the trial from home and texting the prosecutor with suggestions for cross-examination. Jodi Arias herself is tweeting from the jail, through a friend. ("HLN is an acronym for Haters Love Negativity," she tweeted.)

It would be naive to suppose that the Arias jury is immune to the inflammatory rhetoric swirling around the Internet. Some of the more sarcastic questions that jurors submitted for the expert witnesses sounded scripted by Nancy Grace. For example, one juror asked psychologist Samuels whether a bad haircut could induce posttraumatic stress disorder (PTSD), Samuels's diagnosis for Arias.

Yet trial judge Sherry Stevens -- who allowed cameras into the courtroom in the first place -- is now relying on the honor system rather than regaining control by sequestering the jury.  Complained defense attorney Kirk Nurmi: "The court asks the question of the jurors every morning, 'Have you seen anything on the media?' No one raises their hand... It is a fairy tale to assume that this jury is not hearing any of this. It is all over the news."

Kiefer, the Arizona Republic reporter who broke the story of witness LaViolette's cyber-bullying, gave examples of juror social-networking misconduct in other cases: A Michigan juror who posted a Facebook preview of her verdict ("Gonna be fun to tell the defendant they're GUILTY"); a juror in Britain who polled her social-media "friends" as to whether she should find a defendant guilty.

With more and more successful appeals of verdicts due to such Internet or social-media interference, according to a Reuters Legal survey, an appeal of any guilty verdict in the four-month Arias trial is a virtual certainty.

But any appeal will not mend the reputations of the expert witnesses called by the defense. As a retired Maricopa County Superior Court judge told Michael Kiefer, the Arizona Republic reporter, "it's the electronic version of a lynch mob."

Sree Sreenivasan, a journalism professor at Columbia University, told Kiefer he had never seen anything like the attack on LaViolette, but that it likely will become "standard operating procedure in prominent cases" -- witness intimidation taken to its logical extreme in a public culture of shaming and vilification.

If so, experts may think long and hard before about accepting referrals in high-profile cases. That, in turn, could have a chilling effect on defendants' rights to a fair trial.

Michael Kiefer's insightful Arizona Republic reports on the social media debacle are HERE, HERE and HERE. A full collection of the live-streamed trial videos is located HERE.

Upcoming trainings: Assessment; personal injury; sexual violence; ethics in diagnosis

If you are planning to be in or around Florida, New Jersey, Hawaii or London over the next few months, here are some recommended forensic trainings on the horizon:

April 19 and onwards: Sexual violence workshops (London) 

Building on the success of the 2011 sexual violence workshops sponsored by the British Psychological Society (at which I spoke), Middlesex University is hosting another round of BPS-sponsored workshops on various aspects of sexual violence. Multiple-perpetrator rape is the topic of the first workshop, coming right up on April 19. (Also check out the new book, the first-ever text on this topic.) Next up are a June 27 workshop on "negotiating ethical sexual relationships," a Sept. 17 workshop on "intersectionality and sexual violence," and a fourth workshop on the investigation and prosecution of rape (date yet to be decided). All the workshops will be held at Middlesex University's Hendon Campus. More details are HERE.

April 20: Assessing Emotional Damages in Personal Injury and Employment Discrimination Cases (New Jersey)

William Foote, president of the American Psychology-Law Society (APA Division 41), will be presenting a five-stage model for assessing psychological damages in personal injury and workplace discrimination cases at the spring conference of the New Jersey Psychological Association. To find out more about this all-day training, click HERE.

May 3-5: New Directions in Forensic and Clinical Assessment (Florida)

Many big names in forensic psychology will descend upon Miami for this training sponsored by Division 42 (Psychologists in Independent Practice) of the American Psychological Association. The three-day conference will feature trainings on risk assessment, malingering, trial consultation, the DSM-5, intellectual disability, and much more. Information and registration can be found HERE. 


July 31: Controversial Psychiatric Diagnoses in Legal Settings (Hawaii) 

Yours truly is the trainer at this all-day continuing education workshop at the American Psychological Association's annual conference, along Honolulu's idyllic Waikiki Beach. I will focus on the scientific and practical limits of psychiatric diagnoses in forensic cases, and provide ethics guidance on how to present diagnostic testimony in court. Details are HERE; I'd love to see you there!

Risk screening worthless with juvenile sex offenders, study finds

Boys labeled as 'sexually violent predators' not more dangerous

Juveniles tagged for preventive detention due to their supposedly higher level of sexual violence risk are no more likely to sexually reoffend than adolescents who are not so branded, a new study has found.

Only about 12 percent of youths who were targeted for civil commitment as sexually violent predators (SVP's) but then freed went on to commit a new sex offense. That compares with about 17 percent of youths screened out as lower risk and tracked over the same five-year follow-up period.

Although the two groups had essentially similar rates of sexual and violent reoffending, overall criminal reoffending was almost twice as high among the youths who were NOT petitioned for civil commitment (66 percent versus 35 percent), further calling into question the judgment of the forensic evaluators.

Because of the youths' overall low rates of sexual recidivism, civil detention has no measurable impact on rates of sexual violence by youthful offenders, asserted study author Michael Caldwell, a psychology professor at the University of Wisconsin and an expert on juvenile sex offending.

The study, just published in the journal Sexual Abuse, is one in a growing corpus pointing to flaws in clinical prediction of risk.

It tracked about 200 juvenile delinquents eligible for civil commitment as Sexually Violent Persons (SVP's). The state where the study was conducted was not specified; at least eight of the 20 U.S. states with SVP laws permit civil detention of juveniles, and all allow commitment of adults based on offenses committed as a juvenile.

As they approached the end of their confinement period, the incarcerated juveniles underwent a two-stage screening process. In the first phase, one of a pool of psychologists at the institution evaluated them to determine whether they had a mental disorder that made them "likely" to commit a future act of sexual violence. Just over one in every four boys was found to meet this criterion, thereby triggering a prosecutorial petition for civil commitment.

After the initial probable cause hearing but before the final civil commitment hearing, an evaluator from a different pool of psychologists conducted a second risk assessment. These  psychologists were also employed by the institution but were independent of the treatment team. Astonishingly, the second set of psychologists disagreed with the first in more than nine out of ten cases, screening out 50 of the remaining 54 youths. (Only four youths were civilly committed, and a judge overturned one of these commitments, so ultimately all but three boys from the initial group of 198 could be tracked in the community to see whether or not they actually reoffended.)

Evaluators typically did not rely on actuarial risk scales to reach their opinions, Caldwell noted, and their methods remained something of a mystery. Youths were more likely to be tagged for civil detention at the first stage if they were white, had multiple male victims, and had engaged in multiple instances of sexual misconduct in custody, Caldwell found.

However, no matter what method they used or which factors they considered, the psychologists likely would have had little success in predicting which youths would reoffend. Even "the most carefully developed and thoroughly studied" methods for predicting juvenile recidivism have shown very limited accuracy, Caldwell pointed out. This is mainly due to a combination of youths' rapid social maturation and their very low base rates of recidivism; it is quite hard to successfully predict a rare event.

Indeed, a recent meta-analysis revealed that none of the six most well-known and best-researched instruments for appraising risk among juvenile sex offenders showed consistently accurate results. Studies that did find significant predictive validity for an instrument were typically conducted by that instrument's authors rather than independent researchers, raising questions about their objectivity.

"Juveniles are still developing their personality, cognitions, and moral judgment, processes that reflect considerable plasticity," noted lead author Inge Hempel, a psychology graduate student in the Netherlands, and her colleagues. "There are still many possible developmental pathways, and no one knows what causes persistent sexual offending."

Caldwell agrees with Hempel and her colleagues that experts' inability to accurately predict which juveniles will commit future sex crimes calls into question the ethics of civil commitment.

"From the perspective of public policy, these results raise questions about whether SVP commitment laws, as written, should apply to juveniles adjudicated for sexual offenses," he wrote. "If SVP laws could be reliably applied to high risk juvenile offenders, the benefit of preventing a lifetime of potential victims makes for a compelling case. However, the task of identifying the small subgroup of juveniles adjudicated for sexual offenses who are likely to persist in sexual violence into adulthood is at least extremely difficult, and may be technically infeasible."

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The articles are:

Michael Caldwell: Accuracy of Sexually Violent Person Assessments of Juveniles Adjudicated for Sexual Offenses, Sexual Abuse: A Journal of Research and Treatment. Request it from the author HERE.

Inge Hempel, Nicole Buck, Maaike Cima and Hjalmar van Marle: Review of Risk Assessment Instruments for Juvenile Sex Offenders: What is Next? International Journal of Offender Therapy and Comparative Criminology. Request it from the first author HERE.

Study links childhood trauma and adult aggression

Call for trauma-focused treatment of offenders

Children who experience abuse, neglect and family dysfunction have a heightened risk of developing health problems such as obesity, drug addiction, depression and heart disease in adulthood. That common-sense notion is widely accepted, and has been proven in a series of studies funded by the US Centers for Disease Control and Prevention (CDC) and Kaiser Permanente. The Kaiser-CDC project has amassed a large database of the life histories and health trajectories of middle-class residents of San Diego, California.

Now, a San Diego psychologist has deployed that project's Adverse Childhood Experiences (ACE) survey to link these negative childhood experiences with adult aggression and criminality, including domestic violence, sexual assault, stalking and child abuse.

In fact, the correlation is additive, the new study found: The more types of adversities a man underwent in childhood, the higher his likelihood of engaging in criminal aggression as an adult.

Men in the study who were referred to outpatient treatment following convictions for domestic violence, sexual offending, nonsexual child abuse or stalking reported about four times as many adverse childhood events as men in the general population. Men convicted of sex offenses and child abuse were especially likely to report being sexually abused as children.

The link between early damage and later aggression explains why treatment programs that focus primarily on criminal acts are not very effective, say psychologist James Reavis of San Diego, California and his colleagues.

"To reduce criminal behavior one must go back to the past in treatment, as Freud admonished us nearly 100 years ago," wrote Reavis and co-authors Jan Looman, Kristina Franco and Briana Rojas in an article slated for the Spring 2013 issue of The Permanente Journal. "Fortunately, evidence exists in support of both attachment-based interventions designed to normalize brain functioning and in the efficacy of psychoanalytic treatment."

Why the link between abuse and aggression?

Cumulative experiences of abuse and neglect disrupt both a child's ability to form secure attachments to others and his ability to regulate his emotions, the researchers posit. Thus, men abused as youngsters tend to either avoid intimacy altogether or are at risk to become violent in intimate relationships, due to a "bleeding out" of their suppressed inner rage.


Not only must treatment of offenders focus on healing their "neurobiological" wounds, the researchers say, but the findings also point to the need for more early childhood interventions to stop child abuse before its victims grow up to victimize others.

Stay tuned: A second article being prepared for publication will explore the link between early adversity and dysregulation in the hypothalamic-pituitary-adrenal axis that modulates stress responses.

The article, "Adverse Childhood Experiences and Adult Criminality: How Long Must We Live before We Possess Our Own Lives?" can be requested from the first author, psychologist James Reavis of San Diego (HERE). The article includes a copy of the ACE questionnaire, which is potentially useful in forensic cases as a means of quantifying experiences of child abuse and neglect.

Evaluating juveniles: Grisso's classic updated for new era

In the 1990s a moral panic swept through the United States over juvenile "super-predators," ruthless youngsters devoid of empathy or morality who would terrorize the good citizenry -- raping, looting and murdering with abandon. Although the hysterical, racially coded predictions proved unfounded (the spike in violent crime was just a historical blip on the radar screen), politicians passed harsh new laws that set the U.S. apart from all other nations in the magnitude of penal warehousing of children.

At the pinnacle of this frenzied "get-tough era" in juvenile justice, the eminent forensic psychologist Tom Grisso authored Forensic Evaluation of Juveniles, a groundbreaking text that guided practitioners into the burgeoning niche of psychological evaluations in delinquency cases.

Now, in a major overhaul of that influential 1998 text, Grisso writes optimistically of a new trend in juvenile justice that he labels the "developmental era." Social science evidence about adolescent brain development and social maturation will contribute to greater judicial and societal recognition that much delinquency is time-limited, he believes. Although this new direction comes too late for the youths and families shattered by the get-tough policies of the past few decades, Grisso hopes that forensic psychology can help judges, probation officers and policy makers understand the potential of rehabilitation for today's wayward youth.

Photo from Richard Ross's Juvenile In Justice photography project

I'm a little less sanguine about a newer, gentler era. Yes, the U.S. Supreme Court has outlawed the death penalty for juveniles, life without parole for crimes other than murder, and mandatory sentences of life without parole for murder.* But such reversals are a drop in the bucket so long as the punitive architecture remains in place that allows, for example, prosecutorial "direct-files" of juvenile cases to adult courts. We are living in an increasingly repressive culture. About 70,000 young people -- disproportionately poor and non-white -- are currently incarcerated in the U.S., many serving ridiculously long sentences that give them no chance of ever leading productive lives. 

Grisso's practical guide strikes a humanistic tone, refreshing in a field increasingly infiltrated by a gloomy, pathologizing, technocratic worldview. The award-winning director of the Law-Psychiatry Program at the University of Massachusetts Medical School for example cautions evaluators to avoid simple tallies of actuarial risk factors in informing the court of a youth's risk. Rather, evaluators should understand and incorporate the two broad, and complementary, theories of delinquency: The biological and personality-oriented theories of psychology, and the social-environmental theories of criminology, such as the notion of "drift" into delinquency. Evaluators should also understand the individual child's context, and the factors that contribute not only to pathology but also to resilience in the face of adversity.

Perhaps the most radical departure from the first edition is a newfound emphasis on understanding racial, ethnic and cultural factors, historically a major blind spot in forensic psychology. With non-white children comprising the overwhelming majority of those incarcerated in America, this principle cannot be overstated. Grisso addresses the barriers to even basic communication that will become all the more challenging as young immigrants arrive from far-flung lands, many carrying inside them the weight of untold traumas. Although he proffers no facile solutions, he preaches greater awareness of cultural blinders and of the inherent limitations of forensic tools that were not normed on diverse populations.

Disappointingly, given this humanistic tenor and discussion of racial and cultural issues, Grisso soft-pedals criticism of the growing practice of labeling juveniles as psychopaths. He describes evidence for the validity of the psychopathy construct in juveniles as "mixed," yet omits mention of the calamitous -- and often self-fulfilling -- consequences to youths when the psychopathy label is introduced in court.

Like the first edition, this is a practical manual that provides a clearly written historical overview of the field for novice practitioners, and useful review material for more seasoned juvenile evaluators. Chapters address specific types of evaluations, including competency to stand trial, waiver of Miranda rights, risk assessment, waiver to adult court, and rehabilitation and treatment recommendations. New statutes, case law, scientific findings and assessment methods are interwoven throughout, making this an indispensable addition to the juvenile evaluator's bookshelf.

If you found this review helpful, I would appreciate your taking a moment click to visit my Amazon review (HERE) and click on the "YES" button at the bottom ("this review was helpful"). This helps boost the review's ranking. Thanks in advance. 

*The cases are Roper v. Simmons (2005), Graham v. Florida (2010), and Miller v. Alabama (2012), respectively.

Miracle of the day: 80-year-old man recaptures long-lost youth

(Or: How committing a new sex crime can paradoxically LOWER risk on the Static-99R)

"How old is the offender?"

 Age is an essential variable in many forensic contexts. Older people are at lower risk for criminal recidivism. Antisocial behaviors, and even psychopathic character traits, diminish as criminals reach their 30s and 40s. Men who have committed sex offenses become at considerably lower risk for further such misconduct, due to a combination of decreased testosterone levels and the changes in thinking, health, and lifestyle that happen naturally with age.

Calculating a person's age would seem very straightforward, and certainly not something requiring a PhD: Just look up his date of birth, subtract that from today's date, and -- voila! Numerous published tests provide fill-in-the-blank boxes to make this calculation easy enough for a fourth-grader.

One forensic instrument, however, bucks this common-sense practice. The developers of the Static-99R, the most widely used tool for estimating the risk of future sexual recidivism, have given contradictory instructions on how to score its very first item: Offender age.

In a new paper, forensic evaluator Dean Cauley and PsyD graduate student Michelle Brownfield report that divergent field practices in the scoring of this item are producing vastly different risk estimates in legal cases -- estimates that in some cases defy all logic and common sense.

Take Fred. Fred is 80 years old, and facing possible civil commitment for the rapes of two women when he was 18 years old. He served 12 years in prison for those rapes. Released from prison at age 30, he committed several strings of bank robberies that landed him back in prison on six separate occasions.

At age 80 (and especially with his only known sex offenses committed at age 18), his risk for committing a new sex offense if released from custody is extremely low -- something on the order of 3 percent. But evaluators now have the option of using any of three separate approaches with Fred, with each approach producing quite distinct opinions and recommendations.

Procedure 1: Age is age (the old-fashioned method)

The first, and simplest, approach, is to list Fred's actual chronological age on Item 1 of the Static-99R. Using this approach, Fred gets a three-point reduction in risk for a total of one point, making his actuarial risk of committing a new sex offense around 3.8 percent.

Evaluators adopting this approach argue that advancing age mitigates risk, independent of any technicalities about when an offender was released from various periods of incarceration. These evaluators point to the Static-99R's coding manuals and workbook, along with recent publications, online seminars, and sworn testimony by members of the Static-99 Advisory Committee. Additionally, they point to a wealth of age-related literature from the fields of criminology and psychology to support their scoring.

Procedure 2: Reject the Static-99R as inappropriate

A second approach is not to use the Static-99R at all, because Fred's release from prison for his "index offenses" (the rapes) was far more than two years ago, making Fred unlike the members of the samples from which the Static-99R's risk levels were calculated. Evaluators adopting this approach point to publications by members of the Static-99 Advisory Committee, generally accepted testing standards and actuarial science test standards to support their choice to not use the test at all.

Procedure 3: The amazing elixir of youth

But there is a third approach. One that magically transports Fred back to his youth, back to the days when a career in bank robbing seemed so promising. (Bank robbery is no longer alluring; it is quietly fading away like the career of a blacksmith.) The last five decades of Fred's life fade away, and he becomes 30 again -- his age when he was last released from custody on a sex offense conviction.

Now Fred not only loses his three-point age reduction, but he gains a point for being between the ages of 18 and 34.9. A four point difference! The argument for this approach is that it most closely conforms to the scoring methods used on the underlying samples of sex offenders, who were scored based on their date of release from their index sexual offense. These evaluators can correctly point to information imparted at training seminars, advice given by some members of the Static-99R Advisory Committee, and sworn testimony by developers of the test itself. They can also point to an undated FAQ #27 on the Static-99 website to support their opinion.

Fred could rape someone to reduce his risk!

Back-dating age to the time of the last release from a sex offense-related incarceration allows for a very bizarre twist:

Let's say that after Fred was released from prison on his most recent robbery stint, back when he was a vigorous young man of 61, he committed another rape. Being 60 or over, Fred would now get the four-point reduction in risk to which his age entitles him. This would cut his risk by two-thirds -- from 11.4 percent (at a score of 5) all the way down to a mere 3.8 percent (at a score of 1)!

While such a scenario might seem far-fetched, it is not at all unusual for an offender to be released from prison at, say, age 58 or 59, but to not undergo a civil commitment trial for a couple of years, until age 60 or 61. Such an offender's score will vary by two points (out of a total of 12 maximum points) depending upon how the age item is scored. And, as Cauley and Brownfield describe, the members of the Static-99R development team have, at different times, given contradictory advice on how to score the age item.

By completely negating the very substantial body of research on age and crime, this technocratic method creates other very concerning -- and paradoxical -- implications, Cauley and Brownfield argue: As the risk estimate for a more persistent offender is lowered, the offender who does not reoffend is stuck with a risk score that is forever jacked up.

Back-dating an offender's age is also at odds with the research that generated the test itself, they say, because the offenders in the samples used to construct the Static-99R had finished serving their sentences on their index sexual offenses within two years of being studied. In other words, none of the offenders had been released many years earlier, and there was none of this curious time-travel business in regard to their ages. As the instrument's developers noted in a publication just last year, the Static-99 "was developed on, and intended for, sexual offenders with a current or recent sexual offense."

So, if you are evaluating an old geezer in the local pen and he tells you that he is only 30 years old, don't assume that he has a delusional belief that he has discovered the elixir of youth -- or that he's pulling your leg. He just might be reciting the age that he was just assigned by a technocratic Static-99R evaluator.

The paper, "Static-99R: Item #1 -- What is the Offender's Age? A lack of consensus leads to a defective actuarial," is available for download both HERE and HERE.

California high court upholds parolee confidentiality right

Two years ago, I reported on a California appellate opinion upholding the sacredness of patient-therapist confidentiality even for convicted felons who are mandated to treatment as a condition of parole. Today, the California Supreme Court upheld the gist of the ruling -- but with a proviso. Using strained logic, the court held that the breach of confidentiality was not so prejudicial as to merit overturning Ramiro Gonzales's civil commitment, as the Sixth District Court of Appeal had done.

Gonzales is a developmentally disabled man whose therapist turned over prejudicial therapy records to a prosecutor seeking to civilly detain him as a sexually violent predator (SVP). Forensic psychology experts Brian Abbott and Tim Derning testified for the defense; called by the prosecution were psychologists Thomas MacSpeiden and Jack Vognsen.

As I wrote two years ago, the ruling is good news for psychology ethics and should serve as a reminder that we are obligated to actively resist subpoenas requesting confidential records of therapy.

Today's California Supreme Court ruling is HERE. My prior post, with much more detail on the case, is HERE. The Sixth District Court of Appeal opinion from 2011, available HERE, provides a nice overview of both federal and California case law on confidentiality in forensic cases.

 

Hat tip: Adam Alban

Related blog posts:  

• Do sex offenders have right to confidential therapy? (Feb. 22, 2008)

• Confession to prison psychiatrist not confidential (Dec. 11, 2007)

• Treating therapist as police interrogator (Nov. 30, 2008)

• Abandon ethics, all ye who enter here: Special ethics exemption sought for SVP work (Oct. 6, 2010)

Note: Updated version of Sunday's post on "narcoanalysis"

For those of you following the case of Aurora Colorado mass murder suspect James Holmes and the judge's order that he be subjected to a "narcoanalytic interview" if he pleads insanity, I have updated the Psychology Today version of the post. The updated version explains where Judge Sylvester got the idea for this order, and discusses the fascinating landmark case of Ramona v. Ramona, in which a father successfully sued his daughter's therapists for implanting false memories of child sexual abuse during a sodium amytal interview; I've also referenced a curious side note in the Michael Jackson case involving sodium amytal.  Thanks to psychologist Evan Harrington of the Chicago School of Professional Psychology for alerting me to the Ramona opinion, which features an interesting discussion of relevant case law.

"Narcoanalytics" order in Aurora massacre case unprecedented

News flash: There is no such thing as 'truth serum'

The next time the court appoints you to conduct a sanity evaluation, don't forget to order up a vial of truth serum.

In a court order that breaks new legal ground, the judge presiding over the trial of James Holmes ordered the Aurora Colorado massacre suspect to submit to polygraph testing and a "narcoanalytic interview" if he decides to put his mental state at issue.

Chief District Judge William Sylvester ruled that if Holmes elects to pursue an insanity defense, "medically appropriate" drugs can be administered during a forensic examination at the state hospital, presumably to determine whether the mass murder suspect is feigning insanity.

This may be the first time that a court has mandated use of so-called "truth serum" in a sanity evaluation. Indeed, courts have generally taken the opposite stance, of being gatekeepers who exclude the results of both sodium amytal and polygraph examinations from court due to their lack of reliability.

"Mythical aura of infallibility"

In a seminal case, Harper v. State (1982), the George Supreme Court ruled that the use of "truth serum" (sodium amytal) was inadmissible to establish that a murder defendant was being truthful in proclaiming his innocence. "We agree with the trial court that, until it is proven with verifiable certainty that truth serum compels a person to tell the truth, neither the results of truth-serum tests nor the opinions of experts based on the results of these tests shall be admissible in evidence," ruled the court.

Similarly, a defense-retained psychologist published an account of another case from the 1980s in which an appellate court upheld exclusion of "a sodium amytal test" to bolster an insanity defense. The defendant had walked into a nightclub and shot to death a dancer who had jilted him. Under the influence of the barbiturate, the man claimed he thought he was shooting Satan, because the victim had appeared to morph into the devil, "with pitchforks … and fire and everything." In excluding mention of the test, the trial judge expressed worry that a jury "might be overwhelmed by the use of the term 'sodium amytal' and/or 'truth serum' and attribute to it a mythical aura of infallibility."

Back in the 1930s and 1940s, when sodium amytal was all the rage, laypersons and professionals alike believed that people could not lie when under the drug's influence. It turns out that this faith was misguided. Empirical testing showed that although sodium amytal and related drugs lower inhibitions, people remain perfectly capable of lying, withholding information, and exaggerating psychiatric symptoms.

"While it is clear that these substances lower inhibitions and increase loquacity, they provide no assurance as to the truthfulness of the information obtained,” noted attorney Jason Odershoo in a Stanford Law Review analysis focusing on whether such chemicals may legally be deployed against terrorism suspects in the post-9/11 world.

Sodium amytal, or amobarbital, belongs to the same class of barbiturates as Nembutal, Seconal, and Pentothal. As psychiatrist August Piper Jr. describes the procedure, a physician intravenously administers small amounts of the drug (sometimes in tandem with other intravenous drugs like Valium or Ativan) until the subject enters a "twilight state" in which he is relaxed and drowsy but still awake. The drug causes a feeling of warmth and "closeness to the interviewer" that breaks down inhibitions, similar to the effects of acute alcohol intoxication.

However, while sodium amytal makes people more loquacious, it also disrupts memory and increases suggestibility, according to the research summarized by Piper. Reality and fantasy may become hopelessly tangled, such that people cannot distinguish between the two.

Cultural fascination with truth serum in the mid-20th century completely ignored this flawed reality. Rather, the mythology helped to shape the public's understanding of memories as robust and accurate, stored verbatim in the mind just awaiting proper retrieval and extraction. As Alison Winter writes in a 2005 essay on the cultural history of truth serum:

"This view contributed to the production of a public understanding of memory that both diverged from previous claims about memory and recall, and ran counter to the direction of current psychological research. It thus helped lay the groundwork for claims about memory permanence and scientific recall techniques later in the twentieth century."

Perils in Holmes's case

James Holmes's new look

The empirical research suggests not only that Holmes could lie while under the influence of the drugs, but also that subjecting him to a "narcoanalytic interview" could introduce false memories and render his subsequent recall of information potentially even less reliable. As with post-hypnosis statements, this could be a big problem if Holmes decides to testify on his own behalf, either at a trial or a sentencing hearing. Similarly, unreliable information recounted to evaluators during a "narcoanalytic interview" could be given too much credence, thereby jeopardizing the validity of forensic opinions in the case.

But maybe such contamination is the point, writes a commentator at the American Everyman blog. Under the alarmist headline, "Holmes to be Drugged Into Confession -- Apparently Waterboarding is Off the Table," Scott Creighton theorizes: "This 'truth serum' CIA trick will be used to convict Holmes in the court of public opinion before his Vichy lawyers plead him out to life in prison rather than taking it to trial to evaluate the evidence against him." 

Given the recent dispositions of other similar cases such as that of Arizona mass shooter Jared Loughner, maybe the conspiratorially minded blogger is not so far off the mark.

The CIA and a zombie idea

The notion of a magical drug that can ferret out malingering represents a "zombie idea," to borrow a phrase from New York Times essayist Paul Krugman. That is, it is a proposition that has been thoroughly refuted by analysis and evidence, and should be dead -- but stubbornly refuses to stay dead because it serves a political purpose or appeals to public prejudices.

Indeed, Judge Sylvester's court order harkens back to the early to mid-20th century, a time when -- as legal analyst Odershoo recounts -- "the idea of such a magical substance seemed a very real possibility, one holding profound significance for criminal investigation, foreign intelligence, and national security."

The term "truth serum" was coined in the early 1920s by an obstetrician named Robert House, who advocated the use of the barbiturate Scopolamine -- now known as a date-rape drug because of its amnestic properties but at the time administered to women during childbirth to induce a 'twilight sleep' -- in criminal interrogations. Time magazine's 1923 piece, "Medicine: The Truth-Compeller," helped popularize the idea and turned House into a one-hit wonder. In the 1930s, police use of barbiturates on witnesses and criminal suspects became more widespread. During World War II sodium pentothal was used both to treat soldiers suffering from "shell shock" and to detect malingerers trying to duck the military draft.

Then, during the Cold War, the CIA launched a feverish quest for the ultimate "truth drug." Clandestine campaigns with code names such as Projects Chatter, Third Chance, Derby Hat and Bluebird culminated in the ill-fated MK-ULTRA, in which a doctor who was administered LSD leapt to his death from a hotel room window. Revelations of this secret experimentation led to public antipathy towards the spy agency, and a demise in the use of sodium amytal and sodium pentothal as truth serums.

The drugs remain in use as anesthetics, and have also been used by psychotherapists seeking to recover repressed memories. This use has its own sordid history. In 1992, a former patient of eminent Chicago psychiatrist Jules Masserman published an account claiming that the good doctor had repeatedly raped her after administering sodium amytal, purportedly to retrieve her repressed memories of incest. The patient, Barbara Noel, was not the only woman to win a lawsuit over such nefarious abuse.

Legal use officially repudiated 

Use in law enforcement fell rapidly in the wake of a 1963 U.S. Supreme Court ruling that a confession produced under the influence of truth serum was unconstitutionally coerced, and therefore inadmissible. The case of Townsend v. Sain involved a heroin addict who was interrogated after being administered phenobarbital and hyoscine (Scopolamine) to alleviate his withdrawal symptoms. Although India and some other countries still use these drugs in criminal investigations, in the United States their use for that purpose has been "officially repudiated," according to Odershoo.

A scan of the case law suggests that this is by far the most serious case in which narcoanalysis has ever been proposed. Holmes is awaiting trial on 166 felony charges for an attack on Batman moviegoers last July that killed 12 people and wounded 58. His attorneys have mounted a heretofore unsuccessful challenge to Colorado's insanity statute and the judge's interpretation of it. Under Colorado law, the test for insanity is whether the person "who is so diseased or defective in mind at the time of the commission of the act as to be incapable of distinguishing right from wrong with respect to that act." Judge Sylvester has ordered that, if Holmes pleads insanity, he must divulge all information from past mental health treatment. Holmes was seen by a psychiatrist and at least two other mental health professionals at the counseling center of the University of Colorado, where he was a PhD student in neuroscience before withdrawing from school, and his treatment records may contain potentially incriminating information. Such forfeiture of doctor-patient privilege is standard in criminal law when a defendant puts his mental state at issue.

Malingering detection

Holmes's elaborate degree of planning for his attack over at least a four-month period certainly raises a distinct possibility that any claim of mental illness may be feigned. But while no method is foolproof, other techniques have a far better track record at sniffing out deception.

Judge William Sylvester

We have a constantly growing arsenal of formal tools for the assessment of various types of malingering. Especially in high-stakes cases such as this, formal tests are typically augmented by 24/7 observation in psychiatric facilities. It's pretty hard to consistently masquerade as insane when one is under around-the-clock observation by everyone from the doctors and nurses to the janitors. Even one of the most slippery malingerers of insanity, a Mafia don named Vincent "The Chin" Gigante, eventually tripped up and got nailed. 

Judge Sylvester's order is so far removed from both contemporary scientific knowledge and normal legal procedure that it has left many observers scratching their heads. Where did the judge get the wacky idea that truth serum is the way to go? Did he cook it up himself, or was it fed to him by someone who had read a few too many "true crime" books or spy thrillers? Vaughan Bell over at Mind Hacks went so far as to wonder whether "the judge has been at the narcotics himself."

NOTE: An updated version of this essay appears at my Psychology Today blog. That essay explains where Judge Sylvester got this wacky idea, and also references the landmark case of Ramona v. Ramona, in which a father successfully sued his daughter's therapists for implanting false memories of child sexual abuse during a sodium amytal interview, as well as the role of sodium amytal in the Michael Jackson case.  Thanks to psychologist Evan Harrington of the Chicago School of Professional Psychology for alerting me to the Ramona opinion, which features an interesting discussion of relevant case law.

A full set of court documents in the Holmes case is located HERE.