'Authorship bias' plays role in research on risk assessment tools, study finds

Reported predictive validity higher in studies by an instrument's designers than by independent researchers

The use of actuarial risk assessment instruments to predict violence is becoming more and more central to forensic psychology practice. And clinicians and courts rely on published data to establish that the tools live up to their claims of accurately separating high-risk from low-risk offenders.

But as it turns out, the predictive validity of risk assessment instruments such as the Static-99 and the VRAG depends in part on the researcher's connection to the instrument in question.

Publication bias in pharmaceutical research
has been well documented

Published studies authored by tool designers reported predictive validity findings around two times higher than investigations by independent researchers, according to a systematic meta-analysis that included 30,165 participants in 104 samples from 83 independent studies.

Conflicts of interest shrouded

Compounding the problem, in not a single case did instrument designers openly report this potential conflict of interest, even when a journal's policies mandated such disclosure.

As the study authors point out, an instrument’s designers have a vested interest in their procedure working well. Financial profits from manuals, coding sheets and training sessions depend in part on the perceived accuracy of a risk assessment tool. Indirectly, developers of successful instruments can be hired as expert witnesses, attract research funding, and achieve professional recognition and career advancement.

These potential rewards may make tool designers more reluctant to publish studies in which their instrument performs poorly. This "file drawer problem," well established in other scientific fields, has led to a call for researchers to publicly register intended studies in advance, before their outcomes are known.

The researchers found no evidence that the authorship effect was due to higher methodological rigor in studies carried out by instrument designers, such as better inter-rater reliability or more standardized training of instrument raters.

"The credibility of future research findings may be questioned in the absence of measures to tackle these issues," the authors warn. "To promote transparency in future research, tool authors and translators should routinely report their potential conflict of interest when publishing research investigating the predictive validity of their tool."

The meta-analysis examined all published and unpublished research on the nine most commonly used risk assessment tools over a 45-year period:

• Historical, Clinical, Risk Management-20 (HCR-20)
• Level of Service Inventory-Revised (LSI-R)
• Psychopathy Checklist-Revised (PCL-R)
• Spousal Assault Risk Assessment (SARA)
• Structured Assessment of Violence Risk in Youth (SAVRY)
• Sex Offender Risk Appraisal Guide (SORAG)
• Static-99
• Sexual Violence Risk-20 (SVR-20)
• Violence Risk Appraisal Guide (VRAG)

Although the researchers were not able to break down so-called "authorship bias" by instrument, the effect appeared more pronounced with actuarial instruments than with instruments that used structured professional judgment, such as the HCR-20. The majority of the samples in the study involved actuarial instruments. The three most common instruments studied were the Static-99 and VRAG, both actuarials, and the PCL-R, a structured professional judgment measure of psychopathy that has been criticized criticized for its vulnerability to partisan allegiance and other subjective examiner effects.

This is the latest important contribution by the hard-working team of Jay Singh of Molde University College in Norway and the Department of Justice in Switzerland, (the late) Martin Grann of the Centre for Violence Prevention at the Karolinska Institute, Stockholm, Sweden and Seena Fazel of Oxford University.

A goal was to settle once and for all a dispute over whether the authorship bias effect is real. The effect was first reported in 2008 by the team of Blair, Marcus and Boccaccini, in regard to the Static-99, VRAG and SORAG instruments. Two years later, the co-authors of two of those instruments, the VRAG and SORAG, fired back a rebuttal, disputing the allegiance effect finding. However, Singh and colleagues say the statistic they used, the receiver operating characteristic curve (AUC), may not have been up to the task, and they "provided no statistical tests to support their conclusions."

Prominent researcher Martin Grann dead at 44

Sadly, this will be the last contribution to the violence risk field by team member Martin Grann, who has just passed away at the young age of 44. His death is a tragedy for the field. Writing in the legal publication Das Juridik, editor Stefan Wahlberg noted Grann's "brilliant intellect" and "genuine humanism and curiosity":

Martin Grann came in the last decade to be one of the most influential voices in both academic circles and in the public debate on matters of forensic psychiatry, risk and hazard assessments of criminals and ... treatment within the prison system. His very broad knowledge in these areas ranged from the law on one hand to clinical therapies at the individual level on the other -- and everything in between. This week, he would also debut as a novelist with the book "The Nightingale."

The article, Authorship Bias in Violence Risk Assessment? A Systematic Review and Meta-Analysis, is freely available online via PloS ONE (HERE).

Related blog reports:

• Violence risk instruments overpredicting danger (Aug. 2, 2012) 
• Violence risk in schizophrenics: Are forensic tools reliable predictors? (Sept. 14, 2011) 
• Violence risk meta-meta: Instrument choice does matter (June 19, 2011)
• Psychology rife with inaccurate research findings (Nov. 20, 2011)
• International violence risk researchers launch free news service (June 13, 2013) 

Violence prevention: DC to host major collaborative venture

From U.S. Attorney General Eric Holder to legal scholar Barbara Bennett Woodhouse, the speakers at next month's APA-ABA collaborative conference read like a who's who in the field of violence prevention.

To give a flavor:

• Carl Hart, the neuroscientist whose memoir I recently featured, will speak on the contribution of U.S. drug policy to violence
• James Garbarino, author of the terrific book Lost Boys: Why Our Sons Turn Violent and How We Can Save Them, will address the developmental effects of violence -- a topic that forensic psychologists confront daily in our practices
• Mary Ann Dutton, a leading researcher on domestic violence, will discuss preventing intimate partner violence
• Patrick Tolan and Dewey Cornell will address youth violence in the schools 
• Judge Jay Blitzman and colleagues will talk about disrupting the 'cradle to prison pipeline' by implementing alternatives to school suspension and exclusion 
• Charlotte Patterson, a pioneer in LGBT research, will focus on reducing violence against sexual minorities 
• Mark Soler, an attorney who taught my media law class way back in journalism school, will speak on alternatives to incarceration in juvenile justice 
• Edward Mulvey will address mental illness and substance abuse in violence 

And that's just for starters. With more than 40 plenary and invited sessions, the lineup goes on and on, with a wide array of programming that should appeal to psychologists, attorneys, judges, legal and social science scholars, and anyone else interested in the roles of law and psychology in addressing the effects of violence:

• Intergenerational transmission of violence
• Violence in Native American communities
• Offender reentry
• Risk assessment and threat assessment
• Hate crimes
• Poverty and race in violence
• Sexually violent offenders
• Violence among military veterans
• Elder abuse
• and much more

A major goal of the conference, entitled "Addressing the Unspeakable: Confronting Family and Community Violence, The Intersection of Law and Psychology," is to build on the momentum of Eric Holder's Defending Childhood initiative, which aims to address the effects of violence on children, youth and families.

The conference is co-sponsored by the American Psychological Association and the American Bar Association, and continuation education credits will be provided for both legal and mental health professionals. Early registration ends this week, so register now if you're planning to attend.

The preliminary program is HERE; an overview of the event and its logistics is HERE; the online registration form is HERE. 

8-year prison term in long-running Ayres saga

The up-and-down case of a child psychiatrist who sexually molested boys sent to him by the courts for counseling has finally concluded -- at least for now. William Ayres, 81, pleaded no contest to molesting five boys and was sentenced this week to eight years in prison.

The case has been slogging through the courts for as long as this blog has been around, in large part due to disputes over Ayres's competency. Ayres is suspected of molesting dozens of boys over a period of several decades, but many cases were beyond the statute of limitations.

The case had all of the elements of high drama: A once-respected child psychiatrist accused of molesting vulnerable boys sent to him by the courts. Allegations that prosecutors turned a blind eye. Pressure from victim's rights lobbyists. And, of special interest to this blog's readers, a bevy of mental health experts presenting contradictory evidence.

After a jury trial on the issue of competency ended in a deadlock in 2011, both sides stipulated that Ayres was incompetent due to dementia. He spent about nine months at Napa State Hospital -- where defendants in Northern California are sent for competency restoration treatment -- before the hospital decided that he was faking dementia in an elaborate ruse to avoid trial. He was finally found competent to stand trial after a four-day court hearing late last year.

At his sentencing hearing, victims -- now adults, some with children of their own -- spoke of the traumatic effects of being victimized by someone in a position of trust. As evidence that the former head of the American Academy of Child and Adolescent Psychiatry knew the damage he was inflicting, one former victim even read an excerpt from a journal article Ayres co-authored entitled "Practice Parameters for the Forensic Evaluation of Children and Adolescents Who May Have Been Physically or Sexually Abused."

Victims and their family members burst into applause when Ayres was sentenced, hugging and rejoicing over their victory in a lengthy and uphill struggle for justice, according to a news report in the San Mateo County Times.

But the fight may not be quite over yet: Ayres' attorney warned in court that the wheelchair-bound octogenarian may seek to withdraw his no contest pleas.

My prior blog posts on this case include: 

• Ayres case: Final act in long-running competency drama? Notorious psychiatrist found fit for trial on molestation charges (Nov. 24, 2012)
• Psychiatrist accused of faking dementia to thwart retrial (Aug. 5, 2012)
• Professionals behaving badly: Mistrial in psychiatrist molestation case (July 27, 2009)
• Lesson to abusers: Target socially disempowered (April 23, 2007)

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

Deaths at Minnesota detention site bringing public scrutiny

State legislator calls SVP practices Unconstitutional 

Two back-to-back deaths at Minnesota's draconian Moose Lake facility have prompted new calls for reform of the United States' largest per capita preventive detention apparatus. More than 600 men are being indefinitely warehoused behind razor wire at Moose Lake, after having served prison terms for sexual offending. Only one has ever been released.

Yesterday, a state legislator publicly decried the state's current civil detention practices as Unconstitutional, in an interview on Minnesota Public Radio.

LISTEN TO THE INTERVIEW (7 MINUTES)

"Minnesota just can't continue to … lock people up with no hope of release. It isn't Constitutional, and I think there's wide recognition of that fact," said Rep. Tina Liebling, who is leading reform efforts.

Moose Lake

In the wake of a federal class-action lawsuit by detainees, a federal task force recommended a number of changes to the program. But the state legislature is balking at implementing changes, which could include setting up alternative placement facilities and wrestling some power away from the Moose Lake treatment bureaucracy by giving the courts more discretion and mandating bi-annual case reviews by independent forensic experts.

Liebling said that out of the 20 U.S. states with laws allowing civil incapacitation of dangerous sex offenders after they have completed their prison terms, no other state has a "one-size-fits-all" procedure that doesn't allow for any hope of release.

"We can't hold people for their entire lives because we are worried about what they might do in the future," she told reporter Cathy Wurzer. "Unless we're prepared to lock up everybody who might pose any kind of risk … we need to get better at dealing with people as individuals … [and not solely based on] what they did 10 or 15 or 20 years ago."

Liebling expressed optimism about increasing public interest and knowledge stemming from the class-action lawsuit and recent deaths, which included one suicide and one of unexplained causes. "This is definitely something the public needs to be aware of…. People need to know that there are sex offenders living among us, and most of them are doing so successfully."

* * * * *

Related blog posts: 

"Most civilly detained sex offenders would not reoffend, study finds: Other new research finds further flaws with actuarial methods in forensic practice" (July 18, 2013) 

Blogger urges new paradigm for sex offenders (Feb. 23, 2012)

Challenge to Minnesota commitment gains ground (Sept. 23, 2012)

Cluelessness, complacency and the great unknown

The case of the self-blind psychologist

An experienced forensic psychologist -- let's call him Dr. Short -- applies for a job as a forensic evaluator. He is rejected based on his written work sample. He files a formal protest, insisting that the report was fine.

As you all know, forensic reports should be (in the words of an excellent trainer I once had) both "fact-based" and "fact-limited." In other words, we must (a) carefully explain the data that support our opinion, and (b) exclude irrelevant information, especially that which is intrusive or prejudicial.[1]

Dr. Short's report was neither fact-based nor fact-limited. The adduced evidence did not support his forensic opinions, and the report was littered with extraneous material insinuating bad moral character. We learned of the subject's unorthodox sexual tastes and former gang associations, neither of which were relevant to the very limited forensic issue at hand. Using ethnic terms to describe the subject's hair, Dr. Short inadvertently revealed more about his biases than about the subject.

Obviously, based on his vehement insistence that his report was fine, Dr. Short was blind to these deficiencies. Which got me to thinking: Since biases are largely unconscious, can people be made aware of them? Can blind spots be overcome? How can we come to understand what we do not know?

"The anosognosia of everyday life"

Pondering these questions in connection with one of my seminars at Bond University, I stumbled across some intriguing philosophical discourse on the various types of unknowns, and how to remedy them:

The simplest type of unknown has been labeled a "known unknown." This is something we don't know, and know we don't know. Let’s say you learn that someone you are evaluating in a sanity proceeding had ingested an obscure substance just before the crime. If you don’t know the substance’s potential effects, the solution is straightforward (assuming you are motivated): Do the research.

In some cases, we know the question, but no answer exists. For example, we know that six out of ten individuals who score as high risk on actuarial instruments will not reoffend violently, due to the base rates of violence. What we don’t know is how to distinguish the true from false positives. So that’s a known unknown with an unknown answer. But if we are at least aware of the issue, we can explain the field’s empirical knowledge gap in our reports.

However, unknown unknowns [2] are an entirely different kettle of fish. These are things we don't know and don't realize that we don't know. We don't know that there even IS a question that needs to be asked. Without being able to frame the question, we obviously cannot figure out an answer. Put simply: We are clueless.

Unknown unknowns are a major problem in forensic psychology, with its dearth of racial, ethnic and cultural diversity among researchers and practitioners.[3] Vast experiential divides lead evaluators to impose their own moral standards without even realizing they are doing so. In condemning his subject's sexual promiscuity and drug use, for example, Dr. Short made false and universalizing assumptions that revealed ignorance of lifestyles other than his own. (This reminded me of an African American prisoner’s dilemma interacting with white guards in remote, rural prisons; because the farming communities from which these guards were recruited are devoid of mainstream African Americans, the guards tended to assume that all Black people had the characteristics of Black convicts.)

"The anosognosia of everyday life" is the rather gloomy term coined by David Dunning of Cornell University, who specializes in decision-making processes, to describe such routine ignorance.[4] Dunning is a great believer in ignorance as a driving force that shapes our lives in ways in which we will never know. 

"Put simply, people tend to do what they know and fail to do that which they have no conception of. In that way, ignorance profoundly channels the course we take in life."

Apropos of Dr. Short's report, Dunning notes that cluelessness on the part of a so-called expert does not imply dishonesty or a lack of caring:

"People can be clueless in a million different ways, even though they are largely trying to get things right in an honest way. Deficits in knowledge, or in information the world is giving them, leads people toward false beliefs and holes in their expertise."

Laziness a major culprit

Unknown unknowns are not unfathomable mysteries that can never be solved. They are caused by laziness and complacency, which block the process of discovery as surely as a dam holds back water. It’s what German cognitive scientist Dietrich Dorner was talking about when he wrote, in The Logic of Failure, that “to the ignorant, the world looks simple.”[5] We’ve all known people who are incompetent, but whose very incompetence masks their ability to recognize their incompetence. There’s even an unwieldy term for this condition (named after the researchers who studied it, naturally): Just call it the Dunning-Kruger Effect. Quoting Dunning yet again: 

"Unknown unknown solutions haunt the mediocre without their knowledge. The average detective does not realize the clues he or she neglects. The mediocre doctor is not aware of the diagnostic possibilities or treatments never considered. The run-of-the-mill lawyer fails to recognize the winning legal argument that is out there. People fail to reach their potential as professionals, lovers, parents and people simply because they are not aware of the possible."

Before leaving the topic of the great unknowns, I must mention one final type of unknown, an especially pernicious one in forensic work. Unknown knowns, which undoubtedly beset Dr. Short, are unconscious beliefs and prejudices that guide one’s perceptions and interactions. Perhaps the 19th century humorist Josh Billings captured the quality of these unknowns the best when he wryly observed:

"It ain't what you don't know that gets you into trouble. It's what you think you know that just ain't so." [6]

Tackling the great unknown

So, is there any hope for our wayward Dr. Short, oblivious to his biases and blind spots? The answer, as in many facets of life, is: It depends. One of the most elementary lessons one learns as a novice psychologist is that people don’t change unless they are motivated to change. (Hence, a whole area of psychology devoted to enhancing motivation to change, through so-called “motivational interviewing.”) Effective change is rarely compelled. If Dr. Short is open to feedback and correction, this experience could be a wake-up call. On the other hand, his very protest speaks to an impaired capacity for self-reflection, a brittle ego defense that may be difficult to penetrate.

Either way, Dr. Short's dilemma can serve as a lesson for others, including both students and practitioners. The key to opening the locks on the dam of knowledge is readily available: It is simply a genuine desire to learn, and a willingness to confront life’s complexities. To those with a thirst for knowledge, the world is complex, and that complexity is what makes it so fascinating.

Here, in a nutshell, is the advice I gave to the graduate students at Bond during last week’s lecture that touched on the paradoxes of the unknowns:

If you haven't faced it, it's not easy to imagine this life

• To reduce the unknown unknowns, seek broad knowledge. Seek out people from other walks of life, who may not share your views or experiences. Travel outside your comfort zone, not just geographically but in other local cultures as well. These experiences can open one’s eyes to difference. Travel vicariously by reading widely, especially OUTSIDE of the insular, micro-focused and ahistorical field of psychology.

• Study up on cognitive biases and how they work. Especially, understand confirmatory bias, and build in hypothesis testing (including the testing of alternate hypotheses) as a routine practice. (Excellent resources on cognitive biases include Nate Silver's The Signal and the Noise and Carol Tavris and Elliot Aronson's Mistakes Were Made (but not by me), which brilliantly and unforgettably explains how two people can start out much the same but diverge dramatically so that they ultimately stare at each other as strangers across a great chasm.)

• Create formal feedback loops so that you learn how cases you were involved in were resolved, how your work was received, and whether your opinions proved accurate. 

• Don't assume you know the answer. Ask questions. And then ask more questions. 

• Stay humble. Arrogance, or overconfidence in one’s wisdom, can short-circuit understanding as surely as TSA security checkpoints destroy the fun of flying. (That rather strained metaphor is a clue that this post was penned from 40,000 feet in the air.)

• Finally, and most critically: When you look across the table, try to see a fellow human being, someone who perhaps lost their way in life's dark wood, rather than an alien or a monster. Before you judge someone, try to walk a mile in his shoes.

Ultimately, Dr. Short's dilemma flows not only from complacency but from an essential deficit in empathy, an inability to truly see -- and understand -- the fellow human being sitting across from him in that forensic interview room.

* * * * *

Notes

1. This is discussed in both the American Psychological Association's Ethics Code (Standard 4.04, Minimizing Intrusions on Privacy, states that psychologists should include in written reports "only information germane to the purpose for which the communication is made") as well as the Specialty Guidelines for Forensic Psychology (see, for example, 10.01, Focus on Legally Relevant Factors).


2. The term "unknown unknown" is sometimes credited to US Secretary of Defense Donald Rumsfeld, who used it to explain why the United States went to war with Iraq over mythical Weapons of Mass Destruction (WMD’s). Although the phrase gained currency at this time, others had already used it. 


3. Heilbrun, K., & Brooks, S. (2010). Forensic psychology and forensic science: A proposed agenda for the next decade. Psychology, Public Policy, and Law, 16, 219-253. 


4. For further conversation on this topic, see: Morris, E. (2010, June 20), The anosognosic's dilemma: Something's wrong but you'll never know what it is, New York Times blog.  Also see: Dunning, D. (2005). Self-Insight: Roadblocks and Detours on the Path to Knowing Thyself (Essays in Social Psychology), Psychology Press, p. 14-15; Dunning, D. & Kruger, J. (1999), Unskilled and Unaware of It: How Difficulties in Recognizing One’s Own Incompetence Lead to Inflated Self-Assessments, Journal of Personality and Social Psychology 77 (6), 1121-1134. 


5. I cribbed the Dorner quote from Dr. Wayne Petherick, Associate Professor of Criminology and coordinator of the criminology program at Bond University. 


6. Some attribute this quote not to Josh Billings but to Mark Twain, who was kicking around at the same time. Others claim it was neither. For now, the true origin of the quote is just one more of life's unknowns.