Multiple personality excluded in Texas insanity case

A serial rapist’s attempt to claim insanity based on multiple personality disorder fell flat, as a judge ordered the expert's trial testimony stricken from the record as junk science.

Billy Joe Harris

Psychiatrist Colin Ross testified that Billy Joe Harris, the so-called "Twilight Rapist" who targeted elderly women, suffered from multiple personality disorder -- now known as dissociative identity disorder (DID) -- brought on by childhood abuse.

Ross, who runs the Colin A. Ross Institute that provides trainings on psychological trauma and dissociative identity disorder, testified that the condition’s presence in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association establishes it as a "real and valid disorder."

Ross testified that he gave the defendant three tests for DID. However, in a most unusual procedure, rather than personally administering the tests, he gave them to the defense attorney to administer. Thus, he has no way of knowing for sure who filled in the tests, or under what circumstances. 

Ross testified that the defendant's scores on a screening test, the Dissociative Experiences Scale, were so high that he questioned the test's validity. He also conceded that the defendant was "clearly telling stories that are not true" about other aspects of his life, for example falsely claiming to have served in Iraq when he was actually in Saudi Arabia. However, Ross testified that after getting a chance to talk personally with one of Harris's alters, "Bobby," he was convinced of Harris's claim of multiple personalities.

"I don't think he's faking the dissociative identity disorder," he testified. "I could be wrong."

The real culprit, David the Dog

The defendant, a former prison employee, also took the witness stand, "weaving tales of bestiality, aliens, transvestites and combat heroism," in the words of news reporter Sonny Long. Harris testified that he had three other personalities inside him, including a black Great Dane named David who committed the rapes.

A dramatic moment came during cross-examination, when prosecutor Bobby Bell asked to speak to the defendant's alter, also named Bobby. As Long described the scene:

Harris lowered his head momentarily, raised it back up, rolled his neck and declared in a deep voice to be "Bobby."

Several jurors stifled laughter during the subsequent give-and-take between Harris and Bell, according to Long's account in the Victoria Advocate.

But perhaps even more damaging to Harris's credibility was an audiotape played for the jury in which he talks to his girlfriend about having put on "a good show" in court one day. Earlier that day, he had fallen to the floor and twitched and shook until he was restrained. The girlfriend warned Harris that the telephone call was being recorded, to which Harris replied, "I know it."

Forensic psychologist Walter Quijano also testified for the defense. (If the name sounds familiar, he has been in the spotlight for using race as a risk factor in death penalty cases, as I recently blogged about.) He testified that when multiple personality popped up as an issue, he stepped back because that is not an area of expertise for him. However, he did testify that it is unusual for someone to begin a rape career so late in life. Harris is 54.

Mere presence in DSM doesn’t establish validity

After the defense rested, the prosecution called as a rebuttal witness a Minnesota psychologist and attorney who has made a crusade out of pushing so-called "junk science" out of the courts.

Robert Christopher Barden testified that dissociative identity disorder (aka multiple personality disorder) is a controversial condition looked upon with skepticism by the scientific mainstream. He cited several articles rejecting the condition as a viable diagnosis, despite its presence in the DSM.

"Because something is in the DSM doesn't mean it's reliable or should be allowed in a court of law," he testified, according to an article in the Victoria Advocate. "One of the ways to get junk science out of the legal system is you rely on the relevant scientific community. If something is controversial it means it's not generally acceptable."

Barden said the number of mental health professionals who tout dissociative identity disorder as viable are few and far between.

"There are a few pockets of people left who are doing this," he said. "The scientists I know condemn it to be the worst kind of junk science and dangerous to the public. Controversial and experimental theories should not be allowed to contaminate the legal system."

Concerning the tests given to Harris, Barden said, "There's no magic to these tests. It looks scientific. It looks professional, but when you get down into it, it's junk. It's unusual for a psychiatrist to interpret a psychological test and it's highly unethical for Mr. Cohen [the defense attorney] to give the tests."

After Barden’s testimony that the condition is not generally accepted by the scientific community, despite the fact that it is listed in the DSM, District Judge Skipper Koetter ordered Dr. Ross’s testimony on dissociative identity disorder stricken from the record.

Justice, Texas-style

In the end, the defendant’s overdramatization and courtroom theatrics likely did him in. During the trial, he trembled and twitched and sat in the courtroom with paper stuffed in his ears, which his attorney said was “to keep the voices from speaking to him."

The jury took only 10 minutes to convict Harris, and another 10 minutes later in the month to sentence him to life in prison.

After the verdict, Barden said in a press release that the outcome demonstrates “the power of science-law teams in protecting the legal system from junk science testimony."

Barden has been involved in hundreds of lawsuits, criminal prosecutions and licensure actions across the United States over the past two decades, targeting not only multiple personality disorder but also quack therapists in the repressed memory and rebirthing therapy movements.

Judge Koetter's ruling is not the last word, of course, as it is just one trial judge's opinion. Appellate courts in other states have ruled differently. For example, in the 1999 case of State v. Greene (139 Wn. 2d 64), the Washington Supreme Court held that dissociative identity disorder was a generally accepted diagnosis because it was listed in the DSM-IV, and therefore met the Frye test for admissibility. But the Court went on to say that the applicability of this diagnosis to the issue of criminal responsibility was problematic and that testimony about DID was not "helpful" to the jury. (The Trowbridge Foundation has more information on this case HERE.)

The battle lines over dissociative identity disorder have heated up in the dozen years since that ruling, so who knows how an appellate court might rule today.

For those interested in learning more about the controversy, I recommend the chapter "Dissociative Identity Disorder: Multiple Personalities, Multiple Controversies" by Scott Lilienfeld and Steven Jay Lynn, in their book, Science and Pseudoscience in Clinical Psychology.

California deals big blow to bogus paraphilia diagnoses

Government evaluators in California have been instructed to be more cautious in invoking ad hoc psychiatric diagnoses such as "paraphilia not otherwise specified-nonconsent" to justify the civil commitment of sex offenders.

In a report in today's Psychiatric Times, Allen Frances calls the move by California's Department of Mental Health a "giant step forward in ending the Paraphilia NOS fad."

The new marching orders are likely to have national repercussions. California has a large cadre of sexually violent predator evaluators, many of whom moonlight in other states and in federal court as well.

As Frances reports, evaluators were summoned to a training workshop at which "they were explicitly instructed to adhere closely to the intent of DSM-IV and to desist from making idiosyncratic paraphilia diagnoses. The training made clear that a diagnosis of 'Paraphilia NOS nonconsent' would require affirmative supportive evidence that the rapist is sexually aroused specifically by raping rather than all the many very much more common situations in which rape is simply criminal."

Increasingly, government evaluators had been using so-called "NOS" diagnoses to justify civil commitment of men whose sex offenses were not driven by any recognized mental disorder. Because rape is a crime rather than a mental illness, it is not included as a diagnosis in any psychiatric manual. Similarly, evaluators have taken to labeling men who sexually assaulted post-pubertal minors but did not meet the diagnostic criteria for pedophilia with the ad hoc label of "paraphilia not otherwise specified-hebephilia."

Frances expressed optimism that California's policy change signals the beginning of the end for “paraphilia NOS” in court:

The misdiagnosis of rape as a mental disorder has been a forensic disaster,  allowing the widespread misuse of involuntary psychiatric hospitalization.... [T]he California DMH has only limited control over its errant state SVP evaluators, who by contract are entitled to exercise their individual 'clinical judgment' however mistaken and baseless it may be. 'Paraphilia NOS' will likely linger longer than it should. But the tide has clearly turned in California and California is likely to be a bellweather state; its return to proper diagnostic practice undoubtedly will spread across the country.

Blog readers may also be interested in Frances's commentary on a proposed change in the diagnostic criteria for Posttraumatic Stress Disorder (PTSD) in the upcoming DSM-5. The change could open the door for increased forensic misuse of this controversial diagnosis. Frances's report is HERE.

Combating the pull to overpredict violence

Like the moon's effect on tides, the pull to overpredict violence exerts a powerful influence, even on seasoned forensic evaluators who know its strength.

When directly informed that an event has a low base rate of occurrence -- for example, that a homicide offender has only a 1 in 100 likelihood of being arrested for another homicide -- both laypeople and professionals will markedly overpredict violence.

In an article in the Journal of the American Academy of Psychiatry and Law, eminent forensic psychologist Stanley Brodsky and postdoctoral fellow Sarah L. Miller analyze why this is so.

For one thing, the risk of underpredicting violence has more potential to negatively impact the evaluator. Bad publicity, public outrage, even civil litigation. Not to mention the harm committed by a high-risk individual who reoffends. 

Far safer to "err on the side of public safety," goes clinical lore. A claim of dangerousness is well nigh impossible to disprove. And especially in the context of civil commitment of sex offenders, the issue is not framed as punishment but, rather, as "an acceptable restriction of individual rights in the interest of public safety and rehabilitation." It's not as if these guys are sympathetic characters, with a constituency of supporters looking out for their rights.

Certain psychological mechanisms also contribute to bias in the direction of overpredicting risk. These include confirmation bias, or seeking information to support a preconceived conclusion, and illusory correlation, in which the evaluator assumes two things are related just because they co-occurred.

The purpose of Brodsky and Miller's well-argued review is to make evaluators more aware of the natural overprediction tendency, and to provide a checklist that evaluators can use to assess and correct their potential biases.

It's a great idea, although I am a bit skeptical that such a simple approach will make much of an impact in the adversarial arena.

The full article is available for free download HERE.

Russell Banks' new novel explores sex offender banishment

The Kid is all alone in the world, hiding in the shadows under the freeway, part of an ever-growing mass of exiles electronically shackled to a society that despises and shuns them.

But who are these modern-day lepers? And why are there so many of them? What if sex offending is a symptom of a malfunctioning society, and these men are just the canaries in the coal mine, carrying the burden of society' shame? What if the Internet is the snake in the Garden of Eden, and pornography is the forbidden fruit?

In Lost Memory of Skin, best-selling novelist Russell Banks explores the deeper ironies of a culture that condemns pedophiles even while turning its children into dehumanized sexual commodities. But on a deeper level, the novel is about the profound loneliness and alienation of the digital age, the inability of people to get beyond false facades to truly trust and connect with each other.

My review continues HERE.

(As always, if you appreciate the book review, please click "yes" at the Amazon site, to boost the placement of my Amazon reviews.)

Future orientation a major factor in juvenile competency

Photo credit: Richard Ross, Juvenile in Justice

Unlike adults, most children and adolescents who are found incompetent to stand trial are not psychotic. Rather, they have cognitive impairments. And, in a factor gaining greater attention from courts and legislatures, they are often immature.

Indeed, developmental maturity is so important that in California and some other states, juvenile competency evaluators are now required by law to assess for it.

That’s easier said than done. After all, what is immaturity, and how does it affect competency?

In a study just published in the Journal of the American Academy of Psychiatry and Law, four scholars state that one big chunk of maturity is future orientation, or the extent to which a youngster takes long-range consequences into account in making decisions. One reason that youngsters engage in risky behaviors, the theory goes, is because they are present-focused and lack a more mature perspective on the future.

Testing the influence of future orientation on competency, the researchers found that the well-established relationship between age and competency is moderated by a child's degree of future orientation.

Further, competency is particularly "fragile" in immature children. In other words, smaller deficits in cognitive abilities are more likely to influence competency in immature children as opposed to their more mature peers.

I recommend the full article, by Aaron Kivisto, Todd Moore, Paula Fite and Bruce Seidner. It is available for free online, HERE.

What does it take to prove innocence?

Thomas Haynesworth hugs his mother.
Photo: P. Kevin Morley, Richmond Times-Dispatch

One Sunday morning in February 1984, Thomas Haynesworth’s mother sent him to the Trio supermarket to pick up some bread and sweet potatoes. He never got there. Instead, he was stopped and questioned in connection with a recent rape. That began a 27-year odyssey through false accusation, arrest, prison and pain.

So begins yet another Kafkaesque story set in the United States, whose criminal justice system seems to have gone totally berserk. When I was traveling abroad this summer, overseas colleagues expressed amazement about practices they've heard about in our country -- juveniles sent to prison for life, young men placed on lifelong sex offender registries for consensual relationships with teen girlfriends, criminal prosecution of young children. Last week's execution of Troy Davis despite mounting doubts about his guilt is the latest case that has international observers scratching their heads.

But the Haynesworth case is unusual in that prosecutors and even a state attorney general are going to bat for the wrongfully convicted man, yet that still isn't enough to get him an exoneration. 

To recap the facts:

Haynesworth after his release. Photo credit: Morley

When he was 18, Haynesworth was arrested for five rapes in his neighborhood. He had no criminal record, but that didn't matter. He was prosecuted for four rapes, convicted of three, and sentenced to 84 years in prison.

Two years ago, a broad review of old cases in Virginia turned up a DNA match to a serial rapist who was already in prison for a string of rapes that occurred in that same neighborhood after Haynesworth's arrest.

Haynesworth was released this March, on his 46th birthday, and everyone thought his exoneration would follow swiftly.

But, no. 

Instead of apologizing to Haynesworth for robbing him of most of his adult life, what is the court doing? It's asking for more proof of innocence.

Only, there's a slight catch: The state has disposed of the DNA evidence from the other rapes, evidence that could conclusively clear his name.

"It seems paradoxical to demand 'conclusive' evidence from Haynesworth when the commonwealth has deprived him of the opportunity to produce such evidence," said the attorney general of Virginia, a staunch conservative who has even given Haynesworth a job in his office.

Meanwhile, as his bid for exoneration languishes on, Haynesworth must remain on the sex offender registry, with all of the stigma and restrictions that carries. He cannot move without permission, and he must even get approval to visit his nieces.

The trial penalty

This is yet the latest in a string of similar cases focusing public attention on the reliability problems plaguing eyewitness identification and, more broadly, on racial inequities in the administration of justice here in the Land of the Free.

But things are likely to get worse before they get better. That's because across the United States, legal changes have concentrated more and more power in the hands of prosecutors, who can now coerce defendants into pleading guilty by threatening much harsher penalties for those who insist on a trial.

As Richard Oppel reports in an in-depth analysis in the New York Times, prosecutors now wield more discretionary power than judges, and are using that power to punish defendants for exercising their right to a trial:

Threats of harsher charges against defendants who reject plea deals often are the most influential factor in the outcome of a case, but this interplay is never reflected in official data.

Even defendants with winnable cases are opting to plead guilty because the stakes are so high if they lose. The ratio of guilty pleas to trials has nearly doubled in the past two decades, according to Bureau of Justice Statistics reported by Oppel. And the number of acquittals in federal cases has dropped even more dramatically, from one out of every 22 cases 30 years ago to only one out of 212 last year.

So if a young Haynesworth came along today and had the audacity to insist that he was innocent and wanted a trial, he would likely be punished with multiple life prison terms, rather than a mere 84 years.

We may never know how many Haynesworths are being sentenced every year based on faulty eyewitness identification and/or racially biased prosecution. 

New York Times reporter John Schwartz's only-in-America report on the Haynesworth case is HERE.

Richard Oppel's excellent report, Sentencing Shift Gives New Leverage to Prosecutors, is HERE.

Hat tip: J and B