3/11/24

PSY-205-H7711 Forensic Psychology 24EW4 DR

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Module Overview
 Listen
  MODULE 2
Legal Competency for Trial
Competency to stand trial refers to the defendant’s ability and psychological state at the time of the
trial. Competency to stand trial is a legal, rather than a psychological, concept. Although it is most
common for the evaluation to be requested pretrial, it may be requested at any time during the trial.

Legally, to be considered competent to stand trial, a defendant must meet the Dusky
Dusky standard
standard. The
defendant must be able to:

Understand the charges

Contribute to the trial
Assist the attorney in the defense
Understand the possible consequences of the outcome

Even defendants with severe mental disorders may be judged competent so long as they are able to
assist the attorney and can understand the charges and proceedings (though if the defendant wishes to
serve as his/her own attorney, or if the charges are complex, a higher standard of competency may be
applied). The burden of proof that the defendant is incompetent lies on the defense. Other issues of
competence include competence to plead guilty (which holds that the defendant’s plea must be
knowing, voluntary, and intelligent) and competence to waive the services of an attorney. It is currently
debated whether different levels of competence should be applied for these particular competencies.

It is very important to know the difference between competency and sanity. In the insanity defense, the
defendant attempts to prove that he/she was not mentally stable at the time of the crime, and the level
of instability has to be severe enough to indicate that the defendant was not responsible. An example of
an insanity defense would be if someone with a psychotic disorder had a total break from reality and
murdered someone. The bar for insanity is pretty high.

On the other hand, with competency, all prosecutors have to do is show that the person understands
enough about the case (and about reality) to either defend him/herself or assist an attorney in his/her
defense. All we really need to know is if the person is competent enough to get a fair trial. If not, then
the trial generally cannot be held, and a determination must be made if competency can be restored
the trial generally cannot be held, and a determination must be made if competency can be restored
somehow (for example, with medication).

References
Costanzo, M., & Krauss, D. (2012). Forensic and legal psychology: Psychological science applied to law.
New York, NY: Worth.

You are deemed to be

competent unless YOU
can prove that you are not

burden of proof for

incompetence lies
with the defense

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Activity Details
 Dusky v. United States (1960)
types of schizophrenia

[Link]
legal-precedents/dusky-v-united-states

[Link]
mental status
exam is not
enough to
prove or
disprove
competency
insanity defense standards

Quora
 3/1 1/24

PSY 205 Module Two YouTube Lecture Competency vs. Insanity

Hello, class. This is Dr. Barter again. And I'm going to talk to you a little bit about the
difference between competency evaluation and sanity or insanity evaluation. First, let
me put my glasses on and get a good look at you all. Guess we'll be taking those off.

So the difference between sanity and competency is really an important one to

distinguish, because a lot of times, people starting out in forensic psychology may
confuse what those things mean. The one that would come first would generally be the
competency determination. When competency is being assessed, the forensic
psychologist-- sometimes psychiatrist, but usually psychologist-- assesses the ability of
the person who's been charged to participate in their own defense.

So questions are asked such as, is this person able to communicate with their attorney.
Are they able to engage in their own defense using an attorney, using the court system
in a way that's fair to them? Competency to stand trial might be impacted by serious
mental illness. What if the person is psychotic? They're talking to people that aren't
there. They're talking to light switches. They're a paranoid schizophrenic and they have
not been treated for a while. They have not taken medication. Then may be deemed
incompetent to stand trial.

Now, in that particular case, competency might be restored. The judge may order that
the person go on medication. And once they get on medication and their psychosis
remits enough so that they're living in reality again, then they could be deemed
competent. So there can be a restoration of competency by the court.

What if a person has an IQ of 40? An IQ of 40 is an extremely low IQ. Most people, I

would think, with an IQ of 40 have a legal guardian. They're probably not their own
guardian. And they probably function at an age much, much younger than their
chronological age. That person may well be deemed incompetent as well. But can their
competency be restored? It can't. IQ is a fixed number, and especially a low IQ like that
probably couldn't be remediated in any way.

So in a competency evaluation, we try to determine whether the person being

evaluated can participate in their own defense so that they can mount a good court case
and get a fair trial. And can they communicate with and understand their attorney in the
process? That's competency.

Insanity is another construct. It's another thing that we do. And that is more of the guilt
or innocence determination based on a person's state of mind at the time the crime was
committed. So for example, if a person has a psychotic break and they shoot someone,
and they're charged with attempted murder, they may well be found not guilty by
reason of insanity. They didn't know what they were doing. They didn't have control of
their actions or their faculties or their thought processes. And so in that case, they really
 are deemed insane, not having the amount of sanity to make a good decision about
whether something was right or wrong at the time that they did it.

And so an insanity determination is made after the person has been determined
competent to stand trial. So you see where those two things are different. Competency
doesn't have to do with guilt or innocence. Competency has to do with whether the
person can stand trial at all. And sanity doesn't have to do with competence to stand
trial. Sanity has to do with whether the person was guilty or not based on their state of
mind at the time of the crime. Molly, come over here. I'm afraid she's going to knock my
camera over.

So when we make these determinations, we have to be aware that there are different
levels of competency. There are different levels of sanity or insanity. In the long run, we
make a determination, and it is the court that makes the decision, finally. So remember
that-- and I'm going to tell you this many times-- forensic psychologists don't make
decisions in court. We provide a competency assessment. But the judge determines
whether the person is competent or not based on what we say.

There may be opposing opinions. One side may be saying the person is competent, and
the other side may be saying they're not. Same thing with sanity or insanity-- the judge
or the jury makes that determination based on the psychological evaluation, but we
don't make that determination. We do not make those decisions. We're not fact finders,
and we're not decision makers in the court room.

So I hope this helps to clarify the difference between competency and insanity. I know in
module 2, you'll be looking at a competency evaluation, a determination of whether a
young man is competent to stand trial. And your professors and I really look forward to
any input you have in the discussion board about that particular evaluation. So enjoy
the module. Thank you for listening. And Molly thank you as well.

Competency Insanity
• has different levels • has different levels

• usually the determination made first • made after the person has been deemed

• can be restored if first found competent

incompetent, in certain circumstances • cannot be restored, refers to a point in time that

• whether the person can stand trial and has already happened

participate their own defense, • whether is the person guilty or not based on their

communicate with attorney, etc state of mind at the time of the crime
 3/11/24
Discussion 2: A Competent Competency Evaluation
By now you have read the de-identified competency evaluation PDF completed by

Intern Griffin. With the knowledge you have gained from the lecture and

textbook, do you feel the competency evaluation was thorough and appropriately

conducted? If not, what could have been done to improve the evaluation?

For replies:
competency to stand trial is the
What did you agree on? most evaluated forensic issue
What was different?

A defendant’s right to a fair trial is one of the core principles of the United States’
criminal justice system, which strives to provide all defendants with objective and
dignified proceedings.

This requires that all defendants maintain a basic level of competence to proceed .

Within the context of adversarial proceedings, competence refers to a defendant’s

present ability to meaningfully participate in his or her defense and comprehend the
trial process.

Competency to stand trial (CST) is a doctrine of jurisprudence that allows for the
postponement of criminal proceedings should a defendant be unable to participate in
his or her defense on account of mental disorder or intellectual disability.

Issues of competency may be raised at any point during the proceedings and, if a bona
fide doubt exists regarding competency, the issue must be formally considered, thus
requiring a forensic evaluation.
 Discussion 2 3/14/24
The competency evaluation of Donny appeared, in my
opinion, to be conducted thoroughly, As we know, these
evaluations by forensic psychologists are not conducted
to make decisions about competency, but rather to
inform the court as they make their decision (Costanza
& Krauss, 2021). In the lecture video, Dr. Barter said that
the questions to be asked in a competency evaluation
deal with the ability of the person to communicate with
their attorney, their ability to understand the court
system and help in their defense, and if there is mental
illness present that would compromise any of these
abilities.

I thought the evaluation was thorough. Dr. Barter

collected historical information to really see who Donny
was, how he lives, and how he learns in order to make
sure that he has a firm understanding of what is
happening. He also collected collateral information, which
comes from third parties who can offer information
about the defendant's behavior" (Costanza & Krauss,
2021, p. 200). This came from his interview with Janet
Downs, Donny’s grandmother and legal guardian.
While the interview with Ms. Downs was certainly
appropriate and necessary, I wonder if information
from additional third parties would have been helpful.
Obviously, I am not qualified to judge someone else's
professional evaluation. This is also the first one I have
ever read, so I could be totally off base, but I would be
curious to know if Dr. Barter’s opinion would be the
same if he had more information about Donny's
functional capacities. Maybe this could come from a
teacher, doctor, or even friends. Many times, kids act
different depending on their environment, so I would
just question whether the information laid out in the
evaluation was a realistic picture.

Dr. Barter also diagnosed Donny with Asperger’s. I

honestly do not know much about this, so I looked up
some information regarding Asperger's and CST. A 2004
article by Justin Barry-Walsh and Paul Mullen in the
journal of forensic psychiatry and psychology noted
that people with Asperger's have deficits in social
functioning and both verbal and nonverbal
communication.
The article references a known connection between
people with Asperger's and deviant behavior,
including starting fires like Donny, There is a “strong
association between arson and pervasive
developmental disorders" (Barry-Walsh & Mullen,
2004, p. 98). The article noted some case studies
suggesting that the lack of empathy associated
with Asperger's could possibly form the basis for an
insanity defense (Barry-Walsh & Mullen, 2004).
Though we are discussing a competency evaluation,
and insanity and competency are not the same, I
found that to be an interesting piece. However,
regarding both insanity and competence, the case
studies indicated that it would be necessary to
have proof of "the extent to which the subjective
reality of those with Asperger's Syndrome differs
from other individuals" (Barry-Walsh&Mullen, 2004, p.
98). In addition, given that a trial is a "social
performance" (Barry-Walsh&Mullen, 2004, p.104) and
these interactions can be a struggle for those with
Asperger's (and a child at that), Donny may have a
hard time.
All that to say, if I read this as the judge, I may ask Dr.
Barter for some more information on Asperger's and
what the implications are for Donny in the context of
legal proceedings.

References
Barry-Walsh, J., & Mullen, P. (2004, March). Forensic
aspects of Asperger’s Syndrome. The Journal of Forensic
Psychiatry and Psychology, 15(1), 96-107. http://
[Link]/
10.1080/14789940310001638628

Costanza, M., & Krauss, D. (2021). Forensic and legal

psychology: Psychological science applied to law (4th ed.).
Worth Publishers, Macmillan Learning, New York.

SNHU A11y Remediated Videos. (2016, May 16). PSY205:

Module two YouTube lecture [Video]. YouTube. https://
[Link]/gw7uIKXPoT4?si=JPt_-4DrLqO28AHd
 WESTBROOK PSYCHOLOGY

68 PLEASANT STREET
BRUNSWICK, MAINE 04011
Phone: 207-854-4321 or 866-480-1608
Fax: 207-333-3232

Brief Psychological Report

Competency evaluation
Name: Donny Quarrels

Date of Birth: October 12, 1995

defendant is 14
Evaluation Date: October 17, 2009

Evaluation Methods: Wide Range Achievement Test, third edition, reading subtest
(WRAT3); Youth Self-Report (YSR); Child Behavior Checklist (CBCL);Millon Adolescent
Personality Inventory (MAPI); record review; child interview; parent interview.

Examiner: William M. Barter, Ph.D., Licensed Psychologist

Connie Griffin, M.A., pre doctoral internship student

Background: Donny was referred for a psychological evaluation by Marsha Levin, Esq. to
determine if Donny is competent to be a part of the juvenile justice system.

Evaluation Objectives: The purpose of this evaluation is to make recommendations about

Donny’s competency in regards to the juvenile justice system.

Informed Consent: Prior to Donny’s initial meeting with Ms. Griffin, informed consent for
services was obtained from his grandmother, who is his legal guardian. She affirmed
understanding that the purpose of the evaluation was to assess Donny’s competency. She
affirmed that she understood the non-confidential nature of the evaluation if allegations of
child abuse or elder abuse arose in the course of the interview. Finally, she affirmed
understanding the risks and benefits of Donny undergoing such an evaluation. Concurrent
with the first session, the process was explained to Donny in language that he could
understand. He willingly gave his assent. After the evaluation process was explained to him,
he had no questions for Ms. Griffin. He was made aware that he could terminate the
evaluation at any time.

This section left blank.

 Donny Quarrels
Psychological Report
grandmother is current legal guardian Page 2 of 8

Parent Interview: Janet Downs, Donny’s grandmother, stated that she currently has custody
of Donny. She said that his birth mother is Christine Quarrels (37) and his birth father is
James Quarrels (38). Ms. Downs reported that Donny’s parents are no longer in a relationship
together. She stated that he sees his father every other Saturday and his mother more often.
She stated that Donny has a half brother, Paul (8), who lives with his birth father in
Massachusetts.
8 years
According to Ms. Downs Donny has lived with her since he was six years old. She stated that
his parents were living in Massachusetts and she moved to Maine. She reported that during
their separation she encouraged the parents to send Donny to stay with her. She stated that
both parents agreed and sent Donny to live with her. She described his parents as coming for
visits on opposite weekends from one another. Ms. Downs stated things were going fine and
then she had health issues that arose. She described a broken knee and a stroke so she had to
send Donny to live with his father. She reported that once she was feeling better she went to
visit Donny and found him to be unkempt, no sheets on his bed, and overall “he did not look
good.” She stated that Donny’s daycare called DSS in Massachusetts about the care he was
receiving from his parents. Ms. Downs reported that she also made a call to DSS because of
her concerns. She stated that there was no intervention by the state so she hired an attorney
and gained custody of Donny. She reported that he was not happy at first but over time, he felt
safe with her. Once he moved to Maine, he did not see or hear from his parents for some time.
She stated that she made sure he was in counseling. She reported that he was diagnosed with
Attention Deficit Hyperactivity Disorder at the age of three.

Ms. Downs reported that Donny never liked school. She stated that there were no behavior
problems. She stated that there were "small things" that began in grammar school. She
reported that after three years his father came to the door and wanted to visit Donny. She
stated that she allowed one visit and then talked with Donny’s team of providers. It was
agreed that with her supervision visits would occur. She stated that in the beginning, Donny’s
father was bringing presents and seemed to have made changes but she stated that it has
slowly returned to how it was prior to the separation. Ms. Downs stated that over this time
Donny’s mother had another child. She was supposed to come to Thanksgiving at one point
and did not show up. Ms. Downs reported that Donny’s mother was in an unhealthy
relationship. She ended up being hospitalized four times for bipolar disorder. Ms. Downs
reported that things seemed to get better for everyone. Donny’s parents were visiting; his
mother was doing well and in a halfway house. Ms. Downs reported that she then became ill
and as a result could not take care of Donny and lost her home.

Ms. Downs stated that Donny stayed with his mother while she was in the hospital. She stated
that after the hospitalization she moved in with her daughter, her daughter’s boyfriend, and
Donny. She reported that the boyfriend was not healthy and had told Donny many things that
were not true. She stated that her daughter told her she could not stay there and drove her to a
shelter and Donny remained in their care. She stated that she eventually found a new place to
live and Donny came back to live with her. She reported that it took time for Donny to
become comfortable with her again. She stated that since they have moved into their current
home she has noticed huge improvements in Donny.

ADHD has been bounced around

mom has bipolar between houses and caregivers
developmental delays physical abuse - dad asthma
early intervention services emotional abuse - dad/mom Donny Quarrels
Psychological Report
trouble sleeping and eating one close friend Page 3 of 8

When asked about Donny’s developmental history Ms. Downs stated that his mother had a
good pregnancy with him. She stated that he was a healthy baby. She reported that he was
Vyvanse slightly delayed developmentally and received early intervention services. She stated that he
experienced physical abuse by his father and emotional abuse by bother parents. She reported
70 that she does not believe he has been sexually abused. She described him doing well in
school. She stated that he has good interactions with the children that live near their home.
Abilify
She reported that he has one close friend at school. She stated that he is currently in
counseling and she is trying to get him a case manager. She reported that he has no history of
5 substance use.

When asked about his functioning Ms. Downs reported that he has trouble sleeping some
nights and that by Friday he is tired. She stated that his eating is not good due to his
medications. She reported that he is on Vyvanse 70mg per day and Abilify 5mg per day. She
stated that he has asthma and no allergies. She reported that he is a good child and is most
happy when he is “knee deep in grease working on engines.”

When asked to describe the incident that has led to his involvement with the juvenile justice
system she explained that it occurred in August 2009 and he admitted to doing it. She reported
that they were living in a place where the upstairs neighbor was an alcoholic and had
obsessive-compulsive disorder. She stated that the woman was very protective of the hallway
and the backyard. She stated that one evening the neighbor was screaming and yelling at
10pm. She reported that she did not call the police but told the neighbor that if it happened
again she would call the police. She stated that the neighbor was constantly throwing away
Donny’s stuff from the backyard. She reported that one day the police came to the home and
stated that they needed to speak with Donny. They went to school and asked him if he had
been burning holes in the wall of the hallway. Ms. Downs stated that initially he denied doing
this but then he stated that he did. She reported that the management company filed the
complaint against Donny.

When asked if he had been in trouble with the law for anything else she stated that about one
year ago Donny came home with a snow blower. She stated that about three months after he
had brought the snow blower home the police informed her that it was stolen. She stated that
he wrote a letter of apology and no charges were filed.

Child interview: Donny reported that it was Saturday October 2009 but he was unsure of the
actual date. He reported that he was in Lewiston, Maine for an evaluation. When asked why
he was being evaluated he stated, “due to court.” When asked to explain why he was going to
court he responded, “because of paint in the hallway.”

Donny demonstrated an understanding of the difference between a truth and a lie. He

appropriately described the difference between right and wrong. He also appropriately
explained what morals are.

When asked to describe the incidents that occurred he stated that he had used a pipe torch in
the hallway of the building he lived in to make bubbles on the wall. When asked why he did
 Donny Quarrels
lack of foresight, but he is 14
Psychological Report
Page 4 of 8

this he explained that he was upset with the neighbor. He stated that the neighbor had been
throwing away his stuff and she was obsessed with the hallway. He reported that he made two
to three burns on the wall. He stated that he was not trying to burn the building down and had
not actually thought about that as a possibility. When asked what time of day it was when he
did this he stated that it was in the afternoon. He described getting into trouble for it one week
later. He stated that the neighbor lied and said she saw him. He stated that he knew no one
saw him do this. He described the police talking to him at school. He stated that he told them
he did it and then he went back to class. He reported that the police officer did not predict
what was going to happen next. He stated that stated he does not believe the police officer
knew what the consequences were going to be. He reported that he was given a time to go
back to the police station at that time the charges were filed. He stated that he was told he had
to go to court. He reported that at court he does not recall what he was told. He said that he sat
around at court for a while then he said he was not guilty, because that is what he lawyer told
him to say. He stated that his lawyer told him to say not guilty because she did not know
much about the case. He reported that he then went home and that is the only time he has been
in court.

When asked if he had been in trouble for anything else he stated no. When asked about the
snow blower he took he stated that he did not have to go to court. He said that they needed a
snow blower, and the man had ten, so he took one. He stated that the man did not know it was
missing for several months. He stated that the charges were dropped but he is unsure as to
why this occurred. When asked what he believes might happen if he has to go back to court
for burning the bubbles on the wall he stated that he is unsure.

When asked questions about functioning Donny reported that he does not hear voices. He
described no problems with racing thoughts or difficulty remaining focused on a topic. He
stated that he does not believe people are out to get him. He described understanding why he
was being charged for the incident. He reported that he attends counseling but has only been
to one session so far. He stated that he is in the eighth grade. He stated that he does ok and has
passing grades. He reported that he does not participate in extra-circular activities. He said
that he enjoys working on stuff like cars and engines. He also enjoys hanging out with friends.
He described living with his grandmother, whom he describes as nice. He stated that he has
no trouble eating or sleeping.

Clinical Impressions: Donny arrived on time for the evaluation. He was appropriately
dressed for the setting. His attire appeared to be clean and was neat. His person appeared to be
clean. When he first arrived, he appeared agitated and was pacing around until his
grandmother instructed him to sit. He had minimal eye contact throughout the assessment
process. His voice and affect were flat. He appeared to express no sense of humor. At one
point, he was asked a question that he appeared not to understand. His eyelids began to flutter
and he appeared as if he was about to fall asleep then he produced a response that was not
appropriate for the question. The question was rephrased and he answered it appropriately and
returned to his original alert state. He was cooperative throughout the assessment. His
grandmother was unsure if he would answer questions in an interview setting but he was
responsive and polite. When he left, he stated goodbye to the examiner to which his
 Donny Quarrels
Psychological Report
Page 5 of 8

grandmother expressed surprised pleasure as this is not typical behavior for him. He appeared
to be oriented to person, place, and time. There appeared to be no difficulties with his thought
process.

Record Review: Donny participated in an extensive evaluation with the Bridges Program in
the spring of 2009. The following is a summary of material taken from that report.

Team Summary: Donny was referred for the evaluation for concerns of Asperger’s Disorder
due to issues with socialization and some aggressive behavior at home. It was stated that
Donny met the 11 out of 12 criteria for Asperger’s Disorder. The team determined that Donny
meets the criteria for Asperger’s Disorder with a secondary diagnosis of ADHD. They also
reported a mix of depression and anxiety.

Diagnostic impressions:
DSM-IV
Axis I: Asperger’s Disorder with associated ADHD-combined type
Anxiety Disorder, NOS
Disorder of Written Expression Asperger's with
Mathematics Disorder (retrieval of math facts)
Phonological Disorder associated ADHD
Social and Pragmatic Language Disorder
- combined type
Axis II: Deferred

Axis III: Mild Persistent Asthma, May-Hegglin Anomaly

Axis IV: Problems in family of origin, impairments in social and interpersonal style, problems
in academic and legal sphere.

Axis V: GAF 55

Tests administered as part of the Bridges evaluation:

Intelligence:
Wechsler Intelligence Scale for Children-IV (WISC-IV)
Academic Achievement Test
Woodcock Johnson-III Tests of Achievement (WJ-III ACH)
Test of Written Language-III Story Writing section
Neuropsychological Tests
Rey Complex Figure Test and Recognition Trial
Finger Tapping Test
Peabody Picture Vocabulary Test-IV
NEPSY-II: Selected Subtests
Seashore Rhythm Test
Speech Sounds Perception Test
California Verbal Learning Test-Children’s Version
 Donny Quarrels
Psychological Report
Page 6 of 8

Trail Making Test: Parts A and B

Booklet Category Test
Behavioral Ratings and Personality Tests
Clinical interview with Janet Downs
Child Behavior Checklist Teacher Report Form
Thematic Apperception Test
Social Responsiveness Scale
Brown ADD Scales
Review of Records.

The following section is taken verbatim from the report completed by Bridges:

Intelligence Testing Results

On the administration of the WISC-IV Donny achieved a Verbal Comprehension Index (VCI)
score of 116, placing him in the 86th percentile and the High Average range for language
based cognitive functions involving reasoning, comprehension and conceptualization. His
abstract verbal reasoning placed him in the 91st percentile. His expressive vocabulary placed
him in the 63rd percentile. His ability to explain social norms and customs place him in the
91st percentile.

His perceptual reasoning Index (PRI) score of 112 placed him in the79th percentile and the
High Average range for perceptual reasoning, fluid reasoning, and organization. He did well
on a test of hands on visual spatial organization, performing in the 84th percentile. When
asked to analyze visual patterns in his mind he had more difficulty performing in the 37th
percentile. His abstract visual reasoning places him in the 91st percentile.

Donny’s Processing Speed Index (PSI) score of 80 place him in the 9th percentile and the Low
Average to Borderline range for his ability to efficiently process information. Processing
Speed also represents a significant relative weakness for Donny. On a test of coding which
involved the efficient integration of working memory, graph motor output, and visual
scanning he performed in the 5th percentile. On a less demanding test of visual scanning
efficiency, he performed in the 25th percentile. Processing speed has been found to serve as
the foundation for many cognitive actives, including mental capacity, reading development
and performance, conservation of mental energy, and efficient use of working memory for
higher-level fluid reasoning task. Impaired processing speed can contribute to both academic
and behavioral difficulties.

Donny’s full scare I.Q. of 100 placed him in the 50th percentile and the Average range, but
does not adequately represent his higher-level cognitive abilities, which fall in the High
Average range. His General Ability Index score of 110 provides further estimate of his
cognitive functions as falling in the beginning of the High Average range. Working memory
and processing speed are significant relative weaknesses for Donny. Impairments in these
areas will lead to difficulties in executing work efficiently, and in efficient processing of
information. These results are consistent with his previous intelligence testing in 2007.

Processing speed has been found to serve as the foundation for many cognitive actives,
including mental capacity, reading development and performance, conservation of mental
energy, and efficient use of working memory for higher-level fluid reasoning task. Impaired
processing speed can contribute to both academic and behavioral difficulties.
 Donny Quarrels
Psychological Report
Page 7 of 8

Westbrook Psychometric Testing Results for this evaluation: Donny was administered the
reading subtest of the Wide Range Achievement Test (WRAT3). His raw score of 39
indicated the ability to read at the seventh grade level. He was thus deemed able to self-
administer all of the psychometric tests.

Donny completed the Million Adolescent Personality Inventory (MAPI). He did not respond
to the items in a fully reliable manner so the interpretation is done with caution. The MAPI narcissism -
provides information that will be presented in two categories. The first is personality style.
Donny might have an inflated sense of self worth, an air of imperturbability, and a dislike for antisocial
fulfilling social responsibility. His interpersonal relationships are typically narcissistically
personality?
gratifying and fleeting. He does not appear to care that being undependable and socially
exploitive are inconsiderate and presumptuous. When being exploitive and self-centered he is
not motivated by hostility or malice but an assumption that the rules of social responsibility
do not apply to him. When people react to him and become irritated or alienated he may react
with contempt and then flimsy rationalizations. He is likely to project blame onto others.

The second part of the MAPI interpretation is expressed concerns. Overall Donny expresses
no concerns that are typical of his age group. He describes feeling confident of his body and
development. He responded to statements indicating a high level of self-esteem and
confidence. This may be accurate but more likely it is a lack of insight into these issues due to
his Asperger’s diagnosis. He indicated that family is not a part of his problems and finds his
home to be a comfortable and supportive environment. He appears to be a caring and good-
natured person. He is always willing to help others and accepts others imperfections.

The Youth Self Report (YSR) was completed by Donny to obtain his perceptions of his
competencies and problems. He reported that he participates in no sports and that he has
interests in one hobby. He belongs to no social organizations, teams, or clubs. He reported
that he has one job or chore. His responses indicate that he has four or more friends and that
he sees friends one or two times a week outside of regular school hours. He rated his school
performance as average in language arts, average in social studies, average in math, and
average in science. His Total Competence score was in the clinical range below the 10th
percentile for self-reports by boys aged 11 to 18. His score on the Activities scale was in the
clinical range below the third percentile, and his score on the Social scale was in the normal
range. On the YSR problem scales, Donny’s Total Problems, Internalizing, and Externalizing
scores were all in the normal range for boys aged 11 to 18. Scores on all rated syndrome
scales were in the normal range.

The Child Behavior Checklist (CBCL) was completed by Janet Downs, Donny’s
grandmother, to obtain her perceptions of Donny’s competencies and problems. She reported
that Donny participates in two sports and that he has interests in three hobbies. He belongs to
no social organizations, teams, or clubs. She reported that he has two jobs or chores. She
reported that he has one close friend that he sees friends, one, or two times a week outside of
regular school hours. She rated his school performance as average in language arts, average in
social studies, average in math, and average in science. Donny’s total competence score was
in the clinical range below the 10th percentile for parents ratings of boys aged 12 to 18. His
 Donny Quarrels
Psychological Report
Page 8 of 8

scores on the activities and school scales were both in the normal range, and his score on the
social scale was in the borderline range.

On the CBCL problem scales, Donny’s Total Problems, Internalizing, and Externalizing
scores were all in the clinical range above the 90th percentile for boys aged 12 to 18. His
scores on the Somatic Complaints and Aggressive Behavior syndromes were in the normal
range. His scores on the Thought Problems and Attention Problems syndromes were in the
clinical range above the 97th percentile. His scores on the Anxious/Depressed, Social
Problems, and Rule-Breaking Behavior syndromes were in the borderline clinical range.
These results indicate that Donny’s grandmother reported more problems than are typically
reported by parents of boys aged 12 to 18, particularly problems of anxiety or depression,
withdrawn or depressed behavior, problems in social relationships, thought problems,
attention problems, and rule-breaking behavior.

On the CBCL, the DSM-oriented scales indicate Donny’s scores on the Anxiety Problems and
Oppositional Defiant Problems scales were in the normal range. His score on the Attention
Deficit Hyperactivity scale was in the normal range. His scores on the affective problems and
conduct problems scales were in the borderline range.

Conclusions and Recommendations: The basic question to be answered in this evaluation is

this: If Donny has an impairment does it affect his ability to participate knowingly and
meaningfully in the trial and cooperate with the defense attorney? One factor to consider in
answering this question is cognitive ability. Based on Donny’s cognitive testing, he is
competent to stand trial. He has an average to high average I.Q., indicating his ability to
understand information provided regarding the process and to reason with the information that
he acquires or brings to the situation. The second area of functioning to evaluate is his mental
health. The results of this evaluation indicate that a diagnosis of Asperger’s is warranted.
Donny’s limited social functioning and communication skills should not be confused with low
cognitive ability or the inability to participate in the proceedings. At the time of the interview,
he had a firm grasp of reality. His affect was flat and his communication skills were limited;
however, this does not rise to the level of inability to stand trial.

In working with Donny through the court process, it is important that his limitations be
considered. He does have difficulty expressing himself. He also has difficulty in establishing a
typical ebb and flow of conversation; this is all part of his diagnosis of Asperger’s. It may be
helpful for his attorney to educate herself about Asperger’s if she has not already.

_______________________________
Connie Griffin, M.A.
Pre doctoral internship student

________________________________
William Barter, Ph.D.
Licensed Psychologist
Maine License #PS1141
Chapter 8 competency to stand trial (CST) 3/11/24

Jared Lee Loughner - 2011 shooting in Tucson, Arizona CST

Shot US Rep Gabrielle Giffords in the head and killed 6 others most common
ordered competency eval because JLL had strange beliefs
evaluation
about the govt and believed CIA and FBI were watching him performed by
forensic
was diagnosed by makes people lose

two psychologists touch with reality psychologists

with schizophrenia

symptoms persist even

symptoms: when person is shown
auditory hallucinations (hearing things that are not there)
•
evidence otherwise
• thought disorder (difficulty thinking and speaking coherently)
• delusions (holding false beliefs)

JLL found incompetent multiple times, had to be

forcibly medicated for competency to be restored

August 12, 2012 - pled

guilty to 19 charges,
received 7 life terms plus
140 years without parole

types of competency
Competence: (legal definition) • to waive an attorney
refers to whether an individual • to plead guilty
has sufficient present ability to • to confess
meaningfully participate in and • to make treatment decisions
perform necessary personal or • to execute a will or contract
legal functions • to take care of yourself and your money
• to be executed
defendants have the most to lose during criminal proceedings
What should be the definition of "too impaired"?

Why we should be concerned about CST standards:

• if the standard is too high, people who lack knowledge about court
system will not get to have a trial
• if it is too low, people who are not able to participate in their own
defense could be convicted of crimes without knowing how or why
• defendants deserve fairness in trial, their participation makes it
more likely they will get a just verdict
• using the power of the state to prosecute and convict someone
who doesn't know what’s going on undermines the legitimacy of
the justice system

Trial decisions up to the defendant: Dusky v.

1. Whether to plead guilty
2. Whether to waive trial by jury United States
3. Whether to testify
4. Whether to accept a plea bargain (1960)

Legal doctrine of incompetence

Dusky charged with kidnapping
originated in England in 17th
and unlawfully transporting
century (defendants had to
Alison McQuery (15) across
argue their own case)
state lines where she was raped
… sufficient PRESENT ability

CST refers to the psychological state of the

defendant at the time of trial, NOT at the time
of the crime, which is insanity

adjudicative captures the types of abilities needed to participate

competence effectively in all stages of the legal process

two components
(Richard Bonnie, 1993)

foundational competence decisional competence

• the capacity to assist counsel • the capacity to make informed,
• essential for ensuring fairness, independent decisions
dignity, and accuracy • focuses on ability, not willingness, to
if competent to assist counsel
perform relevant legal functions
then decisional comes into play

“ sufficient present ability" is a low standard in order to maximize efficiency

- if someone was not raised here and does not know the American Criminal
Justice system but has the capacity to learn: that would constitute SPA

defendants unwilling to talk to does the defendant understand

their attorney are competent, the roles of prosecutor, judge,
unless it is the result of an jury, etc.
irrational belief system
Functional elements
does not necessarily
mean the person is
100% mentally well
CST is a legal
concept, NOT a
psychological one
a study of 8,000+ competency
evaluations found that over 2/3 of
people with severe mental disorders
were still found competent

it refers to the defendant’s ability to understand and perform a number

of discrete court-related functions, including but not limited to:

1. Understand their current legal situation

2. Understand their charges
3. Understand the pleas available
4. Understand the possible penalties if convicted
5. Understand the roles of the judge, defense counsel, and prosecutor
6. Trust and communicate with the defense counsel
7. Help locate witnesses
8. Aid in developing a strategy for witness cross-examination
9. Act appropriately during the trial
10. Make appropriate decisions about trial strategy

Should CST be a Does a defendant in a huge case with serious charges need
flexible standard?
→ to be more competent than someone with a simpler case?
 presumption of competency to stand trial

You are competent unless Cooper v. Oklahoma (1996)

proven otherwise, and that →
burden is with the defense Medina v. California (1992)

other standards of proof

• Beyond a reasonable doubt (criminal cases) BRD

• Preponderance of the evidence (civil cases) POE
• Clear and convincing evidence (possible intrusion on liberty short of prison) CCE

competency to plead guilty

if you plead guilty, you waive certain rights:
Guilty pleas must be: • right to jury trial
• knowing • right to remain silent
• voluntary • right to appeal
• intelligent • right to confront your accusers
Johnson v Zerbst

“ Anyone who serves as his own lawyer has a fool for a client"

1993 - Colin Ferguson, "black rage syndrome defense"

2008 - Indiana v. Edwards, barring mentally ill from representing themselves

other reasons for requesting CST evals:

• Attempt to delay trial by either side, giving attorneys more time to prepare
• To prevent defendant from being released on bail
• To invalidate any attempt at a future insanity defense
 Methods for evaluating CST There is no (no guarantee of

The law does not say any particular method has 100% certainty)
gold
to be used, it mostly results from clinician
standard
decision based on:
• training • experience
to determine CST
• orientation • sophistication

forensic assessment tests developed

instruments (FAIs) specifically for
CST/legal issues
minnesota multi-phasic
general measure of psychopathology
personality inventory
2nd ed

competency open ended questions left a lot of room for

screening test interpretation

tests understanding of legal system, reasoning

mac-tests*
skills, and appreciation of their own
circumstances
inventory of legal
differentiates between those who are malingering and
knowledge
those who are not

evaluation of competency
only FAI designed for both CST and malingering
to stand trial-revised

*MacArthur Structured Assessment of the Competencies of Criminal Defendants (MacSAC-CD) 82 item

22 item
*MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA)

malingering deliberate faking or gross exaggeration of physical or psychological

symptoms to gain positive outcome or avoid negative one
 CST usually raised at pretrial hearing but can be ordered by the
judge or requested by attorneys anytime, as long as there is bona fide doubt, or
reasonable doubt about the defendant's competency

Evaluator = psychiatrist, clinical psychologist, or social worker

• interviews defendant
• administers psychological tests
can be done inpatient or outpatient
• reviews defendant's history
• writes report

inpatient: defendant in a mental institution

provides multiple opportunities to observe the defendant's behavior over time

can provide information from third parties, such as prison guards, admins, nurses, etc.

collateral sources
these third parties are called →
of information
it is fairly rare for
a judge to reject
outpatient: defendant in jail or local clinic the evaluator's
conclusion
cost less and are less intrusive defendant's rights

usually only needs to provide a written report (may occasionally testify)

most courts allow experts to give

should experts be able to give this opinion?
an opinion as to competency

CST is a legal experts are in the

ultimate issue testimony:
issue and best position to
(ultimate opinion testimony) vs
should only be understand how
testimony about the appropriate
decided by mental deficits affect
legal decision in a case
judge/jury ability to stand trial
Restoration of CST
CFE = competency for execution
restoration of competency to stand trial:
Panetti v Quarterman (2007)
acquisition or re-acquisition of the
Madison v Alabama (2019)
abilities needed to assist one's attorney,
understand the legal proceedings, etc.

28% 80+% 75+%

of defendants
referred for CST
→ of defendants → of defendants

eventually restored restored and facing

found incompetent trial within 6 months

incompetent defendants - who are they?

• tend to live on the fringes of society
• likely unemployed
• likely unmarried
• likely of lower intelligence
• probably have a history of treatment for mental illness
• likely show obvious symptoms of current mental illness
• likely have a history of drug abuse
• usually charged with less serious crimes (not usually violent)

a psychotic
most common mental schizophrenia disorder is the
health problems single strongest
psychotic illnesses predictor of
bipolar
severe affective disorders incompetency
intellectual disability
below average cognitive functioning/adaptive skills
 Jackson v Indiana (1972)

limited the period of confinement in

mental hospitals, said people could
only be held for as long as it took to
determine if competency could be
restored in the foreseeable future
(most states now limit confinement
to between 4 and 18 months)

to restore CST - for involuntary commitment,

direct education on legal person must either be:
procedures "gravely disabled" or "imminently
antipsychotic medication dangerous to self or others"

anosognosia - when people who have a mental illness lack awareness of their
illness and see medication as unnecessary

Riggins v Nevada (1992)

forcing someone to take

medication against their will
deprives them of due process -
involuntary medication is only
permissible to achieve
essential state interests, such
as a fair trial or the safety of
the defendant and others
 Washington v Harper (1990) Sell v United States (2003)
Clarified the type of proceedings that were necessary before
incompetent defendants could be medicated against their will

Harper and Sell

SCOTUS ruling:

'
Sell criteria

• Medically appropriate
• Little to no side effects
• Necessary to further
government interests

most important CST decisions

Dusky v United States (1960)

Jackson v Indiana (1972)

Godinez v Moran (1993)

Sell v United States (2003)

Indiana v Edwards (2008)

Harper hearing: hearing before a neutral decision maker wherever person is held
Adolescents and CST
1990s - all 50 states began to allow juveniles of certain age to be tried in adult
court, for serious crimes, called "transfers to adult court"

MRI showed adolescent

brains look different and
work different from adult
brains - they lack fully
developed frontal lobes and
neuronal connections
(white matter) continue to
develop through age 20.

frontal lobe = impulse control, strategic behavior and

ability to appreciate the risk of certain behaviors

some forensic psychologists think CST should automatically happen if defendant

meets any of the following conditions:

• 12 years old or younger

• previous diagnosis of developmental disability or mental illness

• has a learning disability

• has low or borderline intelligence

• shows significant deficits in attention, memory, or understanding of reality

 4 main factors developmental
mental illness considered for disorders
juvenile CST
evaluations:

intellectual developmental
disability immaturity

Adolescents and CST - findings by age (2003 study)

impairment in CST-related areas: willingness to confess to a crime:

11-13 year olds 30% 11-13 year olds 50%

14-15 year olds 20% 14-15 year olds 20%
16-17 year olds 10% 16-17 year olds 20%

willingness to accept plea bargain:

"significantly more likely”
11-13 year olds 75% to be found incompetent
14-15 year olds 50% under 15
16-17 year olds 50% developmental or
intellectual disability