Neurobehavioral assessment in forensic practice

Abstract

There is a growing awareness among mental health practitioners that many mental disorders previously believed to be primarily behavioral in nature, reflecting character and environment, are actually grounded in brain mal-development or brain disorder. This growing awareness, influenced by the advent of new diagnostic procedures and measures, is also found among forensic practitioners. In this paper, we describe some of the elements involved in conducting a neurobehavioral assessment of cognitive functioning, particularly in capital cases, organizing this material in terms of the professional disciplines – social work, mitigation investigation, psychological, and medical – with which these methods are mainly identified. The paper concludes with a brief discussion of how to integrate the multiple areas of expertise to create an accurate understanding of the neurobehavioral functioning and capacity of the subject. This is the basis from which civil and criminal forensic opinions must emanate.

Neighborhood Effects, Mental Illness and Criminal Behavior: A Review

“…This should also affect how forensic assessment is conducted. Competent forensic neurobehavioral assessment requires a thorough multigenerational social history, along with the integration of information obtained from multiple sources, across a number of disciplinary approaches, each of which assess different aspects of behavior and functioning ( Woods, Freedman, & Greenspan, 2012 ). It is no longer adequate to consider the individual out of context or to seek to explain behavior and functioning without regard to the causal effects of structural forces.…”

The imperfect fit: Fetal alcohol spectrum disorder as the basis to commit individuals involuntarily as sexually violent predators/persons

“…After completing the SVP evaluation, FASD and SVP experts should consult regarding clinical case formulation as it relates to respondent's sexual offense history and differential diagnosis. Such consultation has become the standard of practice in psychology and psychiatry in the forensic context (e.g., Woods et al., 2012) as well as the standard of practice in both clinical and forensic contexts involving FASD (Novick Brown, 2021; Novick Brown et al., 2010). Expert consultation serves at least three important purposes (a) determining whether a respondent suffers from ND‐PAE alone or also has comorbid disorders based on data from multiple sources and methodologies; (b) analyzing sexual offense behavior and sexual offense history to ascertain if such data are consistent with the functional impairments in ND‐PAE (with or without comorbid mental health disorders) or are better explained by paraphilia and/or personality disorder; and (c) concluding whether the respondent's acquired or congenital condition currently affects emotional or volitional capacity by predisposing him to commit criminal sexual acts.…”

The developing significance of context and function: Neuroscience and law

“…Advances in neuroscience and new understandings of how behavior manifests require substantial improvements in how intent and appreciation are assessed. As reviewed above, the current practice relying primarily on clinical interview and incomplete collateral source material no longer meets scientific standards of reliability and validity, if it ever did (Woods, Freedman, & Greenspan, ). Fundamentally shaped by systematic errors, current assessment practices are failing to keep up with the best practice approaches to which psychological and psychiatric sciences ascribe.…”

“…We have previously set out the role and importance of the multigenerational bio‐psychosocial history for behavioral forensic assessment (Woods et al, ). This approach remains the best practice for sentencing issues, but it may also be appropriate and necessary for determining trial‐related culpability issues such as intent.…”

“…This change in focus from the categorical diagnostic model will require changes in diagnostic schemes, in how forensic examiners undertake assessment and reach reasoned and competent opinions, and in how courts understand and use neuroscience evidence to determine whether a defendant has the “evil‐meaning” thoughts that cause the offense. Life course and developmental trajectory approaches to understanding behavior and functioning have reconfigured the accepted approach to mental illness evidence in criminal cases and is now an expected component of the standard assessment, often making early life risk factors as important as immediate symptom presentation (Woods et al, ; Woods & Freedman, ).…”