Translational Application of a Neuro-Scientific Multi-Modal Approach Into Forensic Psychiatric Evaluation: Why and How?

Abstract

A prominent body of literature indicates that insanity evaluations, which are intended to provide influential expert reports for judges to reach a decision “beyond any reasonable doubt,” suffer from a low inter-rater reliability. This paper reviews the limitations of the classical approach to insanity evaluation and the criticisms to the introduction of neuro-scientific approach in court. Here, we explain why in our opinion these criticisms, that seriously hamper the translational implementation of neuroscience into the forensic setting, do not survive scientific scrutiny. Moreover, we discuss how the neuro-scientific multimodal approach may improve the inter-rater reliability in insanity evaluation. Critically, neuroscience does not aim to introduce a brain-based concept of insanity. Indeed, criteria for responsibility and insanity are and should remain clinical. Rather, following the falsificationist approach and the convergence of evidence principle, the neuro-scientific multimodal approach is being proposed as a way to improve reliability of insanity evaluation and to mitigate the influence of cognitive biases on the formulation of insanity opinions, with the final aim to reduce errors and controversies.

Basic principles and new advances in kidney imaging

“…This discrepancy might be addressed by applying machine-learning methods to make inferences based on individual structural or functional imaging data. 95 Although complex, timeconsuming, and expertise-demanding data analysis might forbid rapid clinical decision-making, these obstacles might be thwarted by implementation of automated, user-friendly software tools. The increased volume and added complexity of imaging data could be circumvented by developing powerful data archiving and software tools.…”

Validation of a new instrument to guide and support insanity evaluations: the defendant’s insanity assessment support scale (DIASS)

“…In addition, several factors such as money, prestige, and the amount of public attention attracted by the case have been shown to have an influence on forensic experts' decisional processes [11]. Another source or limit could be represented by the intrinsic limits of psychiatric diagnosis and the longitudinal variability of psychiatric symptoms [12]. Moreover, discrepancies between forensic reports may be accounted for also by the absence of biological markers available and the relative scarcity of reliable diagnostic tools to guide forensic evaluations.…”