Archive for the ‘Forensic evidence’ Category
I first heard the term “over-valued belief” back in the mid-1990’s when I worked in forensic rehabilitation with a man adjudicated not guilty by reason of insanity. He had been very ill (psychotic) and very violent when unmedicated (and had killed more than once due to delusional beliefs) but had been in treatment and well-medicated for years when I met him.
One day he confided that he had been late for our treatment group because he couldn’t stop flushing the toilets on his ward. Later I asked him what he meant and he explained that when the State Legislature was in session and voting on bills, he felt he could also “vote” and perhaps sway their opinions. If he flushed the toilet at the right end of the group bathroom it was a vote for the Republican opinion and if he flushed a toilet at the left end of the group bathroom it was a vote for the Democrat perspective.
I asked him if the strategy worked and he grinned at me—“If I thought it worked, it would be a delusion and I am not delusional anymore. It’s just an over-valued belief at this point”. When I persisted by tilting my head and looking curious, he grinned more widely—“At this point, I can’t stop myself from doing it sometimes “just in case” but it only happens with bills that are really important”.
That lesson stuck with me so when I saw this article on the importance of defining the difference between a delusional belief and an over-valued idea—I knew it would end up as a blog post. It’s a good distinction to be aware of and perhaps especially important for those working on the criminal justice system.
In the aftermath of violent acts such as mass shootings, many people assume mental illness is the cause. After studying the 2011 case of Norwegian mass murderer Anders Breivik, University of Missouri School of Medicine researchers are suggesting a new forensic term to classify non-psychotic behavior that leads to criminal acts of violence.
“When these types of tragedies occur, we question the reason behind them,” said Tahir Rahman, M.D., an assistant professor of psychiatry at the MU School of Medicine and lead author of the study. “Sometimes people think that violent actions must be the byproduct of psychotic mental illness, but this is not always the case. Our study of the Breivik case was meant to explain how extreme beliefs can be mistaken for psychosis, and to suggest a new legal term that clearly defines this behavior.”
Breivik, a Norwegian terrorist, killed 77 people on July 22, 2011, in a car bombing in Oslo and a mass shooting at a youth camp on the island of Utøya in Norway. Claiming to be a “Knights Templar” and a “savior of Christianity,” Breivik stated that the purpose of the attacks was to save Europe from multiculturalism.
In other words, when people commit violent acts (like mass murders), many others often assume mental illness was involved. For the most part, we are unable to imagine the rationale for such acts and so we explain it to ourselves by presuming the killer must be insane. So, if someone commits mass murders, the armchair observer often “diagnoses” the killer with mental illness and/or psychosis. While it may make intuitive sense (e.g., “No one in their right mind would do that….”), it is often, nonetheless, inaccurate.
That is where the forensic examiner enters the scene to see if the level of thought disturbance meets the legal bar for murder driven by delusions. The field of forensic evaluation is very complicated and there are specific rules about the height of the bar over which one must leap (in very technical terms) in order to be declared incompetent to stand trial or to be found competent to stand trial but ultimately tried and found not guilty by reason of insanity or guilty but mentally ill.
When a forensic evaluator adjudges a defendant not legally responsible for having performed an unthinkable act (such as killing one’s family, child, or a group of random strangers), there are generally delusional beliefs (e.g., “I thought my mother was the devil”) driving the behavior. And there are strict definitions for what constitutes a delusional belief (see the DSM-5 diagnostic manual’s criteria here). So today’s researchers use the example of that well-covered mass murder in Norway to explain the killings were not driven by delusional beliefs (the legal bar) but rather, by non-psychotic “extremely over-valued beliefs”.
They define that new term by quoting the work of another author (McHugh in 1998) and say that extreme over-valued beliefs are typically accompanied by fanaticism:
An extreme over-valued belief is one that is shared by others in a persons’s cultural, religious, or subcultural group. The belief is often relished, amplified, and defended by the possessor of the belief and should be differentiated from a delusion or obsession. The idea fulminates in the mind of the individual, growing more dominant over time, more refined, and more resistant to challenge. The individual has an intense emotional commitment to the belief and may carry out violent behavior in its service. It is usually associated with an abnormal personality.
So one with an extreme over-valued belief may still commit very violent acts “in service” of that belief but they would not meet criteria for psychosis and would clearly understand what they were doing was wrong. From a legal perspective, they would be potentially guilty and subject to punishment. The authors say that “the court ultimately had to draw a line” in the Norway case and concluded that the shooter’s beliefs were “neither bizarre or delusional” and noted “the evaluators who opined that he was not criminally responsible should have consulted experts on right-wing ideologies before concluding that his grandeur was culturally implausible”.
In short, having extremely weird or bizarre beliefs is not the same as being mentally incompetent. This is a distinction worth keeping in mind during election years…
The authors (three prominent psychiatrists) say that “extremely over-valued beliefs” are going to be rigidly held (like delusions) but will be non-delusional. They close with two uncommonly clear sentences summarizing why they see this contribution as important.
The fact that a defendant committed a crime because of a delusional belief is a common basis for an insanity defense. It is therefore critically important that forensic psychiatrists properly identify a defendant’s belief as either a delusion or as an extreme over-valued belief.
From a litigation advocacy perspective, the takeaway for the prosecutor is that if a person’s behavior is driven by delusions, they may be successfully treated with medication. There is no medication that will help with the intractable extreme over-valued beliefs. The defendant is thus a potential danger to society since these beliefs are just as intractable as psychotic delusions.
While the distinction is a good one of which to be aware—the reality is that juries may well see the organized, plotting, and planning (probably psychopathic) predator with the “extremely over-valued beliefs” as potentially more dangerous than the mentally ill individual whose delusions will stop driving behavior when properly medicated. It makes sense for forensic examiners to be capable of differentiating between delusions and over-valued beliefs but for the layperson juror—these are just “two very scary” defendants and it’s likely they will want them both locked up.
Rahman T, Resnick PJ, & Harry B (2016). Anders Breivik: Extreme Beliefs Mistaken for Psychosis. The Journal of the American Academy of Psychiatry and the Law, 44 (1), 28-35 PMID: 26944741
Remember Walter Mitty? He was a fictional character who escaped his dull day-to-day existence by constructing elaborate daydreams wherein he was the hero rather than a wallflower. Well, apparently Walter was not so unusual. There are people who spend as much as 60% of their time lost in daydreams. These are people who realize their fantasies are not real but find the fantasies so enjoyable they cannot seem to stop engaging in the behavior. They are calling it maladaptive daydreaming.
Maladaptive daydreaming was defined by Eli Somer (in 2002) as “extensive fantasy activity that replaces human interaction and/or interferes with academic, interpersonal or vocational functioning”. Somer also characterizes maladaptive daydreaming as having “themes that typically include highly complex fantasies of social attractiveness, power, fame, and love, as well as other fanciful plots, accompanied by acted out behaviors”.
There is an incredible amount of information on the internet about this condition—driven mostly by people who have it and want to educate others and relieve the isolation that often accompanies the condition. They have created information pages, symptom lists, descriptions of the behavior being uncontrollable by the person experiencing it, and much more.
The Atlantic recently shared a very readable article on the issue by an author who had experienced maladaptive daydreaming. One of the most descriptive sentences is this: “I made a lot of close friends [in college] and had a few boyfriends, but I found it tiring to keep up with their conversations while watching TV in my mind”. The author describes the proliferation of information on the disorder on the internet and concludes that her 12-year-old self (lost in maladaptive daydreaming) was certainly not alone.
One of the researchers mentioned in the Atlantic piece was Eli Somer (who defined the phenomenon) who is one of the authors of the new paper on maladaptive daydreaming we are looking at today. This article offers information on the daydream qualities of 340 “self-identified maladaptive daydreamers” in comparison to 107 controls—all 447 of whom responded to an online announcement for participation and then completed multiple questionnaires on-line. Here are some of the differences researchers identified between “maladaptive daydreamers” and their control subjects:
Maladaptive daydreamers “differed significantly from normative daydreaming in terms of quantity, content, experience, controllability, distress, and interference with life functioning”.
Maladaptive daydreamers reported higher symptoms of “attention deficit, obsessive compulsive and dissociation symptoms than did controls”.
Maladaptive daydreamers reported spending about 57% of their awake hours daydreaming—compared to 16% for control subjects.
Maladaptive daydreamers reported higher levels of difficulty limiting their daydreaming while at the same time being distressed over how much time they spent in daydream than did the control subjects.
There is now a discussion occurring as to whether maladaptive daydreaming is a condition of its own or symptomatic of another condition. Whichever decision is made, the authors believe that maladaptive daydreaming causes significant distress, interferes with life function, and needs more attention.
From a litigation advocacy perspective, this is an intriguing description of maladaptive daydreaming. While those who maladaptively daydream report they are rarely confused as to what is fantasy and what is reality—we anticipate this defense could certainly arise in the not to distant future.
An expert might testify that while the defendant did not usually have trouble distinguishing between fantasy and reality, in this instance the content of the maladaptive daydream was so disturbing, the dreamer sought to defend against a perceived attacker in the real world.
While another expert could counter that argument by pointing to the numbers of maladaptive daydreamers who do not report confusion between fantasy and reality—we suspect any juror hearing about the richness, depth and texture of maladaptive daydreams—and knowing the proportion of awake time invested in maladaptive daydreaming—would conclude it would be hard for the daydreamer to not be confused by the power of maladaptive daydreaming.
Our mock jurors would ask whether someone should not be held responsible for their actions while also getting treatment for a debilitating condition—they always want to address personal responsibility, and that would certainly be a good point for the prosecution to make. We foresee a lively deliberation room debate if this one ever makes it to the courtroom.
Bigelsen J, Lehrfeld JM, Jopp DS, & Somer E (2016). Maladaptive daydreaming: Evidence for an under-researched mental health disorder. Consciousness and Cognition, 42, 254-66 PMID: 27082138
Sometimes we find articles we want to blog about almost immediately and other times we go through a lot of reading to identify something appropriate for a post. But along the way we almost always have tidbits we thought intriguing, resonant of a past post or series of posts, esoteric, or just plain weird. When we pull together enough of them for a post of assorted “conversation starters”, you know we’ve been reading a lot more than we’re posting!
Calm down, you are not addicted to your smartphone!
You simply have an anxious attachment style. The BPS Research Digest returns to a topic we’ve covered here before called nomophobia—which describes the anxiety experienced when we have no cell phone in our possession. They describe research completed in Hungary which says that everyone would experience anxiety over not having a cell phone—it is just expected in today’s society. The researchers say, that we should think of our relationship with our phones in terms of attachment theory. They suggest that anyone who has a fear of abandonment (an attachment issue) in their human relationships is likely going to be more anxious about being separated from their phone as well—it’s just an anxious attachment style. You were a worrier before, so you also worry about not having your phone. You feel better now, right?
When DNA implicates the innocent & Eye witness identification errors
In the event you missed them, Scientific American has had really good articles on the legal system recently. Don’t miss this article highlighting times when DNA is very, very wrong or this one on how level of certainty in eyewitnesses can improve the efficacy of police lineups. Both are worthy of your time to read.
How to sound charismatic
We’ve written about deep voices and how appealing they can be and now here is an article from the Atlantic dissecting how politicians vary their voice pitch and tone during speaking engagements in order to appeal to the widest audience possible. It’s disturbing.
Neurocriminology, say the authors of today’s paper, is “the study of the brain and how it affects antisocial behavior”. When neurocriminology comes to the courtroom, we call it neurolaw and we have blogged about this intersection between neurosciences and law for years.
The paper we are posting about today is meant as a primer on the various regions of the brain so that those of us who are not brain scientists can understand the relationship between brain abnormalities and “bad” behavior. The authors are two academics in criminal justice and a postdoctoral fellow at the Mind Research Network in New Mexico. The language is plain, straightforward, and succinct—and as such, this is a terrific resource for the attorney who wants to understand basics of brain anatomy and function and how they relate to practical issues such as litigation and criminal behavior in general.
After describing the various parts of the brain and the functions they are supposed to address, the authors go on to discuss the most effective methods of assessing the structure and function of the brain (via CAT or CT scans, MRI, fMRI, PET, SPECT, and EEG—alphabet soup you have seen before if you’ve read any of the neurolaw articles in the media or our posts here). They discuss the advantages and limitations of each of these techniques and offer easy to understand language for what each method actually does.
Then, the authors move on to discuss the impact drugs have on the brain—especially illicit drugs with psychoactive effects, nicotine, alcohol, Viagra, and opiates. They discuss the initial high and the lasting effects on the brain as well as why drug abuse is such a difficult cycle to break. They also discuss pharmacological treatment, vulnerability to addiction, and criminal behavior with the perspective that these are issues directly related to brain function and structure (which may be damaged in multiple ways or have damage since birth).
While, the authors opine, biology is not our destiny—it does contribute at least half of the variance to the equation with the other half being composed of experiences and what we typically refer to as “nurture” in the nature vs. nurture debate.
From a litigation advocacy perspective, this article is a terrific way to familiarize yourself with the issues when neuroscience facts are part of your case narrative and is likely a good reference piece to keep on hand as a refresher course when faced with issues related to brain injury or anomaly.
Jorgensen, C., Anderson, N., & Barnes, J. (2016). Bad Brains: Crime and Drug Abuse from a Neurocriminological Perspective. American Journal of Criminal Justice, 41 (1), 47-69 DOI: 10.1007/s12103-015-9328-0
We’ve written about neurolaw fairly routinely here and recently Science Magazine took a look at what they call “the growing use of neurobiological evidence in criminal trials”. In our own experiences with pretrial research, mock jurors are not often accepting of “my brain made me do it” defenses and will roll their eyes and sometimes openly mock the defense claims. This exemplifies the uphill battle that neurobiological defenses face, but they can succeed. There are increasing numbers of cases with such defenses presented in court. A recent article in the Journal of Law and Biosciences reported that in 2012 more than 250 cases involving “my brain made me do it” defenses were brought to trial and this was more than double the number of similar claims made in 2007. Science Magazine offers this case summary to illustrate:
In 2008, in El Cajon, California, 30-year-old John Nicholas Gunther bludgeoned his mother to death with a metal pipe, and then stole $1378 in cash, her credit cards, a DVD/VCR player, and some prescription painkillers. At trial, Gunther admitted to the killing, but argued that his conviction should be reduced to second-degree murder because he had not acted with premeditation. A clinical psychologist and neuropsychologist testified that two previous head traumas—one the result of an assault, the other from a drug overdose—had damaged his brain’s frontal lobes, potentially reducing Gunther’s ability to plan the murder, and causing him to act impulsively. The jury didn’t buy Gunther’s defense, however; based on other evidence (such as the fact that Gunther had previously talked about killing his mother with friends) the court concluded that he was guilty of first-degree murder, and gave him a 25-years-to-life prison sentence.
This is precisely the sort of reaction we have come to anticipate from mock jurors. You cannot “see” the impact of mental illness or head injury, so mock jurors look for evidence to support guilt despite allegations of brain injury or mental illness. Yet, as pointed out in the Farahany article in the Journal of Law and the Biosciences, the increasing use of “my brain made me do it” defenses means the defense is likely here to stay and neuroscientists need to enter the picture to help us all make sense of the defenses and to know whether the defense is legitimate or if the science cannot yet support the defense claims.
Neuroscientists should be at the forefront of this conversation—as experts in criminal courtrooms, in public presentations, through accessible writing for public audiences, or by filing amicus briefs in legal cases where neurobiological evidence is at issue. Neurobiological evidence has profound implications for some of the most significant decisions we make in law and policy. It’s time we better understand how it’s being used and start to address how it may be better used in our criminal justice system.
From a litigation advocacy perspective, we think this makes a lot of sense. When we have had cases involving illegal or grossly inappropriate behavior following a head injury, it has been very helpful for our jurors to understand the science of what areas of the brain control behavior and were damaged by some sort of trauma. Even when they do understand basic brain function though, the evidence is seen as something for which to have empathy but our mock jurors want to fall back on individual responsibility and believe the defendant should be responsible for behavior.
The implications of the tragedy (both the brain injury of the accused and the victims of their aggression) is too distressing for many people to really accept. If jurors want certainty in life, then the prospect that there are people walking the streets looking mostly normal, who are yet subject to intense, violent outbursts is too upsetting. There is a fear that if we excuse behavior based on genes or brain injuries, we can never feel safe again.
For the time being, the challenge will be to find jurors who can tolerate the uncertainty of life, and the potential that head injuries and biochemistry can turn Dr. Jekyl into Mr. Hyde. Until the defense can come up with a way to help jurors hearing “my brain made me do it” defenses feel safe excusing a defendant, the neurobiological defenses will likely continue to be largely ineffective.
Farahany, N. (2016). Neuroscience and behavioral genetics in US criminal law: an empirical analysis Journal of Law and the Biosciences DOI: 10.1093/jlb/lsv059