Factors influencing adjudicative competence and length of time to restoration

Few studies on adjudicative competence explore the relationship between diagnosis, treatment, and restorability. Most focus on demographics and major psychiatric diagnosis with very few exploring the diagnoses common to the forensic population (i.e., personality disorders and substance abuse). Our s...

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Bibliographic Details
Published in:Journal of forensic sciences 2021-05, Vol.66 (3), p.982-991
Main Authors: Secarea, Cristina M., Cleary, Sean D., Candilis, Philip J.
Format: Article
Language:English
Subjects:
Adjudication
adjudicative competence
Demographics
Diagnosis
Drug use
length of time to adjudication
length of time to restoration
medication adherence
Mental competency
Mental disorders
non‐restored to competence
Personality
Personality disorders
psychiatric diagnoses
psychiatric treatment
restorability
Restoration
restored to competence
substance use disorders
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Summary:Few studies on adjudicative competence explore the relationship between diagnosis, treatment, and restorability. Most focus on demographics and major psychiatric diagnosis with very few exploring the diagnoses common to the forensic population (i.e., personality disorders and substance abuse). Our study of 365 defendants who were incompetent to stand trial at a state psychiatric facility indicates that non‐restored defendants have a greater likelihood of cognitive disorders, misdemeanor charges, and histories of prior hospitalization, and less likelihood of personality disorders. In addition, the odds of having a substance use disorder and being medication non‐adherent was greater among restored defendants. The mean length of time to restoration (LOR) of 56 days was significantly different from the mean length of time to adjudication (LOA) for those not restored (88 days). This study supports prior literature on restorability while distinguishing those treated for psychosis from those treated for substance use and personality disorder. In its novel focus on medication adherence, the study expands the remediable factors available to clinical and forensic professionals and supports interventions that improve treatment and shorten the time to restoration.
ISSN:0022-1198
1556-4029
DOI:10.1111/1556-4029.14669