Abstract
The purpose of this study was to examine the rate of agreement between clinicians and judges in civil incompetency adjudications in incompetency and restoration cases and to determine predictors of court adjudications with clinician recommendation as a predictor. Court files were obtained for court-ordered requests (N = 345) for incompetency evaluations from one urban county. Court files containing the legal opinion were linked with clinical files containing demographic variables such as age, education, sex, race, residency status, relationship status, and cognitive and functional testing. The latter were the Mini-Mental State Examination and Managing Money and Health and Safety subtests of the Independent Living Scales. In each case, we documented the clinician’s opinion about whether the examinee was competent or incompetent. Overall, the court agreed with the clinician 87.1% of the time. However, the rate of agreement was higher for incompetency adjudication (94.4%) versus competency restoration (55.9%). The only difference between cases of agreement versus disagreement was that the former were significantly older. In terms of predicting judicial decision-making, the clinician recommendation was significant even after controlling for demographic and functional variables. We address how these findings compare with clinician-court agreement for criminal cases and the implications of our findings.
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Notes
Five examinations from the first authors’ practice who were evaluated in 2019 were included in this database. Also, 33 were missing court adjudication data.
Respondents or petitioners may seek private examinations—though this is somewhat rare—but we do not include these as these reports are not consistently available.
Of these four examinations, one individual was examined twice for incompetency, one was examined twice for restoration, and two were first examined for incompetency, and then for restoration.
These data were structured so that participants were nested within examiners, thus, observations were not independent of each other because they could be grouped by examiner. However, examiners varied widely in the number of individuals they evaluated: one examiner evaluated 228 participants, a second evaluated 52, a third evaluated 18, and 12 other examiners each evaluated 9 or fewer participants. This wide variation in number of participants evaluated by examiners made it difficult to test for violations of the independence assumption of regression analyses (Grawitch & Munz, 2004); when we did analyze these data using mixed modeling, the models would not converge. Thus, we tested our hypotheses using hierarchical logistic regression and included examiner as a covariate, coded such that the examiner who assessed the majority of cases was compared to all other examiners. There was no effect for the examiner.
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Demakis, G.J., Canevello, A. Clinician-Court Agreement and Predictors of Court Adjudication in Civil Incompetency Examinations. Psychol. Inj. and Law 17, 66–75 (2024). https://doi.org/10.1007/s12207-024-09500-z
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DOI: https://doi.org/10.1007/s12207-024-09500-z