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Conceptualizing and Characterizing Accuracy in Assessments of Competence to Stand Trial


Douglas Mossman


University of Cincinnati College of Medicine

November 15th, 2008

Journal of the American Academy of Psychiatry and the Law, Vol. 36, p. 340, 2008
U of Cincinnati Public Law Research Paper No. 09-20

Abstract:     
This article describes a mathematical framework for conceptualizing the accuracy of forensic experts' opinions on competence to stand trial (CST) and explains how an expert's expressed opinion about CST can be decomposed into four elements: (1) contextual requirements of the defendant (determined partly by the defendant's past actions) that lie outside the defendant's future control; (2) personal attributes of the defendant that are relevant to competence; (3) the expert's intrinsic ability to distinguish competent from incompetent defendants; and (4) the expert's wish to favor or avoid certain types of outcomes (e.g., a preference to avoid seeing an incompetent defendant stand trial for a serious charge). Because experts are imperfect and have varying levels of confidence in their opinions, one can describe the accuracy of CST assessments by using receiver operating characteristic (ROC) analysis. The article describes some types of insights one might derive from ROC analyses of CST assessments if experts, at least for research purposes, expressed opinions as graded levels of confidence. Although no satisfactory gold standard exists for establishing the truth about a defendant's competence, statistical methods developed over the past two decades may allow investigators to make inferences about the diagnostic accuracy of experts' CST assessments.

Number of Pages in PDF File: 13

Keywords: competence to stand trial, expertise, receiver operating characteristic analysis, gold standard

JEL Classification: C00

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Date posted: November 8, 2008 ; Last revised: September 10, 2009

Suggested Citation

Mossman, Douglas, Conceptualizing and Characterizing Accuracy in Assessments of Competence to Stand Trial (November 15th, 2008). Journal of the American Academy of Psychiatry and the Law, Vol. 36, p. 340, 2008. Available at SSRN: http://ssrn.com/abstract=1296132

Contact Information

Douglas Mossman (Contact Author)
University of Cincinnati College of Medicine ( email )
260 Stetson Street, Suite 3200
P. O. Box 670559
Cincinnati, OH 45219
United States
513-558-4423 (Phone)
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