Factors Influencing 2,260 Opinions of Defendants' Restorability to Adjudicative Competency

We examined 2,260 forensic assessments in which the evaluator opined that the defendant was incompetent to stand trial. In approximately one half of these evaluations (52%), the evaluator concluded that the defendant was likely to be restored to competency in the foreseeable future. This opinion was reached more frequently with defendants who were female, under the age of 60, suffering from an affective or psychotic disorder with previous psychiatric hospitalizations, and who were noncompliant with psychiatric medication at the time of the offense. Similarly, defendants were viewed as more likely to be restored to competency if the evaluation had been requested by the defense, the defendant was seen as not impaired on the capacity to understand legal proceedings element of the Dusky v. United States standard, the evaluator had a terminal degree of EdD and the defendant's psychological, medical, and/or criminal records had not been obtained and considered as part of the forensic assessment. Using chi-square automated interaction detector analyses (CHAID; Kass, 1980), we found that psychiatric diagnosis was the most powerful variable in classifying opinions concerning the restorability of incompetent defendants. Defendants diagnosed with an affective or psychotic disorder were more likely to receive an opinion of likely/probable restoration than those defendants diagnosed with pervasive developmental, organic, substance-use, personality, or other disorders. These data suggest that the clinical condition of the defendant lies appropriately at the center of this process of predictive opinion formulation. The results also indicate that referral biases and/or crime-specific motivations for finding offenders restorable, often suggested as possible contaminants to this process, are not statistically significant in our large sample of forensic referrals.