Psychiatric Times
May 2005
Vol. XXII
Issue 6
In their evaluations of 18 males in Texas condemned to death for homicides committed before their 18th birthdays, Dorothy Otnow Lewis, M.D., and colleagues relied on neuropsychiatric, neuropsychological, and educational examinations and assessments (J Am Acad Psychiatry Law 2004; 32(4):408-429).
"The psychiatric evaluation was based on a modified form of the Bellevue Adolescent Interview Schedule and the Dissociative Disorders Interview Schedule [DDIS]," Lewis told Psychiatric Times. "We used a cheat sheet to remind us of the questions from the interviews, but followed a more conversational approach in delivering the questions."
Lewis and colleagues noted that topics in the psychiatric evaluation included histories of neuropsychiatric symptoms, psychiatric treatment, medical history, characteristics of temper, family mental health histories, and histories of child physical and sexual abuse and family violence. An inmate's face, head and body were also examined for scars. Before the modified Bellevue Adolescent Interview was used in Texas, Lewis told PT, it was pre-tested at a residential treatment facility for delinquent children in another state.
"We trained the staff in its use. They liked it so much, they are using it as part of their intake," she said.
The neurological examination not only included mental status; cranial nerve function; and motor, sensory and cerebellar function, it also checked for the presence of frontal lobe deficits. Several tests were used in the neuropsychological assessments. Among them were the Test of Memory Malingering (TOMM), the Personality Assessment Inventory (PAI), the Weschsler Adult Intelligence Scale-III (WAIS-III) and tests of frontal lobe functioning. One tool, Lewis said, that was particularly helpful was the Iowa Gambling Task, an unstructured test of executive function developed by Bechara and colleagues (Cognition 1994; 50(1-3):7-15).
