Special considerations to the assessment of fitness to stand trial in Australia.

Australian criminal law presumes that defendants are fit to stand trial until proven otherwise on the balance of probabilities. Forensic mental health experts often provide opinions to the court about defendants' fitness, which requires them to understand the legal context within which the court decides the defendant's fitness status. This article outlines important case law considerations to the assessment of fitness in Australia, including the notions that fitness must be evaluated when there is a 'real and substantial question', assessments should be 'reasonable and common sense' and accommodations should be considered when impairments in capacity are evident. The essentially negligible impact of delusions, an unhelpful defence, unmanageable behaviour and poor defendant-lawyer relationship are also considered. Finally, precedent is reviewed for the use of the Presser standards in New Zealand and other pacific jurisdictions.

Meta-analysis of second generation competency to stand trial assessment measures: Preliminary findings.

BACKGROUND: Since the 1990s, standardized competency to stand trial assessment measures have been developed to improve the reliability and validity of expert assessment and opinion in legal settings. This study aimed to meta-analyze the psychometric properties of the four 'second generation' assessment tools: the MacCAT-CA, MacCAT-FP, ECST-R and CAST*MR. METHOD: A systematic search of published and unpublished studies was undertaken on PsycNet, PubMed, Scopus, Web of Science and Science Direct up until February 2018. Test manuals were sourced and attempts at finding grey literature included contacting study authors and test developers. RESULTS: Eleven studies were included in the final analysis. The MacCAT-CA, ECST-R and CAST*MR demonstrated acceptable subscale internal consistencies and interrater reliability. The MacCAT-CA and CAST*MR discriminated between competent and incompetent defendants with large effects. The MacCAT-FP had insufficient reliability data and poor discrimination. There was insufficient data to meta-analyze the factor structure, sensitivity, specificity, or effect sizes between types of clinical presentation on any tool. CONCLUSIONS: Very few studies have investigated the psychometric properties of the selected tools. Many studies were excluded for not providing original data or simply re-reporting the psychometric properties stated in test manuals. Whilst the MacCAT-CA and ECST-R have promising psychometric properties, ongoing construct validation is required.

Development and psychometric properties of the Smoking Restraint Questionnaire.

Restraint is a component of self-control that focuses on the deliberate reduction of an undesired behavior and is theorized to play a role in smoking reduction and cessation. However, there exists no instrument to assess smoking restraint. This research aimed to develop the Smoking Restraint Questionnaire (SRQ) to meet this need. Participants were 406 smokers (48% female; 52.2% nondaily) with a mean age of 38.83 years (SD = 12.05). They completed a baseline questionnaire designed to assess smoking restraint. They also completed 21 days of ecological momentary assessment (EMA), during which they recorded each cigarette smoked and answered questions related to planned restraint every morning, and restraint attempts every evening. The 4-item questionnaire of smoking restraint was found to fit a single factor (root mean square error of approximation = .038, comparative fit index = .99, Tucker-Lewis index = .99), and the resulting composite was reliable (composite reliability = 0.74). The questionnaire contains items that assess the setting of weekly restraint goals and attempts at not lighting up when tempted to smoke. Participant SRQ scores positively correlated with EMA data on plans to restrain (p < .001) and frequency of restraint attempts (p < .001). These correlations suggest that the SRQ has good predictive validity in relation to the intention and behaviors of smoking reduction. The SRQ is promising as a measure of smoking restraint and may enable further research and insights into smoking reduction and cessation.