Explanatory Models Differentiating Servicemember Malingering from Delayed Symptom Report.

The military mental health clinic is a medico-legal setting that provides servicemembers with treatment, administrative, and forensic services. Clinicians must be vigilant for malingering in this setting but flexible enough to recognize genuine symptoms. This task is often complicated by servicemembers' delayed report of symptoms. Three explanatory models are proposed that distinguish delayed report from malingering: genuine delayed report of symptoms, acute distress malingering, and disability malingering. These explanatory models improve clinician objectivity and offer a systematic understanding of these different presentations.

Panel Bias During Sexual Assault Courts-Martial.

This article examines criticism from the scholarly community and findings from the military's Judicial Proceedings Panel that training in the U.S. Department of Defense Sexual Assault Prevention and Response program biases panel members during courts-martial. The topic is examined from the perspective of psychological science. Studies on jury bias, stereotypes, decision-making dynamics, and behavioral conditioning are applied to the question of whether sexual assault prevention training can bias panel members. Analysis of the subject suggests that servicemembers are subjected to a range of bias-inducing mechanisms that arise within the military context. This article concludes that expert witnesses in behavioral science should be called during courts-martial to explain how judgements may be influenced by institutional training. Reinforcing the integrity of the military justice system has implications for protecting individual liberties.

Traumatic Brain Injury, Working Memory, and Violent Crime in a Sample of U.S. Service Members Involved in the Military Justice System.

INTRODUCTION: This study examined working memory impairment following mild traumatic brain injury (mTBI) among active duty service members charged with criminal offenses. The prevalence of mTBI among service members involved in the military justice system is unknown. Impairments associated with mTBI may affect cognitive processes related to psycholegal capacities, and history of mTBI may have a persuasive appeal when explaining questions of culpability. The degree to which mTBI affects psycholegal abilities through cognitive impairment, however, is unknown. MATERIALS AND METHODS: This was a retrospective study of U.S. service members who presented for forensic evaluation (n = 80). Completed forensic evaluations (eg, criminal responsibility, competence to stand trial, risk assessment) were the source of data. Working Memory Index (WMI) score of the Wechsler Adult Intelligence Scale, Fourth Edition was used as an index of sequelae after brain injury. RESULTS: A history of mTBI was present in 20% of the sample. The mean time from mTBI diagnosis to presentation for forensic evaluation was 3.96 years. The mTBI-positive group had a mean WMI = 98 and the mTBI-negative group had a mean WMI = 103. The difference in WMI scores between groups was not statistically significant. CONCLUSIONS: This study suggests that a history of mTBI is common among service members charged with criminal offenses. The findings that working memory scores were in the average range among service members with mTBI history may suggest that history of mTBI does not impair psycholegal relevant cognition. More research is needed to clarify how history of mTBI affects service member psycholegal capacities.

An Examination of PTSD and Criminal Responsibility among US Servicemembers.

INTRODUCTION: This retrospective study evaluated the prevalence of posttraumatic stress disorder (PTSD) diagnosis among military servicemembers referred for Sanity Boards (n = 229), which is a military evaluation for competence to stand trial (CST) and criminal responsibility (CR). This study further explored the degree to which PTSD was considered a "severe mental disease or defect," the degree to which PTSD was associated with an opinion of not criminally responsible (NCR), and the degree to which PTSD was associated with incompetence to stand trial (IST). MATERIAL AND METHODS: Completed Sanity Board evaluations were the source of data. This study used an empirical approach to reviewing the Sanity Boards. RESULTS: Sanity Boards diagnosed 13.1% of referrals with PTSD. Of those diagnosed with PTSD, no participants (0%) were opined to meet criteria for incompetence to stand trial (IST), 30% were opined to meet the insanity criteria of "severe mental disease or defect," and one person (0.4%) was found not criminally responsible (NCR) based on PTSD. In the single case in which the person was recommended as NCR based on PTSD, the criminal behavior was deemed to be related to dissociation. CONCLUSIONS: PTSD is often considered a "severe mental disease or defect" during Sanity Board evaluations, which differs from the legal standard for "severe mental disease or defect" used by the military justice system. Forensic practitioners consulting with the military justice system acknowledge that PTSD is a "severe mental disease or defect" often, but they rarely opine that PTSD renders a servicemember NCR. In the rare instance where PTSD was opined to render a servicemember NCR, the symptom of dissociation caused an inability to appreciate the nature and quality or wrongfulness of the action.

Psychiatric Comorbidity of Sex Offenses in a Military Forensic Sample.

OBJECTIVE: To examine the prevalence of psychiatric disorders among service members charged with sexual offenses. METHODS: The sample comprised service members charged with any type of sexual offense and referred for forensic evaluation (N = 67). Forensic mental health evaluations (competency to stand trial, criminal responsibility, risk assessment) of service members charged with sexual offenses were examined and the assigned clinical diagnoses (according to DSM-IV or -5) were enumerated to provide natural frequencies and percentages. Data were collected from February 2018 to May 2018. RESULTS: Findings suggest that alcohol use disorder is the most prevalent disorder both at the time of offense (28%) and time of the forensic evaluation (38%). The 2 most prominent diagnostic categories were substance use disorders and trauma-and-stress-related disorders. CONCLUSIONS: Identification and treatment of psychiatric disorders among service members charged with sexual offenses may facilitate rehabilitation, reduce recidivism, and offer public health benefits. This topic should be further studied in a larger sample to effectively address this public health problem.