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15. Abnormal Psychology and the Law Multiple-Choice Questions 1. ______ attempted to assassinate Congresswoman Gabrielle Giffords A. John Hinckley B. Jared Loughner C. James Earl Ray D. Theodore Bundy Answer: B 2. Appearing before a U.S. district court, Jared Loughner was found to be ________. A. clinically depressed B. suffering from schizophrenia C. competent to stand trial D. incompetent to stand trial Answer: D 3. The formal determination of Jared Loughner’s mental status at the time of the shooting he committed was __________. A. never determined because he later pled guilty to the charges B. severe depression with psychotic features C. paranoid schizophrenia D. brief psychotic disorder Answer: A 4. People who are placed in psychiatric institutions because they show abnormal behaviors and are deemed to be a threat to themselves or others are committed through a process of ______ commitment. A. voluntary B. institutional C. criminal D. civil Answer: D 5. Psychiatric commitment is the same as ______ commitment. A. voluntary B. institutional C. criminal D. civil Answer: D 6. The legal process of placing a person in a mental institution, even against his or her will, is known as ______ commitment. A. civil B. voluntary C. criminal D. institutional Answer: A 7. When an individual seeks admission to a mental hospital for treatment of his or her own volition, it is known as ______ hospitalization. A. civil B. voluntary C. criminal D. institutional Answer: B 8. Someone who is in a mental hospital as a result of ______ can leave the hospital whenever she or he desires. A. civil commitment B. voluntary hospitalization C. criminal commitment D. any type of commitment or hospitalization Answer: B 9. People who are placed in psychiatric institutions because they were acquitted of a crime by reason of insanity are committed through a process of _______ commitment. A. voluntary B. institutional C. criminal D. civil Answer: C 10. The legal process of confining a person found not guilty by reason of insanity in a mental institution is called ______. A. social commitment B. criminal commitment C. civil commitment D. institutional commitment Answer: B 11. People must be judged ______ to be psychiatrically (civilly) committed. A. unable to care for their own needs B. mentally ill, but not necessarily dangerous C. dangerous to themselves or others but not necessarily mentally ill D. mentally ill and dangerous to themselves or others Answer: D 12. The Supreme Court ruled in Addington v. Texas that individuals can be hospitalized involuntarily if they are ______. A. mentally ill and dangerous to others B. mentally ill and dangerous to themselves C. mentally ill and dangerous to themselves or others D. dangerous to themselves or others Answer: C 13. It was not until ______ that the United States Supreme Court ruled that persons must be judged both "mentally ill" and a clear and present danger to themselves or others before they may be involuntarily hospitalized. A. 1919 B. 1939 C. 1959 D. 1979 Answer: D 14. The court case in which the court found that individuals must be judged to be both mentally ill and to present a clear and present danger to themselves or others in order to be involuntarily hospitalized was ______. A. Youngberg v. Romeo B. O'Connor v. Donaldson C. Wyatt v. Stickney D. Addington v. Texas Answer: D 15. One of the most vocal and persistent critics of civil commitment statutes has been ______. A. Hans Eysenck B. Fritz Perls C. Egas Moniz D. Thomas Szasz Answer: D 16. Thomas Szasz, whom the text describes as stridently opposed to the entire concept of civil commitment, was a ______. A. clinical psychologist B. psychiatrist C. social worker D. attorney Answer: B 17. Mental health professionals tend to ______ dangerousness in mental health patients. A. refuse to predict B. underpredict C. accurately predict D. overpredict Answer: D 18. Which statement is true about the prediction of dangerousness by mental health professionals? A. Psychological assessment allows clinician to be very accurate in their predictions of dangerousness. B. They tend to underpredict dangerousness. C. They err on the side of caution in predicting dangerousness. D. They tend to not label individuals as dangerous when they actually are dangerous. Answer: C 19. Both the American Psychological Association and the American Psychiatric Association have gone on record stating that ______ can reliably predict violence among those they treat. A. neither psychologists nor psychiatrists B. psychologists, but not psychiatrists C. psychiatrists, but not psychologists D. both psychologists and psychiatrists Answer: A 20. Clinical predictions of dangerousness are generally less accurate than ______. A. relatives’ predictions B. a layperson’s predictions based on evidence of past violent behavior C. police predictions based on observation D. neighbors’ predictions based on interactions Answer: B 21. Margot, a college senior who majors in criminology, fancies herself as skilled in predicting dangerousness when she reads case histories of teenage thieves. Which piece of information would be most instrumental in enhancing Margot’s accuracy in predicting violence? A. victimized by sexual abuse as a child B. no father in the home C. engaged in past violence D. degree of introversion Answer: C 22. Which of the following statements is true? A. Past violent behavior may not be the best predictor of future violent behavior. B. Clinicians, because of their specialized training, possess a special knowledge and ability for predicting violence that goes far beyond that of the average person. C. Hospital staff are always permitted access to criminal records that would reveal past violent behavior. D. Some critics believe that “dangerousness” should be dropped as a criterion for civil commitment. Answer: D 23. Which of the following is a factor cited to account for the inability of professionals to predict dangerousness? A. Recognizing violent tendencies after a violent incident is easier than predicting it beforehand. B. Violent acts like murder and assault are so common that it is difficult to sort out who will and who won’t commit such acts. C. There is consistency among experts for defining the criteria for violent or dangerous behavior. D. Generalized perceptions of violent tendencies often predict specific acts of violence. Answer: A 24. The “base-rate problem” refers to ______. A. the large number of people with potentially dangerous mental health problems B. the shortage of trained professionals to thoroughly evaluate people with serious mental health problems C. the shortage or properly equipped facilities to treat people with serious mental health problems D. the relative difficulty of making predictions of infrequent or rare events Answer: D 25. Predictions of dangerousness based on clinical judgments of psychologists and psychiatrists ______. A. are less accurate than predictions based on chance alone B. are no more accurate than predictions based on chance alone C. are more accurate than predictions based on chance alone, but less accurate than evidence based on evidence of past violent behavior D. are more accurate than predictions based on chance alone or evidence of past violent behavior Answer: C 26. Incorrectly failing to predict the occurrence of a problematic behavior is known as a(n) ______. A. inherent negative bias B. inherent positive bias C. false negative D. false positive Answer: C 27. Incorrectly predicting the occurrence of a problematic behavior is known as a(n) ______. A. inherent negative bias B. inherent positive bias C. false negative D. false positive Answer: D 28. In predicting dangerousness, clinicians tend to have an excess of ______. A. true positives B. true negatives C. false positives D. false negatives Answer: C 29. In psychotherapy, threats of violence are likely to be ______. A. directed at the therapist B. clear and specific C. directed at a member of the patient’s family D. vague and nonspecific Answer: D 30. Which of the following types of threats is the MOST reliable indicator of dangerousness? A. a vague, indirect threat B. a specific, indirect threat C. a vague, direct threat D. a specific, direct threat Answer: D 31. When a potentially violent patient is being released from the hospital, what is considered the best predictor of future violence? A. quality of behavioral control in the hospital community B. quality of behavioral control when the patient lived in the general community C. quality and quantity of the patient’s individual psychotherapy while hospitalized D. quality and quantity of the patient’s group psychotherapy while hospitalized Answer: B 32. The case of Larry Hogue involves ______. A. the difficulties in trying to predict dangerousness B. the political problems involved in the "duty to warn" C. how to balance the rights of the individual with the rights of society D. how to evaluate one's competency to stand trial Answer: C West 96th Street”? 33. The likelihood of violence in people with serious psychiatric problems is increased by ______. A. lengthy hospitalization B. financial problems C. substance abuse D. extent of I.Q. over 100 Answer: C 34. A mental health professional should be particularly alarmed about potential violence if a schizophrenic person reports experiencing ______. A. command hallucinations B. auditory hallucinations C. delusions of grandeur D. delusions of persecution Answer: A 35. Which classic movie featured abuses in the mental health system? A. Come Back Little Sheba B. Mr. Roberts C. One Flew Over the Cuckoo’s Nest D. Ship of Fools Answer: C 36. The federal court case of ______ established a minimum standard of care in psychiatric hospitals A. Marbury v. Madison B. Lamson v. Alabama C. O’Connor v. Donaldson D. Wyatt v. Stickney Answer: D 37. Ricky Wyatt, the lead plaintiff in Wyatt v. Stickney, was ______. A. schizophrenic B. manic depressive C. mentally retarded D. sociopathic Answer: C 38. In the case that established minimum standards of care for mental patients, the federal court required that mental hospitals must provide which of the following? A. Restitution to patients who had been previously mistreated. B. A humane psychological and physical environment. C. The right for the patient to use her own bedding and to decorate the room she is residing in. D. Choice in terms of when the patient wants to eat and the types of available foods. Answer: B 39. In O’Connor v. Donaldson, Kenneth Donaldson had originally been committed to a psychiatric hospital by ______. A. the police B. his son C. his brother D. his father Answer: D 40. In O’Connor v. Donaldson, Kenneth Donaldson had lived in a state psychiatric hospital for ______ without needing or obtaining treatment before his lawsuit. A. 5 years B. 9 years C. 14 years D. 19 years Answer: C 41. The case of ______ established certain patient rights, including the right not to be required to perform work that is for the sake of maintaining the facility. A. Addington v. Texas B. O’Connor v. Donaldson C. Wyatt v. Stickney D. Tarasoff v. Regents of UC Answer: C 42. The court case in which the court decided that “mental illness [alone] cannot justify a State’s locking a person up against his will and keeping him indefinitely in simple custodial confinement” was ______. A. Youngberg v. Romeo B. O’Connor v. Donaldson C. Wyatt v. Stickney D. Addington v. Texas Answer: B 43. Which of the following is listed in the “Patient’s Bill of Rights” established by the federal court? A. Patients have a right to suitable opportunities to interact with the opposite sex. B. Patients have a right to bring their own bed linens and furniture to the hospital setting. C. Patients have a right to refuse any treatment which they find objectionable. D. Patients have a right to regular exercise and to spend time in the community at their leisure. Answer: A 44. Which of the following is listed in the “Patient’s Bill of Rights” established by the federal court? A. Patients have the right to community entertainment such as shopping, movies, and cultural events. B. Patients shall never be kept in restraints or isolation. C. Patients have a right to visitation and telephone privileges. D. Patients shall not be expected to participate in their treatment plan. Answer: C 45. When Kenneth Donaldson sued a Florida state mental hospital for failing to provide treatment for him during 14 years of confinement, the United States Supreme Court ruled that the state has ______. A. a right to involuntarily confine a person for mental illness even if that person poses no danger and could safely survive in the community B. a right to involuntarily confine a person in a mental hospital if the person is dangerous, even if that person is not mentally ill C. no right to involuntarily confine a person who is dangerous unless the person is proven to be mentally ill D. no right to confine a person for mental illness unless that person poses a clear and present danger or cannot safely survive in freedom Answer: D 46. The case of a profoundly retarded man who was kept in restraints in a Pennsylvania state hospital because he kept injuring himself was ______. A. Youngberg v. Romeo B. O'Connor v. Donaldson C. Wyatt v. Stickney D. Addington v. Texas Answer: A 47. The court case in which the court ruled that patients have a right to training to help them function free of restraints, but only when that training can be provided in reasonable safety, is ______. A. Youngberg v. Romeo B. O’Connor v. Donaldson C. Wyatt v. Stickney D. Addington v. Texas Answer: A 48. The U.S. Supreme Court’s ruling in ______ included an opinion that judges and juries should not ordinarily second guess mental health professionals. A. Rogers v. Orkin B. Addington v. Texas C. O’Connor v. Donaldson D. Youngberg v. Romeo Answer: D 49. The confidentiality of a client’s communication to a psychotherapist is ______. A. absolute B. only breached when the therapist has a duty to warn C. the therapist’s privilege to handle at his or her discretion D. limited by certain conditions Answer: D 50. The case that established the legal basis for a therapist’s duty to warn was the ______. A. Jones case B. Tarasoff case C. Durham case D. M’Naghten case Answer: B 51. The Tarasoff ruling occurred in ______. A. 1966 B. 1976 C. 1986 D. 1996 Answer: B 52. The Tarasoff ruling was made by ______. A. the U.S. Supreme Court B. a Texas court C. the California Supreme court D. the North Carolina Supreme court Answer: C 53. In the Tarasoff case, Poddar’s therapist ______. A. ignored his threat to kill Tatiana Tarasoff B. informed the campus police that he was dangerous C. informed Tatiana Tarasoff’s parents that he wanted to kill their daughter D. informed only his colleagues of his concern about his dangerousness Answer: B 54. The outcome of Poddar’s criminal trial was that he ______. A. served a sentence for manslaughter and returned to India B. was convicted of murder and is serving a life sentence C. was convicted of murder and was executed D. was acquitted by reason of insanity Answer: A 55. In the Tarasoff case, the court ruled that a therapist ______. A. has a duty to warn an intended victim if during therapy a client makes statements indicating that he or she poses a serious threat to that potential victim B. has a duty to contact police if during therapy a client makes statements indicating that he or she is a threat to the health and safety of others C. cannot disclose confidential statements made during therapy sessions, even to warn someone of a threat against them, unless the client has a previous history of violence towards others D. cannot disclose confidential statements made during therapy sessions, even to warn someone of a threat against them Answer: A 56. The Tarasoff ruling places the therapist’s duty to warn in direct conflict with ______. A. the duty to heal B. principles of confidentiality C. principles of competency to stand trial D. judgments of legal sanity or insanity Answer: B 57. Which of the following is a reason why the Tarasoff decision may actually increase the risk of violence? A. Clients may be less willing to confide in their therapists and therefore have built up feelings of anger and resentment that may be discharged more readily into the community. B. Clients may be more likely to act out their violent impulses on therapists rather than on the original intended victims. C. Potentially violent people may be less likely to enter therapy. D. Therapists are more likely to decline the referral of any client dealing with a romantic break-up or conflicted relationships. Answer: C 58. The Tarasoff ruling recognized that the rights of the _______. A. psychotherapy client are as important as those of the intended victim B. psychotherapy client are already specified in state and national laws C. intended victim outweigh the rights of confidentiality D. intended victim cannot impact the sanctity of the psychotherapy session Answer: C 59. During the middle of a psychotherapy appointment, Jason confesses to Dr. Hill that he is going to kill his girlfriend because she is talking about breaking up. “If I can’t have her, nobody can have her,” Jason angrily stated. According to ______, Dr. Hill must ______. A. Wyatt v. Stickney; honor his agreement of confidentiality with Jason B. Tarasoff v. Regents of the Regents of the University of California; honor his agreement of confidentiality with Jason C. Wyatt v. Stickney; warn Jason’s girlfriend about the threat to her life D. Tarasoff v. Regents of the Regents of the University of California; warn Jason’s girlfriend about the threat to her life Answer: D 60. Aside from threat of violence, another murky area where therapists must balance confidentiality with duty to warn obligations is in treating people who ______. A. are unfaithful to their spouses B. have committed crimes like burglary or drug sales C. have disclosed issues about sexual harassment to the therapist D. have not disclosed that they are HIV-positive to their partners Answer: D 61. In a 1979 Massachusetts court case, the court ruled that hospitalized mental patients have ______. A. a right to refuse medication in any situation B. a right to refuse medication except when it is an emergency in which the patients' behavior poses physical risks to themselves or others C. a right to refuse only medications deemed by the court to be "high-risk" medications D. no right to refuse medications that their caregivers deem a necessary and appropriate part of treatment Answer: B 62. The court case in which the court ruled that committed patients cannot be forcefully medicated except in emergency situations is ______. A. Rogers v. Okin B. O'Connor v. Donaldson C. Wyatt v. Stickney D. Addington v. Texas Answer: A 63. In the 1979 case of Rogers v. Okin, the court ruled that ______ has a right to exercise bad judgment within certain broad limits. A. neither a patient with a mental illness nor one without a mental illness B. a patient with a mental illness, but not a patient without a mental illness C. a patient without a mental illness, but not a patient with a mental illness D. a patient with or without a mental illness Answer: D 64. Legal protections ensuring patients’ rights to refuse psychiatric treatments appear to have had ______ on mental-health services or the people receiving these services. A. few damaging or disruptive effects B. few disruptive effects, although there have been some seriously damaging effects C. few damaging effects, although there have been some seriously disruptive effects D. serious long-term damaging and disruptive effects Answer: A 65. About ______ percent of patients refuse medication. A. 10 B. 20 C. 30 D. 40 Answer: A 66. ___________ of patient refusals to take medication are overridden by the courts. A. Very few B. All C. None D. The great majority Answer: D 67. In the Hinckley case, the prosecutor was burdened to demonstrate beyond a reasonable doubt that __________. A. the concept of insanity has never been adequately proven and should not factor into the verdict B. Hinckley did not have capacity to control his behavior and appreciate its wrongfulness. C. Hinckley had the capacity to control his behavior and appreciate its wrongfulness. D. Hinckley had never exhibited any psychological problems before the assassination attempt and therefore his attempt had malevolent intentions. Answer: C 68. John Hinckley’s trial for attempting to assassinate President Reagan resulted in a decision that Hinckley was ______. A. guilty and sentenced to life in prison B. guilty and sentenced to 10 years in prison C. guilty and sentenced to 25 years in prison D. not guilty by reason of insanity Answer: D 69. The public perception of the insanity plea is that it is ______ and ______ successful. A. rarely used, rarely B. widely used , rarely C. rarely used, highly D. widely used, highly Answer: D 70. The insanity defense is actually used in ______ percent of all felony cases. A. less than 1 B. about 2 C. about 4 D. about 8 Answer: A 71. The public ______ the proportion of defendants acquitted on the basis of insanity and ______ the length of hospitalization of those who are confined. A. underestimates, underestimates B. underestimates, overestimates C. overestimates, underestimates D. overestimates, overestimates Answer: C 72. People acquitted by reason of insanity ______. A. must go to prison as soon as they are cleared by a psychiatric hospital B. are often confined to mental hospitals for longer periods than they would have spent in prison C. usually have tricked the jury D. are underestimated in frequency by the public Answer: B 73. As an aftermath of the Hinckley verdict, many states changed their statute to ______. A. eliminate the insanity defense B. limit the insanity defense to cases of schizophrenia and profound mental retardation C. place greater burden of proof on the defense D. place greater burden of proof on the prosecution. Answer: C 74. A person receiving a “guilty but mentally ill” verdict in a criminal trial will receive ______. A. jail time but no extra treatment for mental illness B. hospitalization in lieu of jail time C. hospitalization until cured, and will then serve the remainder of their sentence in jail D. imprisonment, but will receive treatment for their illness while serving their sentence Answer: D 75. The “guilty but mentally ill” verdict was a reaction to ______. A. the Tarasoff decision B. the trial of James Earl Ray C. John Hinckley’s acquittal D. Andrea Watts’s conviction Answer: C 76. Overall, the guilty but mentally ill verdict ______. A. has proven to be completely unworkable and is likely to be eliminated in most states at some point in the near future B. is a social experiment that has not yet proved its usefulness C. is viewed as a major step forward in helping juries and judges find an appropriate sentence in cases in which the insanity plea is used D. has proven to be a panacea, virtually eliminating most problems associated with the use of the insanity defense Answer: B 77. Society has long held to the doctrine of ______ as a basis for determining responsibility for wrongdoing. A. informed consent B. let the buyer beware C. free will D. social duty Answer: C 78. In modern law, there is (are) ______ major court ruling(s) that bear on the insanity defense. A. one B. three C. five D. seven Answer: B 79. Which of the following is a major case that bears on the insanity defense? A. the 1975 O’Connor v. Donaldson case B. the 1982 Youngberg v. Romeo case C. the 1976 Tarasoff ruling D. the 1954 Durham v. United States case Answer: D 80. In an 1834 Ohio case, the court ruled that ______. A. patients have the right to refuse medication under certain conditions B. people do not bear criminal responsibility for their acts if they are unable to tell right from wrong C. people cannot be held responsible if they are compelled to commit criminal actions because of impulses they are unable to resist D. people cannot be hospitalized against their will unless they present a clear and present danger to themselves or others Answer: C 81. In 1843, Daniel M’Naghten intended to assassinate the prime minister of England, ______. A. Benjamin Disraeli B. Sir Robert Peel C. Sir Randolph Churchill D. William Gladstone Answer: B 82. Daniel M’Naghten killed ______. A. the prime minister of England B. a policeman C. the Archbishop of Canterbury D. a secretary Answer: D 83. In the trial of Daniel M’Naghten, he claimed that he wanted to kill the prime minister because ______. A. of the devastating effects of British imperialism B. the prime minister was having an affair with M’Naghten’s wife C. the voice of God told him to kill the prime minister D. he lost his job and blamed the prime minister Answer: C 84. The M’Naghten rule holds that a person does not bear criminal responsibility for an act when ______. A. the act was driven by impulses the person was unable to resist B. the act was the product of mental disease or mental defect C. under the influence of alcohol or drugs at the time of the offense D. the person was unable to tell right from wrong Answer: D 85. The court case in which the court ruled that a jury has to decide not only if a person was mentally ill, but if the mental illness was the cause of the person’s criminal behavior was ______. A. Youngberg v. Romeo B. O'Connor v. Donaldson C. Durham v. United States D. Addington v. Texas Answer: C 86. The effect of the Durham case was to compel juries to have to decide if ______ when committing a criminal act. A. a person was driven by irresistible urges B. a mental illness was the cause of a person’s behavior C. a person was under the influence of drugs or alcohol D. a person was unable to tell right from wrong Answer: B 87. The intent of the Durham case was to ______. A. set a precedent for allowing the insanity defense in North Carolina B. recognize a “guilty but mentally ill” defense C. reject the irresistible impulse and “right–wrong” principles as outmoded D. allow psychiatrists and psychologists to offer expert testimony in criminal cases Answer: C 88. The Durham rule became unworkable for which of the following reasons? A. Juries could not determine at what point “irresistible” impulses became irresistible. B. A lack of precise definitions of such terms as “irresistible impulse” made it difficult for juries to interpret the law. C. It proved difficult for juries to draw conclusions as to whether or not a person’s “disease” had actually caused his or her criminal behavior. D. It has forced jury selections to focus only on potential jurors who have had extensive coursework in psychology. Answer: C 89. By 1972, the Durham rule was replaced in many jurisdictions by ______. A. the M’Naghten rule B. the American Law Institute guidelines C. the social responsibility principle D. Jones rule Answer: B 90. The key phrase added by the American Law Institute related to the insanity defense is ______. A. “irresistible impulse” B. “guilty but mentally ill” C. “incompetent to stand trial” D. “substantial capacity” Answer: D 91. Michael Jones, the subject of Jones v. the United States, was acquitted of ______ by reason of insanity. A. rape B. murder C. kidnapping D. petty larceny Answer: D 92. Michael Jones, the subject of Jones v. the United States, was diagnosed with ______. A. bipolar disorder B. paranoid schizophrenia C. profound mental retardation D. antisocial personality disorder Answer: B 93. In the Jones case, the United States Supreme Court ruled that ______. A. persons found to be insane cannot be institutionalized for periods longer than the jail sentence they would have received if found guilty for the offense of which they were accused B. there is a necessary correlation between the severity of a criminal offense and the amount of time in which a person found to be insane can be institutionalized because of that offense C. persons found to be insane must go to jail if they are "cured" and released from a mental institution in a time period that is shorter than the sentence they would have received if found guilty of the offense for which they were accused D. there is no correlation between the severity of a criminal offense and the amount of time for which a person found to be insane can be institutionalized because of that offense Answer: D 94. In the Jones case, the United States Supreme Court ruled that a person found “not guilty by reason of insanity” can be institutionalized ______. A. only until they are “well"” enough to serve the remainder of their sentence in jail B. only for a period of time equal to the amount of time they would have spent in jail if found “guilty” for the offense C. only for a period of time up to twice the amount of time they would have spent in jail if found “guilty” for the offense D. indefinitely, until such time that the person has regained legal sanity or is no longer a danger to society Answer: D 95. Court rulings have established that criminal defendants who are found not guilty by reason of insanity and committed to a mental hospital may ______ than the time they would have served in jail had they been convicted of the crime. A. not be released sooner or later B. be released sooner, but not later C. be released later, but not sooner D. be released sooner or later Answer: D 96. In dealing with the insanity defense, jurors must cope with which of the following challenges? A. Limiting media bias by avoiding national and local news during the course of the trial. B. Deciding if the defendant was mentally incapacitated at the time of the crime. C. Ascertaining whether the M’Naghten standard or the Durham standard should apply. D. Determining if the client understands if his or her acts were wrong. Answer: B 97. Which of the following is an argument of Thomas Szasz in relationship to the insanity defense? A. It directs attention away from the social ills that may motivate crimes. B. The insanity defense allows real criminals to fake their way into mental hospitals where they are not effectively punished for their actions. C. All people who break criminal laws should be evaluated for the presence of mental illness. D. The insanity defense serves to protect the lives of the mentally ill. Answer: A 98. Thomas Szasz argues that the insanity defense has historically been invoked to ______. A. highlight crimes that were particularly heinous or committed against those of high social rank B. protect those of high social rank from prosecution for the crimes they have committed C. provide a platform for politicians to "grandstand" over issues that have previously been ignored by the public D. confirm stereotypes that the rich and famous are eccentrics who are not like the rest of us Answer: A 99. A defendant who is unable to understand the charges and proceedings brought against him or her in a criminal action is said to be ______. A. incoherent B. incompetent to stand trial C. guilty but mentally ill D. not guilty by reason of insanity Answer: B 100. In the case of ______, the United State Supreme Court ruled that a person cannot be kept in a mental hospital awaiting trial longer that it would take to determine if treatment was likely to restore competency. A. Cummings v. Arkansas B. Lindsay v. Maryland C. Jackson v. Indiana D. Royal v. Ohio Answer: C 101. If a person is ruled unlikely to ever develop adequate competency to stand trial in a criminal case, that person must ______. A. go to trial and plead “not guilty by reason of insanity” B. be released from confinement C. either be released from confinement or committed to a mental institution under the civil commitment procedures D. either be released from confinement or committed to a mental institution under the criminal commitment procedures Answer: C 102. Under the Jackson standard, some states have imposed a minimum length of treatment before acknowledging that a defendant ______. A. should be released back to the public B. is competent to stand trial C. is permanently incompetent D. needs an evaluation by a mental health professional who is not a state employee Answer: C 103. In the 1992 Medina case, the United States Supreme Court ruled that the burden of proof for determining competence to stand trial lies with the ______. A. defendant B. prosecution C. court-appointed expert D. jury Answer: A 104. In the case of ______, the United States Supreme Court ruled that the burden of proof in determining competency lies with the defendant. A. Walters v. Indiana B. Washington v. Oregon C. Lawrence v. Rhode Island D. Medina v. California Answer: D 105. In Sell v. United States, the United States Supreme Court ruled that ______. A. competency to stand trial would be based on the results of a structured behavior interview scale. B. a panel of three court-appointed psychiatrists who would not serve as expert witness in the case would advise the judge on competency issues C. incompetence to stand trial would be limited to mentally retarded citizens D. a defendant could be involuntarily medicated to restore competency to stand trial Answer: D 106. In the case of ______, the United States Supreme Court ruled that mentally ill defendants could sometimes be forcibly medicated to render them competent. A. Sell v. United States B. Brown v. United States C. Diaz v. United States D. Shetrone v. United States Answer: A 107. The Sell decision may result in ______. A. increased use of the incompetency defense B. people coming to trial whose trials had been delayed by incompetency issues C. less use of expert witnesses in determining competency D. treatment in private rather than public psychiatric hospitals for those who have been declared incompetent Answer: B True-False Questions 108. Civil commitment is identical to voluntary hospitalization. Answer: False 109. People can be psychiatrically committed because they are eccentric. Answer: False 110. Szasz argues that the label of mental illness is a societal invention which transforms social deviance into medical illness. Answer: True 111. People can be committed to psychiatric facilities because of odd behavior. Answer: False 112. The United States is the only country that permits involuntary psychiatric hospitalization. Answer: False 113. Clinicians tend to overpredict the dangerousness of their clients. Answer: True 114. Psychologists and other mental-health professionals are quite accurate when it comes to predicting dangerousness of the people they treat. Answer: False 115. Classification within a diagnostic category that is associated with aggressive or dangerous behavior, such as antisocial personality, is sufficient for predicting specific violent acts in individuals. Answer: False 116. Psychologists and other mental health professionals can rely on their clinical judgment to accurately predict the dangerousness of their patients. Answer: False 117. Predictions of dangerousness based on hospital behavior tend to generalize to community settings. Answer: False 118. Short-term predictions of violence are more accurate than longer term predictions. Answer: True 119. The potential for violence is heightened in people with serious psychiatric disorders when they abuse alcohol or other drugs. Answer: True 120. The state has an obligation to provide adequate treatment for people who are involuntarily confined to its psychiatric hospitals. Answer: True 121. According to a precedent-setting legal case in Alabama, patients in mental hospitals may be required to perform general housekeeping duties for the purpose of maintaining the facility. Answer: False 122. Unless there is danger or inappropriateness to a treatment program, psychiatric hospital patients have a right to wear their own clothes rather than uniforms. Answer: True 123. The state has the right to indefinitely confine people who are mentally ill even if they pose no immediate danger to themselves or others and can live safely on their own. Answer: False 124. Involuntarily admitted patients in mental hospitals have always had the right to refuse medications. Answer: False 125. Information provided to a therapist by a client is protected by rules of absolute confidentiality. Answer: False 126. Therapists are not obligated by state laws to breach confidentiality, even to warn intended victims of threats of violence made against them by their clients. Answer: False 127. The courts have ruled that the rights of an intended victim are outweighed by a client’s rights of confidentiality. Answer: True 128. Therapists may not disclose confidential information about clients to third parties, even when their clients threaten violence to the third parties. Answer: False 129. Court rulings have established that hospitalized mental patients do not have the right to refuse medication. Answer: False 130. The Tarasoff ruling carries force of law nationally. Answer: False 131. The Tarasoff ruling only applies to the citizens of Texas. Answer: False 132. In most cases where patients refuse treatment, the courts have sided with the patients during the review process. Answer: False 133. In the Hinckley case, the prosecution had to prove beyond a reasonable doubt that Hinckley was sane, once he used the insanity defense. Answer: True 134. An attempt to assassinate the president of the United States was seen by millions of television viewers, but the would-be assassin was found not guilty by a court of law. Answer: True 135. In the aftermath of the Hinckley verdict, many states have changed their statutes to shift the burden of proof onto the prosecution to prove beyond a reasonable doubt that a defendant claiming insanity is really sane. Answer: False 136. The insanity defense is used in a large number of cases, and usually successfully. Answer: False 137. In states that have adopted it, the "guilty but mentally ill" verdict has substantially reduced the number of "not guilty by reason of insanity" verdicts. Answer: False 138. The insanity defense has a long legal history. Answer: True 139. The Durham ruling on insanity is the cornerstone of modern guidelines regarding use of the insanity defense. Answer: False 140. The Durham ruling has proven to be unworkable. Answer: True 141. Repeated criminal behavior is not sufficient, by itself, to establish a mental disease or defect that might relieve an individual of criminal responsibility. Answer: True 142. The Supreme Court of the United States has ruled that persons acquitted of crimes by reason of insanity constitute a special class who should be treated differently from civilly committed individuals. Answer: True 143. People who are found not guilty of a crime by reason of insanity may remain confined to a mental hospital indefinitely—for many years longer than they would have been sentenced to prison, if they had been found guilty. Answer: True 144. Customary sentences that the law provides for particular crimes have no bearing on criminal commitment. Answer: True 145. The insanity defense places special burdens on juries. Answer: True 146. Psychiatrist Thomas Szasz denies the existence of mental illness. Answer: True 147. There is a basic rule of law that says that those who stand accused of crimes must be able to understand the charges and proceedings brought against them and be able to participate in their own defense. Answer: True 148. It is possible for a defendant to be held competent to stand trial but still be judged not guilty of a crime by reason of insanity. Answer: True 149. More people are confined to mental institutions for being incompetent to stand trial than for being found not guilty by reason of insanity. Answer: True 150. In 1992, the United States Supreme Court ruled that burden of proof for determining competence to stand trial lies with the prosecution. Answer: False Essay Questions 151. Compare and contrast the various types of commitment and hospitalization. Explain why some people are critical of the entire psychiatric hospitalization process and system. Answer: Types of Commitment and Hospitalization; Criticism of Psychiatric Hospitalization: Types of Commitment: • Voluntary Commitment: Individuals admit themselves to a psychiatric facility for treatment voluntarily. • Involuntary Commitment: Court-ordered commitment when individuals pose a danger to themselves or others, or are unable to care for themselves due to severe mental illness. • Emergency Commitment: Immediate hospitalization due to acute psychiatric crisis, pending evaluation and determination of further treatment needs. Hospitalization: • Short-term: Typically for stabilization and crisis intervention. • Long-term: Extended care for severe and persistent mental illnesses requiring intensive treatment and rehabilitation. Criticism of Psychiatric Hospitalization: • Loss of Autonomy: Involuntary commitment infringes on civil liberties and personal autonomy. • Stigmatization: Stigma associated with psychiatric hospitalization and perceptions of being labelled as mentally ill. • Quality of Care: Concerns about the quality of care, treatment effectiveness, and patient rights within psychiatric facilities. • Alternatives: Advocacy for community-based care, outpatient services, and supportive housing as alternatives to hospitalization. 152. Summarize the research concerning the problems of psychologists and other professionals who are given the task of attempting to predict dangerousness. Answer: Research on Predicting Dangerousness: Challenges: • Predictive Accuracy: Difficulty in accurately predicting future dangerous behavior based on psychological assessment. • Ethical Concerns: Balancing individual rights with public safety when making predictions. • Clinical Judgment: Reliance on clinical judgment and risk assessment tools that may have limitations in accuracy and reliability. • Legal Implications: Legal and ethical responsibilities of professionals in managing and disclosing risk information. Research Findings: • Factors: Research identifies factors such as history of violence, substance abuse, mental illness severity, and lack of social support as contributors to dangerousness. • Risk Assessment Tools: Development and use of structured risk assessment tools to aid in clinical decision-making and risk management. • Longitudinal Studies: Long-term studies assessing predictive validity and factors influencing changes in risk over time. 153. Discuss legal developments concerning patients’ right to treatment. Answer: Legal Developments on Patients’ Right to Treatment: Historical Context: • Deinstitutionalization: Movement away from institutional care towards community-based treatment in the 20th century. • Legal Foundations: Court rulings emphasizing patients' rights to receive appropriate and least restrictive treatment. • Legislation: Implementation of mental health parity laws and regulations ensuring access to mental health services comparable to other medical care. Current Issues: • Access to Care: Challenges in accessing timely and appropriate mental health treatment, especially in underserved communities. • Quality Standards: Advocacy for quality standards in mental health treatment and ensuring compliance with legal mandates. • Advocacy: Continued advocacy for funding, resources, and policies supporting comprehensive mental health services. 154. Explain the effects of the Tarasoff case on helping professionals’ duty to warn third parties of threats posed by clients. Answer: Effects of the Tarasoff Case on Duty to Warn: Tarasoff Case (1974): • Background: Legal case establishing duty of mental health professionals to warn third parties of threats posed by clients. • Ruling: Duty to protect foreseeable victims from harm, even if it breaches confidentiality. • Impact: Legal precedent influencing state laws and professional ethical guidelines on duty to warn and protect. Professional Duties: • Assessment: Assessing risk of harm to self or others through comprehensive evaluation and risk assessment. • Notification: Obligation to inform potential victims and appropriate authorities when danger is identified. • Documentation: Maintaining accurate records of assessments, interventions, and communications related to risk management. 155. Discuss some of the conflicts involved in requiring helping professionals to warn third parties of threats. Answer: Conflicts in Duty to Warn Third Parties: Conflicting Obligations: • Confidentiality vs. Public Safety: Balancing duty to maintain client confidentiality with obligation to protect potential victims. • Risk Assessment: Assessing the credibility and seriousness of threats made by clients. • Legal Considerations: Navigating legal requirements and ethical guidelines regarding disclosure of risk information. • Therapeutic Relationship: Maintaining trust and therapeutic alliance while managing risk and safety concerns. Ethical Dilemmas: • Autonomy vs. Paternalism: Respecting client autonomy while considering paternalistic interventions for public safety. • Professional Judgment: Exercising professional judgment and discretion in determining when and how to disclose risk information. • Collaboration: Collaborating with multidisciplinary teams and consulting legal experts in managing complex risk scenarios. 156. Discuss legal developments concerning the right to refuse treatment. Cite the 1979 case, Rogers v. Okin, and details of this case, in your discussion of the issues. Answer: Legal Developments Regarding the Right to Refuse Treatment; Rogers v. Okin Case: Right to Refuse Treatment: • Legal Evolution: Recognition of patients' rights to refuse medical treatment stems from the principle of bodily autonomy and informed consent. • Informed Consent: Patients must be informed about treatment options, risks, and benefits to make autonomous decisions. • Exceptions: Limited exceptions exist for cases involving emergency situations or when a patient lacks decision-making capacity due to severe mental illness. Rogers v. Okin (1979): • Case Details: A landmark U.S. federal court case challenging the involuntary administration of antipsychotic medication to mental health patients. • Legal Issue: Whether patients have the right to refuse psychotropic medication without a judicial determination of their incompetency. • Ruling: Affirmed patients' rights to refuse treatment unless they are deemed incompetent by a court. • Impact: Established legal precedent reinforcing patients' right to refuse treatment, influencing state laws and mental health policies. Issues in Discussion: • Autonomy vs. Paternalism: Balancing patients' right to refuse treatment with concerns for their well-being and public safety. • Capacity Assessment: Challenges in assessing patients' decision-making capacity, especially in cases involving severe mental illness. • Ethical Considerations: Ethical guidelines and professional responsibilities in respecting patients' autonomy while ensuring appropriate care and safety measures. 157. Discuss the history of the legal bases of the insanity plea. Include the “irresistible impulse” and inability to tell if one’s actions were “right” or “wrong” in your essay. Answer: History of the Legal Bases of the Insanity Plea: Insanity Plea: • Legal Concept: Defense strategy asserting that defendants were mentally impaired at the time of the offense, mitigating criminal responsibility. • M'Naghten Rule: Established in 1843, focuses on cognitive impairment affecting the ability to understand right from wrong. • Irresistible Impulse: Introduced in mid-19th century, emphasizes loss of control over actions due to mental illness or emotional disturbance. • Durham Rule: 1954, broader criteria considering whether the crime was a product of mental illness. • Model Penal Code: Proposed in 1955, combining cognitive and volitional elements in assessing criminal responsibility. Controversies: • Subjectivity: Subjective nature of determining mental state at the time of the offense and varying interpretations by legal and mental health professionals. • Legal Standards: Differences in legal standards across jurisdictions, affecting consistency and fairness in applying the insanity defense. • Public Perception: Concerns over misuse or exploitation of the insanity plea in high-profile cases. 158. Discuss the "guilty but mentally ill" verdict. Provide details on the controversy surrounding this verdict and assess its effectiveness. Answer: "Guilty but Mentally Ill" Verdict: Verdict Description: • Definition: Verdict option in some jurisdictions allowing juries to find defendants guilty of a crime while acknowledging mental illness as a mitigating factor. • Intent: Intended to address cases where defendants exhibit mental illness but are still deemed criminally responsible for their actions. • Implementation: Involves treatment within correctional facilities or mental health institutions, depending on the jurisdiction. Controversies: • Stigmatization: Stigma associated with the "mentally ill" label within the criminal justice system. • Effectiveness: Criticisms of inadequate treatment resources and challenges in providing appropriate mental health care within correctional settings. • Legal Ambiguity: Variability in legal definitions and application of the "guilty but mentally ill" verdict across states. • Ethical Concerns: Ethical considerations regarding fairness, justice, and appropriate treatment of individuals with mental illness involved in criminal proceedings. 159. Discuss problems in determining the term of commitment for perpetrators who are found insane. Answer: Problems in Determining the Term of Commitment for Perpetrators Found Insane: Legal Challenges: • Indeterminate Commitment: Lack of clear guidelines or standardized procedures for determining the length of commitment. • Risk Assessment: Difficulties in predicting future dangerousness and assessing potential for rehabilitation. • Legal Standards: Varying state laws and judicial interpretations affecting commitment decisions and review processes. Clinical Considerations: • Treatment Effectiveness: Impact of treatment and rehabilitation programs on reducing risk and promoting recovery. • Patient Rights: Balancing public safety concerns with patients' rights to appropriate mental health care and due process. 160. Discuss the problems the insanity plea creates for jurors. Answer: Problems the Insanity Plea Creates for Jurors: Juror Challenges: • Complexity: Understanding legal definitions and criteria for insanity defense, including cognitive impairment and volitional control. • Evidence Evaluation: Assessing expert testimony, psychiatric evaluations, and conflicting interpretations of defendants' mental state. • Moral Dilemmas: Balancing empathy for defendants' mental health challenges with concerns for justice, victim impact, and community safety. • Legal Instructions: Instructions from judges on applying legal standards and reaching unanimous verdicts based on evidence and deliberation. Legal System Dynamics: • Public Perception: Influence of media coverage, public opinion, and societal attitudes toward mental illness on jury decision-making. • Role of Forensic Psychiatry: Collaboration between legal and mental health professionals in presenting and interpreting psychiatric evidence in court. 161. Discuss Thomas Szasz’s assertion that the insanity plea is degrading to the defendant. Answer: Thomas Szasz, a prominent critic of the concept of mental illness and psychiatric practices, argued vehemently against the insanity plea, contending that it is fundamentally degrading to the defendant. His critique revolves around several key points: 1. Moral and Legal Responsibility: Szasz believed that holding individuals accountable for their actions is a cornerstone of justice and morality. By invoking the insanity plea, he argued, society effectively shifts responsibility away from the individual onto a vague notion of mental illness, thereby undermining personal accountability. 2. Stigmatization and Labeling: According to Szasz, labeling someone as "insane" or mentally ill through the insanity plea can stigmatize the individual. This stigma, he argued, can have long-lasting negative consequences, affecting not only the individual's legal standing but also their social and personal identity. 3. Psychiatric Coercion: Szasz criticized the role of psychiatrists and mental health professionals in the legal system, suggesting that their involvement can lead to coercive practices. He believed that psychiatry, by its nature, tends to expand its jurisdiction and control over individuals' lives, often without their consent. 4. Personal Autonomy: Central to Szasz's argument is the principle of personal autonomy. He asserted that individuals have the right to make decisions about their own lives, including decisions that may result in criminal behavior. By using the insanity plea, Szasz argued, society undermines this autonomy by imposing psychiatric judgments on individuals' actions. In essence, Szasz viewed the insanity plea as a mechanism that diminishes individual responsibility, perpetuates stigma, and allows for potential abuse of psychiatric authority. He advocated for a legal system that holds individuals accountable for their actions without recourse to psychiatric labels that may carry dehumanizing implications. This perspective continues to provoke debate over the intersection of law, psychiatry, and personal autonomy in contemporary legal systems. 162. What is meant by the phrase “competency to stand trial”? Discuss potential abuses for the clients involved in the trial. Summarize the 1972 U.S. Supreme Court case Jackson v. Indiana as it applies to this topic Answer: Competency to Stand Trial The phrase "competency to stand trial" refers to a legal determination regarding a defendant's mental state and ability to understand and participate in the legal proceedings against them. For a defendant to be deemed competent to stand trial, they must meet certain criteria: • Understanding of the Charges and Proceedings: The defendant must have a rational and factual understanding of the charges they are facing and the nature of the legal proceedings. • Ability to Assist in Their Defense: The defendant must be able to communicate effectively with their attorney and participate in their defense, including making informed decisions about legal strategies. Potential Abuses for Clients Involved in the Trial There are several potential abuses that can arise in the context of determining competency to stand trial: • Misuse of Psychiatric Evaluations: Defendants may be subjected to unnecessary or biased psychiatric evaluations. These evaluations could be used to delay proceedings or to coerce defendants into accepting certain legal outcomes. • Prolonged Detention: Defendants deemed incompetent to stand trial may be held in psychiatric facilities for extended periods, sometimes longer than they would have been if convicted and sentenced. This can result in significant deprivation of liberty. • Inadequate Treatment: Defendants in psychiatric facilities may not receive adequate mental health treatment, potentially exacerbating their condition and delaying their ability to become competent to stand trial. • Coercive Practices: The process of determining competency can involve coercive practices, where defendants are pressured into accepting psychiatric labels or treatments against their will. Jackson v. Indiana (1972) The 1972 U.S. Supreme Court case Jackson v. Indiana is a landmark decision regarding the issue of competency to stand trial. In this case, the Court addressed the indefinite commitment of a defendant deemed incompetent to stand trial. Case Summary: • Facts of the Case: The defendant, a mentally disabled man named Jackson, was charged with petty theft. Due to his mental disability, he was deemed incompetent to stand trial. Jackson was committed to a state hospital for an indefinite period, potentially for the rest of his life, without any prospect of being tried for the charges against him. • Supreme Court Ruling: The Supreme Court ruled that the indefinite commitment of a defendant solely on the basis of incompetence to stand trial violates due process. The Court held that a state cannot indefinitely commit a defendant without providing a reasonable likelihood that the defendant will attain competency in the foreseeable future. • Impact on Competency Determinations: The Jackson v. Indiana ruling established that defendants found incompetent to stand trial must be evaluated periodically to determine whether they have gained competency. If it is unlikely that the defendant will attain competency, the state must either release the defendant or pursue alternative civil commitment proceedings under appropriate standards. The Jackson v. Indiana case underscored the importance of protecting defendants' due process rights and preventing indefinite detention without trial. It emphasized the need for periodic reviews of competency and established limits on the duration of commitment for defendants deemed incompetent to stand trial. Test Bank for Abnormal Psychology in a Changing World Jeffrey S. Nevid, Spencer A. Rathus, Beverly Greene 9780205965014, 9780135821688, 9780134458311, 9780205961719, 9780130052162

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