Neuroimaging in Forensic Psychiatry: From the Clinic to the Courtroom

379 Pages·2012·3.746 MB·English

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Neuroimaging in Forensic Psychiatry
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Neuroimaging in Forensic
Psychiatry
From the Clinic to the Courtroom
Edited by
Joseph R. Simpson, M.D., Ph.D.
Clinical Assistant Professor, University of Southern California
Keck School of Medicine; Los Angeles, CA, USA; Clinical Assistant Professor,
University of California, Irvine, CA, USA
A John Wiley & Sons, Ltd., Publication
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Neuroimaginginforensicpsychiatry:fromtheclinictothecourtroom/[editedby]JosephR.Simpson.
p.;cm.
Includesbibliographicalreferencesandindex.
ISBN978-0-470-97699-9(cloth)
I.Simpson,JosephR.
[DNLM:1.ForensicPsychiatry. 2.BrainMapping–methods. 3.MentalDisorders–diagnosis.W740]
614(cid:2).15–dc23 2011044307
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CoverimageshowsbrainfMRIdifferencesbetweenlieandtruthinagroupof22healthysubjects.Lierelated
activationisinyellowandtruthrelatedactivationisinblue.ReproducedcourtesyofKoshaRuparel,M.Sand
DanielLangleben,MD,UniversityofPennsylvania,Philadelphia,PA,USA.
Chapter19©ProfessorStephenMorse.
FirstImpression2012
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Contents
ListofContributors vii
Foreword xi
HenryT.Greely
Introduction xv
PARTI ImagingTechniques
1 PETandSPECT 3
SusanE.Rushing,DanielA.PrymaandDanielD.Langleben
2 MRIandFunctionalMRI 27
ErinD.Bigler,MarkAllenandGaryK.Stimac
PARTII ClinicalandResearchFindings
3 TraumaticBrainInjury 43
RobertP.Granacher,Jr
4 Dementia 67
MelissaLamar,HalWortzel,DavidJ.Libon,DeneneM.Wambach,CatherineC.
PriceandAnandKumar
5 NeuroimaginginPsychopathyandAntisocialPersonalityDisorder:
FunctionalSignificanceandaNeurodevelopmentalHypothesis 81
AndreaL.Glenn,YalingYangandAdrianRaine
6 Pedophilia 99
ChristineWiebking,AlexanderSartorius,HaraldDressingandGeorgNorthoff
7 ImagingPsychoses:DiagnosisandPredictionofViolence 113
JazminCamchongandAngusW.MacDonaldIII
8 NeuroimaginginAffectiveDisorders:ApplicationsinClinicalResearch
andForensicPsychiatry 131
JonathanB.Savitz,JosephR.SimpsonandWayneC.Drevets
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vi CONTENTS
PARTIII NeuroimagingintheCourts
9 ApplicationofNeuroimaginginRelationshiptoCompetencetoStand
TrialandInsanity 147
NathanJ.KollaandJonathanD.Brodie
10 Neuroimaging,DiminishedCapacityandMitigation 163
JudithG.Edersheim,RebeccaWeintraubBrendelandBruceH.Price
11 ImplicationsofNeuroimagingforDangerousnessAssessment 195
JoachimWitzel
12 PotentialUsesofNeuroimaginginPersonalInjuryCivilCases 201
RobertP.Granacher,Jr
PARTIV EmergingAreas
13 BrainImagingofDeception 217
DanielD.Langleben,DanF.X.WillardandJaneC.Moriarty
14 IdentifyingMemoriesandTheirUseinInterrogations 237
JohannaC.vanHooff
PARTV LegalandEthicalConsiderations
15 PracticalLegalConcerns 255
KristenM.Nugent
16 NeuroimagingandtheConstitution 275
KristenM.Nugent
17 PracticalLegalConcerns:TheEnglandandWalesContext 303
ShujaM.ReaguandPamelaJ.Taylor
18 NeuroethicsofFunctionalNeuroimagingintheCourtroom 325
ElizabethFordandNeilAggarwal
19 NeuroimagingEvidenceinLaw:APleaforModestyandRelevance 341
StephenJ.Morse
Index 359
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List of Contributors
Neil Aggarwal MD, MBA, MA, Postdoctoral Clinical Fellow, Columbia University,
NewYork,NY,USA
Mark Allen PhD, Assistant Professor, Psychology Department and The Neuroscience
Center,BrighamYoungUniversity,Provo,UT,USA
Erin D. Bigler PhD, Professor, Psychology Department and The Neuroscience Center,
BrighamYoungUniversity,Provo,UT,USAandDepartmentofPsychiatry,Universityof
Utah,SaltLakeCity,UT,USA
Jonathan D. Brodie PhD, MD, Marvin Stern Professor of Psychiatry, New York Uni-
versitySchoolofMedicine,DivisionofForensicPsychiatry,NewYork,NY,USA
JazminCamchongPhD, NeurobehavioralResearchInc,Honolulu,HI,USA
HaraldDressingMD, ProfessorofPsychiatry,SeniorPsychiatrist,HeadoftheDepart-
mentofForensicPsychiatryatCentralInstituteofMentalHealth(CIMH),MedicalFaculty
Mannheim,UniversityofHeidelberg,Mannheim,Germany
Wayne C. Drevets MD, Director and President, Laureate Institute for Brain Research,
OxleyProfessorofNeuroscienceResearch,DepartmentofPsychiatry,OklahomaUniver-
sityCollegeofMedicine,Tulsa,OK,USA
Judith G. Edersheim JD, MD, Co-Director, The Center for Law, Brain and Behavior,
Massachusetts General Hospital and Assistant Clinical Professor of Psychiatry, Harvard
MedicalSchool,Boston,MA,USA
ElizabethFordMD, ClinicalAssociateProfessorandTrainingDirector,ForensicPsy-
chiatry Fellowship New York University School of Medicine and Director, Division of
ForensicPsychiatry,BellevueHospitalCenter,NewYork,NY,USA
AndreaL.GlennPhD, PostdoctoralResearchFellow,DepartmentofChildandAdoles-
centPsychiatry,InstituteofMentalHealth,Singapore
Robert P. Granacher, Jr, MD, MBA, Clinical Professor of Psychiatry, University of
KentuckyCollegeofMedicine,Lexington,KY,USA
Nathan J. Kolla MD, MA, MSc, Lecturer, Department of Psychiatry, University of
Toronto,Toronto,ON,Canada
AnandKumarMD, LizzieGilmanProfessorandHead,DepartmentofPsychiatry,Uni-
versityofIllinoisatChicago,Chicago,IL,USA
Melissa Lamar PhD, Associate Professor of Psychology in Psychiatry, Department of
Psychiatry,UniversityofIllinoisatChicago,Chicago,IL,USA
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viii LISTOFCONTRIBUTORS
DanielD.LanglebenMD, AssociateProfessorofPsychiatry,UniversityofPennsylva-
niaSchoolofMedicine,Philadelphia,PA,USA
DavidJ.LibonPhD, AssociateProfessor,DepartmentofNeurology,DrexelUniversity,
CollegeofMedicine,Philadelphia,PA,USA
AngusW.MacDonaldIIIPhD, AssociateProfessor,UniversityofMinnesota,Depart-
mentofPsychology,Minneapolis,MN,USA
JaneC.MoriartyJD, CarolLosMansmannChairinFacultyScholarship,Professorof
LawandAssociateDeanforScholarship,DuquesneUniversitySchoolofLaw,Pittsburgh,
PA,USA
Stephen J. Morse JD, PhD, Ferdinand Wakeman Hubbell Professor of Law, and Pro-
fessor of Psychology and Law in Psychiatry, University of Pennsylvania Law School,
Philadelphia,PA,USA
GeorgNorthoffMD,PhD,FRCPC, ResearchUnitDirector,Mind,BrainImagingand
Neuroethics; Canada Research Chair, University of Ottawa; The Michael Smith Chair,
ELJB-CIHR, Royal Ottawa Healthcare Group, University of Ottawa Institute of Mental
HealthResearch,Ottawa,ON,Canada
KristenM.NugentJD, Hunton&WilliamsLLP,Atlanta,GA,USA
Bruce H. Price MD, Chief, Department of Neurology, McLean Hospital, Belmont,
MA, USA and The Center for Law, Brain and Behavior, Massachusetts General Hospi-
tal,Boston,MA,USA
CatherineC.PricePhD, AssistantProfessor,ClinicalandHealthPsychology,Univer-
sityofFlorida,Gainesville,FL,USA
Daniel A. Pryma MD, Assistant Professor of Radiology, University of Pennsylvania
SchoolofMedicine,Philadelphia,PA,USA
Adrian Raine PhD, Richard Perry University Professor, Departments of Criminology,
PsychiatryandPsychology,UniversityofPennsylvania,Philadelphia,PA,USA
Shuja M. Reagu MBBS, MRCPsych, MSc, Clinical Lecturer in Forensic Psychiatry,
DepartmentofPsychiatryandNeurology,SchoolofMedicine,CardiffUniversity,Cardiff,
UKandSpecialistRegistrar,ForensicPsychiatry,WelshDeanery
SusanE.RushingMD,JD, AssistantProfessorofPsychiatry,UniversityofPennsylva-
niaSchoolofMedicine,Philadelphia,PA,USA
Alexander Sartorius MD, PhD, Head, Research Group Translational Imaging, Head,
ECT Supervision and Research, Senior Psychiatrist, Department of Psychiatry and Psy-
chotherapy, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim,
UniversityofHeidelberg,Mannheim,Germany
JonathanB.SavitzPhD, AssistantProfessor,LaureateInstituteforBrainResearchand
TheUniversityofTulsa,Tulsa,OK,USA
JosephR.SimpsonMD,PhD, ClinicalAssistantProfessor,UniversityofSouthernCal-
iforniaKeckSchoolofMedicine,LosAngeles,CA,USAandClinicalAssistantProfessor,
UniversityofCalifornia,Irvine,Irvine,CA,USA
GaryK.StimacPhD,MD, DiagnosticRadiologist,Bellevue,WA,USA
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LISTOFCONTRIBUTORS ix
PamelaJ.Taylor,MBBS,MRCP,FRCPsych,FMedSci, ProfessorofForensicPsychi-
atry, Department of Psychiatry and Neurology, School of Medicine, Cardiff University,
Cardiff,UKandHonoraryConsultantForensicPsychiatrist,ABMUHealthBoard,UK
Johanna C. van Hooff PhD, Assistant Professor, VU University Amsterdam, Depart-
mentofCognitivePsychology,Amsterdam,TheNetherlands
DeneneM.WambachBA, TempleUniversity,Philadelphia,PA,USA
Rebecca Weintraub Brendel MD, JD, The Center for Law, Brain and Behavior, Mas-
sachusetts General Hospital, and Assistant Professor of Psychiatry, Harvard Medical
School,Boston,MA,USA
Christine Wiebking, MSc, PhD (cand.), Clinic of Psychiatry, Otto-von-Guericke Uni-
versity, Magdeburg, Germany and Institute of Mental Health Research, University of
Ottawa,ON,Canada
DanielF.X.WillardBA, ResearchSpecialist,UniversityofPennsylvania,Philadelphia,
PA,USA
Joachim Witzel MD, Central State Forensic Psychiatric Hospital of Saxony-Anhalt,
Uchtspringe,Germany
HalWortzelMD, VeteransIntegratedServiceNetwork19MentalIllnessResearchEd-
ucationandClinicalCenter(VISN19MIRECC),DenverVeteransHospitalandAssistant
Professor,DepartmentofPsychiatry,UniversityofColorado,Denver,CO,USA
YalingYangPhD, PostdoctoralFellow,DepartmentofNeurology,UniversityofSouth-
ernCalifornia,LosAngeles,CA,USA
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Foreword
Thisisaninterestingandimportantbook,bothfortheprofessionalaudiencethatislikely
to read it and, perhaps more importantly, for another audience that needs to read it. It is
aneducationinhowneurosciencemayaffectthelaw,aswellasastarkwarningaboutthe
limitsofourcurrentdiscourseinlawandneuroscience.
I have been involved in neuroethics and, more specifically, in law and neuroscience,
since its inception – or, at least, its ‘re-imagining’ – in 2002. I was one of the co-
directorsfortheLawandNeuroscienceProject,athree-yeareffortfundedgenerouslyby
the MacArthur Foundation that brought lawyers and judges together with neuroscientists
and psychologists, with the more-than-occasional philosopher thrown in for extra flavor.
This book has 34 authors; only one was involved in the Project. In fact I only recognize
the names of three of the authors from the discussions of law and neuroscience. (Nor do
IrecognizemanyofthenamesfortheiractivityintheInternationalNeuroethicsSociety,
anotherhigh-profileeffortthatlooksat,amongotherthings,lawandneuroscience.)Thisis
notanegativereflectiononthequalityoftheseauthors,butitisanegativereflectiononthe
nature of our discourse about law and neuroscience. This book is entitled Neuroimaging
in Forensic Psychiatry: From the Clinic to the Courtroom. Its authors are, by and large,
forensicpsychiatristsorresearcherswithconnectionstoforensicpsychiatry.TheLawand
NeuroscienceProjectcomprisedmainlylawyers,philosophersandneuroscientists.It,and
thebroaderdiscussionsitwaspartofaboutlawandneuroscience,focusednotonthepath
fromtheclinic,butfromthelabtothecourtroom(aswellaspartsofthelegalsystemthat
existoutsidethecourtroom).
The intersections of these worlds have been far too few, and too narrow. As this book
convincesme,thebroadfieldoflawandneurosciencehasmuchtolearnfromtheforensic
psychiatrists, who, after all, are regularly involved in applying brain science in courts.
And,Ibelieve,forensicpsychiatristscouldlearnusefulthings,too,fromthebroaderlaw
andneurosciencecommunity.
Thefirstpartofthebookprovidesanintroductiontoneuroimagingtechnologiesthatis
comprehensive, but that is also accessible to lawyers and judges – at least, to those who
arewillingtoworkjustabitatit.Thetechnologiesmighthavebeenexpanded,bothtoold
standbys, such as CT scans and electroencephalograms (EEGs), as well as to upcoming
possibilities, like near infra-red laser spectroscopy. But it covers the main bases – PET,
SPECT,MRIandfMRI–quitewell.
Thesecondpartwillalsoproveparticularlyuseful.Itprovidesreaderswithusefuldis-
cussionsofsomeofthemostlegallyrelevantdiagnoses–traumaticbraininjury,dementia,
psychopathy, pedophilia, psychosis and affective disorders – as well as strong, critical
reviews of the current, and possible future, roles of neuroimaging in confirming (or rul-
ing out) those diagnoses. Forensic psychiatrists may want to focus on the discussions of
neuroimaging,butmanyreadersfromthelawwilllearnmuchfromthecarefuldiscussions
oftheillnessesthemselves.
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xii FOREWORD
Part III brings us directly to the courtroom and walks through the possible roles of
neuroimaginginthemostcommonreasonsfortestimonybyforensicpsychiatrists:compe-
tency,insanity,mitigation,diminishedcapacity,riskassessmentandpersonalinjurycases.
The most valuable sections lay out just how neuroimaging may, or may not, be useful in
suchcases.
Thefourthpartlooksatsomefrontierlegalissuesforneuroimaging.Onechaptertakesa
hardlookatdetectingdeception;theotheratdetectingmemory.Thesehighlightthereality
thatoneexcitingpossibleuseforneuroimagingistoreadminds–tolookatphysicalbrain
states and correlate them to present mental states. This cannot reveal what, for example,
a defendant was thinking at the time of the alleged offense; the so-called ‘time machine’
problem prevents that. But it may be able to tell us something about their mental states
at the time of their subsequent statements. Normally, if we want to ascertain someone’s
mental state, the best way to do so is to ask them. But if we cannot trustthem to answer
honestly,readingtheirmindsmaybeagoodalternative.Ionlywishthisparthadroamed
a little more broadly across the landscape of possible uses of mind-reading in the law,
fromdetectingwhethersomeoneisfeelingpain(anenormousissueforthelegalsystem)
todeterminingwhethersomeoneis‘truly’feelingbiasorremorseorguilt.
ThelastpartlooksatlegalissuesintheUnitedStatesandinEnglandandWales,andat
ethicalissuesmorebroadly.Thisisterritorythathasbeenbroadlyexploredintheexisting
lawandneuroscienceliterature(see,forexample,[1–6]);thesechaptersarecleardiscus-
sions,andquiteusefulforforensicpsychiatrists,thoughlawyers,judgesandphilosophers
mayprefermorespecializedtreatments.
Forensicpsychiatryandthebroaderlawandneurosciencecommunityneedtotalkmore.
Thedepthandbreadthofforensicpsychiatry’sknowledgeofthetechnologies,thediseases
andthecourtroomsettingswillbeofgreatvaluetothebroaderlawandneurosciencecom-
munity.Ontheotherhand,forensicpsychiatristsshouldfindvalueinthedeeperdiscussion
ofthethornylegalquestions–andoftheethicalandphilosophicalquestionsthatliebehind
them–thatthebroaderlawandneuroscienceliteratureprovides,alongwiththe,admittedly
speculative,lookfartherbeyondtoday’scourtroomuses,tofutureuses–andtotheways
technologicalchangeandsocialchangemayintertwinetoproducesurprisingresults.Itis
unfortunate,andsomewhatsurprising,thattheseperspectiveshavenotyetbeenbetterin-
tegrated.Onecansaythefieldisyoungor,atleast,newlyreconceptualized,butthecurrent
neuroethicsfieldisapproachingtheendofitsfirstdecade.Weshouldnotletthisdistance
continueintoitssecond.
Which leads to my last point. Bringing all the relevant expertise and perspectives
togetherintothisfieldisnotjust‘good’butimportant,becausethefieldisimportant.Neu-
roscienceisvastlyincreasingourabilitytopredict,understandandmodifytheworkingsof
thehumanbrain.Thelawisabouthumanbrains,andonlyincidentallyaboutthefleshin
whichtheyareembodied.Knowingmoreaboutfuturebehaviors,oraboutpresentmental
statesorabouthowtochangementalstatesorbehaviorswillnecessarilybeofgreatinterest
tothelaw(andtotherestofsociety).Butknowingmoreaboutthescienceofthehuman
brain is not the same as knowing enough about how to use that new knowledge. Wayne
Drevets,JonathanSavitzandJosephSimpsonendtheirchapteronaffectivedisorderswith
somecarefullyhedgedprophecy,withcommentsspecificallyaboutaffectivedisordersbut
applicablemuchmorebroadlytolawandneuroscience:
Lookingforward,itseemsreasonabletoanticipatethatastheevidencebasecontin-
uestoaccumulate,neuroimagingmaybeusedincreasinglyinlegalcasestobuttress