An Investigation of the ECST-R in Male Pretrial Patients

Abstract

Forensic clinicians have the option of employing well-validated structured interviews when conducting competency to stand trial (CST) evaluations to ensure adequate coverage of the three prongs delineated in Dusky v. United States. This study evaluates the effects of feigning on the Evaluation of Competency to Stand Trial-Revised (ECST-R) in a sample of 100 male defendants undergoing CST evaluations. The ECST-R competency scales are reliable, with good alpha coefficients and interrater reliabilities, and differentiate patients found competent from those found not competent. The current study suggests that feigning may bridge both psychopathology and cognitive abilities and that clinicians should consider each when conducting CST evaluations. These results are discussed in the context of conducting comprehensive evaluations integrating response style assessments in CST evaluations.