The association between specific competence-related abilities and competence restoration treatment

Abstract

ABSTRACTInpatient competence restoration treatment comes with enormous costs in terms of civil liberties, but also significant financial costs to the state/institution responsible for providing the treatment. The present investigation was designed to evaluate the utility of a commonly used competence assessment instrument, the MacArthur Competence Assessment Tool – Criminal Adjudication (MacCAT-CA), in identifying individuals who may require more tailored, lengthier, and/or more intensive treatment. The sample included 93 men and women who were administered the MacCAT-CA during an inpatient hospitalization for competence restoration treatment in the United States. All of the patients were restored to competence within the study period, ranging from 3 to 32 months of inpatient hospitalization. Results suggest that performance on the MacCAT-CA was associated with hospitalization length, with total scores as the greatest predictor of response to treatment. Sensitivity and specificity estimates are discussed in terms of their utility in identifying patients most at-risk for extended hospitalization, with the authors arguing that instruments like the MacCAT-CA can be used in a practical manner of identifying patients who might require greater or more intensive treatment.