PT - JOURNAL ARTICLE AU - DO Lewis AU - CA Yeager AU - P Blake AU - B Bard AU - M Strenziok TI - Ethics questions raised by the neuropsychiatric, neuropsychological, educational, developmental, and family characteristics of 18 juveniles awaiting execution in Texas DP - 2004 Dec 01 TA - Journal of the American Academy of Psychiatry and the Law Online PG - 408--429 VI - 32 IP - 4 4099 - http://jaapl.org/content/32/4/408.short 4100 - http://jaapl.org/content/32/4/408.full SO - J Am Acad Psychiatry Law2004 Dec 01; 32 AB - Eighteen males condemned to death in Texas for homicides committed prior to the defendants' 18th birthdays received systematic psychiatric, neurologic, neuropsychological, and educational assessments, and all available medical, psychological, educational, social, and family data were reviewed. Six subjects began life with potentially compromised central nervous system (CNS) function (e.g., prematurity, respiratory distress syndrome). All but one experienced serious head traumas in childhood and adolescence. All subjects evaluated neurologically and neuropsychologically had signs of prefrontal cortical dysfunction. Neuropsychological testing was more sensitive to executive dysfunction than neurologic examination. Fifteen (83%) had signs, symptoms, and histories consistent with bipolar spectrum, schizoaffective spectrum, or hypomanic disorders. Two subjects were intellectually limited, and one suffered from parasomnias and dissociation. All but one came from extremely violent and/or abusive families in which mental illness was prevalent in multiple generations. Implications regarding the ethics involved in matters of culpability and mitigation are considered.