Demographic, Criminogenic, and Psychiatric Factors That Predict Competency Restoration

Lori H. Colwell; Julie Gianesini

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Table 1

Demographic Characteristics

Demographic	M (SD), n (%)
Age at discharge, M (SD)	37.9 (11.0)
Ethnicity, n (%)
Caucasian	28 (39.4)
African American	34 (47.9)
Hispanic/Latino	3 (4.2)
Asian	2 (2.8)
Arab/Middle Eastern	1 (1.4)
Other	3 (4.2)
Education, n (%)
Less than high school	26 (36.6)
High school diploma/equivalent	22 (31.0)
Some college	18 (25.4)
College degree	3 (4.2)
Post-college education	2 (2.8)

N = 71. Other ethnicities were Pakistani, Albanian, and Polish.

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Table 2

Legal and Psychiatric Histories

Characteristic	M (SD), n (%)
Prior involvement with legal system, n (%)
Yes	66 (93.0)
No	5 (7.0)
Prior conviction for violence, n (%)
Yes	35 (51.5)
No	36 (48.5)
Age at first arrest, M (SD)	23.3 (9.7)
Prior convictions, M (SD)	4.9 (7.0)
Prior incarcerations, M (SD)	2.6 (3.7)
Controlling offense, n (%)
Felony	54 (81.7)
Misdemeanor	13 (18.3)
Maximum exposure, M (SD)	38.9 (55.9)
Prior mental health treatment, n (%)
Yes	62 (87.3)
No	9 (12.7)
Prior hospitalizations, M (SD)	4.0 (6.9)
Prior episodes of incompetency, n (%)
None	46 (64.8)
One	14 (19.7)
Two or more	11 (15.5)

N = 71.

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Table 3

Current Psychiatric Characteristics

Characteristic	M (SD), n (%)
Primary Axis I diagnosis, n (%)
Psychosis	36 (53.7)
Mood/anxiety	11 (16.4)
Substance abuse	9 (13.4)
Cognitive/other	4 (5.6)
No diagnosis	7 (9.9)
Primary Axis II diagnosis, n (%)
Personality disorder	21 (29.6)
Borderline intellectual functioning	8 (11.3)
Mental retardation	5 (7.0)
Deferred	16 (22.5)
No diagnosis	21 (29.6)
Prescribed medications, n (%)
Yes	53 (74.6)
No	18 (25.4)
Acceptance of medications, n (%)
Accepted voluntarily	32 (60.4)
Initially resistant but ultimately accepted	13 (24.5)
Administered involuntarily or not at all	8 (15.1)
Seclusion/restraint, n (%)
None	61 (85.9)
One	7 (9.9)
Two	2 (2.8)
Three	1 (1.4)
GAF at discharge, M (SD)	44.3 (8.4)

N = 71.

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Table 4

Competent Versus Nonrestorable Defendants

Variable	Competent	Nonrestorable	t	p
Prior hospitalizations	3.06 (3.67)	7.12 (12.21)	−2.09	.04^*
Prior incarcerations	2.16 (2.50)	4.29 (6.09)	−2.03	.05^*
Prior incompetencies	1.35 (0.66)	1.94 (0.90)	−2.90	.01^*
IQ score	87.96 (12.87)	69.67 (13.12)	3.62	<.001^*
Medications prescribed	1.91 (1.01)	3.07 (0.88)	−3.83	<.001^*
Length of stay	98.92 (54.54)	173.18 (106.79)	−3.70	<.001^*
GAF at discharge	47.39 (6.48)	35.65 (8.08)	6.03	<.001^*

* Significant at p < .05. Data are expressed as the mean (SD).

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Table 5

Competent Versus Nonrestorable Defendants

Variable	Competent	Nonrestorable	χ²p	p
Psychosis			13.46	<.01^*
Yes	21 (56.8)	16 (43.2)
No	28 (96.6)	1 (3.4)
Borderline intellectual functioning			14.75	<.01^*
Yes	2 (22.2)	7 (77.8)
No	47 (82.5)	10 (17.5)
Mental deficiency			8.32	<.01^*
Yes	1 (20.0)	4 (80.0)
No	48 (78.8)	13 (21.3)
Personality disorder			5.86	.02^*
Yes	18 (98.0)	1 (5.3)
No	31 (66.0)	16 (34.0)
Prior incompetencies			7.65	.02^*
None	37 (84.1)	7 (15.9)
Yes, 1	7 (63.6)	4 (36.4)
Yes, >1	5 (45.5)	6 (54.5)

N = 49.
* Significant at p < .05. Data are the number of subjects (percentage of the entire group.)

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Table 6

Hierarchical Logistic Regression Analysis for Demographic, Criminogenic, Historical Clinical, and Current Treatment Variables Predicting Restoration

Predictor	B (SE)	Wald	p	OR (95% CI)
Demographic
Age at discharge	0.12 (0.07)	3.17	.08	1.12 (0.99–1.28)
Minority status	0.74 (1.65)	0.20	.65	2.10 (0.08–53.24)
Education	−0.24 (0.87)	0.08	.78	0.79 (0.14–4.34)
Criminogenic
Prior incarcerations	−0.22 (0.25)	0.80	.37	0.80 (0.49–1.31)
Offense class	−1.05 (0.68)	2.36	.12	0.35 (0.09–1.34)
Maximum exposure	−0.01 (0.04)	0.08	.78	0.99 (0.92–1.07)
Historical clinical
Primary Axis I	−0.98 (0.94)	1.10	.29	0.37 (0.06–2.35)
Primary Axis II	−0.49 (0.66)	0.54	.46	0.61 (0.17–2.26)
Prior hospitalizations	0.28 (0.15)	3.39	.07	1.32 (0.98–1.77)
Prior incompetency	2.71 (1.27)	4.55	.03	15.02 (1.25–181.20)^*
IQ class	−2.16 (1.26)	2.95	.09	0.12 (0.01–1.36)
Current treatment
Days until medicated	0.05 (0.02)	4.80	.03	1.05 (1.01–1.09)^*
Attendance	2.94 (1.35)	4.73	.03	18.81 (1.34–264.92)^*
Participation	−1.77 (1.23)	2.09	.15	0.17 (0.02–1.88)
Seclusion/restraint	−0.91 (1.73)	0.27	.60	0.41 (0.01–12.02)
R² = 0.45^*

Values listed are for final model (Block 4); OR, odds ratio; CI, confidence interval; offense class, current controlling (most serious) offense.
* Significant at p < .05.

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Table 7
Correlations Among Predictor Variables and Length of Stay
Age Prison Class Max Hosp IST IQ Days Attend Part S/R Observe GAF
LOS 0.23 −0.09 −0.11 −0.19 −0.06 0.06 −0.37^* 0.13 0.19 −0.15 −0.07 0.26^* −0.39^*

Age, age at discharge; Prison, number of prior incarcerations; Class, controlling offense class; Max, maximum exposure; Hosp, # of prior hospitalizations; IST, # of prior incompetencies; IQ, Full Scale IQ score; Days, days until medicated; Attend, group attendance; Part, group participation; S/R, episodes of seclusion/restraint; Observe, # of days on special observation; GAF, GAF at discharge

* Significant at p < .05.

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Table 8

Hierarchical Multiple Regression Analysis for Demographic, Criminogenic, Historical Clinical, and Current Treatment Variables Predicting Length of Stay

Predictor	B (SE)	β	p	t	Part r
Demographic
Age at discharge	0.87 (3.34)	0.15	.81	0.26	0.07
Minority status	15.66 (50.04)	0.11	.77	0.31	0.08
Education	−1.77 (39.29)	−0.03	.97	−0.05	−0.01
Criminogenic
Prior incarcerations	−20.06 (18.31)	−1.61	.32	−1.10	−0.29
Offense class	−25.04 (34.31)	−0.49	.50	−0.73	−0.19
Maximum exposure	0.76 (1.74)	0.44	.68	0.44	0.12
Historical clinical
Prior hospitalizations	7.88 (6.95)	1.28	.31	1.13	0.30
Prior incompetency	66.90 (70.11)	0.87	.38	0.95	0.25
IQ class	45.36 (73.64)	0.68	.57	0.62	0.16
Current treatment
Days until medicated	0.76 (0.54)	0.60	.22	1.24	0.37
Attendance	−9.03 (36.68)	−0.09	.82	−0.25	−0.06
Participation	7.36 (48.51)	0.08	.89	0.15	0.04
Seclusion/restraint	0.63 (78.50)	0.01	.99	0.01	<0.01
R² = 0.66