ABSTRACT The competence to stand trial literature is vast, whereas the literature on competency restoration pales in comparison. Although such research has accumulated since the 1970s, no quantative synthesis of it has been conducted. Therefore, we considered over 1,000 publications and attempted to conduct the first meta-analysis of restoration data – using 51 independent competency restoration samples published over a 40-year period (1975–2013) with 12,781 defendants – ultimately concluding that the restoration literature does not currently lend itself to meta-analysis. Still, several important findings arose: (a) the base rate for competency restoration was 81% and the median length of stay (LOS) was 147 days overall and 175 days in single restoration group studies; (b) reported competency restoration procedures were overwhelmingly nonspecific across studies and not reported in more than half of them; (c) most studies used correlational designs, with only five studies comparing restored with unrestored defendants, and no useable existing pre- versus post-treatment studies; and (d) competence assessment instruments were used in fewer than one-third of studies, traditional psychological measures were used in fewer than one-quarter, with data presented in such a way as to eliminate the potential for quantitative aggregation and analyses. Overall, our findings are concerning because, despite 40 years of research, the available data essentially highlight the characteristics of those engaging in restoration and do not address variables associated with final restoration status. In addition, we continue to have no collective empirical understanding of the utility of competency or traditional assessment instruments in the restoration context. Finally, virtually no published data reflect specific intervention efforts that lead to competence restoration.

中文翻译：

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能力恢复研究的尝试性荟萃分析：未来方向的重要发现

摘要备受审判的文献的能力很强，而相比之下，恢复能力的文献则显得苍白无力。尽管此类研究自1970年代以来就已积累，但尚未对其进行定量合成。因此，我们考虑了1,000多种出版物，并尝试进行了第一次恢复数据的荟萃分析-使用了40个时期（1975-2013年）发布的51个独立的能力恢复样本，共有12,781名被告-最终得出结论，恢复文献没有目前适合进行荟萃分析。尽管如此，仍然出现了一些重要发现：（a）能力恢复的基本比率为81％，中位住院时间（LOS）总体为147天，单个恢复组研究为175天；（b）报告的能力恢复程序在各个研究中绝大多数是非特异性的，并且在超过一半的研究中未报告；（c）大多数研究使用了相关设计，只有五项研究将恢复的被告与未恢复的被告进行了比较，并且没有可用的现有治疗前和治疗后研究；（d）不到三分之一的研究使用了能力评估工具，不到四分之一的研究使用了传统的心理测评，并且以消除潜在的定量汇总和分析潜力的方式提供了数据。总体而言，我们的发现令人担忧，因为尽管进行了40年的研究，但现有数据从本质上强调了从事修复工作的人员的特征，并未解决与最终修复状态相关的变量。此外，在恢复的情况下，我们对胜任力或传统评估工具的效用仍然缺乏集体经验性的理解。最后，几乎没有公开的数据反映出导致能力恢复的具体干预措施。