Skip to main content
SpringerLink
Log in

The Limited Relevance of Neuroimaging in Insanity Evaluations

  • Review Paper
  • Published:
Neuroethics Aims and scope Submit manuscript

Abstract

Forensic evaluations of insanity have recently borne witness to an influx of neuroimaging methods, especially structural and functional magnetic resonance imaging and positron emission tomography, to assist in the development of explanations that help to excuse legal responsibility for criminal behavior. The results of these scanning methods have been increasingly introduced in legal settings to offer or support a clinical diagnosis that in turn suggests that an individual was incapable of knowing right from wrong, or to pinpoint brain dysfunction suggestive of an inability to control behavior. This paper examines how neuroimaging has been employed in insanity evaluations. After addressing the contentious use of neuroimaging scans in insanity evaluations and synthesizing relevant research, we conclude that such scans presently hold limited applicability for forensic determinations of insanity. Furthermore, they can in some cases distract the trier of fact, potentially leading to erroneous conclusions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Palermo, G.B., M.B. Smith, L.C. Gram, W. Zier, and M.E. Kohler. 1996. Trial by jury: A pilot study of juror perception of mental health professional testimony in NGRI pleas for first degree international homicide. Med Law 15: 17–42.

    Google Scholar 

  2. Hans, V.P., and D. Slater. 1983. John Hinckley, Jr. and the insanity defense: The public's verdict. Public Opin Q 47: 202–212.

    Article  Google Scholar 

  3. Vitacco, M.J., L.A. Malesky, S. Erickson, W. Leslie, A. Croysdale, and A. Bloechl. 2009. Measuring attitudes toward the insanity defense in venirepersons: Refining the IDA-R in the evaluation of juror bias. Int J Forensic Ment Health 8: 62–70. https://doi.org/10.1080/14999010903014754.

    Article  Google Scholar 

  4. Perlin, M.L. (1989). Unpacking the myths: The symbolism mythology of insanity defense jurisprudence, 40 Case Western Law Review, 599.

  5. Perlin, M.L. 2017. The insanity defense: Nine myths that will not go away. In The Insanity Defense: Multidisciplinary Views on its History, Trends, and Controversies, ed. M.D. White. Santa Barbara: Praeger.

    Google Scholar 

  6. Hagen, M.A. 1997. Whores of the Court. New York: Regan Books.

    Google Scholar 

  7. Dror, I.E. 2015. Cognitive neuroscience in forensic science. Understanding and utilizing the human element. Philos Trans 370: 1–8. https://doi.org/10.1098/rtsb.2014.0255.

    Article  Google Scholar 

  8. Dror, I.E., and D.C. Murrie. 2018. A hierarchy of expert performance applied to forensic psychological assessments. Psychol Public Policy Law 24 (1): 11–23. https://doi.org/10.1037/law0000140.

    Article  Google Scholar 

  9. Murrie, D.C., M.T. Boccaccini, L.A. Guarnera, and K.A. Rufino. 2013. Are forensic experts biased by the side that retained them? Psychol Sci 24 (10): 1889–1897. https://doi.org/10.1177/0956797613481812.

    Article  Google Scholar 

  10. Gowensmith, W.N., D.C. Murrie, and M.T. Boccaccini. 2013. How reliable are forensic evaluations of legal sanity? Law Hum Behav 37 (2): 98–106. https://doi.org/10.1037/lhb0000001.

    Article  Google Scholar 

  11. Racine, E., O. Bar-Ilan, and J. Illes. 2005. fMRI in the public eye. Nat Rev Neurosci 6: 159–164. https://doi.org/10.1038/nrn1609.

    Article  Google Scholar 

  12. Satel, S., and S.O. Lilienfeld. 2013. Brainwashed: The seductive appeal of mindless neuroscience. Cambridge: Basic Books.

    Google Scholar 

  13. Gruber, D.R. 2017. Three forms of neurorealism: Explaining the persistence of the “uncritically real” in popular neuroscience news. Writ Commun 34: 189–223. https://doi.org/10.1177/0741088317699899.

    Article  Google Scholar 

  14. Schwartz, S.J., S.O. Lilienfeld, A. Meca, and K.C. Sauvigné. 2016. The role of neuroscience within psychology: A call for inclusiveness over exclusiveness. Am Psychol 71: 52–70. https://doi.org/10.1037/a0039678.

    Article  Google Scholar 

  15. Shafi, N. 2009. Neuroscience and the law: The evidentiary value of brain imaging. Grad Stud J Psychol 11: 27–39.

    Google Scholar 

  16. Denno, D.W. 2015. The myth of the double-edged sword: An empirical study of neuroscience evidence in criminal cases, 56 B.C.L. Rev. 493–551.

  17. Taylor, J.S., J.A. Harp, and T. Elliott. 1991. Neuropsychologists and neurolawyers. Neuropsychology 5: 293–305. https://doi.org/10.1037/0894-4105.5.4.293.

    Article  Google Scholar 

  18. Jones, O.D., A.D. Wagner, D.L. Faigman, and M.E. Raichle. 2013. Neuroscientists in court. Nat Rev Neurosci 14: 730–736. https://doi.org/10.1038/nrn3585.

    Article  Google Scholar 

  19. Motzkin, J.C., A. Baskin-Sommers, J.P. Newman, K.A. Kiehl, and M. Koenigs. 2014. Neural correlates of substance abuse: Reduced functional connectivity between areas underlying reward and cognitive control. Hum Brain Mapp 35: 4282–4292. https://doi.org/10.1002/hbm.22474.

    Article  Google Scholar 

  20. Grant, J.E., B.L. Odlaug, and S.R. Chamberlain. 2017. Gambling disorder, DSM-5 criteria and symptom severity. Compr Psychiatry 75: 1–5. https://doi.org/10.1016/j.comppsych.2017.02.006.

    Article  Google Scholar 

  21. Lushing, J.R., Gaudet, L.M., and Kiehl, K.A. 2016. Brain imaging in psychopathy. In C. B. Gacono (Ed.), The clinical and forensic assessment of psychopathy: A practitioner’s guide., 2nd ed. (pp. 32–53). New York, NY: Routledge/Taylor & Francis Group.

  22. Umbach, R., C.M. Berryessa, and A. Raine. 2015. Brain imaging research on psychopathy: Implications for punishment, prediction, and treatment in youth and adults. J Crim Just 43: 295–306. https://doi.org/10.1016/j.jcrimjus.2015.04.003.

    Article  Google Scholar 

  23. Hafizi, S., H.H. Tseng, N. Rao, T. Selvanathan, M. Kenk, R.P. Bazinet, et al. 2017. Imaging microglial activation in untreated first-episode psychosis: A PET study with FEPPA. Am J Psychiatry 174: 118–124. https://doi.org/10.1176/appi.ajp.2016.16020171.

    Article  Google Scholar 

  24. Harenski, C.L., V.D. Calhoun, J.R. Bustillo, B.W. Haas, J. Decety, K.A. Harenski, et al. 2018. Functional connectivity during affective mentalizing in criminal offenders with psychotic disorders: Associations with clinical symptoms. Psychiatry Res Neuroimaging 271: 91–99. https://doi.org/10.1016/j.pscychresns.2017.11.003.

    Article  Google Scholar 

  25. Chen, C.Y., A. Raine, K.H. Chou, I.Y. Chen, D. Hung, and C.P. Lin. 2016. Abnormal white matter integrity in rapists as indicated by diffusion tensor imaging. BMC Neurosci 17 (45): 1–8. https://doi.org/10.1186/s12868-016-0278-3.

    Article  Google Scholar 

  26. Bueso-Izquierdo, N., J. Verdejo-Roman, O. Contreras-Rodriguez, M. Carmona-Perera, M. Perez-Garcia, and N. Hidalgo-Ruzzante. 2016. Are batterers different from other criminals? An fMRI study. Soc Cogn Affect Neurosci 11 (5): 852–862. https://doi.org/10.1093/scan/nsw020.

    Article  Google Scholar 

  27. Raine, A., M.S. Buchsbaum, J. Stanley, S. Lottenberg, L. Abel, and J. Stoddard. 1994. Selective reductions in prefrontal glucose metabolism in murderers. Biol Psychiatry 36: 365–373. https://doi.org/10.1016/0006-3223(94)91211-4.

    Article  Google Scholar 

  28. Rushing, S.E., and D.D. Langleben. 2015. Neuroimaging and criminal culpability. In Psychiatric expert testimony: Emerging applications, ed. K.J. Weiss and C. Watson, 122–135. New York: Oxford University Press. https://doi.org/10.1093/med/9780199346592.003.0008.

    Chapter  Google Scholar 

  29. Ahmed, A.O., P.F. Buckley, and M. Hanna. 2013. Neuroimaging schizophrenia: A picture is worth a thousand words, but is it saying anything important. Current Psychiatry Report 15: 344–345. https://doi.org/10.1007/s11920-012-0345-0.

    Article  Google Scholar 

  30. Erickson, S.K. 2010. Blaming the brain. Minn J Law Sci Technol 11: 27–76.

    Google Scholar 

  31. Changeux, J.P., P. Courrege, and A. Danchin. 1973. A theory of the epigenesis of neuronal networks by selective stabilization of synapses. Proc Natl Acad Sci 70 (10): 2974–2978.

    Article  Google Scholar 

  32. Batts, S. 2009. Brain lesions and their implications in criminal responsibility. Behav Sci Law 27 (2): 261–272. https://doi.org/10.1002/bsl.857.

    Article  Google Scholar 

  33. Bonnie, R.J., Jeffries, J.C., and Low, P.W. 1986. A case study in the insanity defense: The trial of John W. Hinckley, Jr. New York, NY: Foundation Press.

  34. Taylor, S. 1982. Hinckley’s brain is termed normal. New York Times, pp. A00021.

  35. Kuersten, A. 2016. When Picture Is Not Worth Thousand Words. George Washington Law Review Arguendo 84: 178–191.

    Google Scholar 

  36. Scarpazza, C., S. Pellegrini, P. Pietrini, and G. Sartori. 2018. The role of neuroscience in the evaluation of mental insanity: on the controversies in Italy. Comment on "on the stand. Another episode of neuroscience and law discussion from Italy.". Neuroethics 11: 83–95.

    Article  Google Scholar 

  37. Ake v. Oklahoma, 470 U.S. 68 1985.

  38. Entin, J.L. 1988. Psychiatry, insanity, and the death penalty: A note on implementing Supreme Court decisions. Journal of Criminal Law and Criminology 79: 218–239. https://doi.org/10.2307/1143554.

    Article  Google Scholar 

  39. McWilliams v. Dunn, 582, U.S. __ 2017.

  40. Farahany, N.A. 2016. Neuroscience and behavioral genetics in US criminal law: an empirical analysis. J Law Biosci 2: 485–509. https://doi.org/10.1093/jlb/lsv059.

    Article  Google Scholar 

  41. Perlin, M.L. 2017. “I’ve got my mind made up”: Judicial teleology in cases involving biologically based evidence violates therapeutic jurisprudence. NYLS Legal Studies Research Paper No. 2930061.

  42. Perlin, M.L. 2009. His brain has been mismanaged with great skill: How jurors will respond to neuroimaging testimony in insanity cases. Akron Law Rev 42: 886–914.

    Google Scholar 

  43. Marshall, J., S.O. Lilienfeld, H. Mayberg, and S.E. Clark. 2017. The role of neurological and psychological explanations in legal judgments of psychopathic wrongdoers. J Forensic Psychiatry Psychol 28: 412–436. https://doi.org/10.1080/14789949.2017.1291.

    Article  Google Scholar 

  44. McCabe, D.P., and A.D. Castel. 2008. Seeing is believing: The effect of brain images on judgments of scientific reasoning. Cognition 107: 343–352. https://doi.org/10.1016/j.cognition.2007.07.017.

    Article  Google Scholar 

  45. Farah, M.J., and C.J. Hook. 2013. The seductive allure of seductive allure. Perspect Psychol Sci 8: 88–90. https://doi.org/10.1177/1745691612469035.

    Article  Google Scholar 

  46. Schweitzer, N.J., M.J. Saks, E.R. Murphy, A.L. Roskies, W. Sinnott-Armstrong, and L.M. Gaudet. 2011. Neuroimages as evidence in a mens rea defense: No impact. Psychology, Public Policy, and Law 17(3): 357-393. doi. https://doi.org/10.1037/a0023581.

  47. Gurley, J.R., and D.K. Marcus. 2008. The effects of neuroimaging and brain injury on insanity defenses. Behav Sci Law 26: 85–97. https://doi.org/10.1002/bsl.797.

    Article  Google Scholar 

  48. Saks, M.J., N.J. Schweitzer, E. Aharoni, and K.A. Kiehl. 2014. The impact of neuroimages in the sentencing phase of capital trials. J Empir Leg Stud 11: 105–131. https://doi.org/10.1111/jels.12036.

    Article  Google Scholar 

  49. Berlin, L. 2014. Neuroimaging, expert witnesses, and ethics: Convergence and conflict in the courtroom. AJOB Neurosci 5 (2): 3–8. https://doi.org/10.1080/21507740.2014.880089.

    Article  Google Scholar 

  50. Farisco, M. 2014. In need of meta-scientific experts? AJOB Neurosci 5 (2): 50–52. https://doi.org/10.1080/21507740.2014.884185.

    Article  Google Scholar 

  51. People v. Weinstein, 591 N.Y.S.2d 715 N.Y. Sup. Ct. 1992.

  52. Davis, K. 2017. The Brain Defense: Murder in Manhattan and the Dawn of Neuroscience in America’s Courtrooms. New York: Penguin Press.

    Google Scholar 

  53. Bigenwald, A., and V. Chambon. 2019. Criminal Responsibility and Neuroscience: No Revolution Yet. Front Psychol 10. https://doi.org/10.3389/fpsyg.2019.01406.

  54. Miller, J. 2013. Did brain scans just save a convicted murderer from the death penalty? Wired (online). Accessed December 20, 2018.

  55. Panetti v. Quarterman, 551 U.S. 930 2007.

  56. Perlin, M.L. 2010. “Good and bad, I defined these terms, quite clear no doubt somehow”: Neuroimaging and competency to be executed after Panetti. Behav Sci Law 28 (5): 671–689. https://doi.org/10.1002/bsl.955.

    Article  Google Scholar 

  57. Cochrane, R.E., T. Grisso, and R.I. Frederick. 2001. The relationship between criminal charges, diagnoses, and psycholegal opinions among federal pretrial defendants. Behav Sci Law 19: 565–582.

    Article  Google Scholar 

  58. Gao, B., Y. Wang, W. Liu, H. Zhou, J. Yang, Z. Cohen, Y. Zhu, and Y. Zang. 2015. Spontaneous activity associated with delusions of schizophrenia in the left medial superior frontal gyrus: A resting-state fMRI study. PLoS One. https://doi.org/10.1371/journal.pone.0133766.

  59. Su, K.P., C.Y. Hsu, and W.W. Shen. 2001. Magnetic resonance imaging findings in patients with delusional disorder due to diffuse cerebrovascular disease: A report of seven cases. Psychiatry Clin Neurosci 55: 121–126.

    Article  Google Scholar 

  60. American Psychiatric Association. 2013. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: Author.

    Book  Google Scholar 

  61. Lilienfeld, S.O., and M.T. Treadway. 2016. Clashing diagnostic approaches: DSM-ICD versus RDoC. Annu Rev Clin Psychol 12: 435–463.

    Article  Google Scholar 

  62. Harrington, A. 2019. Mind fixers: Psychiatry's troubled search for the biology of mental illness. New York: WW Norton & Company.

    Google Scholar 

  63. United States v. Montgomery, 635 F.3d 1074 8th Cir. 2011.

  64. People v. Glenn, 233 ILL. App 3d 666 1992.

  65. People v. Fields, 523 N.E.2d 1196 III. App. Ct. 1988.

  66. People v. Haun, 71 Ill.App. 2d 262 1966.

  67. People v. Vanda, 111 Ill.App.3d 551 1982.

  68. Scarpazza, C., S. Ferracuti, A. Miolla, and G. Sartori. 2018. The charm of structural neuroimaging in insanity evaluations: Guidelines to avoid misinterpretation of the findings. Transl Psychiatry 8 (227): 1–10. https://doi.org/10.1038/s41398-018-0274-8.

    Article  Google Scholar 

  69. State v. Thatch, Superior Court of New Jersey, Super. Unpub. Lexis 1509 2016.

  70. Kolla, N.J., and J.D. Brodie. 2012. Application of neuroimaging in relationship to competence to stand trial and insanity. In Neuroimaging in forensic psychiatry: From the clinic to the courtroom, ed. J.R. Simpson, 147–162. New York: Wiley-Blackwell.

    Google Scholar 

  71. Palermo, G.B. 2012. Does neuroimaging have a role in assessing criminal culpability? Int J Offender Ther Comp Criminol 56: 171–173. https://doi.org/10.1177/0306624X12439542.

    Article  Google Scholar 

  72. Redding, R.E. 2006-2007. The brain-disordered defendant: Neuroscience and legal insanity in the 21st Century. American University Law Review 52–123.

  73. Moll, J., P.J. Eslinger, and R. Oliveira-Souza. 2001. Frontopolar and anterior temporal cortex activation in a moral judgment task. Arq Neuropsiquiatr 59 (3–B): 657–664. https://doi.org/10.1590/S0004-282X2001000500001.

    Article  Google Scholar 

  74. Raine, A., and Y. Yang. 2006. Neural foundations to moral reasoning and antisocial behavior. Soc Cogn Affect Neurosci 1: 203–213. https://doi.org/10.1093/scan/nsl033.

    Article  Google Scholar 

  75. Sechrest, L. 1963. Incremental validity: A recommendation. Educ Psychol Meas 23: 153–158.

    Article  Google Scholar 

  76. Schifani, C., S. Hafizi, T. Da Silva, J.J. Watts, M.S. Khan, and R. Mizrahi. 2017. Using molecular imaging to understand early schizophrenia-related psychosis neurochemistry: A review of human studies. International Review of Psychiatry 29: 555–566. https://doi.org/10.1080/09540261.2017.1396205.

    Article  Google Scholar 

  77. Endicott, J.L., and R. Spitzer. 1978. A diagnostic interview: The schedule for affective disorders and schizophrenia. Arch Gen Psychiatry 35: 837–844. https://doi.org/10.1001/archpsyc.1978.01770310043002.

    Article  Google Scholar 

  78. Rogers, R., A. Thatcher, and J.L. Cavanaugh. 1984. Use of the SADS diagnostic interview in evaluating legal insanity. J Clin Psychol 40: 1537–1541. https://doi.org/10.1002/1097-4679.

    Article  Google Scholar 

  79. Knoll, J.L., IV, and P.J. Resnick. 2008. Insanity defense evaluations: Toward a model for evidence-based practice. Brief Treat Crisis Interv 8: 92–110. https://doi.org/10.1093/brief-treatment/mhm024.

    Article  Google Scholar 

  80. Packer, I.K. 2009. Evaluation of criminal responsibility. New York: Oxford University Press.

    Book  Google Scholar 

  81. Morse, S.J. 2016. Actions speak louder than images: The use of neuroscientific evidence in criminal cases. J Law Biosci 3: 336–342. https://doi.org/10.1093/jlb/lsw025.

    Article  Google Scholar 

  82. Baskin, J.H., J.G. Edersheim, and B.H. Price. 2007. Is a Picture Worth a Thousand Words? Neuroimaging in the Courtroom. Am J Law Med 33: 239–269. https://doi.org/10.1177/009885880703300205.

    Article  Google Scholar 

  83. Felthous, A.R., and H. Sass. 2008. Introduction to this issue: International perspectives on brain imaging and the law. Behav Sci Law 26: 1–6. https://doi.org/10.1002/bsl.801.

    Article  Google Scholar 

  84. Moriarty, J.C. 2008. Flickering admissibility: Neuroimaging evidence in the U.S. courts. Behav Sci Law 26 (1): 29–49. https://doi.org/10.1002/bsl.795.

    Article  Google Scholar 

  85. Daubert v. Merrell Dow Pharmaceuticals, Inc 509 U.S. 579, 589 1993.

  86. Kumho Tire Co. v. Carmichael, 526 U.S. 137 1999.

  87. General Electric Co. v. Joiner, 522 U.S. 136 1997.

  88. Herzog, R., D.R. Elgort, A.E. Flanders, and P.J. Moley. 2017. Variability in diagnostic error rates of 10 MRI centers performing lumbar spine MRI examinations within a 3-week period. Spine 4: 554–561.

    Article  Google Scholar 

  89. Frye v. v. United States, 293 F. 101, D.C. Cir. 1923.

  90. Morse, S.J. 2006. Brain overclaim syndrome and criminal responsibility: A diagnostic note. J Criminol Law 3: 397–412.

    Google Scholar 

  91. Burns, J.M., and R.H. Swerdlow. 2003. Right orbitofrontal tumor with pedophilia symptom and constructional apraxia sign. Arch Neurol 60: 437–440. https://doi.org/10.1001/archneur.60.3.437.

    Article  Google Scholar 

  92. Sartori, G., C. Scarpazza, S. Codognotto, and P. Pietrini. 2016. An unusual case of acquired pedophilic behavior following compression of orbitofrontal cortex and hypothalamus by a Clivus Chordoma. J Neurol 263 (7): 1454–1455. https://doi.org/10.1007/s00415-016-8143-y.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry and Health Behavior, Augusta University, Augusta, GA, 30912, USA

    Michael J. Vitacco

  2. Medical University of South Carolina, Charleston, SC, 29425, USA

    Emily Gottfried

  3. Emory University, Atlanta, GA, 30322, USA

    Scott O. Lilienfeld

  4. University of Southern Mississippi, Hattiesburg, MS, 39406, USA

    Ashley Batastini

Authors
  1. Michael J. Vitacco
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Emily Gottfried
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Scott O. Lilienfeld
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ashley Batastini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael J. Vitacco.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vitacco, M.J., Gottfried, E., Lilienfeld, S.O. et al. The Limited Relevance of Neuroimaging in Insanity Evaluations. Neuroethics 13, 249–260 (2020). https://doi.org/10.1007/s12152-019-09421-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12152-019-09421-8

Keywords

Search

Navigation