Mr. Raso had lived with his girlfriend for 10 years before she decided to throw in the towel and throw the bum out. She should have prepared a quick exit first. He became so agitated that he, "just went bananas" with a knife and proceeded to carve her up. By the time he was through, she was dead and he was covered with her blood from 81 stab wounds.
Then, in a condition the defense asserted was psychotic, (but the prosecution asserted was cunning artifice), he told the victim's son he was going out to get some bagels. Raso then he went to the police station, still covered in the victim's blood, where he confessed to the murder.
The appeal of his not surprising conviction for "knowing or purposeful murder," was based on challenges to the testimony of mental health professionals called by the state.
A forensic neuropsychologist testified for the defense that Raso suffered from organic brain dysfunction and borderline personality disorder rendering him in a temporary psychotic state at the time of the murder. The Bender Gestalt Screen Test for brain dysfunction was administered, which assesses the subject' drawings by comparing them with standardized test samples scored according to American Psychological Association standards.
A prosecution expert countered with his own interpretation of the test drawings, concluding that the defendant had given a normal response. However, instead of comparing the defendant's results with standardized test drawings, the witness compared them to drawings made by an unidentified patient.
Holding: The Court reversed and remanded. As hearsay, the comparison with an unknown patient foreclosed impermissibly cross examination of the doctor concerning this patient. Second, the expert's testimony, using the comparison drawing from an unknown source as a reference, was not based on reasonably reliable scientific standards.
 | James Seward, Ph.D. Forensic Psychologist The Forensic Panel |
Dr. Seward comments: Properly administered, a neuropsychological evaluation can aid the trier of fact in cases involving criminal responsibility. For example, the neuropsychologist in such cases can render an opinion regarding the defendant's ability to formulate the intention to plan and carry out a complex series of events, and/or to accurately remember the facts. The qualified neuropsychologist is a doctoral level psychologist with additional specialized training and experience in neuropsychology and neuroscience.
The evolving standard of expert evidence, as reflected in the Supreme Court decisions in Daubert v Merrill Dow Pharmaceuticals, Inc., Kuniho Tire Co v. Carmichael and lower court progeny, mandates that neuropsychologists implement scientific standards in their evaluations (McCaffrey, R. J, et al., 1997. The Practice of Forensic Neuropsychology: Meeting Challenges in the Courtroom. New York: Plenum). It is not enough to give a group of tests to a defendant and conclude that the person is brain damaged just because he or she performed poorly on some or all of the tests. Rather, the interaction between the sensitivity and specificity of the tests with the prevalence of the presumed organic condition must be considered to form the positive predictive power (PPP) of a test. The PPP is an indicator of the probability that a positive test finding indicates the presence of a specific condition (Baldessarini, R. J., et al. 1983. The Predictive Power of Diagnostic Tests and the Effect of Prevalence of Illness. Archives of General Psychiatry, 40, 569-573). For example, a PPP of .5 indicates that there is a 50% chance that a person with a positive test finding has the specific condition. The base rate is the frequency of the pathological condition. In general, psychological and neuropsychological tests do not have adequate sensitivity and specificity to detect conditions with a base rate below 15% or so. That's why testing needs history and other verifiable information to give it specific substance.
The Halstead-Reitan Neuropsychological Battery and the Luria Nebraska Neuropsychological Battery have the important advantage of being well standardized and widely used. Thus, information on their sensitivity and specificity for various neurologic conditions is likely to be available in the literature. Many psychometrically sound tests have norms that are adjusted for age, education, and/or gender, factors that have been shown to correlate with performance on some neuropsychological and cognitive tests.
Malingering should also be accounted for in all forensic neuropsychological testing. According to the literature, the rate of falsified or exaggerated symptoms in inmates presenting with mental difficulties is about 50%; and there is some evidence that this rate is higher with more serious charges.
