Date of Award

Summer 8-2020

Document Type


Degree Name

Doctor of Philosophy (PhD)




Virginia Consortium Program in Clinical Psychology

Committee Director

Robin J. Lewis

Committee Member

Barbara A. Winstead

Committee Member

Desideria S. Hacker

Committee Member

Richard W. Handel

Committee Member

Andrew L. Osborn


Not Guilty by Reason of Insanity (NGRI) acquittees uniquely walk the line of involvement in both the criminal justice and mental health systems, both of which have literature indicating the presence of underlying racial biases related to practices and outcomes. The current study examined 366 forensic charts from an inpatient psychiatric hospital in Virginia to examine potential differences in the number of risk factors assigned for NGRI acquittees based on a variety of demographic variables. Information about demographic characteristics, psychiatric history, and criminal history was recorded and analyzed. It was hypothesized that younger age, male gender, a psychotic diagnosis, violent NGRI offense, and identifying as Black would all be associated with more assigned risk factors. It was also expected that race would account for additional variance in the assignment of risk factors above and beyond other salient demographic variables. Results indicated that Black participants were assigned more risk factors than their White counterparts, men were assigned more risk factors than women, and individuals with a felony offense stayed longer in the hospital than individuals with a misdemeanor offense. Race also accounted for additional variance in the assignment of risk factors above and beyond age, gender, diagnosis, and type of criminal offense. Implications of this study include the need to consider incorporating cultural sensitivity training, specifically related to race, and education around implicit biases into forensic examiner training that may impact risk assessment and clinical judgment.


The VIRGINIA CONSORTIUM PROGRAM IN CLINICAL PSYCHOLOGY is a joint program of Eastern Virginia Medical School, Norfolk State University, and Old Dominion University.


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