Mental disorder and legal responsibility: The relevance of stages of decision making
Abstract
The paper discusses the relevance of decision-making models for evaluating the impact of mental disorder on legal responsibility. A three-stage model is presented that analyzes decision making in terms of behavioral control. We argue that understanding dysfunctions in each of the three stages of decision making could provide important insights in the relation between mental disorder and legal responsibility. In particular, it is argued that generating options for action constitutes an important but largely ignored stage of the decision-making process, and that dysfunctions in this early stage might undermine the whole process of making decisions (and thus behavioral control) more strongly than dysfunctions in later stages. Lastly, we show how the presented framework could be relevant to the actual psychiatric assessment of a defendant's decision making within the context of an insanity defense.
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The three-stage decision-making model was originally developed to assess the degree of personal responsibility of criminals with mental disorders for their illegal actions.
“Для удобства систематизации паттернов дисфункционального принятия решений при психопатологии возьмем за основу трехэтапную модель принятия решений, изначально разработанную для оценки меры личной ответственности преступников с психическими расстройствами за совершенные ими противоправные действия (Kalis, Meynen, 2014).”
From Когнитивные механизмы дисфункционального принятия решений при психических расстройствах (2025) · cites this paper as Kalis, Meynen, 2014
Due to their intrusive and invading character, productive symptoms can not only supplement but also limit the range of options considered by a person for solving a problem.
“В силу своего навязчивого и вторгающегося характера продуктивная симптоматика может не только дополнять, но и ограничивать круг рассматриваемых человеком опций для решения проблемы (Kalis, Meynen, 2014).”
From Когнитивные механизмы дисфункционального принятия решений при психических расстройствах (2025) · cites this paper as Kalis, Meynen, 2014
Productive psychotic symptoms (hallucinatory voices, images, bodily sensations, delusions) can actualize options in patients that neurotypical people usually do not have, or such ideas occupy only an insignificant part of their inner experience compared to standard proven solutions.
“Дело в том, что продуктивная психотическая симптоматика (галлюцинаторные голоса, образы и телесные ощущения, бред) может актуализировать у пациентов такие опции, которых у нейротипичных людей обычно не возникает, либо такие идеи занимают лишь незначительную часть в их внутреннем опыте по сравнению со стандартными проверенными решениями.”
From Когнитивные механизмы дисфункционального принятия решений при психических расстройствах (2025) · cites this paper as Kalis, Meynen, 2014
In dementia, the process of option generation may almost completely cease.
“Аналогичным образом при деменции процесс генерации опций может практически полностью прекратиться (Kalis, Meynen, 2014).”
From Когнитивные механизмы дисфункционального принятия решений при психических расстройствах (2025) · cites this paper as Kalis, Meynen, 2014
Patients with substance use disorders, due to deficits in cognitive flexibility, planning, and inhibition of risky behavior, may make a rational decision to quit addiction but return to their previous habitual stereotype at every opportunity.
“пациенты с расстройствами употребления психоактивных веществ ввиду дефицита у них когнитивной гибкости, планирования и торможения рискованного поведения могут принять рациональное решение избавиться от зависимости, но при каждом удобном случае возвращаться к прежнему привычному стереотипу (Kalis, Meynen, 2014).”
From Когнитивные механизмы дисфункционального принятия решений при психических расстройствах (2025) · cites this paper as Kalis, Meynen, 2014
Cites
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Attentional bias in anxiety and depression: The role of awareness
Mogg, K., Bradley, B. P., & Williams, R. (1995) · British Journal of Clinical Psychology · doi:10.1111/j.2044-8260.1995.tb01434.x · Cited by 559 · see citing works
Decision-making cognition in mania and depression
MURPHY, F. C., RUBINSZTEIN, J. S., MICHAEL, A., ROGERS, R. D., ROBBINS, T. W., PAYKEL, E. S., & SAHAKIAN, B. J. (2001) · Psychological Medicine · doi:10.1017/s0033291701003804 · Cited by 316 · see citing works
Verdellen, C. W. J., Hoogduin, C. A. L., Kato, B. S., Keijsers, G. P. J., Cath, D. C., & Hoijtink, H. B. (2008) · Behavior Modification · doi:10.1177/0145445507309020 · Cited by 112 · see citing works
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Ipatyuk, O. V., & Kozunova, G. L. (2025) · Психология Журнал Высшей школы экономики · doi:10.17323/1813-8918-2025-4-736-752
- Authors
- Kalis, A., & Meynen, G.
- Affiliations
- Utrecht University (NL)
- Tilburg University (NL)
- Corresponding author
- Kalis, Annemarie
- Venue
- International Journal of Law and Psychiatry
- Publisher
- Elsevier BV
- Published
- 2014-11
- Volume
- 37
- Issue
- 6
- Pages
- 601-608
- ISSN
- 0160-2527 (ISSN-L)
- OpenAlex
- W2118405191
- Cited by
- 16
- References
- 4
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 2 · 2017: 1 · 2016: 1 · 2015: 1 · 2014: 2
- FWCI
- 1.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Law and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research portal (Tilburg University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion)
- Funders
- Volkswagen Foundation
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Social Sciences › Sociology and Political Science › Criminal Law and Policy
- Keywords
- mental illness, legal responsibility, decision-making, behavioral control, insanity defense, criminal liability
- MeSH terms
- Mental Disorders, Decision Making, Forensic Psychiatry, Humans, Insanity Defense, Models, Theoretical, Mental Competency, Criminals
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