Encyclopedia of Psychology and Law

extent by the criminal justice system, in particular the

county’s criminal court of commitment. This dual

responsibility can cause professional conflict and con-

fusion, making the release of insanity acquittees a

complex legal and procedural process. None of this

confusion surrounds parole or probation.

While in most states an NGRI finding leads to an

automatic inpatient evaluation, this is not the case in all

states. A few states allow the judge discretion in

bypassing an order for hospitalization. Following an

NGRI commitment, periodic reviews are conducted at

intervals designated by state law: commonly 30 days,

60 days, 90 days, 1 year, and then annually. At this

review, the treating psychiatrist or patient advocate can

recommend or request conditional release. This appli-

cation sets in motion the state’s conditional release pro-

cedures, which range from a simple approval by a judge

in the county where the acquittal was recorded to a

complex, multilayered process in which hospital, state,

and court officials are required to approve the petition.

In some states, the county judge and/or district attorney

have to approve even internal security changes, such as

from closed to open unit, or grounds privileges. The

complexity of the release procedures has an impact on

the likelihood of release, who is released, and the

length of time between approval and actual release. An

important component of conditional release is the avail-

ability of community programs to provide services to

this forensic population.

An innovative program developed in Oregon in

1978 and established in Connecticut in 1985 sought to

gain greater control over persons found NGRI. The

Psychiatric Security Review Board (PSRB) is a multi-

disciplinary independent board with full responsibili-

ties for persons found NGRI. Decision making is

highly centralized, and this board grants and revokes

conditional release and sets the terms of release. This

model has never been attempted in states with large

populations.

Most persons found NGRI and subsequently placed

on conditional release draw little, if any, public atten-

tion, and the petitions are usually supported by the

courts. Who supervises the persons on conditional

release programs varies from state to state. Many

states, in particular larger states with larger NGRI

populations, have special intensive case managers

who have experience or special training with forensic

clients. Their caseload is often smaller than in tradi-

tional aftercare programs. This common model for

conditional release leads to decentralized supervision

and decision making once the person is released. In

addition to possible revocation, conditional release

can be extended by the court, or the person can be dis-

charged from all supervision.

Lisa Callahan

See also Treatment and Release of Insanity Acquittees

Further Readings

Appelbaum, P. S. (1994). Almost a revolution: Mental health

law and the limits of change. New York: Oxford

University Press.

Callahan, L. A., & Silver, E. (1998). Factors associated with

the conditional release of persons acquitted by reason of

insanity: A decision tree approach. Law & Human

Behavior, 22,147–163.

Steadman, H. J., McGreevy, M. A., Morrissey, J. P., Callahan,

L. A., Robbins, P. C., & Cirincione, C. (1993). Before and

after Hinckley: Evaluating insanity defense reform. New

York: Guilford Press.

CONDUCTDISORDER

Conduct disorder (CD) is a repetitive and persistent

pattern of behavior that violates the rights of others or

age-appropriate norms and causes significant impair-

ments in various domains of functioning. CD accounts

for a substantial number of youths who enter into

mental health facilities in the United States and

Canada, and for this reason it is an important disorder

for researchers to investigate and for clinicians to

treat. Although CD continues to be problematic for

the individual and society, remarkable progress has

been made in our understanding of CD. Subtyping

approaches have helped reduce some of the hetero-

geneity of the disorder and provide a better under-

standing of the potential etiologies associated with

various types of CD. In addition, intervention pro-

grams have been developed that have been shown to

be effective. These treatment programs tend to be

intensive and multimodal, focusing on working with

the youth to reduce CD symptoms but also providing

parent training to improve attachment as well as

parental monitoring and supervision practices. It is

hoped that future research focusing on further refining

the subtypes of CD and determining interventions that

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