Interdisciplinary Fitness Interview (IFI)

The Interdisciplinary Fitness Interview (IFI) is a semi-structured assessment device designed to help examiners explore systematically the domain of psycholegal abilities associated with adjudicative competency. Originally developed by Stephen Golding and Ronald Roesch for a National Institute of Mental Health (NIMH)-sponsored comparative validity study of methods of assessing competency, the IFI was developed on the basis of three assumptions. First, the Competency Assessment Interview, which was the most promising and articulated assessment device available at the time, was outdated and did not include many of the psycholegal abilities associated with adjudicative competency that emerged from an extensive review of competency case law and research. Second, an approach was needed that stressed the possible, but not automatically assumed, linkage between psychopathology and incapacity. Third, an assessment approach needed to reflect the highly contextualized nature of adjudicative competence.

As originally designed and tested, the IFI manual stressed the linkage and contextual aspects of competency assessment and emphasized the importance of these aspects of competency evaluation by including both attorneys and forensic mental health professionals in the interview and evaluation process (hence the term interdisciplinary). It was a good, but impractical, idea. In the NIMH-funded pilot project, attorneys proved to be able to contribute in a meaningful and reliable fashion to the competency appraisal, but implementing their routine involvement proved difficult for financial and logistical reasons. In its modern form, the revised version (IFI-R) is designed so that the forensic examiner provides the linkage based on extensive training, knowledge of the legal issues, and consultation with both defense and prosecution about the particular context of a given case. The IFI-R is also designed to include a more extensive linkage analysis and includes additional psycholegal abilities associated with more modern competency cases. Thus, the IFI-R, in addition to the traditional competency domains, also focuses on competencies associated with the decision to proceed pro se or to plead guilty, the competency to comprehend and appreciate rights during a custodial interrogation, and the iatrogenic effects of medication.

The IFI-R organizes 35 specific psycholegal abilities associated with adjudicative competency into 11 broad domains. Thus, the IFI-R spans the entire domain of competency-related psycholegal abilities, ranging from fundamental issues such as understanding the prosecutor’s adversarial role, through common competency concerns such as the ability to communicate relevant information to counsel, to higher-order decisional competencies such as the ability to make a reasoned choice of defense options. Special competency considerations that arise in the context of psychotropic medications, such as deficits in psycholegal abilities induced by such treatments and treatment refusal, are also addressed.

For each psycholegal ability, the IFI-R guides examiners through suggested inquiries meant to explore the linkage, if any, between psychopathological symptoms or cognitive deficits and impairment in each domain. While each psycholegal ability can be “scored” as to degree of impairment, the inherent idiographic nature of the instrument means that the scores are specifically not designed to be summed into a “competency score” but rather are meant to guide a forensic examiner’s structured judgment. Subsequent research across various competency assessment instruments has demonstrated the validity of this assumption.

The IFI-R has not been thoroughly examined from an empirical perspective. The original NIMH developmental and validational studies found that the IFI items were scored with good to excellent interrater reliability. Furthermore, competency judgments based on the IFI aligned very well with both independent assessments by a “blue-ribbon panel” and court judgments. However, it should be pointed out that these results were obtained with a group of interviewers who received intensive training in both the logic and the methodology of the IFI as well as a detailed review of relevant case law. When untrained examiners’ evaluations (using unstandardized methods) are “coded” according to the IFI-R domain/ subdomain scheme or when untrained examiners are provided the IFI-R format without training and supervision, their assessments of individual domains or sub-domains are quite unreliable. Thus, the IFI-R is meant to be used by highly trained and experienced forensic examiners. It has been favorably reviewed in terms of its conceptualization and its usefulness in guiding forensic competency assessments. Most research on the conceptualization of the IFI-R (i.e., using a contextualized semistructured interview to examine the linkage between psychopathology and articulated psycholegal ability domains) has been conducted with the Canadian cousin of the IFI-R, the Fitness Interview Test-Revised (FIT-R).

Unlike most other competency evaluation methods and procedures, the IFI-R and its Canadian cousin, the FIT-R, are the only procedures that have been examined with respect to their comparative validity in a real-world context. Most other competency instruments have been validated by showing that scores on the instrument are significantly different in groups adjudicated as incompetent versus those judged competent. Although such contrasted group designs do provide informative data, they are relatively weak tests of construct validity.

References:

  1. Golding, S. L., Roesch, R., & Schreiber, J. (1984). Assessment and conceptualization of competency to stand trial: Preliminary data on the Interdisciplinary Fitness Interview. Law and Human Behavior, <5(3-4), 321-334.
  2. Roesch, R., Zapf, P., & Eaves, D. (2006). FIT-R: Fitness Interview Test-Revised: A structured interview for assessing competency to stand trial. Sarasota, FL: Professional Resource Press/Professional Resource Exchange.
  3. Viljoen, J., Vincent, G., & Roesch, R. (2006). Assessing adolescent defendants’ adjudicative competence: Interrater reliability and factor structure of the Fitness Interview Test-Revised. Criminal Justice and Behavior, 33, 467-175.
  4. Zapf, P. A., & Roesch, R. (2005). An investigation of the construct of competence: A comparison of the FIT, the MacCAT-CA, and the MacCAT-T. Law and Human Behavior, 29(2), 229-252.

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