Opinion ID: 2523730
Heading Depth: 1
Heading Rank: 14

Heading: Testimony of Dr. Coleman

Text: Sharon Coleman, a clinical psychologist with Forensic Clinical Services, also testified for defendant. Coleman interviewed defendant twice, and prior to those interviews she reviewed the police reports of the murders, defendant's videotaped statement, and defendant's juvenile clinical records. She also reviewed defendant's previous evaluations performed by Forensic Clinical Services' Drs. Rabin, Henry, and Kelly. Coleman testified that, on axis I, she had diagnosed defendant with polysubstance dependence and psychotic disorder not otherwise specified, with the latter as a provisional diagnosis. With respect to the polysubstance dependence, Coleman opined that the origin of defendant's dependence was remarkable because it began with marijuana use with his father around age six. Coleman explained that the diagnosis of psychotic disorder not otherwise specified was based on defendant's report of fleeting auditory and visual hallucinations of one of his victims. On axis II, she diagnosed defendant with antisocial personality disorder and also with personality disorder not otherwise specified with borderline features. The court interjected to confirm that Coleman's diagnosis included two disorders, and that this was permissible under axis II. Coleman confirmed that it was. She then explained that a personality disorder usually first appears in childhood or adolescence and is long standing and present in a variety of contexts. She opined that defendant would therefore have suffered from the effects of his personality disorders at the time of the murders. She also opined that defendant's symptoms were severe enough to constitute emotional or mental disturbance. With respect to antisocial personality disorder, Coleman testified that defendant met six of the seven diagnostic criteria: failure to conform to social norms with respect to lawful behaviors, deceitfulness, impulsivity or failure to plan ahead, irritability and aggressiveness, reckless disregard for the safety of self and others, and lack of remorse. Coleman then explained that personality disorder not otherwise specified is a general category for a personality disorder that does not meet one of the ten specific personality disorders, and that she had found defendant to exhibit some symptoms of borderline personality disorder, although he did not meet the full criteria for that disorder. In particular, Coleman opined that defendant exhibited transient, stress-related paranoia, inappropriate or intense anger, or difficulty controlling anger, recurrent suicidal behavior or gestures, and general impulsive behaviors that are reckless in nature. Coleman testified that defendant's clinical and legal history supported her diagnoses. She noted that other evaluators had also diagnosed defendant with antisocial personality disorder and personality disorder not otherwise specified, although their diagnoses were not based on borderline features. She also stated that her review of defendant's juvenile records showed at least five reports of abuse by his mother's boyfriend, and that defendant had twice elected to remain in the custody of the state rather than return home. Coleman also noted that the symptoms of antisocial behavior disorder tend to improve with age, such that it was definitely possible that the inappropriate behavior associated with that disorder would lessen with age. She testified that defendant had expressed remorse about the murder of Janet Mena, although he had not expressed regret about the death of Juan Estrada. On cross-examination, Coleman acknowledged that she could not say conclusively that defendant was suffering from a mental or emotional disturbance in 1999. When asked how her diagnosis differed from Heinrich's diagnosis of a mixed personality disorder, Coleman answered, My diagnosis is a general diagnosis of personality disorder with related borderline features, although Mr. Baez according to my diagnosis does not meet the whole criteria for borderline personality disorder.    Mixed personality disorder is similar to personality disorder NOS, however, it could include borderline features, antisocial features, paranoid features. It could include features of multiple or different personality disorders. [Heinrich] does not specify necessarily which personality disorders thatwhich features. The State then inquired about Coleman's diagnoses as compared to those of Dr. Henry, a State psychologist who had evaluated defendant's sanity at the time of the murders. Coleman testified that her diagnoses on axis II were the same as Henry's, including the diagnosis of personality disorder not otherwise specified with symptoms of borderline personality disorder. She also agreed that her axis I diagnosis of polysubstance dependence was the same as Henry's, although her axis I diagnosis also included the provisional diagnosis of psychotic disorder not otherwise specified. She explained that her diagnosis was provisional because there were symptoms present of a possible psychotic disorder but not enough information really there to make a firm diagnosis. Coleman also agreed that the only evidence of hallucinations came from defendant's own reports to the Forensic Clinical Services evaluators after defendant was charged in this case; none of defendant's other clinical history indicated reports of hallucinations. Further, she agreed, defendant's affect and behavior in his sessions with the Forensic Clinical Services evaluators, including herself, were inconsistent with somebody who is overtly psychotic, although she indicated that a person with a psychotic disorder could be properly medicated and in remission such that it is still possible to observe a person who can be alert and cooperative and not experiencing hallucinations during an interview and still have a diagnosis of a psychotic disorder. The State then asked Coleman about malingering, which Coleman testified is exaggerating or completely feigning psychiatric symptoms for personal gain. She stated that the DSM-IV-TR recommends that malingering be strongly suspected if any combination of four criteria were present: (1) the person is referred by an attorney to the clinician for examination; (2) marked discrepancy between the person's claimed stress or disability and the objective findings; (3) lack of cooperation during the diagnostic evaluation and noncompliance with prescribed treatment regimen; or (4) antisocial personality disorder. Coleman agreed that defendant suffered from antisocial personality disorder and that he had been referred to her by an attorney. However, she testified that she did not believe defendant's reports of hallucinations represented a marked discrepancy between the reports and his previous lack of psychotic symptoms; Coleman opined that defendant had first reported hallucinations while incarcerated because that is when they first manifested. On redirect, Coleman clarified that defendant was taking prescribed antipsychotic medication when she interviewed him, and that she therefore would not expect him to display psychotic symptoms.