The legal concept of insanity has had many definitions throughout the years, and the precise definition used is critical in determining the status of a person in the legal system. Past research has demonstrated that different professions working in the legal system cannot agree on the definition

of insanity (Weinstein & Geiger, 2003). However, many times the final decision of sanity vs. insanity is made by 12 laypersons-the jury. In the present study, 177 undergraduate students were asked to rate seven different definitions of insanity. There were differences in the level of agreement between the seven definitions, and also differences between professionals and college students were found for 3 definitions: The medical model, the sociological model, and the psychometric model. In addition, depression and alcoholism were viewed as more onset controllable than paranoid schizophrenia.

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Insanity is a concept that most people are familiar with, but also one that they have difficulty clearly defining. Although insanity is purely a legal term, many people would be surprised to realize that psychology does not offer a definition of insanity that most psychologists agree upon. A survey of some frequently used abnormal psychology textbooks (Coleman, Butcher, & Carson, 1990; Comer, 2002; Davison & Neale, 2003; Holmes, 1993; Mears & Gatchel, 1989; Nietzel, Speltz, McCauley, & Bernstein, 1998; Oltman & Emery, 2001; Ullman & Krasner, 1985) revealed at least seven different models or definitions of insanity:

1. A moral model that described insanity as sinful behavior.

2. A medical model, which defined insanity as a disease with diagnosable symptoms and a prognosis.

3. A statistical model, which defined insanity as infrequent or rare behavior.

4. A sociological model which discussed behavior within a society and those who observed that behavior as the two criteria for defining insanity.

5. A psychometric model which defines insanity as scoring above or below a certain point on a test.

6. A professional judgment model, which suggests that any behavior being treated by a qualified physician or clinical psychologist is abnormal.

7. A legal model which defines insanity as abnormal behavior or thinking which shows lack of ability to understand the laws of society, or to appreciate the wrongfulness of one's actions.

With seven prominent definitions of insanity in use, it seems probable that when two people are discussing insanity or abnormal behavior, they may not be working from the same definition. In the legal world where a jury is compromised of 12 individuals who many times make the final decision as to a defendant's sanity or insanity, it is very unlikely that all these individuals start with the same working definition of insanity. Even if they are given the precise legal definition of insanity during jury instructions at the end of the case, their interpretation of the testimony and evidence during the trial is likely to be influenced by the definition which they bring with them to the trial. Support for this influence comes from McGraw and Foley (2000) who pointed out that most people form definitions of insanity independently of the legal definitions. Skeem and Golding (2001) found that mock jurors form a prototype of insanity, and that these conceptions often contradict the legal definitions of insanity. There were an average of seven characteristics of insanity in the prototype, but the mock jurors did not substantially agree on the subset of features that made up the prototypes.

One factor that seems to affect the layperson's determination of insanity is the seriousness of the crime. The more serious the crime and its outcome, the more likely the accused was determined to be sane, and deserving of a prison sentence (McGraw & Foley, 2000). Many people believe that the insanity defense is overused, and is too successful, so a judgment of insanity is seen as letting someone off too easy. Mock jurors in another study (Doyon, 2001) based their definitions of insanity on their belief as to the controllability of the onset of the disorder, where schizophrenia and PTSD were seen to be low in controllability, and led to judgments of insanity. Depression and alcoholism were seen as high in controllability, and the defendant was often judged as sane when diagnosed with these conditions.

There is even disagreement about the definition of insanity among professionals in the legal system, as Weinstein and Geiger (2003) found that lawyers, judges, and physicians showed significant differences as to the degree they endorsed four of the seven definitions. Judges endorsed the legal model more highly than did lawyers and physicians, but the exact opposite was found for the medical model. Also, judges endorsed the statistical model more highly than lawyers did, whereas lawyers endorsed the sociological model more than the judges or physicians. These results show that even the professionals in the legal field are speaking different languages when the term "insanity" is used.

This past research has demonstrated that laypeople which generally make up juries in insanity cases do not use the legal definition of insanity, and instead base their judgments on factors like seriousness of the crime and whether the defendant was responsible for their mental condition. Laypeople which make up juries are presented with information from professionals which allow them to compare the actual case with their prototype of insanity, but even these professionals are not in agreement on the definition of insanity.

Given the past differences between judges, attorneys, and clinicians regarding the seven main definitions of insanity, questions still remain as to how potential jurors define insanity as these definitions will influence their decision making during and after the trial. Therefore, the present study was designed to survey laypeople who would be considered potential jurors for a criminal trial to determine to what degree they endorse seven different definitions of insanity from the Weinstein and Geiger (2003) study. In addition, the present study replicated Doyon's (2001) study to see if depression is still seen as being high in onset controllability, as the recent focus on depression being due to chemical imbalances in the brain may influence participants to view depression as less onset controllable.

Method

Participants

The participants were 177 college students from Cameron University who were enrolled in a General Psychology course.

All participants were surveyed before their course covered the topic of abnormal psychology, so their views were not influenced by course material.

Materials

The survey consisted of seven statements or definitions of the term insanity and space to write Likert-type ratings of the definitions from 10 (being in absolute agreement) to 1 (being in absolute disagreement). The Moral Model definition stated that insanity was sinful behavior. The Medical Model definition stated that insanity was a disease with a set of diagnosable symptoms, treated with drugs, and had a prognosis. The Statistical Model definition said that insanity was an infrequent or rare behavior. The Sociological Model definition stated that for a person to be labeled insane, one has to first look at the behavior and the society in which it occurred, and at the one who observed the behavior.

The Psychometric Model stated that insanity was a point on a psychometric test. The Professional Judgment Model pointed out that anything a qualified physician or clinical psychologist defines as insane could be called insane. The Legal Model definition stated that abnormal behavior involves lack of competency to understand the laws of society.

The onset controllability survey consisted of a short passage describing an individual who commits an act of arson (from Doyon, 2001) with the final sentence stating that a court appointed psychologist determined that he suffered from either: Alcoholism, depression, paranoid schizophrenia, or post-traumatic stress disorder (see Appendix for the passage). Beneath the passage was a 7 point Likert-type scale used to rate the onset controllability of the disorder, from 1 (totally uncontrollable onset) to 7 (totally controllable onset).

Procedure

The participants first read and signed an informed consent form, and then were presented with the survey. There was unlimited time to complete the survey. Each participant received a survey packet with one of the four diagnoses for the onset controllability survey selected at random.

Results

Each of the seven definitions of insanity was rated on a 1 to 10 Likert-type scale, where a 10 indicated total agreement with that definition and a 1 indicated total disagreement with the definition. The mean ratings for each definition are presented in Table 1.

A one-way repeated measures ANOVA found that there were differences in the degree of agreement for the seven definitions, F(6, 1038) = 46.72, p < .05, [[eta].sup.2] = .21.

Pairwise comparisons of the definitions were calculated using Tukey's HSD procedure, and 16 comparisons were found to be significant. The significant comparisons are presented in Table 2. Overall, these results indicated that there were serious disagreements concerning definitions of insanity in the general public.

To test whether college students agreed or disagreed with the opinions of professionals as to the definition of insanity, a series of one-sample t-tests were run, which compared the mean agreement rating in the current sample with the mean agreement rating across professionals (lawyers, judges, and physicians) from the Weinstein and Geiger (2003) study. These comparisons showed that college students differed from professionals in their level of agreement for the medical model (t(176) = 16.27, p < .05), the sociological model (t(175) = 6.42, p < .05), and the psychometric model (t(175) = -8.60, p < .05. The mean agreement level among the professionals for these definitions were 4.10, 4.87, and 5.60, respectively.

In addition, the participants rated the onset controllability of the four disorders from the Doyon (2001) study on a 1 to 7 scale, where 7 indicated that it was a disorder with a totally controllable onset. The mean ratings for each disorder are presented in Table 3.

A one-way ANOVA found that college students view the disorders as differing in onset controllability, F(3, 171 ) = 6.67, p < .05, [[eta].sup.2] = .10. Tukey's HSD test revealed that Alcoholism (M = 5.53) was viewed as more controllable than Paranoid Schizophrenia (M = 4.13), and Depression (M = 5.07) was also more onset controllable than Paranoid Schizophrenia.

Discussion

The results of the present study support the hypothesis that there is a significant difference in the degree of endorsement of different insanity definitions in the general population. The present study used college students as participants but they should be representative of the general population, as all participants were surveyed before they received any information about the legal definition of insanity in their coursework. In addition, the university where the study was carried out consists of a high percentage of non-traditional students, who would also be very representative of the composition of the typical jury. Table 2 shows that there were 16 significant differences found in terms of agreement with pairs of definitions, which indicates that college students do not have a clear cut definition for insanity.

However, in spite of all these differences, some clear cut findings did emerge. The participants endorsed the medical model and the sociological model more than the other five models. The least preferred definition was the moral model. The medical model also received a high degree of endorsement by physicians and lawyers in the Weinstein and Geiger (2003) study. This demonstrates that in the legal setting certain professionals and the jury may be operating from similar definitions of insanity. However, the one-sample t-test showed that the college students endorsed the medical model to an even greater extent than the professionals did. This could be due to the recent focus on mental illness being a biologically based illness. This would also explain why the college students rated the moral model below the other models of insanity, as the medical model and moral model are opposites of each other.

The college students also preferred the sociological model, which was also rated highly by lawyers and judges in the Weinstein and Geiger (2003) study. This would be another area, then, where the jury and certain legal professionals would be in agreement as to the definition of insanity. One reason that college students rate this model highly could be the recent focus on relativism and cultural sensitivity, where behaviors are to be seen in light of the person's cultural background. This view fits closely with the sociological model.

However, the college students disagreed with the professionals on the psychometric model, being much less likely to endorse this model. The professionals in the legal system should be more familiar with the psychometric model, as personality tests, IQ tests, and mental status exams would be common tools to use to determine competence and mental fitness to stand trial. College students have probably had exposure to personality tests, often times "pop psychology" personality tests, but are likely unfamiliar with using such measures to determine sanity and insanity. So college students, and prospective jurors, would feel less comfortable with this definition due to lack of familiarity.

It was surprising that participants still rated depression high in onset controllability. This replicated the Doyon (2001) study, but is unexpected given the preference for the medical model of insanity. People who view insanity from a medical model or biologically based viewpoint would be expected to also view mental disorders as low in onset controllability. The current focus in the popular culture is that depression is caused by a biochemical imbalance (i.e., low levels of Serotonin), and it occurs beyond one's control, just as any other physical illness. The participants in the current study seemed to view insanity in general from this viewpoint, but not the specific disorders of depression and alcoholism. Alcoholism is easy to understand as a high onset controllable disorder because the alcoholic made the decision to start drinking alcohol, but the participants' view of depression is harder to understand. Perhaps participants' thinking involves viewing depression as caused by a biological event, but one does not have to "give in" to the biological lesion.

The overall findings demonstrate that there is still confusion about what the term "insanity" actually means. Non-professionals agree with physicians, judges, and lawyers on some ideas of insanity, but disagree on others. The variability of ratings in the present study also indicates that even non-professionals do not entirely agree as to the appropriateness of each definition of insanity. Part of this disagreement might come from the Doyon (2001) finding that people base judgments of insanity in particular cases partially on how they view the onset controllability of the disorder. Participants were given no particular disorder with which to evaluate the seven definitions on, but it is likely that most of them did have one or a few specific disorders in mind when assessing these definitions. The present study, as well as the Doyon study show that the judgment of onset controllability does vary between disorders. Less variability in ratings might have been obtained if participants were told to judge the seven definitions of insanity in terms of a specific disorder.

Some researchers believe that it is almost impossible to have an agreed upon definition of insanity. One reason would be the variety of mental disorders that fall under the umbrella term "insanity". Quen (1983) pointed out that insanity was originally a medical term and in the nineteenth century the word was applied to varying and disparate behaviors such as idiocy, senility, mania, melancholy, alcoholism, compulsive theft, and compulsive fire setting. He further argues that since the term originally referred to such different problems it is not surprising that a clear definition of insane is not easily found.

The fact remains, though, that a single clear definition of insanity is needed to insure justice and accuracy in the legal and medical professions. The present study found that jurors are just as confused about insanity as the professionals they are working with in the legal system.

Appendix: Onset Controllability Scenario

For this part of the experiment you are to read the following crime scenario which is based on actual details of a case. After reading the scenario, please mark your ratings as to the onset controllability of the person's disorder. Onset controllability refers to the degree to which the person is responsible for their abnormal mental condition. A totally controllable onset means that the person is completely responsible for bringing on the mental illness they are suffering from. A totally uncontrollable onset means the person is in no way responsible for bringing on the mental illness they are suffering from.

According to investigators, on the night of September 29, 1991, a man entered an abandoned warehouse on the waterfront and used gasoline and matches to set it on fire. An automated fire alarm system went off, alerting local authorities. Police apprehended the man standing outside the warehouse as they and the firefighters arrived on the scene. He was charged with one count of arson. The man, who police identify as 52-year-old James M. offered no explanation as to how the fire got started. However, the gasoline can and matches were clearly on his person. Police could offer no motive for the arson. During his trial, the court-appointed psychiatrist stated that James M. has (one of these disorders: alcoholism/depression/paranoid schizophrenia/post-traumatic stress disorder)

Author Note

John F. Geiger and Lawrence Weinstein, Department of Psychology and Human Ecology, Cameron University; Correspondence concerning this article, including a request for reprints, should be addressed to John F. Geiger, Department of Psychology and Human Ecology, Cameron University, 2800 W Gore Blvd., Lawton, Oklahoma 73505. Email: johng@cameron.edu

References

Coleman, J. C., Butcher, J. N., & Carson, R. C. (1990). Abnormal Psychology and Modern Life. Glenview, IL: Scott, Foresman and Company.

Comet. R.J. (2002). Fundamentals of Abnormal Psychology (3rd ed.). New York: Worth Publishers.

Davison, G. C., & Neale, J. M. (2003). Abnormal Psychology (8th ed.). New York: John Wiley & Sons.

Doyon, T. (2000). Does the onset controllability of diagnostic labels affect the perceived appropriateness of an insanity verdict? Journal of Applied Social Psychology, 30, 528-546.

Holmes, D. S. (1993). Abnormal Psychology. New York: Harpercollins.

McGraw, S. L., & Foley, L. A. (2000). Perceptions of insanity based on occupation of defendant and seriousness of crime. Psychological Reports, 86, 163-174.

Mears. F., & Gatchel, R. J. (1989). Fundamentals of Abnormal Psychology. Chicago: Rand McNally.

Nietzel, M. T., Speltz, M. L., McCauley, E. A., & Bernstein, D.A. (1998). Abnormal Psychology. Boston, MA: Allyn and Bacon.

Oltmanns, T. F., & Emery, R. E. (2001). Abnormal Psychology (3rd ed.). Upper Saddle River, N J: Prentice Hall.

Skeem. J. L., & Golding, S. L. (2001). Describing jurors" personal concept of insanity and their relationship to case judgments. Psychology. Public Policy, and Law, 7, 561-621.

Ullmann, L. P., & Krasner, L. (1985). A Psychological Approach to Abnormal Behavior. Upper Saddle River, N J: Prentice Hall.

Weinstein, L., & Geiger, J. F. (2003). Insanity and its Various Interpretations. Psychology and Education, 40, 19-24.

JOHN F. GEIGER AND LAWRENCE WEINSTEIN

Department of Psychology and Human Ecology Cameron University

Table 1
Mean Agreement Ratings, for each Definition of Insanity

Definition            Mean Rating

Moral                 3.17(2.53)
Medical               6.96(2.23)
Statistical           5.34(2.50)
Sociological          6.09(2.55)
Psychometric          3.96(2.41)
Professional          5.04(3.19)
Legal                 5.95(2.82)

Note. Standard Deviation is in parenthesis

Table 2
Significant Pairwise Comparisons on the Definition Agreement Ratings

Moral vs. Medical
Moral vs. Statistical
Moral vs. Sociological
Moral vs. Professional
Moral vs. Legal
Medical vs. Statistical
Medical vs. Sociological
Medical vs. Psychometric
Medical vs. Professional
Medical vs. Legal
Statistical vs. Sociological
Statistical vs. Psychometric
Sociological vs. Psychometric
Sociological vs. Professional
Psychometric vs. Professional
Psychometric vs. Legal

Table 3
Mean Ratings for Onset Controllability

Disorder                           Mean Rating

Alcoholism                         5.53(1.40)
Depression                         5.07(1.49)
Paranoid Schizophrenia             4.13(1.57)
PTSD                               4.74(1.65)

Note. Standard Deviation is in parenthesis