state of texas v. andrea yates exhibits to the testimony of park dietz, md, phd

92
STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Upload: owen-mccormick

Post on 24-Dec-2015

231 views

Category:

Documents


2 download

TRANSCRIPT

Page 1: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

STATE OF TEXAS v.

ANDREA YATES

STATE OF TEXAS v.

ANDREA YATES

Exhibits to the testimony of Park Dietz, MD, PhD

Page 2: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

SPECIALIZED EXPERIENCESPECIALIZED EXPERIENCE

Page 3: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Experience in the Forensic Evaluation of Criminal

Responsibility

Experience in the Forensic Evaluation of Criminal

Responsibility Hundreds of evaluations of this issue since

1977, for courts, defense attorneys, and

prosecutors

Teaching and lecturing on techniques of

evaluation at universities and professional

conferences in the U.S. and other countries

Page 4: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Experience in the Forensic Evaluation of Criminal

Responsibility

Experience in the Forensic Evaluation of Criminal

Responsibility Wrote reports about 30 other defendants

pleading insanity since 1994

Found 9 of 30 insane (30%)

Retained by prosecution in 7 of the 9

cases found insane

Page 5: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Maternal Filicide Forensic Experience

Maternal Filicide Forensic Experience

Evaluated 14 cases from 1996-2006

Reached opinions about criminal

responsibility in 7 cases: 3 sane, 4

insane

Working for prosecution in all 7

Page 6: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Research on Maternal FilicideResearch on Maternal Filicide

FBI research project

175 mothers who killed their

children

Page 7: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

RetentionRetention

Contacted July 6, 2001 (16 days after drownings)

Requested all records and exam ASAP

Notified September 26, 2001, that Court had authorized exam

Page 8: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

SOURCES OF INFORMATIONSOURCES OF INFORMATION

Page 9: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

InterviewsInterviews

Mrs. Andrea Yates, 11/6/01 and 11/7/01 (videotaped and audio taped)

Melissa Ferguson, M.D., 11/6/01

Debra M. Osterman, M.D., 11/7/01

Mr. and Mrs. Robert Holmes, 11/8/01

Mr. Russell Yates: requested but refused

Mrs. Dora Yates: requested but refused

Page 10: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Videotaped Interviews by OthersVideotaped Interviews by Others

Interview of Russell Yates, 6/21/02, Channel 13

Recorded portion of the examination by Phillip Resnick, M.D., 7/14/01

Recorded portion of the examination by Lucy J. Puryear, M.D., 7/27/01

Recorded portion of the examination by Lucy J. Puryear, M.D., 8/10/01 Cont.

Page 11: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Videotaped Interviews by Others (cont.)

Videotaped Interviews by Others (cont.)

Examination by Phillip Resnick, M.D., 11/3/01

Excerpts of an interview of Russell Yates, undated, broadcast on 60 Minutes, 12/9/01

Examination by Lucy J. Puryear, M.D., 2/4/02

Page 12: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Videotaped Interviews by Others (cont.)

Videotaped Interviews by Others (cont.)

Birthday party

Examination by Michael Welner, M.D., 5/3/06 and 5/4/06

Page 13: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Testimony from Prior Proceedings

Testimony from Prior Proceedings

Mohammad A. Saeed, M.D.

Phillip J. Resnick, M.D.

Lucy J. Puryear, M.D.

Melissa A. Ferguson, M.D.

Steven Rosenblatt, M.D.

Page 14: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Testimony from Prior Proceedings

Testimony from Prior Proceedings

Ellen Allbritton, M.D.

Earline Willcott, LMSW

Harry Wilson, M.D.

Park Dietz, M.D., Ph.D.

Page 15: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Educational Records re. Defendant

Educational Records re. Defendant

Transcript from Houston Independent School District

Milby High School Yearbook, 1982

University of Houston records

University of Texas Health Science Center at Houston records

Page 16: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Employment Records re. Defendant

Employment Records re. Defendant

Employment records, M.D. Anderson

Hospital and Tumor Institute

Page 17: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Social Service Records re. Defendant

Social Service Records re. Defendant

Harris County Child Protective Services

records re. Andrea Yates

Page 18: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Medical Records re. DefendantMedical Records re. Defendant

Ben Taub Hospital Emergency Room, 6/17/99

Methodist Hospital, 6/18/99 – 6/24/99

James P. Thompson, Ph.D.

Starbranch Psychiatry Associates, 7/1/99 – 4/3/01

Cont.

Page 19: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Medical Records re. Defendant (cont.)

Medical Records re. Defendant (cont.)

Spring Shadows Glen Hospital, 7/21/99-8/10/99

Samaritan Center for Counseling and Education, 8/26/99-2/24/00

Earline Willcott, LMSW, 5/16/00 – 03/06/01

Devereux Texas Treatment Network, 3/31/01–4/12/01

Cont.

Page 20: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Medical Records re. Defendant (cont.)

Medical Records re. Defendant (cont.)

Devereux Texas Treatment Network, 5/04/01–5/22/01

Mohammad A. Saeed, M.D., 4/19/01 – 6/21/01

Harris County Jail medical records, 6/20/01 – 12/19/01

Portions of the medical and psychiatric treatment records from 2002-2006

Page 21: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Investigative ReportsInvestigative Reports

Complete Houston Police Department investigative file

Tape of 911 call by Andrea Yates

Police crime scene photos

Crime scene videotape 

Page 22: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

StatementsStatements

Statement of Andrea Yates, 6/20/01 (tape and transcript)

Statement of Russell Edison Yates, 6/20/01 (tape and transcript)

Statement of Dora Yates, 6/20/01 (tape and transcript)

Page 23: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Medical Examiner’s Office Investigation

Medical Examiner’s Office Investigation

Medical Examiner’s Office crime scene photos

Autopsy report re. Mary Deborah Yates, age 6 months, by Patricia J. Moore, D.O.

Autopsy photographs of Mary Deborah Yates

Autopsy report re. Luke David Yates, age 2, by Harminder S. Narula, M.D.

Autopsy photographs of Luke David Yates

Cont.

Page 24: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Medical Examiner’s Office Investigation (cont.)

Medical Examiner’s Office Investigation (cont.)

Autopsy report re. Paul Abraham Yates, age 3, by Harminder S. Narula, M.D.

Autopsy photographs of Paul Abraham Yates

Autopsy report re. John Samuel Yates, age 5, by Patricia J. Moore, D.O.

Autopsy photographs of John Samuel Yates

Autopsy report re. Noah Jack Yates, age 7, by Harminder S. Narula, M.D.

Autopsy photographs of Noah Jack Yates

Page 25: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Forensic Evaluation Records re. Defendant

Forensic Evaluation Records re. Defendant

Report by Steven Rosenblatt, M.D., 6/25/01

Report by George M. Ringholz, Ph.D., M.D., undated

Report by Phillip J. Resnick, M.D., 02/27/02

Page 26: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Legal DocumentsLegal Documents

Texas Penal Code, Section 8.01 re. Insanity

Notice of Intent to Offer Evidence of the Insanity Defense, 7/30/01

Various Motions

Page 27: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Miscellaneous DocumentsMiscellaneous Documents

March – June 2001 Chronology prepared

by Debbie Holmes

The Perilous Times, Series: 2000-1J

Various letters to and from Mrs. Yates

Scientific studies of maternal filicide,

postpartum illness, haloperidol, and

benzodiazepine-induced amnesia

Page 28: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

REPORTREPORT

Page 29: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

ReportReport

Peer-reviewed by Daryl Matthews, M.D.,

Ph.D., Bennett Blum, M.D., and Daniel

Martell, Ph.D.

103 pages (single spaced) + 144 pages of

complete examination transcript (single

spaced)

Submitted 2/25/02

Page 30: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

REFERRAL QUESTIONSREFERRAL

QUESTIONS

Page 31: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Referral QuestionsReferral Questions

Did Andrea Yates have a mental disease or defect on June 20, 2001?

What was her mental state during the time she drowned her children?

During that time, did she know her conduct was wrong?

Page 32: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

DID ANDREA YATES HAVE A

MENTAL DISEASE OR DEFECT ON JUNE 20, 2001?

DID ANDREA YATES HAVE A

MENTAL DISEASE OR DEFECT ON JUNE 20, 2001?

Page 33: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Various Doctors’ Diagnoses of Mrs. Yates at Her Worst

Various Doctors’ Diagnoses of Mrs. Yates at Her Worst

Major Depression with Psychotic Features

Schizophrenia Schizoaffective Disorder Postpartum Psychosis Bipolar Disorder + Schizoid Personality

Disorder

Any of these can be a severe mental disease

Page 34: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Effects of These Mental DiseasesEffects of These Mental Diseases

Any of these diseases may cause delusions, hallucinations, or some degree of cognitive impairment in some people, some of the time

People with a particular disease do not all have identical signs and symptoms

A person with a mental disease may have different signs and symptoms at different times

Page 35: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Effects of These Mental DiseasesEffects of These Mental Diseases

Sometimes, individuals with each of these diseases kills someone

When someone with a mental disease kills another, it may or may not be at a time when because of delusions, hallucinations, or other psychotic symptoms, that person does not know that killing is wrong

No mental disease causes every killer with the disease to not know what he or she is doing is wrong

Page 36: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

The Question of Postpartum Onset

The Question of Postpartum Onset

DSM-IV-TR requires onset within 4 weeks of delivery

Some doctors believe the definition should be changed to 3 months or even one year

Changing the definition changes which cases are classified as postpartum onset

Page 37: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

The Question of Postpartum Onset

The Question of Postpartum Onset

DSM-IV-TR says the symptoms do not differ from those of mood disorders without postpartum onset

Some doctors believe there is a unique condition of postpartum psychosis with hormonal causes, additional symptoms, and faster recovery

Page 38: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

The Question of Postpartum Onset

The Question of Postpartum Onset

Whether onset was postpartum is not related to the severity of Mrs. Yates symptoms at the time she drowned her children

Whether onset was postpartum is not related to whether Mrs. Yates knew her conduct was wrong when she drowned her children

Page 39: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Timing of Defendant’s Symptom Onset

After Luke’s Birth

Timing of Defendant’s Symptom Onset

After Luke’s Birth Depression began 6-8 weeks after Luke’s birth (2/15/99), while living in the bus and home schooling

Psychosis was suspected in July (Dr. Starbranch)

The first clear psychotic symptom (delusion of cameras in the house) was in August

Page 40: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Timing of Defendant’s Symptom Onset

After Mary’s Birth

Timing of Defendant’s Symptom Onset

After Mary’s Birth By most accounts, Mrs. Yates’ depression began more than 3 months after Mary’s birth (11/30/00) and after Mrs. Yates’ father’s death (3/12/01)

Unknown when delusions began

Floridly psychotic only after she was in jail

Page 41: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

WHAT WAS MRS. YATES’ MENTAL STATE DURING THE TIME SHE

DROWNED HER CHILDREN?

WHAT WAS MRS. YATES’ MENTAL STATE DURING THE TIME SHE

DROWNED HER CHILDREN?

Page 42: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Mental Disease vs. Mental StateMental Disease vs. Mental State

Mental disease: a serious mental disorder with a known set of signs and symptoms that may fluctuate in severity over time

Mental state: the condition of a person’s mind at a particular time, such as the time of the drownings

Page 43: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Signs and Symptoms Change as Mental State Changes

Signs and Symptoms Change as Mental State Changes

Mood, affect, energy, and appetite may vary

Cognitive functioning may vary (e.g., consciousness, memory, orientation)

Hallucinations may be present or absent

Delusions may be present or absent

Page 44: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Some of the Factors Influencing Mental State

Some of the Factors Influencing Mental State

Natural history of any mental disease

Life events (ordinary, stressful, and traumatic)

Fatigue

Lack of sleep

Medications and other treatment

Page 45: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Some of the Life Events Affecting Mrs. Yates Before Her 1999

Episode of Illness

Some of the Life Events Affecting Mrs. Yates Before Her 1999

Episode of Illness Giving up her career Giving up her possessions Changing her faith Giving up her identity (according to

others) Allowing her husband to make all

decisions Relative social isolation Five pregnancies (four births and a

miscarriage) Living in an RV and a bus Home schooling her children

Page 46: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Treatment Delayed and Refused in 1999

Treatment Delayed and Refused in 1999

Feeling depressed and overwhelmed, she asked her husband for help, but got medical attention only upon taking an overdose (June)

Flushed Zyprexa (July)

ECT recommended by Drs. Thompson and Rios; Mr. and Mrs. Yates refused (August)

Against medical advice, secretly went off all

medication (November)

Page 47: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Medical Advice Disregarded in 2000

Medical Advice Disregarded in 2000

Against medical advice, became pregnant (February)

Against medical advice, failed to take medication during pregnancy

Against medical advice, failed to take medication after Mary’s birth (November 30)

Page 48: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Evidence of Mrs. Yates’ Mental State

11/30/00 – 3/12/01

Evidence of Mrs. Yates’ Mental State

11/30/00 – 3/12/01 Mrs. Yates said she had a reasonably normal Christmas

Resumed fitness routine of morning swim for 2-3 months

According to Mr. Yates, she “was fine” According to Ms. Willicott, she was not

psychotic but rather a devoted, perfectionistic mother worried about her father’s declining health in early March

Kept a detailed journal of home schooling until 3/12/01

Page 49: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

New Stressors in 2001New Stressors in 2001

Mrs. Yates’ father fell (January) and declined in health

Mrs. Yates’ father died (March 12th) Felt guilty about not doing enough for

her father Separation from her family during

admissions to Devereux (March and May) Felt guilty about not attending to her

children as she wished Worried about her children bonding with

Dora and not coming to her Worried about her children being taken

away

Page 50: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Medical Advice Ignored and Delusions Hidden in 2001

Medical Advice Ignored and Delusions Hidden in 2001

Dr. Saeed told Mr. Yates that someone must be with his wife at all times (April)

Dr. Saeed recommended ECT; Mr. and Mrs. Yates refused (May)

Mrs. Yates denied delusions or hallucinations countless times when asked by MDs

Two delusions (cameras and television)—known only to Mr. and Mrs. Yates—were kept secret from all doctors (August 1999-June 2001)

Mrs. Yates was left alone with the children for an hour (June 20, 2001)

Page 51: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Mrs. Yates’ Mental State3/12/01 – 5/22/01

Mrs. Yates’ Mental State3/12/01 – 5/22/01

According to Mrs. Yates, after her father’s death, she began to withdraw, wasn’t eating well, continued to have difficulty sleeping, and began to have thoughts about being a bad mother

Repeated thoughts about the boys (but not Mary) not being righteous returned in March 2001, but she did not have images of the children being stabbed in 2001

Page 52: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Mrs. Yates’ Mental State3/12/01 – 5/22/01 (cont.)

Mrs. Yates’ Mental State3/12/01 – 5/22/01 (cont.)

Mr. Yates observed she was pacing with Mary and not breastfeeding, and he took her to Devereaux

Admitted to Devereaux twice with many signs and symptoms of depression; history of onset 2-3 weeks before March 31st; psychotic symptoms suspected, but no supporting data given

After coming home from Devereaux, she noticed that the children were bonding with Dora and not coming to her, and she held Mary to keep her close (reported to Dr. Welner)

Page 53: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

New Stressors, 5/23/01 – 6/19/01New Stressors, 5/23/01 – 6/19/01

In June, she heard a conversation between Rusty and Dora about Dora leaving in a few weeks (reported to Dr. Welner)

In June, she noticed that the children were becoming more attached to Dora, especially Noah and Luke (reported to Dr. Welner)

Page 54: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

New Stressors, 5/23/01 – 6/19/01 (cont.)

New Stressors, 5/23/01 – 6/19/01 (cont.)

She declined Rusty’s offer to make an appointment for her with Ms. Willcott in the summer of 2001 because “I wasn’t really willing to talk about it” and was concerned she would lose the children to the foster care system [W-8]

She was hearing about drownings from the flood caused by Tropical Storm Allison around the time she began to think of drowning the children (June 10, 2001) (reported to Dr. Welner)

Page 55: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Non-Specific Signs of Severe Depression (and Other

Conditions)

Non-Specific Signs of Severe Depression (and Other

Conditions) Disheveled Poor hygiene Matted hair Slow speech Being nearly mute Staring at ceiling or into space Looking frightened Not wanting to eat Being passive

Page 56: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Non-Specific Signs of Severe Depression and Other Conditions

Non-Specific Signs of Severe Depression and Other Conditions

Appearing very sick Not holding or making eye contact

with her baby Picking at her scalp Biting her lip [W-7]

All of these signs may occur with or without psychosis; they do not prove psychosis

Page 57: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

DSM-IV-TR Definition of Obsession

DSM-IV-TR Definition of Obsession

“Obsessions are persistent ideas, thoughts, impulses, or images that are experienced as intrusive and inappropriate and that cause marked anxiety or distress.”

A common obsession is the impulse to harm one’s own child

Obsessions are a symptom of anxiety; they are not delusions and are not psychotic

Page 58: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

ObsessionsObsessions

When occurring in a major depressive episode, obsessions do not receive a separate diagnosis

Like other symptoms of anxiety, obsessions are common in major depressive episodes

Page 59: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Mrs. Yates had ObsessionsMrs. Yates had Obsessions

A repetitive image of Noah being stabbed in 1999 (Example: at time of overdose) [A]

The exaggerated concern that her children were not developing properly

The fear that her children were not on the path of righteousness (as evidenced by disobedience and rebelliousness) because of her failings as a mother

Page 60: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Mrs. Yates had ObsessionsMrs. Yates had Obsessions

The fear that her children might someday become criminals or a burden on society

The fear that she might seriously harm the children (Example: at time she filled the tub in May 2001) [B]

Page 61: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

DSM-IV-TR Definition of DelusionDSM-IV-TR Definition of Delusion

“A false belief based on incorrect inference about external reality that is firmly sustained despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. The belief is not one ordinarily accepted by other members of the person’s culture or subculture (e.g., it is not an article of religious faith).”

Page 62: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Articles of Faith Shared by Warnecki

Followers Are Not Delusions

Articles of Faith Shared by Warnecki

Followers Are Not Delusions The husband is head of the household A woman is servant to the man and

obeys him God prefers natural childbirth (“Eve’s

curse”) Children who rebel or disobey should be

spanked A woman who disobeys her husband or

fails to discipline her children is a witch Children are unaccountable until age 10

or 12 Satan becomes more influential on

children who are not well disciplined Satan deceives and tempts people

Page 63: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Articles of Faith Shared by Warnecki

Followers Are Not Delusions

Articles of Faith Shared by Warnecki

Followers Are Not Delusions Satan speaks lies into people’s minds If you say your thoughts aloud, Satan will

hear them and use them against you Satan preys on the weak Satan rules the world and is alive and

active now He who falls from righteousness can

never be saved The unrighteous go to hell Those who are righteous and saved go to

heaven Those who die before the age of

accountability go to heaven

Page 64: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Mrs. Yates’ Belief She Was Inadequate as a Mother in June

2001 Was Not a Delusion

Mrs. Yates’ Belief She Was Inadequate as a Mother in June

2001 Was Not a Delusion Mothers with depressive symptoms have significantly reduced odds of continuing breastfeeding, showing books, playing with the infant, talking to the infant, and following routines

A delusion must be a false belief, but it was true that despite her very best efforts, Mrs. Yates was unable to function well as a mother

Page 65: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Andrea Yates Had Two Kinds of Delusions Before the DrowningsAndrea Yates Had Two Kinds of

Delusions Before the Drownings Delusions of reference on approximately

six occasions between May 24 and June 19, 2001, that movies and television were targeting her family:

Oh! Brother Where Art Thou? Cast Away A cartoon character talking about candy Cartoon Christmas carols A game show MTV None the morning of the drownings

Page 66: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Andrea Yates Had Two Kinds of Delusions Before the DrowningsAndrea Yates Had Two Kinds of

Delusions Before the Drownings Ongoing delusion that cameras had

been placed in the ceiling of the house to monitor whether she was a good enough mother or would hurt the children (at various points she suspected Dr. Starbranch, CPS, Dora, or Rusty were involved in this)

Page 67: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

DSM-IV-TR Definition of Hallucination

DSM-IV-TR Definition of Hallucination

“A sensory perception that has the compelling sense of reality of a true perception but that occurs without external stimulation of the relevant sensory organ. Hallucinations should be distinguished from illusions, in which an actual external stimulus is misperceived or misinterpreted. . . . The term hallucination is not ordinarily applied to the false perceptions that occur during dreaming, while falling asleep (hypnagogic), or when awakening (hypnopomic). Transient hallucinatory experiences may occur in people without a mental disorder.”

Page 68: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Andrea Yates Had No Hallucinations Before or During

the Drownings

Andrea Yates Had No Hallucinations Before or During

the Drownings On one occasion in 1999, Mrs. Yates thought she heard voices from the wall say in a growl, “Andrea, come here” while awakening from a nap in the hospital—a hypnopompic experience, not a true hallucination [H]

In Dr. Resnick’s interview, Mrs. Yates denied that Satan had ever told her to “grab the knife”

Page 69: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Andrea Yates Had No Hallucinations Before or During

the Drownings

Andrea Yates Had No Hallucinations Before or During

the Drownings In Dr. Welner’s interview, Mrs. Yates said that a few months after Noah’s birth in 1994, she had a “fleeting thought” to get a knife, and in 1999 she had obsessive images of Noah being stabbed [W-1]

Mrs. Yates said little about these experiences because of what Mr. Warnekci had told her, and out of concern the children would be taken away [W-2]

Page 70: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Andrea Yates Had No Hallucinations Before or During

the Drownings

Andrea Yates Had No Hallucinations Before or During

the Drownings In Dr. Welner’s interview, Mrs. Yates indicated that she did not hear any voices of any kind the morning of the drownings [W-5]

Mrs. Yates told Dr. Welner she took exception to false reports in the press that she had killed her children on orders from Satan

In my interview, Dr. Welner’s interview, and a letter she wrote to a penpal, Mrs. Yates indicated that new symptoms began after she was arrested and began to reflect on what had happened [W-6]

Page 71: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Cognitive FunctioningCognitive Functioning

Components include level of consciousness, motor behavior, use of language, memory, concentration, orientation, attention, ability to think abstractly, plan, and organize

Impairment in cognitive functioning may vary from insignificant to extremely severe

Page 72: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Mrs. Yates had No Significant Cognitive Impairment During the

Drownings

Mrs. Yates had No Significant Cognitive Impairment During the

Drownings She was able to dress herself that morning She awakened the children to say “goodbye” to

Rusty, as usual She remembered who each of her children was She was able to stick to the task of drowning all

five children She was attentive to completing her task before

Dora arrived She remembered to call the police so they

would be there before Dora arrived She was able to call 911 and provide accurate

information She was able to dial her husband’s phone

number

Page 73: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Andrea Yates Had Thoughts about Satan Before the

Drownings

Andrea Yates Had Thoughts about Satan Before the

Drownings In the weeks before the drownings, Mrs. Yates felt tormented by her “bad thoughts,” delusions of reference, delusion about cameras in the house, fears that the children would be ruined, and impulses to harm the children

Medically, these would all be seen as symptoms of her illness, but Mrs. Yates blamed her symptoms on Satan and even wondered if Satan might be inside her giving her directions [C]

Page 74: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Andrea Yates’ Mental State at the Time of the Drownings on

June 20, 2001

Andrea Yates’ Mental State at the Time of the Drownings on

June 20, 2001 No hallucinations Recent delusions of receiving messages from

the television and movies, but none that day Recent delusion about cameras in the house,

but no thoughts about this at the time of the drownings

Obsessions that her children could grow up unrighteous and that she was a bad mother

Worry that her children could be taken away Minimal or mild cognitive impairment, if any Faith-based beliefs that by drowning her

children, she could send them to heaven and save them from possible unrighteousness on earth

Page 75: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Factors Changing Mental State Between the Drownings and June

21, 2001

Factors Changing Mental State Between the Drownings and June

21, 2001 Hearing Rusty’s and Dora’s grief Being arrested Hearing a radio commentator say he’d

kill her himself Being booked Being interrogated by the police Beginning to contemplate what had

happened Being stripped of her clothing Being placed in solitary with no bedding

and no clothes Being given lorazepam (Ativan)

Page 76: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Andrea Yates’ Mental State at the Time of Dr. Ferguson’s Exam.

on June 21, 2001

Andrea Yates’ Mental State at the Time of Dr. Ferguson’s Exam.

on June 21, 2001 Visual illusions and possible hallucinations in her cell

A new urge to “figure out Satanic things” in her cell

“Very distraught and anxious” New delusions about a werewolf, the

Mark of the Beast (“666”), a prophecy, Satan being inside her, and the state destroying Satan

Inaccuracies in reporting her history (e.g., the Matrix, a voice telling her to grab the knife, recent growling noises)

Page 77: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Known Triggers to Auditory Hallucinations

Known Triggers to Auditory Hallucinations

Traumatic experience (70%, in one study)

Sleep deprivation

Solitary confinement

Anxiety

Page 78: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Possible Causes of Mrs. Yates’ Amnesia for Certain Statements

in Jail

Possible Causes of Mrs. Yates’ Amnesia for Certain Statements

in Jail Psychosis with disorganized thinking

Lorazepam (Ativan)

Page 79: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Lorazepam (Ativan) Lorazepam (Ativan)

Lorazepam (Ativan) is a high-potency benzodiazepine

Benzodiazepines induce amnesia for information learned after the drug is taken

Research suggests that benzodiazepines preserve the memory of recent events before the drug is administered

Page 80: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Lorazepam (Ativan) Lorazepam (Ativan)

Ativan is similar to Rohypnol, the “date-rape drug”

Page 81: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

DID MRS. YATES KNOW HER

CONDUCT WAS WRONG IN

DROWNING HER CHILDREN?

DID MRS. YATES KNOW HER

CONDUCT WAS WRONG IN

DROWNING HER CHILDREN?

Page 82: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Before the DrowningsBefore the Drownings

Mrs. Yates considered her obsessive thoughts of and impulses to harm her children “bad thoughts,” for which she blamed Satan

For weeks, she concealed from everyone her thoughts of harming the children and her plan to drown the children

She made up her mind the evening of June 19th to drown the children the next day [D]

She had no “visions” of drowning the children; she agreed it was just an idea [W-4]

Cont.

Page 83: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Before the Drownings (cont.)Before the Drownings (cont.)

She tried to behave as normally as possible so Rusty wouldn’t know anything unusual was happening

She waited for an opportunity when no one was home so that she would not be stopped from drowning the children

She believed that killing the children would be sinful and would be the last of the Seven Deadly Sins for her to commit

She believed she was not raising the children properly, did not pay enough attention to them, and that they might get in trouble

Cont.

Page 84: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

Before the Drownings (cont.)Before the Drownings (cont.)

She believed that killing the children would guarantee that they go to heaven and prevent them from one day becoming unrighteous, criminal, a burden on the state, or vulnerable to Satan, and for these reasons thought it was right for the children [E]

She did not believe that the children were already suffering at the hands of Satan but rather from lack of guidance (reported to Dr. Resnick)

Page 85: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

During the DrowningsDuring the Drownings

Knew she would be arrested and put in jail

Knew her conduct was illegal

Knew society would judge her conduct as “bad” [F]

Believed God would judge her conduct as “bad” Cont.

Page 86: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

During the DrowningsDuring the Drownings

Felt “the presence” of Satan during the drownings, but did not think he was “in her” until after her arrest [G]

Anticipated being punished by the state [W-3]

Acted with determination to accomplish her plan of drowning each child before Dora arrived

Cont.

Page 87: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

During the Drownings (cont.)During the Drownings (cont.)

Found it most difficult to drown Paul and Noah and “tried to numb myself to it” [W-9]

At the time of the drownings, she had doubt whether killing her children was the right thing for them (reported to Dr. Resnick 7/14/01)

.

Page 88: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

After the DrowningsAfter the Drownings

Called 911 and asked for the police because “that’s who you call . . . when you’ve done something wrong,” and she thought she had done something wrong

Called the police quickly because she wanted them to arrive before Dora did “because I didn’t want her to see what I had done”

Told Sgt. Mehl she was prepared to go to hell for what she had done

Cont.

Page 89: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

After the Drownings (cont.)After the Drownings (cont.)

Told Sgt. Mehl she wanted to be punished by the criminal justice system for what she had done and asked when her trial would be

After her psychosis worsened in solitary confinement in jail, Mrs. Yates for a time believed her execution would kill Satan and that the killings had something to do with a prophecy

Page 90: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

OpinionsOpinions

Page 91: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

At the Time of Drowning Each Child:

At the Time of Drowning Each Child:

Mrs. Yates knew that her conduct was wrong in the eyes of the law

Mrs. Yates knew that her conduct was wrong in the eyes of society

Mrs. Yates believed that her conduct was wrong in the eyes of God

Page 92: STATE OF TEXAS v. ANDREA YATES Exhibits to the testimony of Park Dietz, MD, PhD

At the Time of Drowning Each Child:

At the Time of Drowning Each Child:

Mrs. Yates thought, with some doubt, that the killings were in the best interests of the children and that the ends (saving the children’s souls) justified the means (her conduct in wrongly and illegally killing them)