Cognitive biases in forensic psychiatry: A scoping review

Forensic psychiatry plays a critical role in legal contexts but is highly susceptible to cognitive biases that can undermine the accuracy and objectivity of evaluations. This scoping review, guided by the Arksey and O'Malley framework, aims to identify and analyze cognitive biases within forensic psychiatric practice across criminal, civil, and testimonial domains. A comprehensive search across five databases yielded 7002 records, with 24 studies meeting the inclusion criteria. From these studies, ten distinct cognitive biases were identified, with the most frequently discussed being gender bias (29.2 %), allegiance bias (20.8 %), and confirmation bias (20.8 %), followed by hindsight, cultural, and emotional biases. Most studies focused on criminal settings, with only two addressing civil contexts. Among the mitigation strategies reviewed, structured methodologies and the "considering the opposite" technique were the most positively evaluated and widely discussed approaches. Conversely, the self-awareness strategy was criticized for its limited effectiveness in reducing bias. Emerging tools, such as artificial intelligence, offer potential solutions but require robust ethical safeguards to prevent the perpetuation of systemic biases. This scoping review provides a comprehensive overview of the current state of research on biases in forensic psychiatry, underscoring the need for further empirical studies to explore their prevalence, mechanisms, and effective mitigation strategies in greater depth.