OPINION OF THE COURT ON FURTHER REVIEW
MITCHELL, Senior Judge:
While appellant’s conviction for the premeditated murder of his Korean girlfriend in violation of Article 118, Uniform Code of Military Justice, 10 U.S.C. § 918, was originally pending before us, the United States Court of Military Appeals in its decision in United States v. Frederick, 3 M.J. 230 (C.M.A.1977) adopted the American Law Institute’s (ALI) definition of insanity.1 This Court set aside the findings and sentence after deciding that the trial court’s application of the rejected standard of mental responsibility presented a fair risk of prejudice to appellant, who claimed, unsuccessfully, that he was not mentally responsible for his crime. A rehearing was authorized. Upon remand, the military judge, sitting as a general court-martial, applied the ALI standards and found appellant guilty of premeditated murder.2 We now address anew the question of the mental responsibility of appellant at the time of the offense.
I
Appellant testified that on the night before the murder he dreamed of bloody and headless corpses strewn on the floor of his living quarters. Minutes before he began stabbing his victim a shadowy, grotesque human shape appeared on an adjoining wall. This apparition commanded him in Spanish to kill himself and the girl. Appellant asserts that he tried to overcome his servile compulsion to kill actuated by this diabolic command by praying to a holy picture which he carried in his wallet. His religious resources were apparently inadequate and toadyish because he savagely in[719]*719flicted numerous, deep, and fatal lacerations to his victim’s face, chest, back and hands with a butcher knife and superficially wounded himself in the chest.
Appellant denied having any major arguments with his girlfriend during the course of their relationship or of having fought with her immediately preceding the killing. He had planned to marry her and had purchased wedding bands for this purpose. He also believed his girlfriend had obtained a valid divorce from another soldier. It was, according to appellant, not until after his first trial that he learned she was still married at the time of her death.
The former testimony of the victim’s sister, read into evidence after stipulation by both parties that she was unavailable as a witness, revealed she had heard loud screams and shouting coming from the room in which the appellant and his girlfriend were staying on the evening before and on the morning and afternoon of the day of the tragedy. The witness testified that she entered the room on the afternoon in question and found her sister lying on the floor with her hair disheveled and appellant leaning against the wall. After telling her sister that the two of them should return to their family home, the witness left the room. The victim did not heed her sister’s advice and within 20-30 minutes thereafter, appellant began his fatal assault. Attempts by the sister to restrain appellant were fruitless. By the time she had fled the room and returned with help, the victim was mortally wounded, lying alongside appellant in an expanding pool of blood.
Two military policemen who arrived at the scene found affixed to the wall two wedding bands and a note addressed to appellant’s mother.3 No trace of blood was found on the note. One of the investigators testified he heard appellant state that the victim was a military dependent, that she had an ID card, and request that she be taken to a U.S. military hospital.
Appellant allegedly suffered a subsequent hallucinatory episode at a military hospital where he was taken for treatment of his minor chest wound. Although he claimed to remember little if anything of what transpired earlier, appellant told a chaplain that the devil had directed him in his ghastly actions. Later, when talking to a social worker, he began repeating the Spanish word for devil, “diablo,” while gesturing toward a hospital desk. He then lunged forward and butted the desk with his head. Specialist Cortes-Crespo also claimed that he heard the voice of his dead victim calling to him during his first trial and complained of his bed mysteriously shaking at night during his confinement at the United States Disciplinary Barracks.
Testimony from persons who knew appellant before the offense portrayed him as an individual without any disciplinary problems, neat and well dressed, and who held a responsible position as a supervisor. He appeared to them to be well-adjusted socially with no inclination toward anger or violence.
Appellant’s past civilian history presented a different picture. He reportedly had been hospitalized in Puerto Rico after attempting to stab his mother with a knife. His condition on that occasion was diagnosed as “(1) Psychosis with cerebral trauma; (2) Alcoholism; (3) Sharp psychotic outbursts with schizophrenic traces.” There were also reports of an attack on his brother, of deliberately causing his automobile to overturn, resulting in injuries to himself and a girlfriend, and of sadistic acts with domestic animals.
II
The events leading to the murder, appellant’s past medical and social history, and [720]*720his actions after the offense was committed, were considered by the psychologist and four psychiatrists who examined appellant and testified as to his mental condition.4 Their interpretations of these facts and the degree of importance they placed on them in making their final diagnoses differed considerably.
A psychologist and a psychiatrist who testified for the defense respectively diagnosed appellant’s condition as residual and latent schizophrenia.5 Both witnesses defined these conditions as a mental disease or defect because of which appellant could neither appreciate the criminality of his actions, nor conform his conduct to the requirements of law. The third expert witness for the defense had examined appellant shortly after the offense was committed, and served as a member of appellant’s sanity board in Korea. This psychiatrist was of the opinion that appellant was suffering from a hysterical personality disorder.6 Refusing to characterize this condition as a “mental disease or defect,” be[721]*721cause he believed such terms were legal rather than medical, he defined hysterical personality as well as psychosis and schizophrenia as “mental disorders.”7 He believed that although appellant understood what he was doing, had the capacity to appreciate that his act was wrong, and to premeditate, his ability to prevent himself from doing the act was “significantly impaired.”
The two psychiatrists who testified for the Government also diagnosed appellant’s condition as a hysterical personality disorder, but differed with the defense witness as to the meaning of the term and the degree of impairment. Hysterical personality did not, in their opinion, fall within the category of “mental disease or defect,”8 and it did not significantly impair appellant’s ability to control his actions at the time of the offense.
Ill
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OPINION OF THE COURT ON FURTHER REVIEW
MITCHELL, Senior Judge:
While appellant’s conviction for the premeditated murder of his Korean girlfriend in violation of Article 118, Uniform Code of Military Justice, 10 U.S.C. § 918, was originally pending before us, the United States Court of Military Appeals in its decision in United States v. Frederick, 3 M.J. 230 (C.M.A.1977) adopted the American Law Institute’s (ALI) definition of insanity.1 This Court set aside the findings and sentence after deciding that the trial court’s application of the rejected standard of mental responsibility presented a fair risk of prejudice to appellant, who claimed, unsuccessfully, that he was not mentally responsible for his crime. A rehearing was authorized. Upon remand, the military judge, sitting as a general court-martial, applied the ALI standards and found appellant guilty of premeditated murder.2 We now address anew the question of the mental responsibility of appellant at the time of the offense.
I
Appellant testified that on the night before the murder he dreamed of bloody and headless corpses strewn on the floor of his living quarters. Minutes before he began stabbing his victim a shadowy, grotesque human shape appeared on an adjoining wall. This apparition commanded him in Spanish to kill himself and the girl. Appellant asserts that he tried to overcome his servile compulsion to kill actuated by this diabolic command by praying to a holy picture which he carried in his wallet. His religious resources were apparently inadequate and toadyish because he savagely in[719]*719flicted numerous, deep, and fatal lacerations to his victim’s face, chest, back and hands with a butcher knife and superficially wounded himself in the chest.
Appellant denied having any major arguments with his girlfriend during the course of their relationship or of having fought with her immediately preceding the killing. He had planned to marry her and had purchased wedding bands for this purpose. He also believed his girlfriend had obtained a valid divorce from another soldier. It was, according to appellant, not until after his first trial that he learned she was still married at the time of her death.
The former testimony of the victim’s sister, read into evidence after stipulation by both parties that she was unavailable as a witness, revealed she had heard loud screams and shouting coming from the room in which the appellant and his girlfriend were staying on the evening before and on the morning and afternoon of the day of the tragedy. The witness testified that she entered the room on the afternoon in question and found her sister lying on the floor with her hair disheveled and appellant leaning against the wall. After telling her sister that the two of them should return to their family home, the witness left the room. The victim did not heed her sister’s advice and within 20-30 minutes thereafter, appellant began his fatal assault. Attempts by the sister to restrain appellant were fruitless. By the time she had fled the room and returned with help, the victim was mortally wounded, lying alongside appellant in an expanding pool of blood.
Two military policemen who arrived at the scene found affixed to the wall two wedding bands and a note addressed to appellant’s mother.3 No trace of blood was found on the note. One of the investigators testified he heard appellant state that the victim was a military dependent, that she had an ID card, and request that she be taken to a U.S. military hospital.
Appellant allegedly suffered a subsequent hallucinatory episode at a military hospital where he was taken for treatment of his minor chest wound. Although he claimed to remember little if anything of what transpired earlier, appellant told a chaplain that the devil had directed him in his ghastly actions. Later, when talking to a social worker, he began repeating the Spanish word for devil, “diablo,” while gesturing toward a hospital desk. He then lunged forward and butted the desk with his head. Specialist Cortes-Crespo also claimed that he heard the voice of his dead victim calling to him during his first trial and complained of his bed mysteriously shaking at night during his confinement at the United States Disciplinary Barracks.
Testimony from persons who knew appellant before the offense portrayed him as an individual without any disciplinary problems, neat and well dressed, and who held a responsible position as a supervisor. He appeared to them to be well-adjusted socially with no inclination toward anger or violence.
Appellant’s past civilian history presented a different picture. He reportedly had been hospitalized in Puerto Rico after attempting to stab his mother with a knife. His condition on that occasion was diagnosed as “(1) Psychosis with cerebral trauma; (2) Alcoholism; (3) Sharp psychotic outbursts with schizophrenic traces.” There were also reports of an attack on his brother, of deliberately causing his automobile to overturn, resulting in injuries to himself and a girlfriend, and of sadistic acts with domestic animals.
II
The events leading to the murder, appellant’s past medical and social history, and [720]*720his actions after the offense was committed, were considered by the psychologist and four psychiatrists who examined appellant and testified as to his mental condition.4 Their interpretations of these facts and the degree of importance they placed on them in making their final diagnoses differed considerably.
A psychologist and a psychiatrist who testified for the defense respectively diagnosed appellant’s condition as residual and latent schizophrenia.5 Both witnesses defined these conditions as a mental disease or defect because of which appellant could neither appreciate the criminality of his actions, nor conform his conduct to the requirements of law. The third expert witness for the defense had examined appellant shortly after the offense was committed, and served as a member of appellant’s sanity board in Korea. This psychiatrist was of the opinion that appellant was suffering from a hysterical personality disorder.6 Refusing to characterize this condition as a “mental disease or defect,” be[721]*721cause he believed such terms were legal rather than medical, he defined hysterical personality as well as psychosis and schizophrenia as “mental disorders.”7 He believed that although appellant understood what he was doing, had the capacity to appreciate that his act was wrong, and to premeditate, his ability to prevent himself from doing the act was “significantly impaired.”
The two psychiatrists who testified for the Government also diagnosed appellant’s condition as a hysterical personality disorder, but differed with the defense witness as to the meaning of the term and the degree of impairment. Hysterical personality did not, in their opinion, fall within the category of “mental disease or defect,”8 and it did not significantly impair appellant’s ability to control his actions at the time of the offense.
Ill
The facts of this case illustrate the perplexing task of courts faced with the question of mental responsibility, when bombarded by esoteric medical labels and widely conflicting nosological opinions of expert witnesses. The correctness or adequacy of the factual assumption on which the expert’s opinion is based, the reasoning used in reaching a conclusion, interest or bias, inconsistencies or contradictions in testimony, and the reliability of medical reports upon which the witness relied in arriving at a diagnosis, are issues which must be examined closely by opposing counsel skilled in the art of cross-examination.9 However, we do not believe that the fact finders’ determination as to whether the expert’s definitions and conclusions are correct should be trusted entirely to how well counsel have been able to penetrate the inner workings of the expert’s mind. The court is entitled to more. A consensus on controversial diagnostic categories would be a notable supplement. Thus a meaningful collaboration between academicians and experts in everyday matters would without question improve both diagnostic reliability and lagging public confidence.
The ALI/Frederick test provides the Court a standard to use in determining the effect mental disease or defect has on an accused before he can be relieved of criminal responsibility for his actions. This standard, however, does not include a definition of “mental disease or defect.” The second paragraph of the ALI test defines these terms only in the negative: “[T]he terms ‘mental disease or defect’ do not include an abnormality manifested only by repeated criminal or otherwise antisocial conduct.” Except for its retention of this paragraph, the Court of Military Appeals in Frederick provided no other clue as to which mental conditions and behavior patterns found within the large psychiatric arena would be included in the legal definition of “mental [722]*722disease or defect.”10 Failure to provide a definition will continue to cause confusion at both trial and appellate levels, for “what psychiatrists may consider a ‘mental disease or defect’ for clinical purposes, where their concern is treatment, may or may not be the same as mental disease or defect for the jury’s purpose in determining criminal responsibility.” McDonald v. United States, 312 F.2d 847, 851 (D.C.Cir.1962); Morris v. United States, 217 F.Supp. 220, 230 (N.D. Texas 1963).11
This Court has previously invited the Court of Military Appeals to define “mental disease or defect.” See United States v. Chapman, 5 M.J. 901 (A.C.M.R.1977) (Jones, Sr. J., concurring, Mitchell, J., concurring in part and dissenting in part). Such a definition has not been forthcoming. We believe the facts of this case present us with the opportunity and responsibility to formulate a needed definition.
Prior to United States v. Frederick, supra, the 1951 and 1969 Manuals for Courts-Martial contained identical language as to the military’s test for mental responsibility and the definition of mental disease or defect included therein.12 Under these tests, a character and behavioral disorder was not generally regarded as a mental disease or defect that would exonerate an accused from criminal responsibility,13 although such a condition could negate an accused’s capacity to entertain the specific intent required for the particular act charged. United States v. Dunnahoe, 6 U.S.C.M.A. 745, 21 C.M.R. 67 (1956); United States v. Kunak, 5 U.S.C.M.A. 346, 17 C.M.R. 346 (1954); United States v. Silva, 37 C.M.R. 803 (ABR), pet. denied 16 U.S.C.M.A. 664, 37 C.M.R. 471 (1966).
After the Court of Military Appeals adopted the ALI standard of mental responsibility the opinion has been advanced that the distinction between mental disease and defect, and personality, character and behavioral disorders was no longer as certain, for adoption of the new standard may have had the implied effect of eliminating the old definition and prior interpretations of it. See United States v. Chapman, supra (Jones, Sr. J., concurring, Mitchell, J., concurring in part and dissenting in part). We doubt whether personality, character and behavioral disorders were meant to be characterized as a mental disease or defect that can excuse criminal conduct under the ALI standard.14 Rejection of the old standard [723]*723and adoption of a new one for determining mental responsibility requires only that the old terminology be reexamined to determine the legal and practical consequences of its application to the new test.15
In United States v. Kunak, 5 U.S.C.M.A. 346, 17 C.M.R. 346 (1954) and United States v. Smith, 5 U.S.C.M.A. 314, 17 C.M.R. 314 (1954), the Court of Military Appeals reviewed the D.C. Circuit Court of Appeals decision in Durham v. United States, 214 F.2d 862 (D.C.Cir.1954), in considering whether to adopt a standard of mental responsibility different from that contained in the 1951 Manual for Courts-Martial.16 One of the Court of Military Appeals’ primary points of criticism of the Durham test was the uncertainty as to what types of mental abnormalities would be included therein and to what degree the act must have been the product of the illness. United States v. Smith, supra, at 322, 323. The same criticism was raised by other federal courts. United States v. Currens, 290 F.2d 751 (3d Cir. 1961) at 762, 763; Sauer v. United States, 241 F.2d 640 (9th Cir. 1957), cert. denied 354 U.S. 940, 77 S.Ct. 1405, 1 L.Ed.2d 1539 (1957).17
Although the Court of Military Appeals rejected the Durham test for mental responsibility, it impliedly adopted the distinction between the terms “disease” and “defect,” contained in the Durham decision, when it found in the later case of United States v. Chappell, 19 U.S.C.M.A. 236, 41 C.M.R. 236, 239, n.1 (1970) that an accused with a limited intellect (I.Q. of 69) was “not a person suffering from either a ‘disease’ or a ‘defect’ as those terms are used in United States v. Durham.”18 “Mental disease” was defined in Durham as “a condition which is considered capable of either improving or deteriorating,” while “defect” existed when there is present “a condition which is not considered capable of either improving or deteriorating and which may be either congenital, or the result of injury, or the residual effect of a physical or mental disease.” Durham, supra, 214 F.2d at 875.
Several years after Durham, the D.C. Circuit Court went a step further in McDonald v. United States, supra by actually defining the terms “mental disease or defect.” The court stated:
In Durham, rather than define either term, we simply sought to distinguish disease from defect. Our purpose now is to make it very clear that neither the court nor the jury is bound by ad hoc definitions or conclusions as to what experts state is a disease or defect. [Consequently, for that purpose the jury should be told that a mental disease or defect includes any abnormal condition of the mind which substantially affects [724]*724mental or emotional processes and substantially impairs behavior controls. McDonald, supra, 312 F.2d at 851. (Emphasis supplied.)
In United States v. Brawner, 471 F.2d 969 (D.C.Cir.1972) (on rehearing en banc), the D.C. Circuit abandoned the Durham test for mental responsibility and adopted instead the ALI standard. In doing so, it elected to substitute the McDonald definition of mental disease or defect for that contained in the second paragraph of the ALI recommendation. The court reasoned that McDonald acted as a safeguard
against the danger of misunderstanding and injustice that might arise from an expert’s classification that reflects only a conception defining all criminality as reflective of mental illness. There must be testimony to show both that the defendant was suffering from an abnormal condition of the mind and that it substantially affected mental or emotional processes and substantially impaired behavioral controls. Brawner, supra, 471 F.2d at 993-994.19
The only other jurisdiction we have found that has followed Brawner in applying the McDonald definition to the ALI standard is the District of Columbia Court of Appeals 20 in the case of Bethea v. United States, 365 A.2d 64 (D.C.App.1975), cert. denied 433 U.S. 911, 97 S.Ct. 2979, 53 L.Ed.2d 1095 (1977).
Other Federal courts have rejected the McDonald definition on the basis that the ALI test eliminates the problem of vagueness that was found in Durham as to when a criminal act is the product of a mental disease or defect.21 In the words of one court, “The jury, when informed of the result of a mental disease or defect which would constitute legal insanity [under the ALI formula], is able better to understand what a mental disease or defect is.” Government of Virgin Islands v. Fredericks, 578 F.2d 927, 932-933 (3rd Cir. 1978). For this reason, a definition of the terms was believed to be unnecessary.
The opinions of these courts are unpersuasive, for in our view neither the ALI test nor the McDonald definition, whether standing alone or combined, eliminate the uncertainty as to the meaning of “mental disease or defect.” McDonald attempted to restrict expert testimony as to the meaning of these terms, but in the process, created its own ambiguity. The use of the phrase “any abnormal condition of the mind” is an open ended definition that requires in most cases an inquiry into causality. The problem is succinctly stated by Judge Bazelon in his separate concurring and dissenting opinion in United States v. Brawner, supra:
“[T]he defense is not restricted to persons suffering from the gravest types of mental disorders. While the jury must find that the defendant’s ‘mental or emotional processes’ have been ‘substantially affected’ and his ‘behavior controls’ ‘substantially impaired,’ the jury is not bound by whether these consequences flow from what the psychiatrists label a ‘psychosis,’ ‘psychoneurosis,’ a ‘sociopathic personali[725]*725ty,’ an ‘emotionally unstable personality,’ or whatever.” If we are indeed to retain the expansive definition of mental illness implicit in Durham and formalized in McDonald, then the productivity question will remain a source of controversy and debate. Brawner, supra, 471 F.2d at 1025.
As we noted earlier in this opinion, the productivity question and the uncertainty as to what types of mental abnormality would be included therein had been foreseen by the Court of Military Appeals as objectionable consequences to adopting the Durham test. United States v. Smith, supra, at 322. The McDonald definition without further refinement maintains this uncertainty. In our view, the courts at the trial and appellate levels will have a greater understanding of what conditions may be included in the terms “mental disease or defect” if the definition in McDonald is combined with those definitions not in conflict with the ALU Frederick standard that have been time tested through the years and approved by military and other federal jurisdictions. For this purpose we turn to the following sources: McDonald v. United States, supra, at 851; the sample instructions contained in United States v. Brawner, supra, at 1008-1009; that portion of the definition of mental disease or defect contained in paragraph 120b, Manual for Courts-Martial, United States, 1969 (Revised edition) which is not in conflict with the ALU Frederick standard;22 the distinction between mental disease and defect found in United States v. Durham, supra, and impliedly adopted by the Court of Military Appeals in United States v. Chappell, supra; and the wording presently included within paragraph, two of the ALI test and adopted by the Court of Military Appeals in United States v. Frederick, supra23
Accordingly, we have formulated the following definitions: The terms “mental disease or defect” include any abnormal condition of the mind which substantially affects mental or emotional processes and substantially impairs behavior controls and are the result of deterioration, destruction, malfunction, or nonexistence24 of the mental, as distinguished from the moral faculties. The term “behavior controls” refers to the processes and capacity of a person to regulate and control his conduct and his actions.25 A “mental disease” is distinguished from a “mental defect” in that the former condition is considered capable of either improving or deteriorating, while a “mental defect” exists when there is present a condition not capable of either improving or deteriorating and which maybe either congenital, or the result of injury, or the residual effect of a physical or mental disease. The terms mental disease or defect do not include an abnormality manifested only by repeated criminal or otherwise antisocial conduct.
We believe that these definitions will eliminate some of the uncertainties of the ALU Frederick standard and at the same time further limit the phrase “any abnormal condition of the mind” contained in the McDonald definition to only the most serious mental disorders that result from one of the debilitating factors listed in the Manual and included herein.
IV
We have carefully considered the conflicting diagnoses presented by the defense and government expert witnesses and the facts and assumptions upon which they based their conclusions. While we must choose between some of their opinions, we need not, and do not, choose between their [726]*726diagnostic categorizations.26 In choosing between their opinions we have considered, inter alia, the experts’ training and experience, the time they spent in evaluating the appellant, the reports upon which they relied, and their conclusions and assumptions as to the facts and circumstances surrounding the killing. From all of the proof presented, we believe that appellant’s offense was triggered by some act of provocation. This conclusion is supported by evidence that appellant had learned that he could not consummate the planned marriage with his girlfriend because she had not obtained a divorce, and testimony from the victim’s sister that she heard the appellant and his girlfriend revilingly arguing on several occasions immediately preceding the offense. We have also placed considerable emphasis on the murder/suicide note that was written by appellant to his mother expressing guilt and/or sorrow for his actions.
We are not in complete accord as to whether or not appellant, at the time of the slaying, was affected by a mental disease or defect as we have defined those terms. However, after considering all the evidence in the record, we unanimously agree, either on the basis of being convinced beyond a reasonable doubt that appellant was not suffering from a mental disease or defect, or on the basis of being convinced beyond a reasonable doubt that appellant did not lack substantial capacity either to appreciate the criminality of his conduct or to conform his conduct to the requirements of law, that the killing by appellant may not be excused on the basis of insanity.
We are equally convinced that appellant was able to, and did, premeditate the murder.
The findings of guilty and the sentence are AFFIRMED.
Judge DRIBBEN and Judge GARN concur.
Appellant's nickname.