Altered states of consciousness and culpable mental state

In terms of culpable mental state, and evaluations of intent to kill how does a forensic psychologist assess a sleepwalking murder case, or a dissociative amnesia case, particularly when other factors are involved such as in the case I saw recently about the boyfriend who "had been up all night drinking" yet claims he was sleepwalking because he hadn't slept in two days or something like this and fell asleep for a few minutes before stabbing his wife multiple times. While the timeline didn't add up because of how long it would take to reach REM sleep, some sleep specialists still claimed that it is quite possible given he had been "up all night drinking for days." Is it the sleepwalking then or the alcoholism? Why was the focus on the sleepwalking and not the alcohol abuse? Where do we draw the line in terms of these complex assessments, given human beings are made up of much more than altered states of consciousness. What does having some form of altered state of consciousness mean for individuals in the legal system?

Another story that comes to mind is the one about the kid who had a tumor in a specific region of the brain that caused severe aggression and violence. This article sums up some great questions related to this broader question about altered states of consciousness:

"If their actions were caused by brain damage and a disrupted neural network, were they acting under their own free will? Should they be held morally responsible for their actions and found guilty in a court of law? Should we see them as patients or perpetrators—or both?"

https://www.scientificamerican.com/article/how-responsible-are-killers-with-brain-damage/

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