{"title":"Medicolegal Considerations in the Psychiatric Management of Pregnancy and Postpartum Disorders.","authors":"Allison R Horan, Dale E McNiel, Renée L Binder","doi":"10.29158/JAAPL.250105-25","DOIUrl":"10.29158/JAAPL.250105-25","url":null,"abstract":"<p><p>Psychiatrists who treat mental disorders in pregnancy must navigate the risks associated with prescribing medication to pregnant and breastfeeding people alongside the risks associated with untreated mental illness. This article examines how U.S. courts have engaged with this complex landscape when tasked with evaluating allegations of clinician and pharmaceutical negligence in cases involving pharmacological management of perinatal mental health disorders (PMHDs). We begin first with a review of the legal theories that form the basis of negligence lawsuits related to PMHDs. We then explore cases of both pharmaceutical negligence (which are usually pursued under product liability claims) and professional negligence (i.e., malpractice), distinguishing how the courts' interpretation of liability has varied for errors of omission and errors of commission. We then provide an analysis of relevant themes in this area of case law with the goal of informing expert witnesses of considerations when called to opine upon questions related to negligence in the treatment of PMHDs.</p>","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":"39-48"},"PeriodicalIF":2.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Forensic Violations and Therapeutic Shortcomings in the Use of AI Chatbots for Therapy.","authors":"Davis McCoy Chambers","doi":"10.29158/JAAPL.250073-25","DOIUrl":"https://doi.org/10.29158/JAAPL.250073-25","url":null,"abstract":"","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":"54 1","pages":"6-11"},"PeriodicalIF":2.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vivian Au, Aariz Naeem, Paul Benassi, Sarah Bonato, Roland M Jones
{"title":"A Systematic Review of the Predictive Validity of the VRAG-R.","authors":"Vivian Au, Aariz Naeem, Paul Benassi, Sarah Bonato, Roland M Jones","doi":"10.29158/JAAPL.260001-26","DOIUrl":"10.29158/JAAPL.260001-26","url":null,"abstract":"<p><p>Structured risk assessment tools are essential in forensic psychiatry to evaluate the likelihood of recidivism. The Violence Risk Appraisal Guide-Revised (VRAG-R) was developed as an update to the VRAG, but its predictive validity across offender populations remains underexamined. Our study aimed to examine the predictive validity of the VRAG-R for general, violent (including and excluding sexual offenses), and sexual recidivism. We conducted a systematic review and meta-analysis, searching 10 databases and gray literature sources for studies reporting psychometric outcomes for the VRAG-R published since 2013. Risk of bias was assessed using Prediction Model Risk of Bias Assessment (PROBAST) and data extraction followed the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies (CHARMS) checklist. Area under the curve (AUC) values were pooled using random-effects meta-analysis. In total, 15 studies comprising 3,932 participants were included. The VRAG-R showed acceptable predictive validity for general recidivism (pooled AUC = .71, 95% CI: .67 to .75) and violent recidivism (AUC = .72, 95% CI: .69 to .75). Predictive validity for sexual recidivism was modest (AUC = .65, 95% CI: .61 to .68). In conclusion, the VRAG-R demonstrates acceptable predictive validity for general and violent recidivism, comparable with other tools. Its performance in predicting sexual recidivism, however, is limited and concerns about generalizability remain. Future research should prioritize diverse samples, reporting of calibration, and continued evaluation of performance.</p>","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":"59-70"},"PeriodicalIF":2.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Call to Evaluate Our Forensic Treatments.","authors":"Katherine Michaelsen, Tobias Wasser","doi":"10.29158/JAAPL.250091-25","DOIUrl":"https://doi.org/10.29158/JAAPL.250091-25","url":null,"abstract":"","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":"54 1","pages":"2-5"},"PeriodicalIF":2.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katherine Michaelsen, Chandrika Shankar, Michael A Norko
{"title":"Recent Political and Research Appraisals of the Psychiatric Security Review Board Model.","authors":"Katherine Michaelsen, Chandrika Shankar, Michael A Norko","doi":"10.29158/JAAPL.260006-26","DOIUrl":"10.29158/JAAPL.260006-26","url":null,"abstract":"<p><p>Professional, political, and public debates are ongoing regarding the best way to assess risk and monitor individuals who have been found not guilty by reason of insanity (NGRI). Political and public impressions are often confounded by few, often dramatic and highly publicized cases of NGRI acquittees reoffending, rather than by an accurate understanding of the process and actual rearrest rates. States have implemented their own policies and practices for NGRI pleas (if allowed) and the subsequent evaluations, monitoring, and care for acquitted individuals, resulting in significant variation across jurisdictions. In the last five years, Arizona dissolved its Psychiatric Security Review Board (PSRB) and there were calls for ending the Connecticut PSRB. We review some of the past and current practices and evidence from PSRBs in Oregon, Arizona, Connecticut, and Washington. We discuss the challenges of comparing state practices because of variation in the connections between policy and practice and competing stakeholders' interests.</p>","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":"81-93"},"PeriodicalIF":2.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gary M Graca, Maxmoore T Potkin, Sela E Dragich, Debra A Pinals, Leah G Pope, Elizabeth B Ford
{"title":"How Mental Illness Influences Pretrial Release Decisions for People Charged with Misdemeanors.","authors":"Gary M Graca, Maxmoore T Potkin, Sela E Dragich, Debra A Pinals, Leah G Pope, Elizabeth B Ford","doi":"10.29158/JAAPL.250074-25","DOIUrl":"10.29158/JAAPL.250074-25","url":null,"abstract":"<p><p>Many jurisdictions are focused on pretrial reform aimed at reducing pretrial detention for nonviolent misdemeanors. How this reform affects people with mental illness, who have historically experienced lengthier and higher rates of pretrial detention, remains unknown. This qualitative study explores state laws and practices related to pretrial detention of people with mental illness across the United States, with a focus on perceptions about if and how, mental illness influences likelihood of appearance in court, dangerousness, and likelihood of jail detention. Statutes of all 50 states and the District of Columbia related to pretrial detention were reviewed, followed by semistructured interviews with 25 state forensic mental health directors and 15 judges who preside over first appearances or arraignments. The results highlight how state laws afford wide discretion to judges to determine the impact of mental illness on pretrial release. Judges and forensic mental health directors perceive this discretion as leading to a higher likelihood of detaining people with mental illness charged with misdemeanors, often for perceived concerns related to likelihood of appearance, unmet social service needs, and public perceptions of dangerousness. These findings have important implications for ongoing pretrial reform, improvement in community supports, and diversionary behavioral health services.</p>","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":"405-414"},"PeriodicalIF":2.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145597970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Framework for Developing Mental Health Educational Interventions for Correctional Officers.","authors":"Jason Quinn, Kiran Patel, Shaheen A Darani","doi":"10.29158/JAAPL.250078-25","DOIUrl":"10.29158/JAAPL.250078-25","url":null,"abstract":"<p><p>The overrepresentation of persons with mental illness in carceral settings has led to justifiable concerns about their wellbeing and the appropriateness of their care. Correctional officers may be the first point of recognition and management for incarcerated persons experiencing mental illness. Correctional officers thus unknowingly participate in mental health care without a formally recognized mental health care role or knowledge of mental health educational best practice standards. This article reviews the small literature linking specific factors in mental health educational interventions for correctional officers to improvement in knowledge, skills, attitudes, and potentially to incarcerated persons' mental health outcomes. Synthesizing that literature with the authors' experience in creating a mental health educational program for correctional officers at a large provincial detention center in Ontario, Canada, we propose a five-principle framework to guide such programs. We propose such programs be intentionally designed and evaluated with educational and quality improvement best practices in mind, an inclusive attitude toward participants and the intersectional factors in mental health in carceral settings, the use of interactive teaching methods, consideration of instructor relatability, and integration of educational programs into broader philosophical changes in carceral institutions.</p>","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":"429-436"},"PeriodicalIF":2.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter.","authors":"Jack C Lennon","doi":"10.29158/JAAPL.250075-25","DOIUrl":"https://doi.org/10.29158/JAAPL.250075-25","url":null,"abstract":"","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":"53 4","pages":"465"},"PeriodicalIF":2.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jill C Fodstad, Rachel Russell, Lauren O Bryant, Lauren J Tadevich, Deanna Dwenger, Michael A Gray
{"title":"Improving Care for Autistic Youth in Correctional Settings.","authors":"Jill C Fodstad, Rachel Russell, Lauren O Bryant, Lauren J Tadevich, Deanna Dwenger, Michael A Gray","doi":"10.29158/JAAPL.250079-25","DOIUrl":"10.29158/JAAPL.250079-25","url":null,"abstract":"<p><p>Youth on the autism spectrum who engage in delinquent or violent crimes can be adjudicated to juvenile correctional settings. These settings, which are meant to successfully reintegrate youth back into the community through education, counseling, and skills programs, are often ill-equipped to navigate the unique needs of youth on the autism spectrum. As a result, autistic youth in juvenile correctional settings often do poorly, minimizing the likelihood that successful reintegration occurs. The purpose of this review is to summarize the literature on the prevalence of autistic youth in correctional settings and their needs, as well as the standard of care often afforded to them in these settings. Finally, we will present suggested strategies informed by the literature whereby adjudicated autistic youth are provided services and support that are feasible in a correctional setting and align with autism-informed, evidence-based practices.</p>","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":"363-372"},"PeriodicalIF":2.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christina L Riggs Romaine, Shannon Williamson-Butler, Ahmar Zaman, Kathleen Kemp
{"title":"The Role of Community-Based Supportive Services in Remediating Juvenile Adjudicative Competence.","authors":"Christina L Riggs Romaine, Shannon Williamson-Butler, Ahmar Zaman, Kathleen Kemp","doi":"10.29158/JAAPL.250060-25","DOIUrl":"10.29158/JAAPL.250060-25","url":null,"abstract":"<p><p>This mixed methods study examined initial and reevaluation reports of youth opined incompetent to proceed to investigate the impact of community interventions on changes in functional abilities. Using a structured quantitative chart review and an inductive and deductive qualitative coding scheme, we coded court-ordered, juvenile competence reports for 73 youth (85% male; ages 9-19, <i>M<sub>age</sub></i> = 14.07, <i>SD =</i> 2.36) opined incompetent. Upon reevaluation, 51 youth were opined to remain incompetent, and 22 were opined competent by the evaluator. No age differences were observed between youth who remained incompetent and those who were remediated. Higher IQ scores were associated with successful remediation of understanding, appreciation, decision-making, and assisting counsel. Thematic analysis suggested that stabilization in place of residence and family functioning were often noted for remediated youth. School functioning and mental status at the time of the evaluation may be indicative of competence abilities and highlight existing skill deficits. Results highlight the complexity of factors influencing juvenile adjudicative competence and how stabilization of placement, school, and family functioning may be useful points of intervention, particularly when focused remediation efforts are not available.</p>","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":"392-404"},"PeriodicalIF":2.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}