The Bulletin of the American Academy of Psychiatry and the Law最新文献

Medroxyprogesterone and paraphiles: do testosterone levels matter? 甲孕酮和性冷淡:睾酮水平有影响吗?

The Bulletin of the American Academy of Psychiatry and the Law Pub Date : 1996-01-01

H M Kravitz, T W Haywood, J Kelly, S Liles, J L Cavanaugh

{"title":"Medroxyprogesterone and paraphiles: do testosterone levels matter?","authors":"H M Kravitz, T W Haywood, J Kelly, S Liles, J L Cavanaugh","doi":"","DOIUrl":"","url":null,"abstract":"We examine the associations between pretreatment testosterone (TTS) levels and sociodemographic, clinical, and sexual behavioral characteristics. Two groups, low and normal pretreatment TTS, were treated with medroxyprogesterone acetate (MPA) and compared on clinical response (deviant and nondeviant sexual behaviors; recidivism) and length of time to return to pretreatment TTS after discontinuing MPA. Thirteen paraphilic men who were treated with MPA and had TTS levels monitored at approximately three-month intervals during and after MPA were followed naturalistically. The principal outcome measures pertained to TTS levels and data from a self-report psychosexual inventory, which quantified deviant and nondeviant sexual activities. Time to return to baseline TTS levels were analyzed with Kaplan-Meier survival analysis. Nonparametric methods were used to compare the two groups on other variables. Multiple regression was used to examine the contribution of combinations of variables to TTS outcome. Subjects with low pretreatment TTS received MPA for longer periods of time, and older subjects took longer to return to pretreatment TTS levels despite being treated for shorter periods of time. Although subjects with lower pretreatment TTS levels may be more sensitive to MPA's TTS-suppressive effects, the multiple regression analysis showed that age may be an important determinant of the time it take for TTS levels to return to pretreatment baseline. Sociodemographic, clinical, and self-reported measures of sexual behavior did not distinguish between low and normal TTS level groups. Only one relapse was detected. Further studies with larger samples are required to better understand the role of TTS monitoring of sex offenders treated with MPA, in order to justify its continued use as a measurement of treatment adequacy and to study its potential role as a predictor of treatment outcome.","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"24 1","pages":"73-83"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19857619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Forensic significance of the limbic psychotic trigger reaction. 边缘精神病触发反应的法医意义。

The Bulletin of the American Academy of Psychiatry and the Law Pub Date : 1996-01-01

A A Pontius

{"title":"Forensic significance of the limbic psychotic trigger reaction.","authors":"A A Pontius","doi":"","DOIUrl":"","url":null,"abstract":"During the \"decade of the brain,\" competent expert testimony should encompass widely neglected, even novel, neurophysiologically plausible explanations for otherwise unexplainable acts. In the case presented here, a sudden, out-of-character, motiveless, unplanned homicidal attack was committed by a patient who demonstrated flat affect, preserved consciousness, and memory of the episode. Transient autonomic hyperactivation and psychosis were suddenly experienced when the victim happened to move his mouth while eating. Following a sudden memory revival of repetitive but moderate bodily stresses, the patient suffered visceral hallucinations of his entire body being cut into pieces with the delusional belief that he was about to be \"cannibalized.\" The patient's sudden and very transient symptomatology is characteristic of 13 interrelated symptoms and signs (including autonomic, e.g., visceral, hyperactivation and psychosis) proposed as a new subtype of a partial seizure, called \"limbic psychotic trigger reaction,\" which has been consistently delineated thus far in 18 white social loners (14 homicidal men, 3 fire setters, and 1 bank robber), who ruminated about past, moderately painful, but repeated events. This rendered them liable to seizure kindling, particularly of the limbic system. Apparently a post-ictal transient frontal lobe deficiency is secondary to the limbic storm. The forensic impact of seizures on cognition (appreciation of the quality of the act) and on volition is discussed.","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"24 1","pages":"125-34"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19856894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Myths, realities, and the political world: the anthropology of insanity defense attitudes. 神话、现实和政治世界:精神错乱辩护态度的人类学。

The Bulletin of the American Academy of Psychiatry and the Law Pub Date : 1996-01-01

M L Perlin

引用次数: 0

Seroprevalence of human immunodeficiency virus among inpatient pretrial detainees. 人类免疫缺陷病毒在住院审前拘留者中的血清流行率。

The Bulletin of the American Academy of Psychiatry and the Law Pub Date : 1996-01-01

K McKinnon

引用次数: 0

Detection of misreported drug use in forensic populations: an overview of hair analysis. 在法医人群中误报药物使用的检测:毛发分析的概述。

The Bulletin of the American Academy of Psychiatry and the Law Pub Date : 1996-01-01

K S Kelly, R Rogers

引用次数: 0

A clinical study of competency in psychiatric inpatients. 精神科住院病人胜任力的临床研究。

The Bulletin of the American Academy of Psychiatry and the Law Pub Date : 1996-01-01

S B Billick, P W Naylor, M F Majeske, W Burgert, G P Davis

引用次数: 0

California's diminished capacity defense: evolution and transformation. 加州能力减弱的防御:进化与转变。

The Bulletin of the American Academy of Psychiatry and the Law Pub Date : 1996-01-01

R Weinstock, G B Leong, J A Silva

{"title":"California's diminished capacity defense: evolution and transformation.","authors":"R Weinstock, G B Leong, J A Silva","doi":"","DOIUrl":"","url":null,"abstract":"Diminished capacity survives in California as a severely attenuated mens rea defense known as diminished actuality. Some other states have similar limited strict mens rea defenses. The lost advantages of California's former expanded concept of diminished capacity are reviewed. As opposed to the all-or-none insanity defense, mens rea defenses permit the trier of fact to find gradations of guilt but are generally inapplicable unless the elements of a crime are redefined to permit consideration of motivational aspects, as California had done. The change from diminished capacity to a diminished actuality defense was a return to the complex, somewhat artificial legal concept of intent and a resurrection of confusing and antiquated common law definitions. The change was made in response to an unpopular jury verdict and a political climate in which little interest existed or still exists for understanding the reasons behind the commission of any crime. Some of the later restrictions imposed by the California Supreme Court on allowing voluntary intoxication to reduce murder to voluntary manslaughter logically should not apply to mental illness. Knowledge of the complex mens rea issues and the various relevant current defenses is essential for any forensic psychiatrist evaluating defendants in jurisdictions in which such defenses are admissible.","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"24 3","pages":"347-66"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19853485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Factitious sexual harassment. 人为性骚扰。

The Bulletin of the American Academy of Psychiatry and the Law Pub Date : 1996-01-01

S Feldman-Schorrig

引用次数: 0

Myths, realities, and the political world: the anthropology of insanity defense attitudes. 神话、现实和政治世界:精神错乱辩护态度的人类学。

The Bulletin of the American Academy of Psychiatry and the Law Pub Date : 1996-01-01

B S Joseph

引用次数: 0

Are pedophiles with aggressive tendencies more sexually violent? 有攻击性倾向的恋童癖者是否更具有性暴力倾向?

The Bulletin of the American Academy of Psychiatry and the Law Pub Date : 1996-01-01

D M Greenberg, J M Bradford, S Curry

引用次数: 0