{"title":"APA resource document: II. Regulatory guidelines for protecting the interests of psychiatric patients in emerging health care systems.","authors":"S K Hoge","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"24 3","pages":"407-18"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19853490","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}
{"title":"A descriptive study of emergency admissions to Farview State Hospital.","authors":"F Fox, J R Ruby, K Siska, T Singer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The prison population in the United States has grown steadily in the past 15 years. Farview State Hospital in Waymart, Pennsylvania annually provides service to approximately 350 to 400 inmates. This is less than 10 percent of the potential need for psychiatric treatment for the state. Emergency psychiatric admissions are a burden on the mental health system, as these inmates are given priority. This descriptive study identified profiles of emergency admissions for the period of July 1, 1990 to June 30, 1993. During this time, 86 emergency admissions occurred. Differences between state correctional and local county prison inmate admissions are described. The short stays of emergency admissions indicate that Farview is achieving its goal of stabilization of the mentally disordered inmate for return to the correctional facility. More research needs to be done to compare emergency and regular admissions for both diagnosis and length of stay.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"24 2","pages":"237-45"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19776578","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}
{"title":"Veterans affairs disability compensation: a case study in countertherapeutic jurisprudence.","authors":"D Mossman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article examines the disability compensation programs and health care system of the Department of Veterans Affairs (VA) from the perspective of therapeutic jurisprudence scholarship. VA psychiatric patients have unambiguous financial incentives to endlessly litigate disability claims, to seek lengthy hospitalization rather than outpatient treatment, and to be ill, disabled, and unemployed. These countertherapeutic incentives reward incapacitation, encourage perceiving one-self as sick, diminish personal responsibility, taint treatment relationships, and lead to disparaging perceptions of VA patients. In addition, such perceptions produce moral dilemmas that arise from mutual distrust and frustration when patients and caregivers have antagonistic goals for the clinical encounter. Changes in disability determination procedures, compensation levels, and patterns of payment for treatment could give VA patients and caregivers a \"healthier\" health care system that encourages personal responsibility and promotes respectful attitudes toward patients. In the absence of such changes, an awareness of countertherapeutic financial incentives can help clinicians distinguish between psychopathological behavior and the pursuit of a rational income strategy, and can help practitioners recognize that apparently deceitful or litigious behavior represents a reasonable response to the economic contingencies that VA patients face.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"24 1","pages":"27-44"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19857616","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}
{"title":"Delayed traumatic recall in adults: a synthesis with legal, clinical, and forensic recommendations.","authors":"J O Beahrs, J J Cannell, T G Gutheil","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Despite considerable consensus on what is known and unknown about delayed traumatic recall in adults, this topic remains one of the most polarized issues within both forensic psychiatry and society as a whole. Competing priorities of values contribute to this polarization. So do often subtle confusions of categories: experiential with substantive realities; clinical with legal priorities and criteria; distinctions between explicit and implicit with declarative and procedural memory; conditioned avoidance with declarative knowledge; and prediction of traumatic sequelae from known traumatic events with postdiction of possible traumatic events from symptoms that may imply prior traumatization. Memories are rendered more vulnerable to falsification through social influence and intrinsic suggestibility-- and probably more so when suggestive input bypasses conscious scrutiny. Legal, clinical, and forensic guidelines are proposed to sort out these complexities, balance conflicting professional duties and priorities, balance protection of children with defending legitimate social structures such as the family, and better use our growing knowledge about the vicissitudes of human memory.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"24 1","pages":"45-55"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19857617","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}
{"title":"Role of serotonin in forensic psychiatry.","authors":"P Buckley, G Gardner, S Lee, F Torigoe","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"24 3","pages":"419-22"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19853491","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}
{"title":"Threats against clinicians: a preliminary descriptive classification.","authors":"G P Brown, W R Dubin, J R Lion, L J Garry","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Threats against psychiatrists are common, but existing studies on the subject lack descriptive information about the nature and resolution of the threat. In the present study, clinicians who had received threats were interviewed in person or by telephone, and case histories were summarized. Threats were classified as situational and transferential. Demographic factors, precipitating events, and legal actions taken are described. The manner in which clinicians reacted to threats is also discussed.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"24 3","pages":"367-76"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19853486","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}
{"title":"Forensic aspects of medical student abuse: a Canadian perspective.","authors":"K J Margittai, R Moscarello, M F Rossi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The mistreatment and consequences of mistreatment involving medical students have only recently been recognized and studied. This article reports on the nature, frequency, and sequelae of \"abuse\" that is prohibited by the Criminal Code of Canada, as experienced by fourth year medical students. A 160-item, multiple choice questionnaire, the Medical Student Abuse Survey (MSAS), was administered on a voluntary and anonymous basis in February 1992 and 1993 at the University of Toronto (Canada) Faculty of Medicine. All students enrolled in their fourth year (n = 500) were eligible. Of those present when the survey was administered (n = 415), 72.5 percent (301 of 415) responded. Of all respondents, 8.3 percent (25 of 301) experienced either threats of bodily harm, assault, or assault with a weapon; 12.6 percent (38 of 301) experienced physical sexual advances; four students experienced both. Perpetrators were most often clinicians in a surgical setting. Only about one-third of these students (21 of 59) complained to someone in a position of authority within the medical school, and no one reported these incidents to the police. There is a need within medical training programs to disseminate a \"code of conduct\" to all parties, familiarize students with complaint procedures, and improve the identification and rehabilitation of perpetrators. The lack of objective measures for verifying students' experiences of abuse remains a limitation of this study.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"24 3","pages":"377-85"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19853487","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}
{"title":"APA resource document: I. The professional responsibilities of psychiatrists in evolving health care systems.","authors":"S K Hoge","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"24 3","pages":"393-406"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19853489","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}
{"title":"Crime and memory.","authors":"J. Herman","doi":"10.2307/j.ctv1h9dj03.6","DOIUrl":"https://doi.org/10.2307/j.ctv1h9dj03.6","url":null,"abstract":"The conflict between knowing and not knowing, speech and silence, remembering and forgetting, is the central dialectic of psychological trauma. This conflict is manifest in the individual disturbances of memory, the amnesias and hypermnesias, of traumatized people. It is manifest also on a social level, in persisting debates over the historical reality of atrocities that have been documented beyond any reasonable doubt. Social controversy becomes particularly acute at moments in history when perpetrators face the prospect of being publicly exposed or held legally accountable for crimes long hidden or condoned. This situation obtains in many countries emerging from dictatorship, with respect to political crimes such as murder and torture. It obtains in this country with regard to the private crimes of sexual and domestic violence. This article examines a current public controversy, regarding the credibility of adult recall of childhood abuse, as a classic example of the dialectic of trauma.","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 1 1","pages":"5-17"},"PeriodicalIF":0.0,"publicationDate":"1995-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68792280","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}
{"title":"Denouement of an execution competency case: is Perry pyrrhic?","authors":"D Mossman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In October 1992, the Louisiana Supreme Court ruled that that state could not forcibly medicate condemned, mentally ill prisoners to make them competent to be executed. State v. Perry has been seen as a victory for psychiatrists, but the decision contains bad news as well as good: although the Court extricated psychiatrists from having to medicate convicts involuntarily in preparation for their execution, the Court justified its decision by invoking a distortion-filled, highly critical interpretation of standard psychiatric treatment for psychoses. This article summarizes the Perry case and the Court's opinion, describes the perceptions of antipsychotic medication that animated the majority's legal conclusions, and reviews subsequent decisions in which Perry has been influential. The article suggests that Perry's description of pharmacotherapy may not have been motivated by a reasoned view of neuroleptic therapy so much as the Court's desire to uphold the institution of capital punishment. By studying the Perry majority's opinion, psychiatrists can appreciate how certain characterizations or descriptions of psychotic symptoms and antipsychotic therapy lend themselves to distortion and misunderstanding by legal decisionmakers. Recently developed conceptions of schizophrenic symptoms and pharmacological therapy may provide psychiatrists with sophisticated modes of explanation that courts will find more difficult to misconstrue or misrepresent.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 2","pages":"269-84"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19585338","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}