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

{"title":"Rape trauma syndrome in the military courts.","authors":"S A Young","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The military courts have developed a rich case law tradition in the area of rape trauma syndrome testimony. These cases are particularly important in the context of a military that is both increasingly female and increasingly sensitive to mixed gender relationships. This article reviews the military court's approach to rape trauma testimony over the past 15 years. The author notes that military courts have been accepting of this testimony within certain well defined limits. The author analyzes the approach to testimony at one military medical center and offers a testimony model for the forensic psychiatrist who testifies in a military setting.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 4","pages":"563-71"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19617884","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: legal sanctions for mental health professional-patient sexual misconduct.","authors":"S K Hoge,&nbsp;L Jorgenson,&nbsp;N Goldstein,&nbsp;J Metzner,&nbsp;R Patterson,&nbsp;G Robinson","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 3","pages":"433-48"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19813980","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 psychiatry in Britain.","authors":"J C Beck","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This report provides an overview of the criminal forensic mental health system in Great Britain, that is England and Wales. The report is based on the author's participant observation as a visiting consultant psychiatrist at a regional forensic facility in Manchester, England during early 1994. British law casts a net over a wider population of forensic patients than does U.S. law. There is a forensic care system in the British National Health Service that is parallel to and independent of the general psychiatric care system. The forensic system provides continuity of care from prison through maximum security hospitals to regional medium secure facilities, and finally, into the community. Community care is provided by psychiatrists and social workers and, if necessary, by psychiatric nurses. This system appears to provide effective treatment for persons with major mental disorders and histories of violence. Differences between Britain and the United States in philosophy of government, in law, and in forensic training and practice are discussed. The fundamental difference is a greater British belief in the capacity of government to act in the best interests of the individual. Current problems in the British health care system and plans to privatize some services are also discussed.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 2","pages":"249-60"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19585335","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":"Biological parents regaining their rights: a psycholegal analysis of a new era in custody disputes.","authors":"E J Kermani,&nbsp;B A Weiss","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The evolving American family presents new psycholegal dilemmas. Recently many publicized landmark cases have involved custody disputes in which settlements turn on the genetic component. Although the court acknowledges the principle of \"the best interest of the child\" as important to the determination of custody, this interest is not absolutely paramount. Court rulings have taken the position that the rights of biological parents are a threshold issue that must be resolved first. Thus, children may be removed from their adoptive and psychological parents through a court order. The authors present a psycholegal analysis of important cases with a guideline for the future.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 2","pages":"261-7"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19585336","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":"Regulating pastoral counseling practice: the problem of sexual misconduct.","authors":"J L Young,&nbsp;E E Griffith","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Growing concern about sexual abuse covers many kinds of perpetrators. Therapist and clergy abusers have been increasingly targeted, yet clergy counselors who sexually abuse their clients have so far largely escaped effective sanctions from the courts. This article identifies the justifications given by these courts, identifying and evaluating their supporting arguments. This analysis suggests that the courts have decided not to enter this public policy fray, or to do so with considerable caution because of their fundamental respect for the freedom of religion. It is a choice especially problematic in regard to pastoral counselors practicing outside the discipline of either a central church authority or a professional counseling organization. The authors suggest potential legal bases for reaching sexually abusive clergy counselors without encroaching on religious freedom. They urge the churches to meet their responsibility and assume a more active stance toward helping to resolve this problem. The question of whether society does in fact value religious freedom above protection of clients sexually abused by clergy counselors remains an important policy issue.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 3","pages":"421-32"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19813979","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":"Stalking as a variant of domestic violence.","authors":"J L Kurt","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Much of what is presently known about stalking in a domestic context has been depicted by the popular press, typically following a tragic outcome, and suggests that it is a problem of increasing dimensions. However, scientific literature on this subject is quite limited. This article provides an overview of scientific data related to stalking and associated psychiatric syndromes, including erotomania. It reviews the current antistalking legislation and the National Institute of Justice Model Anti-Stalking Code. Four case studies of stalkers with psychotic disorders versus personality disorders are presented, and the differential diagnoses are discussed. The implications of diagnostic classification, with respect to criminal responsibility, are also discussed.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 2","pages":"219-30"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19584790","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 comparison of female versus male insanity acquittees in Colorado.","authors":"A Seig,&nbsp;E Ball,&nbsp;J A Menninger","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This study was undertaken to investigate the authors' clinical impression that there are significant differences between the male and female insanity acquittees in Colorado, and that these differences result in significantly different treatment needs. The study sample included 149 patients: 112 men and 37 women committed to the Colorado Mental Health Institute at Pueblo as not guilty by reason of insanity (NGRI). Data were collected from a computerized data system and from chart reviews. The study provides descriptive data regarding demographic, legal, and mental health parameters of these acquittees. Demographic items included prior history of incarceration, age at first arrest, type of NGRI crime committed, and severity of NGRI crime. Mental health variables included prior psychiatric hospitalization history of suicide attempts, substance abuse history, inpatient substance abuse treatment history, diagnoses, escape history and length of stay. Percentages of male and female subjects were calculated for those variables with discrete categories. Means and medians were calculated for continuous variables. Results indicate that women are significantly more likely to be given a diagnosis of mood disorder or borderline personality disorder, are significantly older than men at the time of commitment, and are statistically more likely to have committed a single violent crime than men. Men were found to have a significantly higher rate of prior and current substance abuse, a significantly higher rate of antisocial personality disorder, a significantly greater history of violent crime prior to the NGRI offense, and arrests beginning at a significantly younger age than women. Despite the higher severity of crime rating for women, their length of stay was significantly shorter than for men. The implications of the findings with regard to different treatment needs are discussed, and the findings are compared to four other studies addressing female versus male insanity acquittees in other states.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 4","pages":"523-32"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19617185","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":"Medroxyprogesterone treatment for paraphiliacs.","authors":"H M Kravitz,&nbsp;T W Haywood,&nbsp;J Kelly,&nbsp;C Wahlstrom,&nbsp;S Liles,&nbsp;J L Cavanaugh","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This study addresses the following questions: (1) what are the essential components of a medroxyprogesterone acetate (MPA) pretreatment evaluation?; (2) do paraphilic men treated with MPA (Depo-Provera) report a lowering of both deviant and nondeviant sexual drive and activities?; (3) is behavioral improvement associated with testosterone level reductions?; and (4) what significant side effects are associated with MPA treatment? A total of 29 paraphilic men who underwent a comprehensive psychiatric, medical, and legal evaluation and were eligible for treatment with MPA were followed naturalistically while receiving concurrent MPA and group therapy. The principal outcome measures were data obtained from a weekly self-reported psychosexual inventory that quantified five dimensions of deviant and nondeviant sexual activities and testosterone levels that were drawn pretreatment and after three and six months of MPA. Self-reported data were analyzed by nonparametric methods. Because MPA's effectiveness is evident early in treatment, we report on data from the first six months. Subjects reported a differential rate of suppression of sexual activities, a median of up to two weeks for deviant and 2 to 10 weeks for nondeviant behaviors (p < or = .01 for each of the five dimensions). Testosterone levels suppressed to less than 0.5 ng per milliliter for all but two subjects at three months and for all at six months. Recidivism was reported for one subject. Except for one subject who developed pulmonary emboli, no major medical problems were encountered. MPA safely and effectively reduced sex drive, controlled deviant sexual impulses and behavior, and lowered the testosterone levels of these paraphilic men during the first six months of treatment. However, the relative rapidity and completeness of the response raises questions regarding possible distortions in self-reported sexual activities. This should alert the practicing clinician to consider the use of collateral sources of information in interpreting treatment outcome for patients with paraphilic behaviors. Also, longer follow-up periods are required for monitoring treatment efficacy.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 1","pages":"19-33"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18604644","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":"Interaction of the criminal justice system and psychiatric professionals in which civil commitment standards are prohibitive.","authors":"P Solomon,&nbsp;R Rogers,&nbsp;J Draine,&nbsp;A Meyerson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Three case studies are the basis for a discussion of the criminalization hypothesis as it may apply to psychiatric probationers and parolees in the criminal justice system. In each of these cases, the treating psychiatrist faced the problems of noncompliance with treatment and/or restrictive civil commitment standards. The patient's status as a probationer or parolee played a pivotal role in strategies for ensuring treatment through the criminal justice system as opposed to the mental health system or civil commitment process.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 1","pages":"117-28"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18605385","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":"Civil commitment viewed from three perspectives: professional, family, and police.","authors":"J R Husted,&nbsp;A Nehemkis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This study was designed to uncover differences in interpretation and implementation of civil commitment laws. Such problems in interpretation may contribute to mentally ill persons remaining untreated and potentially joining the thousands of homeless mentally ill persons in our communities or the incarcerated mentally ill persons in our prisons and jails. The study examines differences in the assessments of the severity of mental illness, and the appropriateness and judged feasibility for commitment in different commitment categories, made by emergency room admitting personnel, police officers, and families of mentally ill persons. The results demonstrate that police are significantly less likely than families or mental health professionals to perceive mental disability or a need for involuntary commitment on any grounds. Professional psychiatric staffs were much more likely than the other two groups to consider commitment in all three cases as legally feasible. Family ratings of appropriateness for commitment based on the presented symptomatology are similar to those of professionals. However, they are significantly less likely than professionals to judge the cases as legally feasible for commitment, and they interpret the laws similarly to the police raters in believing that commitment laws will not allow involuntary hospitalizations. Consequences and implications of these differences are discussed.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 4","pages":"533-46"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19617881","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}