P Buckley, J Bartell, K Donenwirth, S Lee, F Torigoe, S C Schulz
{"title":"Violence and schizophrenia: clozapine as a specific antiaggressive agent.","authors":"P Buckley, J Bartell, K Donenwirth, S Lee, F Torigoe, S C Schulz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pharmacological management of persistent aggression in patients with schizophrenia is a difficult clinical dilemma. Clozapine has been shown to be an effective agent in this regard. This study sought to compare the symptomatic response on the Brief Psychiatric Rating Scale (BPRS) between hostile schizophrenic patients and patients without aggression. While dramatic improvements were evident in aggression, both groups were indistinguishable with respect to BPRS response. These results suggest that clozapine may have a selective antiaggressive effect.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 4","pages":"607-11"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19617888","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":"California law enforcement agencies and the mentally ill offender.","authors":"J R Husted, R A Charter, B Perrou","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article reviews the results of a survey of California law enforcement agencies, designed to assess the experience of these agencies with mentally ill offenders (MIOs) and the training of their officers to interact with this population. The results suggest that most law enforcement officers are given insufficient training to identify, manage, and appropriately refer the MIOs they are increasingly likely to encounter. The data indicate that, in contrast to their training and expectations, peace officers are as likely to be called to a mental illness crisis as to a robbery. The MIO is likely to be arrested for nonviolent misdemeanors and to be screened by officers with little of the training or knowledge needed to divert them to appropriate mental health treatment. Respondents report that increased communication and cooperation between law enforcement and mental health professionals is the single greatest improvement needed for handling mental illness crises.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 3","pages":"315-29"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19812824","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}
K Christensen, A Haroun, L J Schneiderman, D V Jeste
{"title":"Decision-making capacity for informed consent in the older population.","authors":"K Christensen, A Haroun, L J Schneiderman, D V Jeste","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We discuss key concepts and review 12 published research studies relevant to informed consent and decision-making capacity in the older population. The literature suggests that aging is associated with impaired decision-making capacity; the following additional factors amplify the detrimental effect of aging: lower vocabulary level, lower educational level, chronic medical illness (as in nursing home residents), and acute medical illness. Aging may be associated particularly with impaired comprehension of consent forms. We discuss guidelines for clinicians and researchers for improving the process of obtaining a truly informed consent.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 3","pages":"353-65"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19812827","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":"Comparative forensic psychiatry: II. The perizia and the role of the forensic psychiatrist in the Italian legal system.","authors":"J R Ciccone, S Ferracuti","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 3","pages":"453-66"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19813982","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":"Examination of treatment completion and predicted outcome among incarcerated sex offenders.","authors":"T A Shaw, M J Herkov, R A Greer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article addresses the prediction of treatment completion and outcome of 114 adult sex offender using variables found to predict treatment outcome in outpatient sex offender programs. The variables of reading ability, marital status, age, presence of antisocial personality disorder, offense and victim discrimination, and instant offense were used. Three outcomes of treatment were assessed: (1) those who were rejected from the program during the evaluation phase; (2) those who dropped out of treatment; and (3) those who successfully completed the program. Results indicated that only reading ability and marital status were predictive of treatment outcome, with those with high reading ability and married having the best outcome. Failure of the other variables to differentiate between groups is attributed to differences in psychopathology between incarcerated and outpatient sex offenders and differences in structure between programs.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 1","pages":"35-41"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18604645","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":"Axis I and personality comorbidity in adolescents with conduct disorder.","authors":"R C Burket, W C Myers","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This study was undertaken to investigate psychiatric comorbidity in male and female adolescents with conduct disorder diagnoses. Twenty-five hospitalized adolescents (11 females, 14 males) with conduct disorder were evaluated using structured diagnostic interviews for Axis I and personality disorders. The most common Axis I comorbid diagnoses were: depressive disorders (major depression and/or dysthymia), 64 percent; anxiety disorders (separation anxiety disorder, overanxious disorder, panic disorder, obsessive-compulsive disorder, phobias, and/or posttraumatic stress disorder), 52 percent; substance abuse, 48 percent; and attention-deficit hyperactivity disorder, 28 percent. Common Axis II disorders included passive-aggressive personality disorder, 56 percent, and borderline personality disorder, 32 percent. When compared with the male subjects, the females had significantly more total Axis I disorders and a trend toward more total personality disorders, anxiety disorders, depression, and borderline personality disorders. These findings support conduct disorder as a complex illness with extensive Axis I and II involvement as well as some gender differences in presentation.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 1","pages":"73-82"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18605216","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":"Public evaluations of unrepresented defendants.","authors":"R D Miller, J Olin, G Beven, J Covey","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Previous articles have addressed the ethical and legal issues involved when private psychiatrists perform forensic evaluations on criminal defendants before the defendants have access to counsel; but there have been few studies addressing evaluations requested through public facilities and by clinicians other than psychiatrists. The authors present the results of a detailed study of defendants admitted for evaluations of competency to proceed to a forensic inpatient unit in one state, as well as data from a national survey of state forensic facilities. The studies were designed to measure the incidence of unrepresented defendants in a population referred for competency evaluation, as well as to examine the reasons for such occurrences. The data reveal that court-ordered evaluations of unrepresented defendants are rare, but continue to exist.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 1","pages":"93-103"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18605218","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":"Cult membership as a source of self-cohesion: forensic implications.","authors":"T B Feldmann, P W Johnson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The study of cults and the types of individuals drawn to them has long been of interest to psychiatrists. Although many studies have been done on personality types and psychopathology in cult members, no consensus has emerged. Studies of psychopathology in cult members have viewed these individuals as having either no significant impairment, displaying elements of character pathology, or being severely impaired. The result is that no clear theoretical framework has been developed to explain cult membership. Psychoanalytic self psychology, as developed by Heinz Kohut, can provide such a framework. The cult may be understood as serving a number of functions for its members, all of which are designed to restore self-cohesion. Such a formulation implies a degree of self, or narcissistic, pathology in many cult members. This article reviews the literature on cults, offers a self psychology formulation to explain the function that cult membership serves for narcissistically vulnerable personalities, and describes forensic applications of these principles.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 2","pages":"239-48"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19585334","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":"The psychological autopsy: a useful tool for determining proximate causation in suicide cases.","authors":"D Jacobs, M Klein-Benheim","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This overview article examines the applications of the psychological autopsy method in determining proximate causation in suicide cases. The article reviews the history of the psychological autopsy and describes its procedure and how it has proved helpful in explicating proximate causation. The five standards currently used by the courts to determine proximate causation in suicide cases are described, as are a variety of applications of the psychological autopsy method, including its application to workers' compensation cases, product liability cases, and medical malpractice cases. In particular, issues of prediction and protection are addressed. Finally, there is a discussion of an application of the psychological autopsy to criminal cases. The article concludes with a discussion of the issues raised in the use of the psychological autopsy during expert testimony and the considerations that should be addressed by an expert witness contemplating the use of the psychological autopsy method.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 2","pages":"165-82"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19584785","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":"Is liability possible for forensic psychiatrists?","authors":"R Weinstock, T Garrick","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Forensic psychiatrists are not as vulnerable to liability as general psychiatrists. The absence of a traditional physician-patient relationship and judicial and quasijudicial immunity are all protective against malpractice actions. Although the absence of a doctor-patient relationship removes an essential element of malpractice, other types of liability such as defamation and ordinary negligence are possible and may not be covered by malpractice insurance. A model is proposed for forensic psychiatry of a partial secondary doctor-patient relationship out-weighted in most circumstances by duties to truth and/or the hiring attorney. Such a model seems most consistent with conflicting duties currently forced on all psychiatrists. This model has advantages of a duty, a violation of which is likely to be covered by malpractice insurance. Rather than deemphasizing partial secondary physician-patient responsibilities, it is advised to stress the important protection provided by judicial and quasijudicial immunity.</p>","PeriodicalId":76615,"journal":{"name":"The Bulletin of the American Academy of Psychiatry and the Law","volume":"23 2","pages":"183-93"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19584786","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}