The association between specific competence-related abilities and competence restoration treatment

Inpatient competence restoration treatment comes with enormous costs in terms of civil liberties, but also significant financial costs to the state/institution responsible for providing the treatment. The present investigation was designed to evaluate the utility of a commonly used competence assessment instrument, the MacArthur Competence Assessment Tool – Criminal Adjudication (MacCAT-CA), in identifying individuals who may require more tailored, lengthier, and/or more intensive treatment. The sample included 93 men and women who were administered the MacCAT-CA during an inpatient hospitalization for competence restoration treatment in the United States. All of the patients were restored to competence within the study period, ranging from 3 to 32 months of inpatient hospitalization. Results suggest that performance on the MacCAT-CA was associated with hospitalization length, with total scores as the greatest predictor of response to treatment. Sensitivity and specificity estimates are discussed in terms of their utility in identifying patients most at-risk for extended hospitalization, with the authors arguing that instruments like the MacCAT-CA can be used in a practical manner of identifying patients who might require greater or more intensive treatment.     

Mental Illness and Legal Fitness (Competence) to Stand Trial in New York State: Expert Opinion and Criminal Defendants' Psychiatric Symptoms,

Fitness to Stand Trial is a critical concept in the adjudication of justice‐involved persons. A retrospective study was conducted to examine criminal defendants' specific psychiatric symptoms and those symptoms' associations with expert opinions on Competence to Stand Trial. One hundred charts were reviewed: 50 Cases (opined as Not Fit) were compared against 50 Controls (opined as Fit) with respect to ratings on the Brief Psychiatric Rating Scale (BPRS). A significance level of 0.001 was selected a priori. Statistically significant differences were found in seven of the eighteen BPRS symptom constructs (with the highest differences in Conceptual Disorganization and Unusual Thought Content) and two of the four BPRS higher‐order syndrome factors (Thinking Disorder and Hostile‐Suspiciousness). Consistent with previous reports, psychotic symptoms are found in this study to be inversely associated with Fitness. Validity, reliability, and limitations of this study, as well as directions for future research, are discussed herein.     

Use of a television crime-drama series to promote legal understanding in mentally ill, incompetent defendants: a pilot study

Videotaped material is used for educational purposes in many areas of medicine. In forensic facilities, programs designed to restore competency to stand trial (CST) in incompetent, mentally ill defendants have utilized videotaped courtroom proceedings as learning tools. This pilot study reviewed the progress of incompetent defendants (N = 15) who participated in a program that utilized videotaped segments of the television crime-drama "Law & Order", among other techniques, to promote CST in individuals deemed unfit to stand trial. The authors hypothesized that participation in at least one cycle of the Competency Restoration Group (CRG)'s curriculum would be associated with improvement in the areas of understanding, reasoning and appreciation. In order to assess whether the group was beneficial to the patient's treatment goal of competency restoration, patients were screened using the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA) prior to starting the group and after completing a cycle of the group's curriculum. The Wilcoxon signed ranks test was employed to analyze the results from the pre- and post-group MacCAT-CA testing. The tests yielded significant (p < 0.005) post-test differences in the hypothesized direction for each of the three subsections: Understanding, Reasoning, and Appreciation as well as a significant post test improvement in the total MacCAT-CA scores. These results suggest that a didactic program, using a popular crime drama series, can be effective in facilitating learning in competency restoration programs. Limitations of this study include its lack of a control group and small population.     

Assessing the Latent Factor Association Between the Dysphoria Model of PTSD and Positive and Negative Affect in Trauma Victims from India

The recent release of the DSM-5 comes with the division of posttraumatic stress disorder (PTSD) symptoms across four symptom clusters (American Psychiatric Association, 2013). This division is based on the support garnered by two four-factor models; Emotional Numbing (King et al., 1998) and Dysphoria (Simms et al., 2002) and a five-factor model; Dysphoric Arousal (Elhai et al., 2011). Much debate centered on the validity of the Dysphoria factor as a non-specific factor of PTSD within the Dysphoria model. In line with this, we assessed relations between the four factors of the Dysphoria model (Simms et al., 2002) and positive (PA) and negative affect (NA) in natural disaster victims (N?=?200) from Leh, India, using the PTSD checklist (PCL-S) and Positive and Negative Affect Schedule (PANAS short form). Confirmatory factor analysis was implemented to assess the best-fitting model for both the PCL (PTSD) and the PANAS (affect). Two optimal models (the Dysphoria model and a two-factor model for affect) were subsequently used to assess latent variable associations across constructs. It was hypothesized that differential associations between latent factors would be evident with the Dysphoria factor being highly correlated with negative affect compared to alternative PTSD factors. Significant correlations were found between factors of the Dysphoria model and NA (0.52–0.65, p?<?0.001). Comparing the association of pairs of PTSD factors with NA and PA, Wald’s tests revealed that no single PTSD factor was more related to NA than the other. Avoidance and Hyperarousal factors were correlated with PA. Results are discussed in line with literature questioning Dysphoria factor’s unique association with general distress.     

Assessment of the Capacity to Express Informed Consent for Organ Donation in Patients with Schizophrenia

Abstract: In Italy, the “silent‐consent” principle of donor’s willingness regulates organ donation for postmortem transplantation, but civil incompetence excludes it. We investigated decisional capacity for organ donation for transplantation of 30 controls and 30 nonincompetent patients with schizophrenia as related to clinical symptoms, cognition, and functioning. Assessments were carried out through the Competence for Donation Assessment Scale (CDAS), Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms, Life Skills Profile (LSP), Raven’s Colored Progressive Matrices (RCPM), Wisconsin Card Sorting Test, Rey RI, Rey RD, and Visual Search. Patients and controls differed on the CDAS Understanding and Choice Expression areas. Patients showed significant inverse bivariate correlations between CDAS Understanding and scores on total BPRS, LSP self‐care scale, and RCPM cognitive test. Our results show that decisional capacity for participating in research does not predict decisional capacity for postmortem organ donation in patients with schizophrenic or schizoaffective psychosis; hence, before judging consent for donation, patients must be provided with enhanced information to better understand this delicate issue.     

PTSD symptom clusters, feelings of revenge, and perceptions of perpetrator punishment severity in victims of interpersonal violence

Feelings of revenge have often been found to correlate with symptoms of posttraumatic stress disorder (PTSD). Which PTSD symptom cluster prevails in this association is, however, unknown. Furthermore, previous studies suggest that revenge may be satisfied by perceptions of perpetrator punishment severity, but did not control for concurrent symptoms of PTSD. Therefore, this study explored associations between PTSD symptom clusters, feelings of revenge, and perceived perpetrator punishment severity in a sample of victims of interpersonal violence. Results indicated that the re-experiencing/intrusion symptom cluster was the only index of PTSD which was related to victims' feelings of revenge (n = 207). Revenge correlated negatively with perceptions of punishment severity in victim who knew that the perpetrator had been sentenced, but not after adjustment for PTSD symptoms (n = 96).     

Adaptation and development of the Empathy Assessment Index (EAI)

The purpose of this study was to adapt and develop a multidimensional measure of interpersonal empathy, the Empathy Assessment Index (EAI). The EAI is a self-report measure developed in the US that is applicable in most contexts where empathy is considered a relevant construct. The focus of this work is on professions dealing with complex interpersonal situations, such as the police or other professions that can be categorized as street-level bureaucrats. The added value of the EAI relative to previous measures of interpersonal empathy stems from its incorporation of subconstructs such as self-other awareness (SOA) and emotion regulation (ER) to augment the cognitive dimension of empathy. The Swedish version of the EAI was administered to a sample of 330 participants, most of whom were police recruits. An exploratory factor analysis identified a four-factor structure, which was supported by a confirmatory factor analysis. The factors identified in the analysis were affective response, SOA, perspective taking (PT), and ER. Evidence for the scale’s concurrent validity was established in relation to the empathic concern and PT subscales from the Interpersonal Reactivity Index. The adapted version of the EAI will be used in further studies within the police context.     

Classifying the torture experiences of refugees living in the United States

Few research studies have systematically categorized the types of torture experienced around the world. The purpose of this study is to categorize the diverse traumatic events that are defined as torture, and determine how these torture types relate to demographics and symptom presentation. Data for 325 individuals were obtained through a retrospective review of records from the Bellevue/NYU for Survivors of Torture. A factor analysis generated a model with five factors corresponding to witnessing torture of others, torture of family members, physical beating, rape/sexual assault, and deprivation/passive torture. These factors were significantly correlated with a number of demographic variables (sex, education, and region of origin). Post Traumatic Stress Disorder, anxiety, and depression symptoms were significantly correlated with the rape factor but no other factors were uniquely associated with psychological distress. The results offer insight into the nature of torture and differences in responses.     

Subtypes of female juvenile offenders: a cluster analysis of the Millon Adolescent Clinical Inventory

The current study sought to explore subtypes of adolescents within a sample of female juvenile offenders. Using the Millon Adolescent Clinical Inventory with 101 female juvenile offenders, a two-step cluster analysis was performed beginning with a Ward's method hierarchical cluster analysis followed by a K-Means iterative partitioning cluster analysis. The results suggest an optimal three-cluster solution, with cluster profiles leading to the following group labels: Externalizing Problems, Depressed/Interpersonally Ambivalent, and Anxious Prosocial. Analysis along the factors of age, race, offense typology and offense chronicity were conducted to further understand the nature of found clusters. Only the effect for race was significant with the Anxious Prosocial and Depressed Intepersonally Ambivalent clusters appearing disproportionately comprised of African American girls. To establish external validity, clusters were compared across scales of the Behavioral Assessment System for Children - Self Report of Personality, and corroborative distinctions between clusters were found here.     

Malingered Posttraumatic Stress Disorder (PTSD) and the Effect of Direct Versus Indirect Trauma Exposure on Symptom Profiles and Detectability

Posttraumatic stress disorder (PTSD) is arguably prone to malingering due to its subjective and heterogeneous nature. Various factors can influence PTSD symptom profiles including trauma type and trauma exposure. However, it is unknown whether trauma exposure influences malingered PTSD symptom profiles. We used a malingering simulation design with trauma type controlled to compare (1) PTSD symptom profiles (Posttraumatic Stress Checliklist-5; PCL-5) at the syndrome, symptom cluster, and individual symptom levels and (2) symptom validity profiles (Structured Inventory of Malingered Symptomatology; SIMS) at the overall and subscale level, as a function of direct and indirect trauma exposure. Seventy-three participants were randomly assigned to either the direct (“witnessed” trauma) or indirect (“learned about” trauma) condition. Participants were coached about symptoms and instructed to simulate PTSD. PCL-5 profile analyses revealed that simulators in the direct exposure group reported greater overall PTSD severity. Significant differences were found on cluster D (changes in cognition and mood) and individual symptoms including intrusive thoughts, amnesia, difficulty experiencing positive emotions, and risk-taking. No differences were identified for any other symptom scores nor for the symptom validity profile, except for the SIMS total score (direct: M?=?33.0, SD?=?12.8, indirect: M?=?26.5, SD?=?13.9, t(71)?=?2.06, p?=?.043, d?=?.48). These findings indicate that trauma exposure can influence malingered PTSD profiles at the syndrome, symptom cluster, and individual symptom levels (small effects), but, with one exception for a summary score, it does not produce a detectable difference on symptom validity testing. This study may provide insight for clinicians into the how malingered PTSD profiles can manifest as a result of direct and indirect trauma exposure; however, further research is strongly indicated.     

The Use of the MacCAT-CA with Adolescents: An Item Response Theory Investigation of Age-Related Measurement Bias

Despite the application of the MacCAT-CA to juveniles, questions been raised regarding the appropriateness of this tool for adolescents. The current study tested for age-related measurement bias using data from the MacArthur Juvenile Adjudicative Competence Study (n = 1393). Five of the MacCAT-CA items showed age-related measurement bias (i.e., DIF) for adolescents aged 11–15, and three items showed DIF for adolescents aged 16–17. Several items (e.g., understanding of juries) were more difficult for adolescents than adults matched at the same latent level of capacity, suggesting that these items might underestimate adolescents’ legal capacities. Contrary to expectations, there was little evidence of age-related measurement bias on the Appreciation scale. The use of the MacCAT-CA in research and clinical settings is discussed.

Toward a Typology of High-Risk Major Stressful Events and Situations in Posttraumatic Stress Disorder and Related Psychopathology

The diagnosis of posttraumatic stress disorder (PTSD) was introduced in 1980 with the publication of the Diagnostic and Statistical Manual of the American Psychiatric Association, Third Edition (DSM-III). DSM-III put forward a novel syndrome consisting of intrusive, avoidance/numbing, and arousal symptoms as distinctive psychopathology following exposure to traumatic events. The traumatic stressors, although expanded in later editions published in 1987 (DSM-III-R) and 1994 (DSM-IV), focus on life-threatening events and situations. However, at least 12 studies, most of them recent, have found associations between the PTSD symptoms and the PTSD symptom syndrome with stressors, such as unemployment and divorce that would not qualify, even in the broadened DSM-IV diagnosis, as traumatic stressors. These findings challenge the basic assumption on which the PTSD diagnosis is based, the assumption that exposure to life-threatening stressors is the primary cause of a unique set of stress response symptoms. The purpose of this paper is to show how to confront this challenge by developing a typology of stressful situations and events that can be tested systematically for their relation to the PTSD symptom syndrome and other relevant variables. The typology includes but is not limited to the types of situations and events defined as "traumatic" in the DSMs.     

Predictive Validity of the Neuropsychological Assessment Battery-Screening Module for Assessing Real-World Disability in Patients with Mild Traumatic Brain Injury

The present study set out to examine the ecological validity of the Neuropsychological Assessment Battery-Screening Module (NAB-S) and to examine more specifically, whether performance on this test battery is related to real-world disability status in patients who have sustained a mild traumatic brain injury (mTBI) as a consequence of a motor vehicle collision (MVC). Seventy-nine patients were recruited from a random sample of litigating patients who incurred an mTBI and were referred for a neuropsychological examination due to subjective complaints of cognitive function. Of the total sample, 54 patients were categorized into the non-disabled group and 25 patients were categorized into the disabled group using the 4th edition of the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment (AMA; 1993). A multivariate analysis of variance revealed that performance on the NAB-S significantly differed between the two groups, and that memory and attention domains provided a more discriminative index of disability than general neuropsychological functions. In addition, discriminant function analyses revealed that the NAB-S correctly classified 73% of patients according to their group membership. The current findings provide evidence for the ecological validity of the NAB-S as a reliable index of real-world disability status as defined by the AMA Guides.     

Elaborating on the Construct Validity of the Levenson Self-Report Psychopathy Scale in Incarcerated and Non-Incarcerated Samples

The Levenson Self-Report Psychopathy Scale (LSRP) is a promising, efficient measure of the psychopathic personality. Previous examinations of its latent structure have yielded inconsistent results; therefore, the goal of the current study was to evaluate previously reported two- and three-factor models in three separate groups of male correctional inmates (n = 573), male college students (n = 202), and female college students (n = 200). Confirmatory factor analyses revealed that the best-fitting model across all the three groups was the three-factor model proposed by Brinkley et al. (Assessment 15:464–482, 2008). The convergent and discriminant validity of this three-factor structure as well as a revised 19-item total score were elaborated on in terms of predicting scores on conceptually relevant external criteria. The LSRP total and factor scales evidenced good convergent and discriminant validity with a few notable exceptions. Implications for theory and future research are discussed.     

Reductions in Perceived Injustice Are Associated with Reductions in Posttraumatic Stress Symptoms Among Individuals Receiving Treatment for Whiplash Injury

Research has accumulated to suggest that perceived injustice is a risk factor for poor recovery outcomes in individuals with whiplash injuries. The present study examined the relative contributions of treatment-related reductions in perceived injustice and pain severity, in the prediction of reductions in posttraumatic stress symptoms in individuals with whiplash injury. The study sample consisted of 146 individuals (66 women, 80 men) who sustained whiplash injuries in motor vehicle collisions and were enrolled in a multidisciplinary rehabilitation program designed to promote functional recovery following whiplash injury. Participants completed measures of pain severity, disability, posttraumatic stress symptoms, and perceived injustice prior to treatment and after treatment. Pearson correlations revealed that all study variables were significantly correlated. Regression analyses revealed that, at the time of enrollment in the intervention, perceived injustice accounted for a significant proportion of the variance in posttraumatic stress symptom severity, beyond the variance accounted for by pain severity. Paired sample t-tests revealed significant reductions in perceived injustice, pain severity, and posttraumatic stress symptom severity through the course of treatment. For individuals who scored above clinical threshold on a measure of posttraumatic stress symptoms at the time of enrollment in the intervention (N?=?71), regression analyses revealed that reductions in perceived injustice accounted for a significant proportion of the variance in reduction of posttraumatic stress symptoms, beyond the variance accounted for by reduced pain severity. Clinical and theoretical implications of the present findings are discussed.     

The application of chemometrics on Infrared and Raman spectra as a tool for the forensic analysis of paints

The aim of this work is to evaluate the capabilities and limitations of chemometric methods and other mathematical treatments applied on spectroscopic data and more specifically on paint samples. The uniqueness of the spectroscopic data comes from the fact that they are multivariate - a few thousands variables - and highly correlated. Statistical methods are used to study and discriminate samples. A collection of 34 red paint samples was measured by Infrared and Raman spectroscopy. Data pretreatment and variable selection demonstrated that the use of Standard Normal Variate (SNV), together with removal of the noisy variables by a selection of the wavelengths from 650 to 1830 cm(-1) and 2730-3600 cm(-1), provided the optimal results for infrared analysis. Principal component analysis (PCA) and hierarchical clusters analysis (HCA) were then used as exploratory techniques to provide evidence of structure in the data, cluster, or detect outliers. With the FTIR spectra, the Principal Components (PCs) correspond to binder types and the presence/absence of calcium carbonate. 83% of the total variance is explained by the four first PCs. As for the Raman spectra, we observe six different clusters corresponding to the different pigment compositions when plotting the first two PCs, which account for 37% and 20% respectively of the total variance. In conclusion, the use of chemometrics for the forensic analysis of paints provides a valuable tool for objective decision-making, a reduction of the possible classification errors, and a better efficiency, having robust results with time saving data treatments.     

法治评估的有效性和准确性——以中国八项法治评估为检验分析对象

自余杭法治指数初创至今,法治评估实践在我国已历经15载,现俨然成为中国法治实践学派的标签。那么量化法治实践中究竟如何才能保证法治评估的有效性和准确性?要回答这一问题,首先需要对我国现有法治评估的有效性和准确性进行科学检验。在明确界分法治评估有效性和准确性概念基础上,采用验证性因子分析法、探索性因子分析法对我国4项法治评估的有效性进行检验。经检验,我国法治评估的有效性特征表现为:结构效度低,理论构想的整体符合度低。采用主成分分析法、重新赋值法对我国8项法治评估的准确性进行检验,结果表明,余杭法治指数、四川依法治省评估、中国法治满意度评估等3项准确度低;江苏依法行政评估等1项准确度一般;中国法治政府评估、广东法治政府满意评价、广东法治社会满意度评价、上海法治满意度指数等4项准确度高。文末根据检验结论,提出保证法治评估有效性和准确性4个方面的实验研究路径。     

Vacuum metal deposition: factors affecting normal and reverse development of latent fingerprints on polyethylene substrates

Vacuum metal deposition (VMD) is an established technique for the development of latent fingerprints on non-porous surfaces. VMD has advantages over cyanoacrylate fuming, especially in circumstances where prints are old, have been exposed to adverse environmental conditions, or are present on semi-porous surfaces. Under normal circumstances, VMD produces 'negative' prints as zinc deposits onto the background substrate and not the print ridges themselves. A phenomenon of 'reverse' development, when zinc deposits onto the print ridges and not the background, has been reported by many authors but its causes have not been conclusively identified.Four plastic substrates were used in this study and these could be easily divided into two groups based on the types of development observed as the amount of deposited gold was increased. On group I plastics, identified as low-density polyethylene (LDPE), normal development then reverse development and finally no development resulted with increasing gold. On group II plastics, identified as high-density polyethylene (HDPE), normal development then over-development and finally poor-quality normal development resulted with increasing gold. Our results suggest that the difference between these plastic types causes variations in the gold film structure which in turn dictates the nature of the zinc deposition.On group I plastics, the structure and thickness of the gold film has been identified as the critical factor in the occurrence of normal or reverse development. Thin gold films on plastic substrates form small 'clusters' (or agglomerates) rather than the atoms being uniformly spread over the surface. The size and shape of these clusters is critical. Once the clusters reach a certain morphology, they no longer act as nucleation sites for zinc, and hence, zinc will not deposit onto the substrate.On group II plastics, results suggest that the gold clusters are smaller and more densely packed. Hence, even though the same amount of gold has been deposited, the gold clusters in this case do not reach the critical morphology and so continue to act as nucleation sites for zinc.Typically, zinc will not deposit onto the fingerprint ridges as the gold nucleation sites are buried within the print residue. However, when more gold is deposited, gold emerges at the surface of the latent print allowing zinc deposition onto the ridges.The rate of gold evaporation was found not to affect the structure of the gold film, although a slower rate of evaporation resulted in more effective deposition.     

Recalled peritraumatic reactions, self-reported PTSD, and the impact of malingering and fantasy proneness in victims of interpersonal violence who have applied for state compensation

The present study explores the associations between three types of peritraumatic reactions (dissociation, distress, and tonic immobility) and posttraumatic stress disorder (PTSD) symptoms in a sample of 125 victims of interpersonal violence who had applied for compensation with the Dutch Victim Compensation Fund (DCVF). In addition, the confounding roles of malingering and fantasy proneness are examined. Results indicate that tonic immobility did not predict PTSD symptom levels when adjusting for other forms of peritraumatic reactions, whereas peritraumatic dissociation and distress did. However, after the effects of malingering and fantasy proneness had been controlled for, malingering is the only factor associated with increased PTSD symptomatology. Implications for policy practice as well as study strengths and limitations are discussed.     

Tobacco status,impulsivity, and the five-factor of the PANSS in paranoid schizophrenia

There is consistent evidence that impulsivity is linked to tobacco consumption and to symptomatology in schizophrenia. In the current study, we propose a new integrative model of the relationship between impulsivity, psychopathological symptoms, and tobacco status in patients with paranoid schizophrenia. We investigated 33 paranoid schizophrenia patients and 37 healthy controls using a battery of psychopathological scales included the Structured Clinical Interview for DSM-IV (SCID), the five-factor model of the Positive and Negative Symptom Scale (PANSS), the Barratt Impulsiveness Scale (BIS-10), and the UPPS Impulsive Behavior scale (UPPS). Step-wise regression analysis revealed that positive factor of the PANSS and tobacco status contributed positively and significantly to the explained variance of impulsivity. In addition, non-planning impulsivity and sensation-seeking emerged as significant predictors of tobacco status, while smoking predicted non-planning impulsivity and sensation-seeking. Our results suggest that the relationship between sensation-seeking and tobacco use is reciprocal and proposes a new integrative model of the relationship between impulsivity, positive symptoms and tobacco status in patients with paranoid schizophrenia. However, the exact mechanisms for these relationships deserve further investigation.