Criminality and moral dysfunctions: neurological,biochemical, and genetic dimensions

In this article, the author attempts to demonstrate a relationship between neurobiological dysfunctions and/or genetically determined deviant behavior and personality traits as well as moral abnormalities. Data from neuroscience show that a number of neurological dysfunctions are linked to cognitive and emotional disturbances. Cognitive and emotional abnormalities, in turn, are frequently related to moral dysfunctions. Moreover, neurological disorders can produce dramatic psychological and social problems, personality changes, and behavioral problems in patients. Those mental, emotional, and psychosocial problems and related moral dysfunctions are frequently linked to violence and/or criminal behavior. Genetic research found evidence of inheritability of antisocial traits, which interfere with moral development and activities. This information has consequences for any assessment and disposition within the legal system. More research on the interrelationship between neuro(bio)logical, genetic, emotional, and mental aspects of moral dysfunctions is needed for the development of adequate treatment, prevention, and intervention programs.     

Neuropsychological Services Following Motor Vehicle Collisions

Motor vehicle collisions (MVCs) are the second leading cause of traumatic brain injury (TBI), accounting for between 17 and 28 % of all TBIs. Although about 86 % of those who are involved in MVCs sustain no injuries, the remaining 14 % commonly experiences temporary or permanent cognitive, physical, and emotional problems; decreased functioning; and adverse lifestyle changes, which often result in litigation or pursuit of disability benefits. Although by far the most common severity of brain trauma resulting from MVCs falls at the mild end of the spectrum, many patients sustain moderate and severe brain injuries. Because of differing neuropathology, clinical presentations, recovery courses, and treatment and care needs, the neuropsychological conceptualization of, and services provided to, those who have sustained mild traumatic brain injuries typically differ from the conceptualization and services needed for those who sustained moderate–severe TBIs. Physical pain, emotional distress, effects of medications, and various motivations to seek services often contribute to the complexity of issues experienced by patients and confronted by clinicians. The purpose of this article is to review the assessment and treatment of cognitive, emotional, and behavioral problems experienced by persons who have been involved in MVCs, with a primary focus on outpatient settings and TBIs that fall at the mild end of the severity spectrum.     

Impact of Pain on Cognitive Function in Forensic Neuropsychology Context

Chronic pain is a biopsychosocial condition with a complex neuroscientific and neuropsychological literature. Common types of pain that are seen in the medicolegal context include headaches and musculoskeletal and neuropathic pain, all of which are known to affect neuropsychological test results. Differentiating between the cognitive impact of pain and the effects of traumatic brain injury and other factors, such as emotional distress or fatigue, is often challenging, especially in forensic determinations. Cutting through the polarization of forensic examiners’ opinions on the significance and nature of chronic pain impact on neuropsychological function with research evidence can make neuropsychological assessments more objective and defensible in court. This review focuses on surveying and integrating the available vast empirical evidence from neuroscience and neuropsychology regarding the cognitive impact of chronic pain. Our critical review will emphasize the implications of the new evidence for the forensic assessment determinations regarding causality, diagnosis, impact on function, and prognosis and treatment. To this end, electronic search engines, including PubMed, PsycINFO, and Google Scholar (up to January 2018), have been screened and reviewed both for the neuroscience and neuropsychological literature related to chronic pain, and subsequently updated for content and referencing.     

Deficits in Behavioral Inhibition Predict Treatment Engagement in Prison Inmates

Many inmates do not respond favorably to standard treatments routinely offered in prison. Executive cognitive functioning and emotional regulation may play a key role in treatment responsivity. During intake into treatment, inmates (N = 224) were evaluated for executive functioning, emotional perception, stress reactivity (salivary cortisol), IQ, psychological and behavioral traits, prior drug use, child and family background, and criminal histories and institutional behavior. Outcome measures included program completion, treatment readiness, responsivity and gain, and the Novaco Reaction to Provocation Questionnaire. Relative deficits in behavioral inhibition significantly predicted treatment outcomes, more so than background, psychological, or behavioral variables, and other neurocognitive and emotional regulatory measures. Future replications of these results have potential to improve assessment and treatment of offenders who are otherwise intractable.     

The professional responsibility of lawyers: emotional competence, multiculturalism and ethics

Traditional legal education and the Socratic method it utilises are by and large successful at training lawyers to think, reason and analyse. The cultivation of lawyers' intrapersonal and interpersonal skills, however, has been, at best, neglected by the profession. All lawyers, like all human beings, are emotional. Emotions affect who they are and how they practise law, whether or not they are conscious of them. As emotions cannot be removed from the practice of law, it is essential that lawyers learn to understand and manage their emotions, as well as learn to be attuned to their clients' emotional lives. Ignorance of concepts such as countertransference, denial and unconscious bias adversely impact the lawyer-client relationship. Lawyers who understand basic psychological principles and behaviours, who are aware of their own psychological makeup, understand their cultural perspective and recognise and credit their clients' differences, will enhance their effectiveness as counsellors. The client whose lawyer has these competencies will enjoy a therapeutically superior counselling or representational experience. The neglect of either the lawyer's or the client's emotional life threatens to sabotage the lawyer's ability, and thus professional responsibility, to render competent and impartial legal advice. Through drawing parallels to the training and practice in other counselling disciplines and relationships, this article argues that psychological-mindedness and multicultural competence are essential elements of ethically responsible legal representation.     

Anoxia-Hypoxia in Forensic Neuropsychological Assessment: Cognitive Impact of Pulmonary Injuries,Respiratory Distress,Cerebral Blood Hypoperfusion,and Major Surgeries

Pulmonary injuries, respiratory distress, blood loss-related cerebral blood perfusion, and major surgeries are common features of medical histories in forensic neuropsychological assessments. Unless the explicit reason for referral is determination of the cognitive impact of one of these adverse medical conditions, their contribution to neuropsychological causality determination can be overlooked, minimized, or misattributed to other causes. Given the underlying common denominator among these conditions, that is, sub-optimal oxygen delivery to the brain, transient or long-term debilitating injuries causing neuropsychological change of various degrees can result. A thorough understanding of the impact of these medical events is paramount in forensic neuropsychological assessment for diagnosis, causality, and functional impact determination, prognosis, rehabilitation, and recommendations. In this paper, we critically review the available empirical evidence regarding anoxia and hypoxia arising from pulmonary injuries and respiratory distress, cerebral blood hypoperfusion, and major surgeries, together with evidence of their impact on cognitive functioning. Medical and psychological electronic search engines [PubMed, PsycINFO, and Google Scholar (up to January 2018)] have been screened for neuroscience-related and neuropsychological literature pertaining to pulmonary injuries and respiratory distress, cerebral blood perfusion, and major surgeries, and subsequently optimized for the issue under review.     

Impact of Common Mental Health Disorders on Cognition: Depression and Posttraumatic Stress Disorder in Forensic Neuropsychology Context

The assessment and diagnosis of posttraumatic stress disorder (PTSD) and depression in forensic evaluations may lack an acknowledgement of the neurocognitive impact of these disorders and how they interact with other causative factors, such as traumatic brain injury (TBI), pain or fatigue. Both PTSD and depression have a complex, growing and consolidating neuroscientific and neuropsychological evidence base, and both can affect neuropsychological test results. In forensic neuropsychological assessments, they are often considered to be confounding factors in evaluating TBI and neurodegenerative disorders but not a source of cognitive impairment in their own right. Yet, an accurate neuropsychological assessment of both cognition and affect is vital to causality determination, prognosis and treatment planning. To complicate matters, selective brain injuries, contingent on the location of injury, can produce symptoms of depression that also affect the neurocognitive profile. Therefore, behavior can overlap not only due to overlapping or comorbid diagnoses, but also due to similar neuroanatomical correlates of both conditions. This paper focuses on reviewing and integrating the available empirical evidence from neuroscience and neuropsychology regarding the cognitive impact of PTSD and depression. Our critical review will emphasize the implications of the more recent evidence for forensic assessment determinations regarding causality, diagnosis, and the impact on function, prognosis and treatment. Hence, electronic search engines, PubMed, PsycINFO, and Google Scholar (up to January 2018) were screened and reviewed both for the neuroscience and neuropsychological literature related to depression and PTSD.     

The BDAE Complex Ideational Material—a Measure of Receptive Language or Performance Validity?

Scores on the Complex Ideational Material (CIM) were examined in reference to various performance validity tests (PVTs) in 106 adults clinically referred for neuropsychological assessment. The main diagnostic categories, reflecting a continuum between neurological and psychiatric disorders, were epilepsy, psychiatric disorders, postconcussive disorder, and psychogenic non-epileptic seizures. Cross-validation analyses suggest that in the absence of bona fide aphasia, a raw score ≤9 or T score ≤29 on the CIM is more likely to reflect non-credible presentation than impaired receptive language skills. However, these cutoffs may be associated with unacceptably high false positive rates in patients with longstanding, documented neurological deficits. Therefore, more conservative cutoffs (≤8/23) are recommended in such populations. Contrary to the widely accepted assumption that psychiatric disorders are unrelated to performance validity, results were consistent with the psychogenic interference hypothesis, suggesting that emotional distress increases the likelihood of PVT failures even in the absence of apparent external incentives to underperform on cognitive testing.     

实施中的“软”“硬”之法:规则的不服从与服从

法律在实施中既有执行软弱的问题,也有执行过于刚硬的问题。如何避免执法者和守法者在服从法律规则上的过于僵硬或机械?主要可从两个方面解决:一是处理好原则与规则的适用关系。当规则与原则一致时,先适用具体的规则;当规则与原则不一致时,应优先适用原则。二是公民的抵抗权问题。法律应赋予公民出于道德良知的判断(或特殊行业的执业者出于职业道德)而故意违反现行法律规定的权利。总之,法制应该具有"温情"的一面。     

Impact of Tinnitus on Cognitive Function in Forensic Neuropsychology Context

Tinnitus, a common hearing condition encountered in medicolegal evaluations, often but not always in association with traumatic brain injuries, can adversely impact both cognitive and affective functioning and neuropsychological test results. Although it has been traditionally conceptualized as primarily related to cochlear pathology, tinnitus has been seen more recently as a condition involving brain plasticity. Its persistent clinical effect on cognition and affect is compounded by comorbid psychiatric syndromes such as depression. Understanding the impact of tinnitus, a factor often difficult to capture and neglected in forensic neuropsychology, is essential for determination of causality, diagnosis, prognosis, functional outcomes, and treatment in medicolegal neuropsychological assessment. This paper aims to critically review and integrate the available empirical evidence from neuroscience and neuropsychology regarding the cognitive and affective impact of tinnitus. Our research review will emphasize the implications of the new evidence for the forensic assessment determinations. To this end, electronic search engines, including PubMed, PsycINFO, and Google Scholar (up to January 2018), have been screened and reviewed for the neuroscience and neuropsychological literature related to tinnitus.     

Psychological Injury and Law: Special Issue Epilogue

To conclude the special series in the issue, which marks the end of the first volume of the journal, Psychological Injury and Law, the epilogue highlights its major goals and contributions. The special issue takes the field in more diverse directions. It demonstrates the multiple research and practice foci that are emerging in the field and its interdisciplinarity, from the law and forensics to practice and treatment. The field needs to view the person in context and not from one side or the other of the adversarial divide.     

从规则到行为：试论我们为何守法

人们为何守法一直以来是很多领域的学者探讨的问题。本文从规则与法的起源问题到个体对之内化,直至把它们外化为行为,这一动态的过程对我们为何遵守规则与法进行阐释,在此过程中,充分强调了个体间的合作、社会化的过程、自我的执行以及认知调节等的重要作用,以期对守法行为的研究提供一个崭新的视角。     

Professional Minimalism? The Ethical Consciousness of Commercial Lawyers

This article investigates empirically, through semi‐structured interviews, what shapes the professional ethical consciousness of commercial lawyers. It considers in‐house and private practice lawyers side by side, interrogating the view that in‐house ethics are different and inferior to private practice to suggest as much similarity as difference. In both constituencies, and in very similar ways, professional ethical concepts are challenged by the pragmatic logics of business. We examine how their ethical logics are shaped by these pragmatic logics, suggesting how both groups of practitioners could sometimes be vulnerable to breaching the boundary between tenable zeal for the client and unethical or unlawful conduct. Although they conceive of themselves as ethical, the extent to which practitioners are well equipped, inclined and positively encouraged to work ethically within their own rules is open to question. As a result, we argue professional ethics exert minimal, superficial influence over a more self‐interested, commercially‐driven pragmatism.     

WHEN THE COST IS TOO GREAT: THE EMOTIONAL AND PSYCHOLOGICAL IMPACT ON CHILDREN OF INCARCERATING THEIR PARENTS FOR DRUG OFFENCES1

The advent of the modern “war on drugs” and its accompanying “lock 'em up and throw away the key” crime policies largely explain the evolution of mass incarceration in the U.S. and account for much of the emotional and psychological pain caused to children who have lost their parents to long prison sentences. It is by reducing reliance on incarceration to tackle the “drug problem” in the United States that there will be a positive impact on reducing the number of parents being separated from their children for inordinate amounts of time, thereby potentially reducing the negative emotional and psychological impact on children. Aiding parents combat their addiction outside of prison walls is perhaps to most sensible criminal justice policy in addressing the needs of children who are caught in the cross‐fire of the war on drugs. In the meantime, as policy makers review, assess, and, eventually, reform draconian drug laws and sentencing policies, it is imperative that front‐line service providers who work with children and family and juvenile court judges be mindful of the emotional and psychological impact that parental incarceration has on youth. A more in‐depth understanding of the complexities of these young people's life experiences will hopefully enable the development of appropriate support services.     

Traumatic Event Exposure and Behavioral Health Disorders among Incarcerated Females Self-Referred to Treatment

At least half of the women inside prison have mental health problems, have experienced physical, sexual, or emotional abuse during their formative years and often in adulthood, and have addiction problems. Only a minority of these women receive treatment for their behavioral health problems associated with trauma while incarcerated, even though these problems are risk factors for returning to prison after release. This study focuses on the traumatic experiences and behavioral health problems of a group of female inmates who volunteered in August 2009, to be screened for admission into an integrated trauma-reentry program implemented at an adult female correctional facility. Of the 278 women who self-referred for screening, 196 preliminarily met the time eligibility criterion of residing at the prison for eight to 24 more months. Half of these women (n?=?97) were actually time-eligible for screening and agreed to be screened. Of this sample of treatment-seeking soon-to-be-released female prisoners, the vast majority (93%) reported significant and complex histories of traumatic event exposure and high rates of either posttraumatic stress disorder (PTSD) or sub-threshold PTSD, past alcohol and other substance abuse or dependence, other axis I psychiatric disorders, and subjective distress. Identifying trauma exposure histories and associated behavioral health problems within this population and providing effective interventions holds potential promise for preparing incarcerated women to manage their post-release lives in ways that will keep them safe, healthy, and in the community.     

医务人员兼职执业法律探讨

医务人员能否到其他医疗机构兼职执业,而不仅限于其依法注册所在的医疗机构?此话题受到社会的广泛关注并引发激烈争论。本文作者试从法律角度探讨现行法律框架内的可行性解决方案,同时也对可以期待的医疗行业相关立法发表个人一点拙见。     

Working to Avoid Collateral Emotional Harm to Clients: Cases and Recommendations for the Personal Injury Attorney

Attorneys working in the area of personal injury face complex cases in addition to many potential ethical and practice hazards. They are trained, educated, and have experience in handling and discharging their responsibilities in such cases to the best advantage of their clients, whether plaintiff or defense, while maintaining a professional integrity and appropriate ethical stance. Ideally, personal injury attorneys will practice from a position of virtue, serving their clients in their efforts to recover and regain their quality of life. Nevertheless, factors such as financial and work pressures can intervene, leading to inappropriate conduct that may harm their clients and risk professional alienation and malpractice. In the present article, seven case examples are provided that illustrate how personal injury attorneys working for plaintiffs can act in unethical and harmful ways, ultimately endangering their practice. The article is oriented to attorneys at all phases of their careers and includes recommendations for avoiding the types of harm and unethical practice that have been described. Also, the article presents strategies that psychologists treating these patients can take to remedy further emotional damage to patients.     

Neuroscience and behavioral genetics in US criminal law: an empirical analysis

The goal of this study was to examine the growing use of neurological and behavioral genetic evidence by criminal defendants in US criminal law. Judicial opinions issued between 2005–12 that discussed the use of neuroscience or behavioral genetics by criminal defendants were identified, coded and analysed. Criminal defendants are increasingly introducing such evidence to challenge defendants’ competency, the effectiveness of defense counsel at trial, and to mitigate punishment.     

The Influence of Case and Professional Variables on the Identification and Reporting of Child Maltreatment: A Study of Licensed Psychologists and Certified Masters Social Workers

All 50 states have laws requiring mental health and other professionals to report suspected maltreatment. Unfortunately, many professionals who are mandated to report suspicions of child maltreatment often fail to recognize potential maltreatment or fail to report their suspicions. The present study examines several factors that may influence identification and reporting of child maltreatment. Subjects were licensed psychologists in the Midwest and certified Masters social workers in Nebraska. Child maltreatment included neglect, physical abuse, psychological maltreatment, and sexual abuse. Characteristics associated with the family or “case” (race, socioeconomic status of family, age of victim, type of maltreatment) were manipulated and presented in hypothetical case vignettes. Characteristics of the professional (e.g., training and experience with identification and reporting, personal history of maltreatment and violence) were also investigated. Ratings of the severity of the potential maltreatment situation, suspiciousness that maltreatment is occurring, and likelihood of reporting maltreatment were completed after reading each case vignette. The results indicate that a variety of case and professional factors may influence identification and reporting of maltreatment. Implications for training professionals and further research are discussed.     

Medicare and Medicaid programs; hospital conditions of participation: anesthesia services. Health Care Financing Administration (HCFA), HHS. Final rule

This final rule amends the Anesthesia Services Condition of Participation (CoP) for hospitals, the Surgical Services Condition of Participation for Critical Access Hospitals (CAH), and the Ambulatory Surgical Center (ASC) Conditions of Coverage Surgical Services. This final rule changes the physician supervision requirement for certified registered nurse anesthetists furnishing anesthesia services in hospitals, CAHs, and ASCs. Under this final rule, State laws will determine which professionals are permitted to administer anesthetics and the level of supervision required, recognizing a State's traditional domain in establishing professional licensure and scope-of-practice laws. States and hospitals are free to establish additional standards for professional practice and oversight as they deem necessary. The hospital anesthesia services CoP, CAH surgical services CoP, and the conforming change to the anesthesia Conditions of Coverage apply to all Medicare and Medicaid participating hospitals, CAHs, and ASCs.