The Psychiatric Aspects of Solitary Confinement

Mental health workers who work in correctional facilities frequently have to assess and treat clients in solitary confinement (SC). SC is used as a procedure in correctional facilities for a variety of reasons including punishment, protection of the person, security of the institution, or for more intensive observation. In this article we have taken a fresh and critical view of the literature to attempt to delineate the effects of SC on mental health. The research in this area reveals mixed findings. Some studies extrapolate findings from social isolation experiments and the findings from prisoner of war (POW) camps. Many other studies have severe limitations. Most of the better studies suggest that SC is not harmful to the majority of people but conclude that some may be less resilient due to their personality construct or perhaps due to mental illness. Further research is needed to clarify this issue.     

Bacterial Profiling of Soil Using Genus‐Specific Markers and Multidimensional Scaling*

Abstract: Forensic identification of soil based on microbial DNA fingerprinting has met with mixed success, with research efforts rarely considering temporal variability or local heterogeneity in soil’s microbial makeup. In the research presented, the nitrogen fixing bacteria rhizobia were specifically examined. Soils were collected monthly from five habitats for 1 year, and quarterly in each cardinal direction from the main collection site. When all habitats were compared simultaneously using Terminal Restriction Fragment Length Polymorphism analysis of the rhizobial recA gene and multidimensional scaling, only two were differentiated over a year’s time, however pairwise comparisons allowed four of five soils to be effectively differentiated. Adding in 10‐foot distant soils as “questioned” samples correctly grouped them in 40–70% of cases, depending on restriction enzyme used. The results indicate that the technique has potential for forensic soil identification, although extensive anthropogenic manipulation of a soil makes such identification much more tentative.     

Functional Neuroimaging of Symptom Validity Testing in Traumatic Brain Injury

The Word Memory Test (WMT) is a commonly used symptom validity test (SVT) that assesses recognition verbal memory. The task has been adapted for use within a functional magnetic resonance imaging (fMRI) paradigm so the neural correlates of WMT activation patterns can be studied. In the current investigation, performance on the delayed recognition subtest of the WMT was examined in two patients who sustained severe TBI and compared to ten healthy controls. The patients underwent comprehensive neuropsychological evaluations and structural MRI. All participants completed two versions of the WMT: full-effort and simulated poor effort conditions. Despite extensive structural brain damage, the fMRI activation patterns during full-effort WMT performance were somewhat similar in the two TBI patients and likewise, somewhat similar to controls. The fMRI activation pattern in both patients demonstrated intact activation of the basic neural structures necessary to perform the WMT. Dissimilar patterns of activation were obtained during the simulated poor effort condition of WMT performance suggesting that fMRI techniques may be sensitive in demonstrating non-credible cognitive performance. The results of our study represent the first fMRI investigation of normal and simulated poor effort SVT performance in individuals with documented brain damage. The implications of fMRI techniques in SVT research and their clinical application are discussed.     

Impact of emergency department intimate partner violence intervention

The objective of the study is to assess the impact of emergency department (ED) intimate partner violence (IPV) counseling and resource referrals on patient-perceived safety and safety planning. ED patients with risk factors were offered consultation with trained IPV advocacy counselors who completed safety assessments, provided resource referrals, and helped patients develop safety plans. Patients were contacted after ED intervention to assess progress and further assist in IPV counseling. Over 96% of patients perceived an increase in their safety after the intervention, and approximately 50% had completed a portion of their safety plan. Legal assistance and/or law enforcement were considered the most beneficial resource referrals. Although follow-up was limited, this study appears to demonstrate that an ED IPV intervention program may be useful in helping IPV victims achieve safer living environments and access local resources.     

The Rigor of Research Design and “Forensic” Publications in Neuropsychological Research

Seven neuropsychology journals that publish on topics relevant to clinical neuropsychology were examined for their experimental rigor according to the standards of the American Academy of Neurology (AAN) in their Clinical Practice Guidelines. By using a keyword approach on topics relevant to forensic neuropsychology, all articles that reported empirical findings from 2003 through 2008 were identified. Each study was rated by AAN classification criteria that ranged from a level I classification (prospective, most rigorous, and independent) to level IV (least rigorous). The typical forensic neuropsychological study averaged a class III ranking. Few studies were based on large sample sizes or utilized a reported masking or blind technique with regards to subject selection and how diagnostic criteria were met and/or data analyzed. While the authors for the average study reported a university affiliation, few reported explicit Institutional Review Board statements. Considerable variability across these seven journals with regards to conflict of interest (COI) disclosure policies was observed and only a few studies reported explicit statements about funding or COI issues. These observations suggest that neuropsychological research on forensic topics currently has many limitations and that future research needs to address these issues.     

A Multi-Level Conceptual Model to Examine Child Welfare Worker Turnover and Retention Decisions

There is little disagreement about the importance of a healthy stable workforce in promoting effective provision of child welfare services. This review proposes a multi-level conceptual model of child welfare workforce turnover combining traditional individual and organizational impacts with factors associated with community context. Identified gaps in the literature along with a related research agenda are reviewed. Also presented is an overview of the Florida Study of Professionals for Safe Families, a longitudinal study of new hires into the child welfare workforce across Florida, providing opportunities to address gaps and test model characteristics regarding turnover decisions and related outcomes.     

Post-Traumatic Stress and Alcohol-Related Problems Following a College Shooting: Effect of Help-Seeking

Our aim was to test the hypothesized relationships between trauma exposure and alcohol-related problems, mediated by PTS symptoms, moderated by prior trauma exposure and help-seeking. Participants were 244 members of a private university who were enrolled or employed at the school on the date of a campus shooting. Online measures were distributed via e-mail in October 2014, and included the AUDIT, BTQ, PCL-5, and self-report measures of trauma exposure and counseling services utilized. The overall moderated mediation model examining the indirect effect of exposure to trauma on alcohol-related problems through PTSD symptoms, moderated by prior trauma and help seeking was significant, β(SE) = .310(.3554), p = .0001. This study highlights the importance of crisis interventions following trauma exposure.     

Symbolic Hate: Intention to Intimidate,Political Ideology,and Group Association

In Virginia v. Black (123 S.Ct. 1536, 2003), the Supreme Court ruled that the First Amendment did not bar statutes that prohibit cross burnings in which defendants acted with intention to intimidate others. Using a variety of symbols including cross burnings, swastikas, confederate flags, and skin fists, the current research tested how mock jurors used alternative actor intentions to judge culpability in symbolic hate speech cases. Only partially validating the Court’s assumptions, participants rated guilt certainty highest when they believed the speakers conveyed direct threats, sometimes regardless of whether defendants intended to intimidate others. Further, results showed the level of perceived intimidation only partially mediated the relationship between type of fact pattern and guilt certainty ratings. While alternative intentions did produce different levels of intention to intimidate, path analysis showed that the participants’ ratings of the defendant’s intention to convey a direct threat influenced guilt certainty ratings in all cases. Perceived intimidation levels predicted culpability in only some of the cases and not for cross burning on private property.

Comparing ethics education in medicine and law: combining the best of both worlds

This article compares various models of ethics education and how these models are employed by both medical schools and law schools. The authors suggest ways in which each profession can enhance their ethical teaching and argue that ethics education in both medicine and law should combine the best elements of each education model, thereby producing graduates who are more knowledgeable and appreciative of ethical issues in practice.