Chronic Pain in the DSM-IV and the DSM-5 Draft: The Pain of It All

The Diagnostic and Statistical Manual, DSM-IV-TR (American Psychiatric Association 2000) includes the diagnosis of pain disorder, and it has been revised in major ways in the DSM-5 draft (American Psychiatric Association 2010). Pain disorder has been relegated as a specifier of the new diagnosis of complex somatic symptom disorder. It cannot be diagnosed prior to 6 months of the pain’s onset. Also, there are still the pejorative connotations with which the disorder is associated. In terms of treatment, it might be more difficult to get treatment plans accepted as a result of the changes, and in terms of the legal arena, it might prove more difficult to have the disorder serve as the basis of action in legal proceedings.     

The DSM-5 Draft: Critique and Recommendations

The series of articles in this special topic on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) draft (American Psychiatric Association 2010), which is preparatory to publication of the DSM-5, deals with issues and disorders and conditions pertinent to the field of psychological injury and law. The articles describe and critique the changes anticipated for the diagnoses of posttraumatic stress disorder, pain disorder, and neurocognitive disorder, in particular. Further, changes suggested in the draft for personality disorder are analyzed with a critical eye. In addition, the articles examine the lack of change for dealing with malingering and the general lack of consideration of group differences such as for race, in areas pertinent to psychological injury and law. This summary of the articles concludes that some of the changes in the DSM-5 draft are premature, and it calls for continued research and evidence-informed bases for recommended changes for the DSM-V.     

Posttraumatic Stress Disorder in the DSM-5: Group Difference Commentary

This article provides a commentary on the proposed Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 changes with respect to diagnosing posttraumatic stress disorder (PTSD) in diverse cultural groups in clinical and forensic settings. PTSD is the most common diagnosis in personal injury litigants (Koch et al. 2006). By reviewing the symptoms that have been changed in the DSM-5 draft for PTSD in terms of ethnoracial and minority–cultural factors, this article highlights the lack of data needed in the area and that the DSM project should pay more attention to such factors.     

Bill of Sale Lending: Reforming a ‘Toxic’ Form of Credit

The Bills of Sale Acts were enacted in Victorian times as a form of secured credit whereby ‘goods’ owned by a borrower could be assigned under the bill of sale to a lender who would have title to the goods transferred to him. The lender would then allow the borrower to retain possession of the goods in exchange for instalment payments with interest. In the twenty‐first century these bills are most commonly used as ‘logbook loans’ for vehicles with extortionate interest rates and very little protection for individual consumers. This article examines the operational background to the Bill of Sale Acts. It focuses upon particular concerns for consumers and businesses and provides critique of the registration process before examining the proposals and consultations for reform currently before the Law Commission.     

A step towards improving workflow practices for volume crime investigations: outcomes of a 90-day trial in South Australia

The provision of forensic science services in volume crime investigations works most successfully as a partnership between police agencies and external forensic laboratories as opposed to a client/provider model where unlimited demand ignores finite resources. The principles of Lean Six Sigma have been applied in various laboratories to improve workflow through identification of wasteful work practices. These strategies are aimed at process optimisation through the application of triaging, a concept that has rarely been studied yet referenced strongly in the literature. The South Australia End to End 90-Day Trial: facilitating quicker justice through timely evidence processing, is a collaborative approach between South Australia Police and Forensic Science South Australia. This trial applied evidence-based policing principles, a law enforcement philosophy that uses research undertaken with scientific processes to inform law-enforcement decision-making. The results demonstrate how a review of processes and the removal of non-value adding activities can improve service delivery while not exhausting those ‘finite resources’.     

Prospects for health impact assessment in the United States: new and improved environmental impact assessment or something different?

Health impact assessment (HIA) has been advanced as a means of bringing potential health impacts to the attention of policy makers, particularly in sectors where health impacts may not otherwise be considered. This article examines lessons for HIA in the United States from the related and relatively well-developed field of environmental impact assessment (EIA). We reviewed the EIA literature and conducted twenty phone interviews with EIA professionals. Successes of EIA cited by respondents included integration of environmental goals into decision making, improved planning, and greater transparency and public involvement. Reported shortcomings included the length and complexity of EIA documents, limited and adversarial public participation, and an emphasis on procedure over substance. Presently, EIAs consider few, if any, health outcomes. Respondents differed on the prospects for HIA. Most agreed that HIA could contribute to EIA in several areas, including assessment of cumulative impacts and impacts to environmental justice. Reasons given for not incorporating HIA into EIA were uncertainties about interpreting estimated health impacts, that EIA documents would become even longer and more complicated, and that HIA would gain little from the procedural and legal emphasis in EIA. We conclude that for HIA to advance, whether as part of or separate from EIA, well-formulated methodologies need to be developed and tested in real-world situations. When possible, HIA should build on the methods that have been utilized successfully in EIA. The most fruitful avenue is demonstration projects that test, refine, and demonstrate different methods and models to maximize their utility and acceptance.     

What helps and what hinders the process of surviving the suicide of somebody close?

This paper presents similar findings about the lack of support and understanding for people bereaved through suicide from four different countries and reports on each country's unique response to this challenge. This paper reports on presentations made at the conference workshop of the International Association for Suicide Prevention meeting in Chennai in 2001, and on participants' suggestions of how best to help the bereaved.