Barriers to successful treatment completion in child sexual abuse survivors

Child sexual abuse (CSA) often requires psychological treatment to address the symptoms of victim trauma. Barriers to entry and completion of counseling services can compromise long-term well-being. An integrated medical and mental health evaluation and treatment model of a child advocacy center (CAC) has the potential to reduce barriers to mental health treatment. Objective: (a) to describe characteristics between CSA patients who engage versus those who do not engage in mental health treatment and (b) to identify factors associated with successful completion of mental health treatment goals. For design/setting, a retrospective cohort study was conducted of CSA patients (ages 3-16 years) referred to mental health services following a CAC assessment. Outcome variables included linkage with treatment and completion of treatment. Independent variables included demographics, abuse characteristics, and therapist characteristics. Data were abstracted from the CAC and billing databases. Results: Four hundred ninety subjects were evaluated. Subjects were as follows: predominately female (74%), White (60%), and more than half received Medicaid (56%). Mean age was 8.4 years. About 52% linked with mental health services and 39% of patients that successfully linked with mental health services completed therapy. Successful linkage was independently associated with referrals to other counseling services (AOR 8.4 [2.5, 27.7]). Successful completion of therapy was independently associated with caregiver participation in therapy (AOR 3.2 [1.8, 6.0]) and if the patient was referred to other counseling services (AOR 4.1 [1.9, 8.5]). There were no differences between subjects that linked and/or completed therapy and those that did not with regard to demographic characteristics or abuse severity. Conclusion: In contrast to previous reports, efforts at our CAC seem to overcome linkage barriers in this population. However, there remain challenges in achieving successful completion of treatment goals in this population. Engaging caregivers' involvement in therapy services had a positive effect with successfully achieving treatment goals.     

Observational Case Series: An Algorithm Incorporating Multidetector Computed Tomography in the Medicolegal Investigation of Human Remains after a Natural Disaster

An algorithm incorporating multidetector computed tomography (MDCT), digital radiographs, and external examination was used to triage cases for noninvasive or complete autopsy after a natural disaster. The algorithm was applied to 27 individuals who died during or soon after the earthquake that struck the Republic of Haiti on January 12, 2010. Of the 27 cases reviewed, 7 (26%) required a complete autopsy to determine cause and manner of death. In the remaining 20 (74%), cause and manner of death were determined with a reasonable degree of medical certainty after review of circumstances, an external examination, and postmortem imaging by MDCT and digital radiography (noninvasive autopsy). MDCT was particularly useful in detecting skeletal fractures caused by blunt force injury which were not evident on digital radiographs. The algorithm incorporating postmortem MDCT can be useful in the triage of human remains for autopsy after a natural disaster.     

“That shit doesn't fly”: Subcultural constraints on prison radicalization

Many observers describe prison subcultures as inherently and irredeemably antisocial. Research directly ties prison subcultures to violence, gang membership, and poor reintegration. In extreme cases, research has also suggested that prison subcultures contribute to incarcerated people joining radical groups or embracing violent extremist beliefs. These claims, however, ignore key differences in the larger cultural and social context of prisons. We examine the relationship between prison subcultures and prison radicalization based on semistructured qualitative interviews with 148 incarcerated men and 131 correctional officers from four western Canadian prisons. We outline several imported features of the prison subculture that make incarcerated people resilient to radicalized and extremist messaging. These features include 1) national cultural imaginaries; 2) the racial profile of a prison, including racial sorting or a lack thereof; and 3) how radicalization allowed incarcerated men and correctional officers to act outside the otherwise agreed-to subcultural rules. Our research findings stress the importance of contemplating broader sociocultural influences when trying to understand the relationship between radicalization and prison dynamics and politics.     

Rethinking the training of intelligence analysts

Abstract

Despite intense scrutiny and promised fixes resulting from intelligence ‘transformation’ efforts, erroneous analytic assessments persist and continue to dominate news coverage of the US intelligence community. Existing analytic training teaches analysts about common cognitive biases and then aims to correct them with structured analytic techniques. On its face, this approach is eminently reasonable; on close inspection, incomplete and imbalanced. Current training is anchored in a mid-twentieth century understanding of psychology that focuses on checking over-confidence and rigidity but ignores the problems of under-confidence and excessive volatility. Moreover it has never been validated against objective benchmarks of good judgment. We propose a new approach: (a) adopting scientifically validated content and regularly testing training to avoid institutionalizing new dogmas; (b) incentivizing analysts to view training guidelines as means to the end of improved accuracy, not an end in itself.     

The relationship between urbanisation and cross-national homicide rates: robustness across multiple estimation methods

Urbanisation has generally been found to be a non-significant predictor of homicide rates in cross-national studies. Despite this, there is strong theoretical support for the presence of a positive association between the two. The present study analyses data for up to 57 nations for the period 1993–2005 and examines the relationship between urbanisation and homicide using pooled ordinary least squares, feasible generalised least squares, panel-corrected standard errors, fixed-effects, and random-effects estimation. The results show that urbanisation is one of the strongest predictors of homicide in the cross-national context. This is consistent with the expected relationship according to modernisation theory and suggests that rapidly urbanising nations should be concerned with the unintended consequences of urbanisation.     

Neuropsychological,Psychological, and Vocational Assessment of High Achievers in a Medicolegal Context

High achievers are a unique subset of persons referred for neuropsychological and psychological assessments in medicolegal contexts, including personal injury, disability, and workers’ compensation cases. Literature in this area is limited and poorly integrated, and neither a conceptual model nor best evidence-informed practices for the assessment of high achievers in the medicolegal context have yet emerged. Construct and methodological issues also hamper the ability of assessors to accurately and fairly assess this specialist group, which is particularly troubling in high-stakes forensic assessments. This paper reviews the current methodological issues involved in the assessment of high achievers and proposes an integrated, multimethod assessment model based on a particular vocational group, namely that of business leaders and entrepreneurs, that draws from available empirical research in different fields of psychological inquiry.     

The promise of humanistic policing: Is higher education living up to societal expectation?

More police agencies require incoming personnel to have a college education background. The hope is that collegeeducated officers will be more rounded thinkers and exhibit a greater humanistic bent. This study attempts to evaluate the efficacy of that line of reasoning. Students from three southern colleges read vignettes and sentenced a murder defendant and an automobile theft defendant to a term of imprisonment. Three hypotheses are tested. First, it is expected that policeoriented criminal justice majors will not issue more severe sentences. Second, it is anticipated that greater exposure to college from the freshman to the senior years will be accompanied by less severe sentences. Third, sentencing will be independent of social characteristics. The results provide little evidence supporting a more authoritarian and more punitive stereotype of criminal justice majors interested in pursuing police careers. A draft of this paper was presented at the annual meeting of the Southern Criminal Justice Association, Chattanooga, TN, 1999