Barriers to Cross-Systems Collaboration in Child Welfare,Education, and the Courts: Supporting Educational Well-being of Youth in Care Through Systems Change

Cross-systems collaboration between child welfare, education, and the courts benefits when challenges and priorities are identified early. We measured perceptions of educational stability in foster youth with a statewide survey of 1,603 professionals in education, child welfare, and the courts. Results reveal commonalities among perceived challenges to collaboration across systems (e.g., multiple foster care placements; school changes) and differences in perceived importance or significance of a given issue by professional group. Results guided collaborative work in Kansas and may assist other states seeking strategies that inform cross-systems collaboration to improve educational well-being for youth in foster care.     

The psychiatrist's guide to right and wrong: judicial standards of wrongfulness since M'Naghten

In insanity defense litigation, the precise legal definition of wrongfulness is often critically important. References in the M'Naghten Rules to the appropriate standard of wrongfulness were ambiguous, resulting in a divergence of judicial opinion as to whether wrongfulness means legal wrong, subjective moral wrong, or objective moral wrong. This article reviews and analyzes these three judicial standards of wrongfulness in the context of case law from jurisdictions that follow each of the respective standards. The evolution of knowledge of right and wrong tests of criminal responsibility is traced back to its philosophical roots. Most psychiatrists claim no expertise in matters of morality or law. The American Psychiatric Association would bar psychiatric expert testimony on the ultimate issue of insanity, on the grounds that there are "impermissible leaps in logic" when psychiatrists opine on the probable relationship between medical concepts and moral-legal constructs. Whether or not they testify on the ultimate issue, psychiatrists should ascertain the applicable standard of wrongfulness in order to properly relate their findings to the relevant legal criteria for insanity and thereby enhance the probative value of their testimony.     

Splenic rupture as a cause of sudden death in undiagnosed chronic myelogenous leukemia

A 35-year-old man died suddenly in a clinic waiting area after repeated visits for flu-like symptoms. At autopsy, hemoperitoneum, splenic capsular rupture, and splenomegaly were found. Microscopic examination, special stains, and immunoperoxidase studies revealed findings consistent with chronic myelogenous leukemia. Spontaneous splenic rupture is an unusual presenting feature of chronic myelogenous leukemia. The symptoms of leukemia may mimic those of other "benign" disorders and misdiagnosis may lead to catastrophic consequences in some instances.     

Litigious paranoids and the legal system: the role of the forensic psychiatrist

Forensic psychiatrists should be aware of the many ways that paranoid individuals may present within the legal system. Litigious paranoids often utilize the legal system as a vehicle to act out their fantasies and delusional preoccupations. Imaginary grievances, accusations based on delusional ideation, and irrational vindictiveness toward imagined persecutors may find full expression in any number of legal contexts. They can defeat the rational and legitimate objectives of the legal system, enmesh innocent and unsuspecting victims in nightmarish legal entanglements, and subvert the process of justice. The forensic psychiatrist can assist the court by alerting it to the presence of paranoid illness in parties or witnesses and by clarifying what the effects of such psychopathology are and what the most favorable response should be. Three legal contexts wherein paranoid individuals may present within the legal system are discussed: the "hypercompetent" defendant, the paranoid party in a divorce proceeding, and the paranoid complaining witness. Case illustrations are presented for each legal context. Two issues are discussed: the dividing line between paranoid ideation (and its impact on the legal process) and so-called "normal" thinking (and its objective to use the legal process to obtain certain ends); and the degree to which psychiatric opinions in this area should influence the way an individual's case is handled by the legal system. The author concludes that, despite the costs involved, it is preferable that even paranoids have their "day in court."     

Adolescents' response to nuclear threat: Before and after the chernobyl accident

This study investigated adolescent responses to nuclear threat during intervals preceding and following the Chernobyl disaster. The Nuclear Threat Index was administered to 96 Israeli subjects two months prior to and two months following the disaster. In addition, they were tested with Rotter's Locus of Control Scale. The data results indicate that on the whole there were differences in scores between the two administrations, especially with respect to self-reported activity (behavioral subscales). Adolescents reported significantly more past nuclear-related activity before the accident as well as fewer anticipated activities after the accident. Adjusted for the preaccident score differences data reveal that after the accident younger adolescents reported less pessimism and more previous activity than the older adolescents. In addition, males reported more nuclear-related activity than females; younger males reported more past activity and less pessimism than older males; external males reported more activity than internal males. Discussion focuses on possible explanations for the results, on limitations of the investigation, and on implications for further research.Received Ph.D. in school counseling from Tel Aviv University. Research interests: evaluation of primary prevention programs, crisis intervention in mass disasters, and death studies.Received D.Sc. from the Technion (Israel Institute of Technology) Department of Management Science. Research interests: Statistics.Received M.A. in Education from University of Haifa, School guidance and counseling, Haifa, Israel.