Disentangling the Disability Quagmire in Psychological Injury and Law

This paper aims to critically analyze the evolution of six models of conceptualization, determination, and prediction of occupational disability relevant in the medico-legal context of psychological injury. The six models are the (a) biomedical, (b) forensic, (c) psychosocial, (d) ecological, (e) economic, and (f) biopsychosocial. We will discuss the key commonalities and differences among the models, including disciplinary tradition, research paradigm, recognition of person–environment interaction, key tenets, and implications for practice and research in psychological injury. The paper will highlight and discuss psychosocial issues, often underemphasized in forensic psychological practice, including: (a) balanced assessment of primary, secondary, and tertiary gains and losses, (b) self-perception, (c) disability identity, (d) beliefs and expectations, (e) coping, (f) adaptation and positive growth, (g) social stigma and social reactions to disability, including disability harassment, and (h) recognition of system-based environmental influences and demands. We will provide a special focus on the current state of the science and practice of prediction of disability, of particular interest to researchers and clinicians involved in clinical and occupational prognostication in psychological injuries. Finally, we will draw conclusions and recommendations for future research and best practices in the psychological injury area using a cross-diagnostic, dynamic, functionally based, and integrated biopsychosocial and forensic model of disability.     

Trauma and Psychological Injury: Practice, Clinical, Legal, and Ethical Issues

Psychologists need continuing education in areas pertinent to their practice. The area of psychological injury and law presents issues and conundrums that need careful ongoing evaluation for appropriate clinical practice, adherence to ethical standards, and functioning in the legal context. In this article, we prepared a series of vignettes that illustrate these difficulties in the practice, clinical, legal, and ethical spheres related to the area of psychological injury and law. The vignettes, together with accompanying commentaries, are meant for use in workshops, and they aim to educate, stimulate, and provoke. Furthermore, the article has been written with the aim of interaction with readers, in that we seek commentaries from readers both for purposes of publication and use in workshops.     

Cognitive Impact of Fatigue in Forensic Neuropsychology Context

Physical and mental fatigue are common factors affecting function and recovery in litigated injuries and illnesses. Despite the high prevalence of fatigue-related symptoms and anticipated impact on cognitive functioning, forensic neuropsychological assessments are often challenged by the following approaches to the evaluation of fatigue: (1) confusing physical and mental fatigue; (2) referencing fatigue as a factor in existence but disregarding its specific cognitive impact; (3) over-attribution of all identified problems to fatigue; and (4) neglecting the impact of fatigue on effort in testing. In the context of a wide range of idiosyncratic approaches applied by neuropsychologists with respect to the significance of fatigue factors and the role of the assessor in accounting for them, there is a risk of confusion. Yet, impairments caused by fatigue can be disabling and resistant to treatment, and even more so when the treatment is based on incorrect diagnostic, causality, and prognostic assumptions. The current review will focus on integrating the available empirical evidence from neuroscience and neuropsychology regarding our current understanding of the cognitive impact of fatigue. Our critical review will emphasize the implications of the accumulating new evidence for forensic assessment determinations regarding causality, diagnosis, and impact on function, as well as 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 mental fatigue.     

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.     

Disentangling the Disability Quagmire in Psychological Injury: Part 1—Disability and Return to Work: Theories, Methods, and Applications

This paper critically reviews and integrates multidisciplinary literature informing conceptualization and determination of disability and return to work from a psychological injury perspective. It focuses on dissecting and disentangling the ambiguities and complexities of theories and definitions of disability, impairment, and return to work, highlighting the conceptual quagmires that affect both research and clinical methodology in the field. The paper discusses the strengths and limitations of the main theoretical perspectives on disability and return to work—social, medical, and biopsychosocial—and the associated applied perspectives, including the legal/administrative, clinical, and research oriented. It provides a special focus on the Americans with Disabilities Act and the American Medical Association’s Guides for the Evaluation of Permanent Impairment as leading applied perspectives. The paper also highlights the features and methodological implications of the integrative framework of the International Classification of Functioning, Disability and Health (World Health Organization, International classification of functioning, disabilities and health, WHO, Geneva, Switzerland, 2001). Finally, it draws implications for the field of psychological injury in a legal context.     

The Transition from Education to Employment Abroad: The Experiences of Young People from Poland

This article examines the subject of the transition from education to the labour market among young people moving directly from education in Poland to first jobs abroad. With free labour mobility in the European Union (EU), there are now more options for transitions into adulthood, including working abroad. This study uses mainly qualitative empirical material with some contextual quantitative data to examine the characteristics of young people who opted for a first job abroad, how they made their transitions from education to the foreign labour market, and the impact of their first jobs abroad on their subsequent occupational paths after returning home.     

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.     

The production of the war criminal cult: Radovan Karadžić and Vojislav Šešelj at The Hague

This article examines how defendants on trial at the International Criminal Tribunal for the former Yugoslavia (ICTY) appropriate the tribunal as a platform for national myth and group making. Specifically, the article analyzes Radovan Karad?i? and Vojislav ?e?elj’s “performances” at The Hague in order to highlight the particular ways in which the defendants craft and mobilize the nationalist narrative. The article introduces the phenomenon of “the war criminal cult” and traces three stages of its production, including the defendants’ collectivization of guilt, epitomization of The Hague as the ultimate enemy of the nation, and construction of “Serbs” as the biggest victims of international justice and of themselves as martyrs befallen with the task of defending the dignity of the nation. The “war criminal cult” is thus “made” in conversation with the “imperial West” in a collective narrative that contests the legitimacy and the intention of The Hague while disguising individual responsibility.