CHILD PROTECTION EVALUATIONS The Forensic Stepchild

In child protection cases, the mental health evaluator is required to have a broad range of expertise in family violence and child and adult psychological issues. This article reviews epidemiological as well as other quantitative data to provide an empirical foundation by which to understand the problem of family violence, the characteristics of abusers and victims, and the consequences to the child who is a witness to or victim of family violence. Forensic evaluation guidelines and recommendations for structuring child protection evaluations are addressed.     

A middle-aged female serial killer

The case of a 48-year-old woman accused of killing at least 12 elderly women and attempting to kill another one during the last 3 years is presented. Extensive neuropsychological, electrophysiological, and neuropsychiatric testing showed no evidence of a DSM-IV-TR Axis I diagnosis, but a decrease in executive functions and abnormalities in the processing of affective stimuli were found. Behavioral and psychophysiological studies revealed dissociation between knowing how to behave and actually behaving in socially acceptable ways. According to the woman, killing was just her response to "humiliating situations." Two potentially significant conditions in her past history are found: (i) childhood abuse; and (ii) multiple head injuries. It is conjectured that the nature of her crimes, paranoid and personality traits, a probable frontal brain dysfunction, as well as a specific demographic and social context represent unusual factors accounting for her violent behavior.     

Social,Academic, and Behavioral Competence of Depressed Children: Relationship to Diagnostic Status and Family Interaction Style

This study compared the social adjustment and academic performance of 15 psychiatrically hospitalized children with depression to 14 children with schizophrenia spectrum disorders and 20 normal community children, ages 7–14. The relationship between children's interpersonal and academic competence and the quality of direct family interactions was also examined. Analyses revealed an association between children's adaptive functioning and both diagnostic status and family transactional processes, as assessed by two 10-minute conflict-solving tasks. Major findings were as follows: (a) depressed children and children with schizophrenia spectrum disorders received similarly low ratings of social competence in comparison to normal controls; (b) academic performance of depressed children was similar to normal controls and better than children with schizophrenia spectrum disorders; and (c) children with poorer social competence and more behavioral problems were more likely to have parents who showed negative affect during family problem-solving tasks. The implications of these results for understanding the relationship between psychiatric impairment and children's social and academic development were discussed.