Medication noncompliance in schizophrenia: codification and update

Risk of relapse and recidivism makes the failure to take antipsychotic medication as prescribed a significant issue in forensic psychiatry. This question may arise in such contexts as the setting of bail, plea bargaining, the insanity defense, and sentencing. We have reviewed the literature on medication noncompliance in schizophrenia and present here the results, organized by topics relevant for the work of forensic mental health experts. Reported rates of noncompliance vary widely, reflecting major differences in the populations studied and the methods used as well as the complexities involved in defining noncompliant behavior. A noncompliance rate of 50 percent has been attributed globally to chronic patients, both medical and psychiatric. The tendency of significant factors to interact precludes a simple typology of noncompliance. However, environmental security and supportiveness correlate positively with adherence; whereas anxiety, paranoia, grandiosity, depression, and side effects correlate negatively. Clinicians' assessments of whether medication is being taken have proven to be unreliable. Although monitoring by chemical measurement, particularly a radioreceptor assay for urine samples, can be useful, depot injection ensures that prescribed medication is being taken. Less invasive means of promoting compliance are described; psychodynamic and ethical issues to be considered in the monitoring and promotion of compliance over extended time periods are presented. We also probe the link between medication noncompliance and behavioral relapse. The time between default and relapse is most often measured in weeks. Whether due to medication withdrawal or not, the relapse pattern of each individual tends to repeat, allowing its recognition before recidivism occurs. Restarting medication at this stage, especially with a dosage increase, is usually effective. In sum, the forensic mental health expert can now readily use a large and diverse literature to assist with a variety of significant issues.     

Transnational Competence in an Emergent Epoch

The article elaborates a framework for understanding the relevance of transnational competence to the dynamics that mark the transformations of our time. Nongovernmental stakeholders interacting through dense civil-society networks that permeate domestic-foreign frontiers bear increasing responsibility for the course of events. Based on linked interests, interorganizational knowledge generation and aggregation, partnerships, and interpersonal/intercultural interactions, they are deeply involved in addressing the many challenges posed by an ever more interdependent world. Transnational competence lubricates transterritorial networks and projects. Here, the authors extend earlier work that posited a worldwide skill revolution both by developing explicit dimensions of transnational competence and by introducing a behavioral component. The new framework provides analytical groundwork for explaining why some people, groups, and networks are more effective than others in forging meaningful transnational solidarities, negotiating and benefiting from the intensifying experience of globalization, and waging successful transnational campaigns. The article also probes how the spread of transnational competence is being facilitated by global migration and transmigration trends. The final section explores the governance implications of expanding transnational competency for the emergent epoch.     

Legitimacy of Authority and Protest Actions in Response to Collective Disadvantages

Social Justice Research - A wealth of evidence has demonstrated that individuals’ participation in collective actions largely derives from perceived group disadvantages. In the present...     

“Sex change” in skeletal remains: Assessing how heat-induced changes interfere with sex estimation

The true impact of heat-induced changes in human bone regarding their sex estimation has not been comprehensively documented having a potentially negative impact on forensic anthropology. The objective of this paper was to evaluate how heat exposure affects sex estimation based on both morphological and metric features. The study focused in both low-to-medium intensity burns and high intensity burns. Selected sexually dimorphic features were analysed in 51 experimentally burnt skeletons from the 21st Century Identified Skeletal Collection. Bones were burnt to maximum temperatures between 450 °C and 1050 °C achieved after 75 to 257 min. Morphological methods tested in this study comprised the recommendations for hipbone features from Buikstra and Ubelaker (1994) and from Bruzek (2002). On the other hand, metric references tested here were the ones from Wasterlain (2000), Curate et al. (2016) and Gonçalves et al. (2013) focused on the humerus, femur, calcaneus and talus. Agreement was tested with Gwet’s AC1 test and was further assessed by calculating the relative amount of perfect agreements. Results demonstrated that heat-induced changes affected not only the scoring of morphological features burnt at high temperatures but also the scoring of features burnt at lower intensities. On the other hand, metric features were only considerably affected in high intensity burns, no major changes being documented for low-to-medium intensity burns. For low-to-medium intensity burns, the Bruzek and Curate et al. methods revealed a better agreement between the pre- and post-burning scores. For high intensity burns, better agreement was obtained by using the Bruzek (2002) and Gonçalves et al. (2013) methods. As expected, heat-induced warping, fracture and metric change had a major impact on the pre- and post-observations’ agreement. Contrary to what has been systematically assumed over the years, this impact is also quite substantial in bones burnt at low-to-medium burn intensities so caution is advised during the analysis of this kind of burnt skeletal material.     

Calling Attention to the Importance of Assisting Male Survivors of Sexual Victimization

ABSTRACT

Most of the research focusing on sexual victimization on college campuses has focused on females as victims. This attention is warranted given that studies have consistently found that females are at more risk of experiencing victimization compared to males. However, a drawback of this emphasis is that laypersons may incorrectly believe that men cannot be victims too. This belief is directly challenged by various findings that indicate college men are also sexually assaulted. In order to draw attention to this under researched topic, we used data from a recent climate survey conducted at a mid-sized rural institution of higher education. The results of this study indicated that males, in addition to females, experienced various types of sexual victimization in this setting.     

House money effects on trust and reciprocity

In a typical laboratory “Investment Game” experiment, participants’ endowments are provided by the experimenter; thus, the worst case for the investor is that she loses all of her “found” money. By contrast, in naturally occurring environments, investment decisions can often lead to a loss of one’s own money. This paper investigates whether “trust” found in one-shot anonymous laboratory interaction is robust to “own money” environments. Our results show that, consistent with previous investment game results, most investors send a positive amount, and most trustees return at least the transfer amount, regardless of whether the investors purchase or are gifted their endowment. However, investments are on average lower when participants use their own money, and the fraction of maximum investments (the most “risky” investment decision) is only half as large under “own money” as it is under gifted endowments. Our results explain why one should exercise caution in placing trust in any government’s ability to spend other people’s money prudently.     

Citizen Participation in City Governance: Experiences From Vietnam

The radical political and economic reforms sweeping through former socialist countries during the last several decades have facilitated economic growth and urbanization. During this period of market reform and urbanization, citizen participation is greatly needed yet easily lost to other priorities. We employ stakeholder theory to examine whether citizen participation differs between large and small cities and between the poor and non‐poor people in Vietnam. Using data from a sample of citizens in five centrally managed cities, we found that citizens in large cities and citizens that belong to “unofficially poor” groups participate less. For policy makers, this implies that citizen participation should be of central importance in the management of current cities' expansions. In addition, the categorization of “poor households” needs to be closely monitored to minimize the risk of de facto poor households being excluded from the group. Copyright © 2015 John Wiley & Sons, Ltd.     

Female serial killers in the United States: means,motives, and makings

Most studies that have focused on female serial killers (FSKs), although informative, have examined limited sample sizes. We consulted mass media reports of demographics, motives, methods, mental health, and victim characteristics of 64 FSKs who committed their crimes in the US from 1821 to 2008. Consistent with other studies, our data showed that FSKs were typically White, educated, have been married, and held a caregiving role (e.g. mother, health care worker). Nearly 40% of FSKs in this sample experienced some form of mental illness. Their most common motive for murder was financial gain, and their most common method of killing was poisoning. FSKs knew all or most of their victims, and most were related to their victims. In all cases, FSKs targeted at least one victim who was a child, elderly, or infirm – those who had little chance of fighting back. We interpret these killers’ behaviors from clinical and evolutionary angles.