Decision making in a schizophrenic population

Over the past decade, competence to make decisions has become a prominent topic in forensic psychology. We employed a gambling paradigm to measure ability to weigh risks, benefits, and probabilities in an internally consistent manner. Decision-making behavior of chronic, involuntarily committed schizophrenic inpatients was compared to outpatient schizophrenics and first-degree relatives of the patients. We found significant differences between inpatients and non-mentally-ill relatives, and between inpatient and outpatient schizophrenics. When WAIS-R Vocabulary subtest score was statistically controlled,no significant differences between any of the groups remained. Vocabulary x group interactions revealed that Vocabulary subtest predicted decision-making behavior for outpatients and controls, but not inpatients. Severity of psychiatric symptoms and number of prior hospitalizations predicted decision-making behavior for inpatient schizophrenics. Results suggest that competence assessments that rely primarily on verbal abilities may be inadequate to assess competence in acutely ill psychiatric patients.     

Structured Assessment of Correctional Adaptation (SACA): a measure of the impact of incarceration on the mentally ill in a therapeutic setting

Clinicians have observed that psychiatric patients with correctional histories evidence attitudes and behaviors that seem adaptive in penal environments but are maladaptive in mental health settings. This study sought to assess the reliability and concurrent validity of a rating scale designed to measure correctional adaptation using a sample of 64 patients from a state psychiatric hospital. Scale ratings were obtained through structured interviews, whereas predictor variables were gleaned from chart review and self-report. The scale demonstrated good interrater reliability (ICC = .83) and acceptable internal consistency (alpha= .67). Of the variables evaluated, two were significantly correlated with Structured Assessment of Correctional Adaptation (SACA) total scores, total months sentenced to prison or jail (r = .26), and frequency of disciplinary tickets while in prison or jail (r = .31). Stepwise regression analyses revealed only the latter variable significantly predicted SACA score (R = .31), F(1, 58) = 6.27, p < .05. Clinical implications of these findings, the scale, and the construct of correctional adaptation are discussed.     

Recidivism in Stalking and Obsessional Harassment

Despite the rapidly growth of mental health attention focused on the phenomenon of stalking, no empirical research to date has attempted to assess the frequency of repeat offending or attempted to identify predictors of recidivism. A total of 148 stalking and harassment offenders who were court-ordered to undergo a mental health evaluation were followed for a period of 2.5–13 years in order to assess the frequency of repeat offenses and the variables that differentiated high versus low risk offenders. Recidivism data were obtained from a variety of sources, including criminal justice records, mental health records, and reports from probation officers and victims. A number of potential predictor variables were selected on the basis of the existing recidivism literature in other criminal justice populations. Frequency analysis were used to identify variables that significantly differentiated offenders who did and did not reoffend while survival analysis was used to analyze the impact of these covariates on time to reoffense. A total of 49% of the offenders reoffended during the follow-up period, 80% of whom reoffended during the first year. The strongest predictors of recidivism included the presence of a personality disorder, and in particular, a Cluster B personality disorder (i.e., antisocial, borderline, and/or narcissistic). In addition, those offenders with both a personality disorder and a history of substance abuse were significantly more likely to reoffend compared to either of these risk factors alone. Surprisingly, the presence of a delusional disorder (e.g., erotomania) was associated with a lower risk of reoffender. The findings are discussed in terms of the legal system and treatment implications.     

Whose decision is it anyway?: identifying the Medicaid planning client

In the Medicaid planning context, the answers to seemingly easy questions are often quite elusive. Client identification is fundamental to every attorney-client relationship, yet resolving this basic question for Medicaid planners has sparked some debate. This essay explores the difficult question Medicaid planners encounter regarding client identification. The author, Mr. Rosenfeld, reveals the lack of guidance provided by contemporary legal ethic codes and then investigates some of the client representation models currently used by practitioners. Upon identifying the inherent conflict of interest that often develops in estate planning, Mr. Rosenfeld argues that individual client representation is the only ethically acceptable model of representation.     

The Law of Crime Concentration: An Application and Recommendations for Future Research

Objective

We address four outstanding empirical questions related to the “law of crime concentration” (Weisburd in Criminology 53:133–157, 2015): (1) Is the spatial concentration of crime stable over time? (2) Do the same places consistently rank among those with the highest crime counts? (3) How much crime concentration would be observed if crimes were distributed randomly over place? (4) To what degree does the spatial concentration of crime depend on places that are crime free?

Methods

The data are annual counts of violent and property crimes in St. Louis between 2000 and 2014. Temporal stability in the spatial inequality of crime is measured by computing the fraction of crimes that occur in the 5% of street segments with the highest crime frequencies each year. The spatial mobility of crime is measured by computing the number of years each street segment appears in the top 5% of street segments. Poisson simulations are used to estimate the fraction of crimes that could appear in the top 5% of street segments on the basis of chance alone. The impact of crime-free locales on the spatial concentration of crime is evaluated by comparing results from analyses that include and exclude crime-free street segments from the crime distributions.

Results

The concentration of crime is highly unequal and stable over time. The specific street segments with the highest crime frequencies, however, change over time. Nontrivial fractions of street segments may appear among the 5% with the highest crime frequencies on the basis of chance. Spatial concentration of crime is reduced when crime-free street segments are excluded from the crime distributions.

Conclusions

The law of crime concentration is not a measurement artifact. Its substantive significance, however, should be assessed in future longitudinal research that replicates the current study across diverse social settings.

     

“Plug into Choice”? The Trouble with Common-Sense Participation in a Smart Electric Grid

Smart electric grids add digital technologies to the grid. While some suggest that they offer many environmental and social benefits, others remain critical and call them a neoliberal project. Considering smart grids a boundary object [Star, Susan L., and James R. Griesemer. 1989. “Institutional Ecology, Translations and Boundary Objects: Amateurs and Professionals in Berkeley’s Museum of Vertebrate Zoology, 1907–39.” Social Studies of Science 19 (3): 387–420], I examine how multiple social groups come together in cooperation and conflict in the installation of one smart grid. In what follows, I first argue that participation is Gramscian common sense (1971), a taken-for-granted good in producing a smart grid. Gramsci points out that common sense can be used to reinforce oppressive ideologies of a hegemonic status quo, but that it also contains “good sense” that can be developed into counter-hegemonic narratives and movements. Second, I argue that in the course of cooperation and conflict, the smart grid indeed becomes more neoliberal, and this occurs through participation. While the utility often seeks or accepts public participation, the meaning of participation gradually becomes limited to individualistic and financially motivated “choice.” In the discussed case, many of the (less neoliberal) social and environmental benefits of the grid and more collectivist forms of participation were precluded. This article offers a grounded examination of a smart grid and a sympathetic critique of common-sense participation.