Major depression – a study on the validity of clinicians’ diagnoses in medicolegal assessment

Major depression ranges among the most frequently diagnosed psychiatric disorders. Accordingly, diagnoses of depression are often underlying insurance, compensation or disability claims. This report evaluates the validity of clinicians’ diagnoses of major depression in a sample of claimants. In 2015, n = 127 consecutive cases were examined for medicolegal assessment. For all of them, a diagnosis of major depression had been established by clinicians. All testees underwent a psychiatric interview, a physical examination, they answered questionnaires for depressive symptoms according to DSM-5, embitterment disorder, post concussion syndrome (PCS) and unspecific somatic complaints. Performance and symptom validity tests were administered. Only 31% fulfilled the diagnostic criteria for DSM-5 major depression according to self-report, while none did so according to psychiatric assessment. Negative response bias was found in 64% of cases, feigned neurologic symptoms in 22%. Symptom exaggeration was indiscriminate rather than depression-specific. By self-report, 64% of the participants qualified for embitterment disorder and 93% for PCS. In conclusion, clinicians’ diagnoses of depression seem often confounded by improper assessment of the diagnostic criteria, confusion of depression with bereavement or embitterment and also by response bias.     

Gender in the Context of Same‐Sex Divorce and Relationship Dissolution

This article identifies ways that judges, lawyers, researchers, and policy makers may attend to the role of gender and gender dynamics facing same‐sex couples upon divorce or other relationship dissolution. When same‐sex couples marry, the legal system and society at large may project conceptions of gender onto same‐sex couples, often in a manner that conflicts with couples' intentions and practices. Gender and gender dynamics may affect the bases for dissolution, the financial aspects of dissolution, and the determination of child custody. The article also suggests directions for future research on the impact of gender on the dissolution of same‐sex relationships.     

Transgender Family Law

Transgender people face unique issues in parentage, custody, and divorce cases. Many transgender people are raising children or wish to do so. This article examines the main legal issues facing transgender people who become parents by giving birth or impregnating a partner, through assisted reproduction, through marriage, by raising a child, or through adoption. In the past, some courts viewed a parent's gender transition as a sufficient reason to terminate parental rights. Today, the law has shifted to provide much more security for transgender parents, though significant bias still remains, particularly in divorce and child custody cases. In addition, many states have not yet fully addressed how to determine the legal parentage of children born through assisted reproduction. I analyze the legal landscape for transgender parents and spouses and offer critical suggestions to ensure that transgender people are able to protect their families and their parental rights.     

Diagnosing Crime and Diagnosing Disease‐II: Visual Pattern Perception and Diagnostic Accuracy

Previously, we reviewed how general cognitive processes might be susceptible to bias across both forensic and clinical fields, and how interdisciplinary comparisons could reduce error. We discuss several examples of clinical tasks which are heavily dependent on visual processing, comparing them to eyewitness identification (EI). We review the “constructive” nature of visual processing, and how contextual factors influence both medical experts and witnesses in decision making and recall. Overall, studies suggest common cognitive factors uniting these visual tasks, in both their strengths and shortcomings. Recently forensic sciences have advocated reducing errors by identifying and controlling nonrelevant information. Such efforts could effectively assist medical diagnosis. We suggest potential remedies for cognitive bias in these tasks. These can generalize across the clinical and forensic domains, including controlling the sequencing of contextual factors. One solution is an agnostic primary reading before incorporation of a complete history and interpretation.     

Contextual information management: An example of independent-checking in the review of laboratory-based bloodstain pattern analysis

This article describes a New Zealand forensic agency's contextual information management protocol for bloodstain pattern evidence examined in the laboratory. In an effort to create a protocol that would have minimal impact on current work-flow, while still effectively removing task-irrelevant contextual information, the protocol was designed following an in-depth consultation with management and forensic staff. The resulting design was for a protocol of independent-checking (i.e. blind peer-review) where the checker's interpretation of the evidence is conducted in the absence of case information and the original examiner's notes or interpretation(s). At the conclusion of a ten-case trial period, there was widespread agreement that the protocol had minimal impact on the number of people required, the cost, or the time to complete an item examination. The agency is now looking to adopt the protocol into standard operating procedures and in some cases the protocol has been extended to cover other laboratory-based examinations (e.g. fabric damage, shoeprint examination, and physical fits). The protocol developed during this trial provides a useful example for agencies seeking to adopt contextual information management into their workflow.     

Doubling Down: Inequality in Responsiveness and the Policy Preferences of Elected Officials

Is bias in responsiveness to constituents conditional on the policy preferences of elected officials? The scholarly conventional wisdom is that constituency groups who do not receive policy representation still obtain some level of responsiveness by legislators outside of the policy realm. In contrast, we present a theory of preference‐induced responsiveness bias where constituency responsiveness by legislators is associated with legislator policy preferences. Elected officials who favor laws that could disproportionately impact minority groups are also less likely to engage in nonpolicy responsiveness to minority groups. We conducted a field experiment in 28 US legislative chambers. Legislators were randomly assigned to receive messages from Latino and white constituents. If legislators supported voter identification laws, Latino constituents were less likely to receive constituency communications from their legislators. There are significant implications regarding fairness in the democratic process when elected officials fail to represent disadvantaged constituency groups in both policy and nonpolicy realms.     

Does User Co-Production of Public Service Delivery Increase Satisfaction and Trust? Evidence From a Vignette Experiment

Whereas it is assumed that involving users in the delivery of public services yields more positive evaluations of those services, this study shows that levels of satisfaction and trust are not necessarily positively affected by such user co-production. An experimental vignette design among students (n = 174) is used to analyze the differences concerning trust and satisfaction between co-produced and non-co-produced public services. In some cases, the results suggest, co-production actually leads to less satisfaction and trust. This might be explained by the self-serving bias, which states that co-producers take credit for success but blame service providers for failure.     

Effects of collaborative recall: Denying true information is as powerful as suggesting misinformation

We tested whether someone's ability to tell a good story, in terms of the Reality Monitoring (RM) tool, affects the way s/he judges the stories told by others. Forty participants (undergraduate students) wrote down two statements – one about activities they did 30 minutes ago, and the other about a past event. Subsequently, they rated the quality of a target statement written by someone else. We found that the tendency to provide a not so detailed or a very detailed statement was stable across the two statements the participants wrote. Furthermore, this tendency affected how they judged the target statements: The richer a participant's statements were compared to the target statement, the more critical the participant was in judging the target statement. These findings imply that RM is subject to biases which are related to individual differences. We discuss the implications of these findings for applying the RM lie detection tool in the field.     

Gender differences in violent offending: results from a multicentre comparison study in Dutch forensic psychiatry

ABSTRACT

The past two decades, a disproportionate growth of females entering the criminal justice system and forensic mental health services has been observed worldwide. However, there is a lack of knowledge on the background of women who are convicted for violent offenses. What is their criminal history, what are their motives for offending and in which way do they differ from men convicted for violent offenses? In this study, criminal histories and the offenses for which they were admitted to forensic care were analyzed of 218 women and 218 men who have been treated between 1984 and 2014 with a mandatory treatment order in one of four Dutch forensic psychiatric settings admitting both men and women. It is concluded that there are important differences in violent offending between male and female patients. Most importantly, female violence was more often directed towards their close environment, like their children, and driven by relational frustration. Furthermore, female patients received lower punishments compared to male patients and were more often considered to be diminished accountable for their offenses due to a mental illness.