A review and update on the practice of evaluating Miranda comprehension.

This article summarizes recent developments in constitutional law relevant to the Miranda warning. We describe the origins of the warning, concerns about the use of the Miranda warning, perspectives on the utility of the warning, and the relevance of the warning. We describe how the warning has changed over time, requirements for administering the warning, and procedures that police use in delivering the warning and obtaining confessions. We review case law relevant to "coerced" Miranda waivers and confessions, changes over time in the court's interpretation of what constitutes "coercion," use of the warning with special populations, and the recent focus in case law on individual factors that might impair Miranda comprehension. We review empirical research on factors associated with deficits in Miranda comprehension. We integrate case law rulings and empirical research into suggested approaches to forensic assessment of Miranda comprehension.

Preadolescent adjudicative competence: methodological considerations and recommendations for practice standards.

This article examines developmental and legal issues directed toward a downward age extension of forensic evaluation practice standards for preadolescent defendants whose competence is questioned. Existing research and practice standards were developed for cases involving adolescents and adults, but they lack sufficient application to evaluations of young children because of the ways in which legal parameters affect young children. We review practice implications of the legal role of "immaturity" for adjudicative competence, alterations of Dusky in some juvenile courts, and the role of parens patriae in competence hearings held in juvenile court. We examine competence abilities in a developmental framework. Examining practice standards is timely because adjudicative competence in preadolescent defendants has taken on recent significance. The last decade saw changes in the stringency of delinquency statutes, increased emphasis on adversarial approaches to juvenile proceedings, and a de-emphasis on rehabilitation and parens patriae protections. Statutory changes and increased referrals have heightened inquiry into the meaning of preadolescent adjudicative competence.

Malaria in the United Republic of Tanzania: cultural considerations and health-seeking behaviour.

Malaria is one of the biggest health problems in sub-Saharan Africa. Large amounts of resources have been invested to control and treat it. Few studies have recognized that local explanations for the symptoms of malaria may lead to the attribution of different causes for the disease and thus to the seeking of different treatments. This article illustrates the local nosology of Bondei society in the north-eastern part of the United Republic of Tanzania and shows how sociocultural context affects health-seeking behaviour. It shows how in this context therapy is best viewed as a process in which beliefs and actions are continuously debated and evaluated throughout the course of treatment.

Mentally ill and non-mentally ill defendants' abilities to understand information relevant to adjudication: a preliminary study.

The legal construct of competence to stand trial, or "adjudicative competence," is based on the premise that some mentally disordered defendants have impaired abilities when compared with most defendants and that adjudication should be barred if these competence-related abilities are significantly impaired. Where the line is drawn between sufficient and insufficient abilities has important consequences: as a result of being adjudicated incompetent, defendants may be detained and treated involuntarily and their trials will be delayed. However, no studies have systematically compared the capacities of relevant groups of defendants. In this study, 84 criminal defendants--42 of whom were hospitalized as incompetent and 42 of whom were regarded as unquestionably competent--were administered three instruments measuring capacity to understand legally relevant information. Incompetent defendants performed more poorly on all measures of understanding. Twenty-eight incompetent defendants were administered the measures a second time, after restoration to competence. Restored defendants improved their performance on all measures of understanding and their performance was similar to that of normal, competent defendants.

Psycholegal issues in child sexual abuse evaluations: a survey of forensic mental health professionals.

Mental health professionals play a significant role in assessment, rendering expert opinions, and making dispositional recommendations in cases involving allegations of child sexual abuse. Although there have been recent efforts to develop guidelines for practice, little is known about how evaluators actually prefer to proceed in such evaluations, or whether there is consensus with respect to how to proceed. In this study, a sample of Massachusetts child forensic mental health professionals who specialize in conducting evaluations of children in cases involving allegations of sexual abuse were surveyed to assess their normative evaluation and testimony practices with respect to information gathered during clinical interviews and psychosocial assessment of the child. The survey assessed evaluators: (a) opinions; (b) reasons for opinions; and (c) typical practices concerning psycholegal issues associated with child sexual abuse evaluations. Survey questions covered three topics: (a) the evaluation process and methods; (b) the limits of expert opinions and testimony; and (c) child advocacy. Results of the survey are presented, and implications for child forensic practice are discussed.

Work satisfaction among community-based mental health service providers: the association between work environment and work satisfaction.

This is a study of work environment and work satisfaction among 601 community mental health service providers in the central United States. Aspects of the work environment may limit resources and strategies available to minimize staff burnout and maximize effective service delivery. Three human resource issues related to work satisfaction are reviewed: (a) unique constraints in rural mental health service delivery, (b) the role of paraprofessionals in service delivery, and (c) community-based services for seriously mentally ill individuals. This study demonstrates hypothesized associations between work environment and work satisfaction variables. The results suggest that staff members working with seriously mentally ill individuals are vulnerable to dissatisfaction and stress, and may require special skill and mastery enhancement.