The QAnon Conspiracy Theory and the Assessment of Its Believers.

Pizzagate and its progeny QAnon are two conspiracy theories with a growing number of believers worldwide. QAnon has entered mainstream conservative politics, with followers identifying themselves with posters and t-shirts at rallies for former President Trump beginning in 2018. With growing numbers of QAnon theorists the world over, psychiatrists will begin to encounter such individuals with increasing frequency. Because some individuals are motivated to engage in criminal behavior on the basis of their beliefs, forensic psychiatrists may also encounter QAnon more commonly in the future. It is therefore important that psychiatrists understand the QAnon conspiracy theory, as well as how it is consistent with and different from other conspiracy theories. Particularly noteworthy is the rapid and global spread of QAnon via social media. Clinically, it is important for psychiatrists to be able to differentiate QAnon beliefs from other types of beliefs, including delusions and other delusion-like beliefs. For forensic psychiatrists, understanding the role that conspiracy theories may play in individuals' legal proceedings is particularly important.

Recidivism Risk Assessment for Adult Sexual Offenders.

Sexual offending is a significant public health problem in the USA due to its prevalence and the substantial impact it has on victims, victims' families, and the legal and mental health systems. The assessment of sexual offender recidivism risk is an important aspect of developing effective management strategies for sexual offenders in terms of placement, treatment, and other interventions. Researchers have developed numerous tools to aid in the assessment of sexual violence recidivism risk, including actuarial measures, structured professional judgment methods, and psychophysiologic assessment of sexual interests. The Static-99R and Sexual Violence Risk-20 are two instruments that have received substantial research attention for their ability to accurately compare offenders' risk of recidivism to normative group data. Penile plethysmography and visual reaction time are used to evaluate subjects' responses to sexual stimuli in an effort to characterize offenders' sexual arousal and interest, respectively. Though current research has focused on risk assessment tools' predictive utility, future research will need to examine the impact that actuarial and structured professional judgment tools have on reducing recidivism if they are to have relevance in the management of sexual offenders.

Assessment of aggression in inpatient settings.

The threat of violence is a major concern for all individuals working or receiving treatment in an inpatient psychiatric setting. One major focus in forensic psychology and psychiatry over the past several decades has been the development of risk assessments to aid in the identification of those individuals most at risk of exhibiting violent behavior. So-called second- and third-generation risk assessments were developed to improve the accuracy of decision making. While these instruments were developed for use in the community, many have proven to be effective in identifying patients more likely to exhibit institutional aggression. Because the purpose of risk assessment is the reduction of violence, dynamic factors were included in third-generation risk instruments to provide opportunities for intervention and methods for measuring change. Research with these instruments indicates that both static factors (second-generation) and dynamic factors (third-generation) are important in identifying those patients most likely to engage in institutional aggression, especially when the aggression is categorized by type (impulsive/reactive, organized/predatory/instrumental, psychotic). Recent research has indicated that developing a typology of aggressive incidents may provide insight both into precipitants to assaults as well as appropriate interventions to reduce such aggression. The extant literature suggests that both static and dynamic risk factors are important, but may be differentially related to the type of aggression exhibited and the characteristics of the individuals exhibiting the aggression.