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1.
J Am Acad Psychiatry Law ; 52(2): 153-160, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38834368

RESUMO

A systematic review of the literature on restoration of competence to stand trial identified a predominance of retrospective case studies using descriptive and correlational statistics. Guided by National Institutes of Health (NIH) quality metrics and emphasizing study design, sample size, and statistical methods, the authors categorized a large majority of studies as fair in quality, underscoring the need for controlled designs, larger representative samples, and more sophisticated statistical analyses. Implications for the state of forensic research include the need to use large databases within jurisdictions and the importance of reliable methods that can be applied across jurisdictions and aggregated for meta-analysis. More sophisticated research methods can be advanced in forensic fellowship training where coordinated projects and curricula can encourage systematic approaches to forensic research.


Assuntos
Competência Mental , Humanos , Competência Mental/legislação & jurisprudência , Psiquiatria Legal/normas , Psiquiatria Legal/educação , Projetos de Pesquisa/normas , Estados Unidos
2.
Crim Behav Ment Health ; 34(4): 347-359, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38824652

RESUMO

BACKGROUND: Psychosocial rehabilitation in forensic psychiatric services requires sound measurement of patient and staff perceptions of psychosocial function. The recommended World Health Organisation Disability Assessment Schedule 2.0 (WHODAS), designed for this, has not been examined with offender patients. AIMS: To examine patient and staff WHODAS ratings of secure hospital inpatients with psychosis, any differences between them and explore associations with other clinical factors. METHODS: Seventy-three patients self-rated on the WHODAS after 3 months as inpatients. An occupational therapist interviewed the patient's primary nurse and care team at about the same time (staff ratings). Scores were calculated according to the WHODAS manual. WHODAS scores and interview-rated symptom severity, cognitive measures, daily antipsychotic dose and duration of care were compared. RESULTS: Patient ratings indicated less disability than staff ratings for total score and for the domains of understanding and communicating, getting along and life activities. Self-care and participation ratings were similar. Patients were more likely to rate themselves as disabled in getting around (mobility). Only one-fifth of patient- and staff- ratings (16, 22%) were similar, while for nearly a third of the patients (23, 32%) self-ratings were higher than staff ratings. More severe positive symptoms were associated with higher self-rated WHODAS disability after accounting for treatment duration, negative symptoms, cognitive score and antipsychotic dose. No variable accounted for the staff/patient differences in ratings. CONCLUSION: Our mean WHODAS score findings echoed those in other patient samples-of patient underestimation of disability, linked to severity of symptoms. In this study using the WHODAS for the first time in a forensic mental health secure inpatient service, however, we found that, by comparing individuals, half of the patients reported equivalent or greater disability than did staff. Future research should focus on elucidating from patients what contributes to their self-ratings. Understanding their thought processes in rating may enhance rehabilitation planning.


Assuntos
Avaliação da Deficiência , Psiquiatria Legal , Pacientes Internados , Transtornos Psicóticos , Organização Mundial da Saúde , Humanos , Masculino , Feminino , Adulto , Pacientes Internados/psicologia , Pessoa de Meia-Idade , Pessoas com Deficiência/psicologia , Criminosos/psicologia
3.
Aggress Behav ; 50(3): e22150, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38764372

RESUMO

Structured clinical risk assessments represent a preferred means of assessing levels of aggression risk at different times and in different individuals. Increasing attention has been given to capturing protective factors, with sound risk assessment critical to high-secure forensic mental health care. The aim was to assess the predictive value of the HCR-20v3 for aggression risk and the long-term care pilot version of the SAPROF (the SAPROF-LC-pilot) in a high-secure forensic mental health inpatient population and to determine the incremental value of protective over risk factors. Participants were adult males detained in a high secure forensic mental health service, with a primary diagnosis of schizophrenia and/or personality disorder. The focus was on examining hospital based aggression (self- and other-directed) at two time points; up to 6 months (T1) and between 7 and 12 months (T2). The HCR-20V3 and SAPROF-LC-pilot demonstrated good predictive validity but with variability across subscales and aggression types/periods. Historical factors of the HCR-20V3 and External factors of the SAPROF-LC-pilot failed to predict, aside from a medium effect at T1 for verbal aggression and self-harm, for Historical factors. There was evidence for protective factors adding to prediction over risk factors alone, with the integration of protective and risk factors into a risk judgement particularly helpful in improving prediction accuracy. Protective factors contributed to risk estimates and particularly if integrated with risk factors. Combining risk and protective factors has clear predictive advantages, ensuring that protective factors are not supplementary but important to the aggression assessment process.


Assuntos
Agressão , Pacientes Internados , Humanos , Masculino , Agressão/psicologia , Adulto , Medição de Risco , Pacientes Internados/psicologia , Pessoa de Meia-Idade , Fatores de Proteção , Fatores de Risco , Psiquiatria Legal/métodos , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia , Adulto Jovem , Esquizofrenia
4.
Int J Law Psychiatry ; 94: 101988, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38735266

RESUMO

The number of women involved with forensic mental health systems internationally is rising, however, limited research has explored the characteristics of those assessed for criminal responsibility. We investigated the demographic, psychiatric, and criminological characteristics of women recommended as eligible or ineligible for the defence of Not Criminally Responsible (NCR) on account of mental disorder following a criminal responsibility assessment in Central Canada. Data were collected through retrospective chart reviews of court-ordered criminal responsibility assessments for 109 women referred for evaluations between 2003 and 2019. Accused were an average age of 34.55 years, predominately identified as Indigenous (37.7%) or Caucasian (20.8%), and had often been charged with assault (47.7%). Women identified in the reports as NCR-eligible were significantly more likely to be employed, experience delusions during the index offence, and have expert reports linking their mental health symptoms to NCR legal criteria. They were also significantly less likely to have a personality disorder, substance-related diagnosis, or have used substances during the index offence. Delusions during the index offence significantly predicted assessment recommendations when controlling for age at assessment order, current substance-related diagnosis, and whether the expert report linked mental health symptoms to NCR legal criteria. Findings indicate the key factors considered by forensic mental health professionals when conducting criminal responsibility assessments with women. Meaningful differences exist between women identified as NCR-eligible and ineligible, with findings illustrating who may be more likely to receive services within the Canadian forensic mental health system.


Assuntos
Transtornos Mentais , Humanos , Feminino , Adulto , Canadá , Estudos Retrospectivos , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Psiquiatria Legal , Competência Mental/legislação & jurisprudência , Competência Mental/psicologia , Criminosos/psicologia , Adulto Jovem , Defesa por Insanidade
5.
Acad Psychiatry ; 48(3): 238-243, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38619806

RESUMO

OBJECTIVE: This study examined the current state of forensic education among child and adolescent psychiatry (CAP) fellowship programs, regarding specific forensic topics, teaching resources, methods, and experiences. The authors aimed to gather and analyze this data to assess the need for additional standardization of forensic psychiatry education in CAP fellowship, such as broader access to resources, and/or inform the development of a standardized curriculum, including milestones, in child and adolescent forensic psychiatry. METHODS: The authors collaboratively developed a survey instrument on child and adolescent forensic psychiatry education, which was then sent to 135 accredited CAP fellowship programs. The items included in the survey instrument were designed based on literature review, expert consensus, and a 1992 American Association of Directors of Psychiatric Residency Training survey on teaching ethics and forensic psychiatry. RESULTS: Completed response data was returned by 25 of the 135 programs surveyed. Complete responses came primarily from academic institutions (52% public, 36% private) with small- or medium-sized programs (1-12 total fellows, 88%; 11-29 faculty members, 56%). Programs reported on CAP forensic rotation sites, faculty members' level of expertise and involvement in forensic CAP, common forensic topics and experiences offered, and programs' attitudes towards specific topics and experiences. CONCLUSIONS: Child and adolescent psychiatrists must gain a clear understanding of the essential components of CAP forensic psychiatry during CAP fellowship, to mitigate discomfort when interacting with the legal system and meet the rising need for forensic CAP expertise across systems and structures impacting youth populations.


Assuntos
Psiquiatria do Adolescente , Psiquiatria Infantil , Currículo , Bolsas de Estudo , Psiquiatria Legal , Humanos , Psiquiatria do Adolescente/educação , Psiquiatria Legal/educação , Psiquiatria Infantil/educação , Adolescente , Inquéritos e Questionários , Criança , Estados Unidos
6.
Behav Sci Law ; 42(4): 265-277, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38583136

RESUMO

With its firm establishment as a neuropsychology subspecialty, forensic neuropsychological assessment is integral to many criminal and civil forensic evaluations. In addition to evaluating cognitive deficits, forensic neuropsychologists can provide reliable information regarding symptom magnification, malingering, and other neurocognitive and psychological issues that may impact the outcome of a particular legal case. This article is an overview and introduction to neuropsychological assessment in the forensic mental health context. Major issues impacting the current practice of forensic neuropsychology are summarized, and several examples from case law are highlighted.


Assuntos
Psiquiatria Legal , Testes Neuropsicológicos , Humanos , Psiquiatria Legal/métodos , Simulação de Doença/diagnóstico , Simulação de Doença/psicologia , Neuropsicologia , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Psicologia Forense
7.
Behav Sci Law ; 42(3): 163-175, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38450761

RESUMO

Functional neurological disorders (FND) and somatization are common in clinical practice and medicolegal settings. These conditions are frequently disabling and, if arising following an accident, may lead to claims for legal compensation or occupational disability (such as social security disability insurance). However, distinguishing FND and somatization from symptoms that are intentionally produced (i.e., malingered or factitious) may pose a major forensic psychiatric challenge. In this article, we describe how somatoform disorders and FND lie along a spectrum of abnormal illness-related behaviors, including factitious disorder, compensation neurosis, and malingering. We provide a systematic approach to the forensic assessment of FND and conclude by describing common litigation scenarios in which FND may be at issue. Forensic testimony may play an important role in the resolution of such cases.


Assuntos
Psiquiatria Legal , Simulação de Doença , Doenças do Sistema Nervoso , Transtornos Somatoformes , Humanos , Transtornos Somatoformes/psicologia , Transtornos Somatoformes/diagnóstico , Simulação de Doença/diagnóstico , Simulação de Doença/psicologia , Doenças do Sistema Nervoso/psicologia , Doenças do Sistema Nervoso/diagnóstico , Transtornos Autoinduzidos/diagnóstico , Transtornos Autoinduzidos/psicologia , Avaliação da Deficiência
8.
J Forensic Leg Med ; 103: 102661, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38461694

RESUMO

As Forensic Psychology continues to expand as an independent field, professionals regularly resort to psychological assessment tools to assess people involved within the justice system. The Personality Assessment Inventory (PAI) is a 344-item, self-report inventory that aims to provide meaningful information for diagnosis and clinical decision-making, specifically relating to psychopathology, personality, and psychosocial environment. Its applicability in forensic settings has been increasingly recognized on account of its benefits in comparison to other self-report inventories (e.g., MMPI-2, MCMI-III), since it includes scales that are relevant to forensic settings (e.g., violence risk levels, psychopathy, substance abuse), and the existence of profile distortion indicators is useful when dealing with highly defensive and/or malingering populations. The goal of this paper is to conduct a thorough review of the PAI's utility in forensic settings, by focusing on the relevant forensic constructs assessed by the PAI (e.g., personality disorders, psychosis, substance abuse, aggression, recidivism risk, and response distortion), as well as its application to offender and inmate populations, intimate partner violence contexts, family law cases, and forensic professionals. Overall, the PAI continues to gather international recognition and its relevance and usefulness in forensic settings is generally accepted and acknowledged.


Assuntos
Determinação da Personalidade , Humanos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Reincidência , Psicologia Forense , Estabelecimentos Correcionais , Prisioneiros/psicologia , Psiquiatria Legal , Inventário de Personalidade , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Agressão , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia
9.
Psychol Bull ; 150(5): 487-553, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38358684

RESUMO

Indigenous peoples are overrepresented in correctional systems internationally, reflecting a history of systemic racism and colonial oppression, and the practice of risk assessment with this population has been a focus of legal and sociopolitical controversy. We conducted a systematic review and meta-analysis of the risk assessment literature comparing Indigenous and non-Indigenous (White majority) groups. We retrieved 91 studies featuring 22 risk tools and 15 risk/need/cultural domains (N = 59,693, Indigenous; N = 237,729, non-Indigenous/White) and four documents identifying culturally relevant factors. Most measures demonstrated moderate predictive validity but often had significant ethnoracial differences, particularly for static measures. The Service Planning Instrument/Youth Assessment Screening Inventory, Level of Service Inventory youth variants, Psychopathy Checklist-Revised and Youth Version, and the Violence Risk Scale and its Sexual Offense version had the strongest predictive validity and least ethnoracial discrepancy. The Static Factors Assessment and Dynamic Factors Identification and Analysis-Revised had the weakest predictive validity. For Indigenous persons, the strongest individual predictors of recidivism were low education/employment, substance abuse, antisocial pattern, and poor community functioning, while mitigating factors that predicted decreased recidivism were measures of risk change (i.e., from culturally integrated programs combining mainstream and traditional healing approaches), cultural engagement/connectedness, and protective factors. In practice, static measures need to be supplemented with dynamic ones, and assessors should select measures with at least moderate predictive validity and ideally the least ethnoracial bias. These conclusions are tempered by the quantity and quality of the literature coupled with the circumstance that some study authors have coauthored tools in this review. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Povos Indígenas , Humanos , Medição de Risco/métodos , Povos Indígenas/psicologia , Reincidência/estatística & dados numéricos , Violência/psicologia , Psiquiatria Legal
10.
J Am Acad Psychiatry Law ; 51(4): 542-550, 2023 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-37788863

RESUMO

As racial influences on forensic outcomes are identified in every aspect of practice, scholars are exploring methods to disentangle race from its historical, economic, and attitudinal antecedents. Because jurisdictions vary in these influences, definitions and data may differ among them, creating inconsistencies in analysis and policy. This retrospective database review compared differences in racial outcomes among 200 pretrial defendants, 160 Black and 40 White, exploring a wide range of socioeconomic, clinical, and forensic influences before, during, and after hospitalization. Because of the tight relationship of socioeconomic factors and race, investigators hypothesized that it would be difficult to distinguish racial influences alone. Using a confirmatory approach to data collection and a statistical analysis based in logistic regression, only differences in referral for psychological testing were identified. Application of this method based on local demographics and culture may prove useful for institutions interested in evaluating racial influences on forensic outcomes.


Assuntos
Psiquiatria Legal , Transtornos Mentais , Humanos , Psiquiatria Legal/métodos , Competência Mental/psicologia , Transtornos Mentais/psicologia , Estudos Retrospectivos , Testes Psicológicos
11.
Orv Hetil ; 164(35): 1373-1380, 2023 Sep 03.
Artigo em Húngaro | MEDLINE | ID: mdl-37660349

RESUMO

INTRODUCTION: Decrease in the number of forensic psychiatric experts recently reached a critical level. Shortage of forensic experts caused difficulties in the health care as well as in the justice system. OBJECTIVE: Surveying of how the field of forensic psychiatry and the forensic psychiatric expert work can be made more attractive. METHOD: We performed an online survey among forensic psychiatric experts and specialists in psychiatry. We complied a questionnaire that beside demographic data contained questions in 4 areas. The first 2 areas of the questionnaire - simplifying the forensic psychiatry training (10 items), decreasing the cost of the forensic psychiatry training (5 items) - consisted of simple tatements. Responders had to indicate on a 10-point Likert scale their level of agreement. In the last 2 areas, participants were asked to describe in unstructured format whether they see any circumstance that makes forensic psychiatry attractive or unattractive. The questionnaire was sent out in electronic form to the forensic psychiatric experts on the mailing list of the Hungarian Forensic Expert Chamber, and all specialists in psychiatry on the mailing list of the Hungarian Medical Chamber. RESULTS: Altogether 171 persons filled in the questionnaire with a mean age of 57.26 ± 11.57 years. There were 122 (71.3%) females among the participants. The following proposals received the highest ratings from the forensic psychiatric experts as well as from the specialists in psychiatry: increasing the number of the training institutes; decreasing the costs of the training; making the Hungarian Forensic Expert Chamber course free of charge; and introducing a stipend to cover the costs of the training. DISCUSSION: Results of the survey indicate that active forensic psychiatric experts and specialists in psychiatry representing a potential professional resource, concur that forensic psychiatry training can be made more attractive mainly with increasing the number of training institutes and decreasing the total costs of the training which is compiled from different constituents. CONCLUSION: Due to the critical lack of necessary professionals, urgent action is needed to make forensic psychiatry more popular and the forensic psychiatry qualification easier to obtain. Orv Hetil. 2023; 164(35): 1373-1380.


Assuntos
Psiquiatria Legal , Psiquiatria , Feminino , Humanos , Pessoa de Meia-Idade , Idoso , Masculino , Medicina Legal , Academias e Institutos , Honorários e Preços
13.
Med Sci Law ; 63(4): 309-315, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37186798

RESUMO

Electronic monitoring (EM) of individuals has been used by the criminal justice system for the past thirty years, and in the UK, use is on the increase. Its use has been justified as an alternative to prison to reduce recidivism and allowing early release of prisoners, however, the evidence base for this remains mixed. In 2010, it was employed for the first time in a forensic psychiatry setting. A study investigating the effects of EM on leave episodes concluded that EM may improve the speed of patient progress and reduce the length of admission, leading to reduced costs and increased public safety. However, the intervention generated considerable controversy and sparked discussion about ethical concerns. Here, we consider specifically legal and human rights issues that emerge from use of EM in forensic healthcare settings, scrutinising its use in the context of the Mental Health Act and the Human Rights Act. We conclude that EM is legal and justifiable, providing it is used judiciously and with due consideration of concerns for the individual and the given context.


Assuntos
Saúde Mental , Prisioneiros , Humanos , Psiquiatria Legal , Direitos Humanos , Reino Unido , Eletrônica
14.
Behav Sci Law ; 41(5): 415-431, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36934388

RESUMO

Forensic evaluations have advanced considerably with the development of specialized measures validated on forensic and correctional samples. Prior to this progress, such evaluations relied heavily on extrapolations from general psychological tests to crucial, legally relevant questions. Since then, decades of empirical work have produced forensic assessment instruments (FAIs) addressing psycholegal standards in addition to forensically relevant instruments (FRIs) examining issues central to forensic practice (e.g., malingering) but not the standards themselves. This article provides a critical examination of the development, validation, and modern applications of six published FAIs that each address one of three broad criminal forensic issues (i.e., insanity, competency to stand trial, and Miranda abilities and waivers). Evaluations of the measures' reliability and validity particularly in forensic samples are highlighted. To complement FAIs, FRIs related to response styles are briefly explored. As a primary goal, forensic practitioners are provided with the knowledge and background about FAIs to enhance their criminal forensic practices.


Assuntos
Criminosos , Transtornos Mentais , Humanos , Defesa por Insanidade , Competência Mental , Reprodutibilidade dos Testes , Psiquiatria Legal , Transtornos Mentais/psicologia
15.
Law Hum Behav ; 47(1): 292-306, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36931864

RESUMO

OBJECTIVE: Our first goal in this study was to identify cultural mistrust critical items (CMCIs) on two versions of the Minnesota Multiphasic Personality Inventory (MMPI)-the MMPI-Second Edition-Restructured Form (MMPI-2-RF) and MMPI-Third Edition (MMPI-3)-that might be endorsed by people of color because of cultural mistrust rather than clinical paranoia. Our second goal was to determine whether CMCIs and items on the MMPI-2-RF/MMPI-3 Ideas of Persecution scale (Restructured Clinical Scale 6 [RC6]) were endorsed at different rates across cultural groups in a nonclinical college sample and a forensic inpatient sample. HYPOTHESES: Our primary hypothesis was that expert raters would reliably identify a subset of MMPI-2-RF and MMPI-3 items as reflective of cultural mistrust. Black college students would endorse the highest level of CMCIs, followed by Latina/o students, and then White students. We hypothesized that the same pattern of findings would occur in forensic inpatients but that the differences would be attenuated because of the high base rate of psychiatric symptomatology and the nature of the forensic assessment setting. METHOD: Three Black female and three Black male psychologists rated the degree to which each item on the MMPI-2-RF and MMPI-3 reflected cultural mistrust. Black (n = 90), Latina/o (n = 83), and White (n = 100) college students were compared on CMCIs and on MMPI-2-RF/MMPI-3 RC6 item endorsement. The same comparisons were made among Black (n = 221), Latina/o (n = 142), and White (n = 483) forensic inpatients who completed the MMPI-2-RF. RESULTS: Black college students endorsed the highest levels of cultural mistrust, followed by Latina/o students, and then White students, resulting in small-to-medium effect sizes (Hedges's gs = 0.14-0.52). Although we observed some item-level differences in forensic patients, the overall pattern of item endorsement did not significantly differ in this group. CONCLUSIONS: There are multiple reasons for the reporting of clinical paranoia and cultural mistrust in forensic assessment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Psiquiatria Legal , MMPI , Feminino , Humanos , Masculino , População Negra , Hispânico ou Latino , Pacientes Internados , Reprodutibilidade dos Testes , População Branca
16.
J Am Acad Psychiatry Law ; 51(1): 56-60, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36627151

RESUMO

Developing a comprehensive theory of forensic ethics has proved a challenge for the profession since Alan Stone questioned the presence of psychiatrists in the courtroom in 1982. Two schools of thought have developed: a "principlist" approach associated with Appelbaum and an approach focused on narrative and context associated with Griffith. Both approaches, and their intellectual progeny, focus primarily upon the relationship between forensic evaluator, forensic subject, and the legal system. Yet the scarcity of forensic psychiatrists renders them a resource whose allocation, often self-driven, has significant implications for ethics. Rather than focus primarily upon questions related to subject-evaluator relations and evaluator work product, a comprehensive ethic for forensic psychiatry must also prioritize the ethics concerns of resource allocation.


Assuntos
Ética Médica , Psiquiatria , Humanos , Psiquiatria Legal , Alocação de Recursos
17.
Int J Law Psychiatry ; 86: 101854, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36528930

RESUMO

BACKGROUND: In China, police departments usually initiate assessment of criminal responsibility after patients with mental disorders commit crimes. However, the specific conditions demanding assessment are not clearly stipulated by law. Few studies have been conducted on the epidemiological characteristics and assessment of criminal responsibility in patients with mental disorders. This study aimed to analyze the features and identify influencing factors for assessment of criminal responsibility for patients with mental disorders in a single-center cohort. METHODS: Cases undergoing criminal responsibility assessment at the Center of Forensic Science, East China University of Political Science and Law in Shanghai (CFS, ECUPL) between 2010 and 2020 were retrospectively reviewed. Criminal responsibility was categorized as criminal irresponsibility, diminished criminal responsibility, and full criminal responsibility. Differences among the groups were then statistically analyzed. RESULTS: In the study period, 437 patients including 361 males (82.61%) were referred for criminal responsibility assessment. Their ages ranged from 15 years to 91 years. After assessment, the number of cases with criminal irresponsibility, diminished criminal responsibility, and full criminal responsibility were 196 (44.85%), 181 (41.42%), and 60 (13.73%), respectively. The Chi-square test and nominal regression analysis showed that influencing factors for assessment of criminal responsibility comprised crime in public places (OR = 14.734; 95% CI: 1.463-148.424), crime in victim's residence (OR = 10.852; 95% CI: 1.068-110.214), crime in suspect's residence (OR = 9.542; 95% CI: 1.046-87.092), forensic psychiatric diagnosis of F1X (OR = 0.014,0.011; 95%CI:0.001-0.261,0-0.5), F2X (OR = 5.75; 95%CI:1.315-23.145), F4X (OR = 0.077; 95%CI:0.016-0.38,) and F6X (OR = 0.112,0.075; 95% CI: 0.022-0.558,0.006-0.959), criminal object of property (OR = 9.989; 95% CI: 1.305-76.455), cases of theft (OR = 0.09, 0.087; 95% CI: 0.013-0.648,0.012-0.654), and cases of endangering public security (OR = 0.152, 0.205; 95% CI: 0.034-0.678, 0.045-0.931). CONCLUSION: Crime in public places, suspect's residence and victim's residence, forensic psychiatric diagnosis of F1X, F2X, F4X and F6X, criminal object of property, case types of theft and endangering public security were influencing factors in assessment of criminal responsibility. Therefore, special attention should be paid to patients with mental disorders under such circumstances in order to avoid bias on assessment of criminal responsibility.


Assuntos
Criminosos , Transtornos Mentais , Masculino , Humanos , Adolescente , Psiquiatria Legal , Estudos Retrospectivos , China/epidemiologia , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia
18.
Psychol Assess ; 35(1): 42-55, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36455028

RESUMO

Readministration of multiple risk assessment instruments to determine the risk of aggression over the short, medium, and long term is common practice in many forensic mental health settings. Justification for the repeated administration and use of multiple instruments is based on purported differences in discriminative validity of risk factors according to whether they are characterized as static, stable, or acute, and the composition of these tools, in terms of the relative balance of different types of risk factors, which can impact the discriminative validity of these instruments over different follow-up periods. However, research has yet to determine whether the use of multiple and repeated administration of risk assessment instruments improves identification of risk, and it may be the case that the heavy burden on service providers to administer multiple instruments is unwarranted. In this study, time-dependent cox regression with repeated assessments and recurrent events was used to investigate the dynamic nature and incremental validity of the dynamic appraisal of situational aggression (DASA), short-term assessment of risk and treatability (START), and HCR-20v3, which were repeatedly rated on a sample of forensic mental health inpatients (N = 240) over a 2-year period. Results suggest that using the rolling mean or the most recent risk assessment yielded the most accurate characterization of change in aggression risk. Repeated administration of dynamic risk instrument instruments improved the identification of aggression beyond the initial risk assessment. Although static, stable, and acute factors were significantly related to aggression, the combination of data from multiple risk assessment instruments may not result in clinically meaningful improvements in risk identification. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Hospitais Psiquiátricos , Transtornos Mentais , Humanos , Psiquiatria Legal/métodos , Medição de Risco/métodos , Agressão/psicologia , Saúde Mental , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia
19.
Nord J Psychiatry ; 77(3): 240-246, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35697296

RESUMO

INTRODUCTION: Risk assessment is integral to forensic psychiatry. Previous work has highlighted the benefits of using scalable and evidence-based actuarial risk tools developed within forensic populations, such as the online Forensic Psychiatry and Violence Oxford (FoVOx) violence risk assessment tool. We examined the feasibility of using FoVOx in a Swedish forensic cohort and tested whether adding modifiable (dynamic) factors would increase its useability to clinicians. METHODS: We completed FoVOx assessments on all patients discharged from forensic psychiatric hospitals in Stockholm County, Sweden, between 2012 and 2017 and investigated recidivism rates. In addition, interviews were conducted with the clinicians responsible for each patient on the perceived accuracy, usefulness, and impact of FoVOx, which was examined using thematic analysis. RESULTS: Ninety-five discharges from forensic psychiatric hospitals were followed up. The median FoVOx score was a 7% likelihood of violent reoffending in two years after discharge. Six discharged patients (6%) were confirmed as violent recidivists using official records with a similar distribution of FoVOx risk categories as the rest of the sample. FoVOx was considered accurate by clinicians in more than half of cases, who suggested that modifiable risk factors could be added to increase acceptability. All clinicians thought that FoVOx was useful, and in 20% of discharges, it would have materially altered patient care. Overall, FoVOx was thought to impact decision-making and risk management, was practical to use, and could be completed without reference to written case material. CONCLUSION: Completing FoVOx in forensic psychiatric hospitals can complement current approaches to clinical decision-making on violence risk assessment and management.


Assuntos
Transtornos Mentais , Violência , Humanos , Estudos de Viabilidade , Violência/prevenção & controle , Violência/psicologia , Medição de Risco , Fatores de Risco , Psiquiatria Legal , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia
20.
Psicol. ciênc. prof ; 43: e261750, 2023. tab, graf
Artigo em Português | LILACS, Index Psicologia - Periódicos | ID: biblio-1529225

RESUMO

Este estudo objetivou descrever a identidade profissional de psicólogos judiciários, partindo do cenário contemporâneo da Psicologia Jurídica brasileira, contexto que envolve crises e conflitos sobre a forma de responder a atribuições e demandas do campo legal. Pela perspectiva da sociologia das identidades profissionais de Claude Dubar, sustenta-se a hipótese de que a identidade profissional do psicólogo judiciário depende de estratégias de compatibilização entre o pertencimento à categoria e as atribuições legais e institucionais. Participaram 95 psicólogos do quadro ativo do Tribunal de Justiça de São Paulo, que responderam a um formulário online sobre a percepção de si e do campo de atuação. Os dados foram submetidos à análise de conteúdo. Os resultados indicam a saliência da avaliação psicológica e da interdisciplinaridade na identidade profissional, e as rupturas identitárias diante de práticas verificatórias. Tais achados apontam a necessidade de participação da categoria na construção de suas atribuições; e dificuldades para o exercício das funções por limitações à autonomia profissional.(AU)


This study aimed to describe the professional identity of forensic psychologists, considering Brazil's Legal Psychology contemporary scenario which relates to a critical issues on how practitioners respond the demands of the legal system. Based on Claude Dubar's sociology of professional identities, we support the hypothesis that forensic psychologists' professional identity depends on strategies of compatibilization between belonging their reference group and the institutional attributions. There were 95 participants, all from the current staff of the Court of Justice of the state of São Paulo, who answered an online form. The data were subjected to content analysis. The results indicate a professional identity with noted salience on psychological assessment and interdisciplinarity, and the identity crises regarding verification practices. Such findings highlight the importance of practitioners taking part on the construction of their own tasks.(AU)


Este estudio tuvo como objetivo describir la identidad profesional de los psicólogos forenses, considerando el escenario de la Psicología Jurídica brasileña, que se relaciona con una crisis sobre si estos profesionales responden a las demandas del sistema legal. Teniendo en cuenta la sociología de las identidades profesionales de Claude Dubar, sostenemos la hipótesis de que la identidad profesional de los psicólogos forenses depende de estrategias de compatibilización entre la pertenencia a su grupo profesional y a instituciones. Participaron 95 psicólogos, quienes actuaban en el Tribunal de Justicia del Estado de São Paulo, a los cuales se aplicó un formulario en línea. Los datos se sometieron a análisis de contenido. Los resultados indican una identidad profesional saliente en cuanto a la evaluación psicológica y la interdisciplinariedad, pero también crisis de identidad en relación con las prácticas de verificación. Tales resultados señalan la importancia de que la categoría participe en la construcción de sus propias atribuciones.(AU)


Assuntos
Humanos , Masculino , Feminino , Identificação Social , Psiquiatria Legal , Capacitação Profissional , Psicologia Forense , Organização e Administração , Filosofia , Área de Atuação Profissional , Psicologia , Psicologia Social , Pesquisa , Autoimagem , Desejabilidade Social , Meio Social , Ciências Sociais , Seguridade Social , Serviço Social , Socialização , Fatores Socioeconômicos , Trabalho , Tomada de Decisões Gerenciais , Administração de Serviços de Saúde , Encenação , Sistemas de Apoio a Decisões Administrativas , Brasil , Adaptação Psicológica , Escolha da Profissão , Defesa da Criança e do Adolescente , Demografia , Saúde Mental , Epidemiologia Descritiva , Entrevistas como Assunto , Inquéritos e Questionários , Desenvolvimento de Pessoal , Direitos Civis , Autonomia Profissional , Negociação , Local de Trabalho , Confidencialidade , Diversidade Cultural , Conhecimento , Direito Penal , Cultura , Impacto Psicossocial , Democracia , Designação de Pessoal , Eficiência , Definição da Elegibilidade , Emprego , Avaliação da Pesquisa em Saúde , Recursos Humanos , Acolhimento , Prova Pericial , Comportamento Exploratório , Fatores Sociológicos , Capital Social , Sistemas de Apoio Psicossocial , Engajamento no Trabalho , Direitos Socioeconômicos , Liberdade , Funcionamento Psicossocial , Fatores Sociodemográficos , Pertencimento , Relevância Clínica , Diversidade, Equidade, Inclusão , Grupos Populacionais , Condições de Trabalho , Promoção da Saúde , Desenvolvimento Humano , Relações Interpessoais , Descrição de Cargo , Jurisprudência , Conhecimento Psicológico de Resultados , Liderança , Antropologia Cultural
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