Individual Differences Relate to Support for Insanity and Postpartum Depression Legal Defenses: The Mediating Role of Moral Disengagement.

Postpartum depression defense (PPDD) is a form of insanity defense often used when mothers harm their children. Although courts have determined that insanity defenses, including PPDD, can be used as legitimate criminal defenses, such defenses are often misunderstood among jurors and laypersons. The current survey of 467 undergraduates examines relationships between individual differences and support for PPDD and the insanity defense. Need for cognition was found to be positively related to support for PPDD and the insanity defense, while legal authoritarianism (LA) was found to be negatively related to support for both defenses. Faith in intuition is negatively related to support for the insanity defense. In this sample, women are more likely than men to support the PPDD, but not the insanity defense. Additionally, relationships between support and both the need for cognition and LA are partially mediated by moral disengagement, which is negatively related to support for PPDD and insanity defenses. These results replicate a model used in different legal contexts. Implications for legal and academic communities are discussed.

The Relationship between Workplace Incivility and Well-Being in Administrative Court Judges.

Judicial stress is an important area of study, as judges' decisions have life-altering consequences for the immediate parties and, sometimes, society in general. Although there are numerous studies of judicial stress, few have specifically investigated the relationship between judicial stress and workplace incivility (i.e., rude or condescending behavior with ambiguous intent). This survey investigated relationships between workplace incivility and judicial stress, health, and job outcomes in a group of administrative judges. Overall, judges reported moderate levels of stress and low exposure to incivility. They indicated that incivility is a moderate problem, with attorneys as the most common source of incivility. Supporting the Model of Judicial Stress, workplace incivility was positively associated with levels of stress and compassion fatigue and negatively associated with job satisfaction. The relationships between incivility and measures of mental health, physical health, and compassion fatigue were all mediated by stress. Implications for judicial stress interventions include the need for judicial training and interventions to curb incivility.

Methadone dosing and prescribed medication use in a prospective cohort of opioid-dependent pregnant women.

AIMS: This study aimed to (i) describe methadone dosing before, during and after pregnancy, (ii) to compare the incidence of neonatal abstinence syndrome (NAS) between those with dose decreases and those with steady or increasing doses and (iii) to describe prescribed medication use among opioid-dependent pregnant women. DESIGN: Prospective cohort study. SETTING: Two Irish tertiary care maternity hospitals. PARTICIPANTS: A total of 117 pregnant women on methadone maintenance treatment (MMT) recruited between July 2009 and July 2010. MEASUREMENTS: Electronic dispensing records from addiction clinics and the Primary Care Reimbursement Service were used to determine methadone doses and dispensed medications in the year preceding and the month following delivery. The Finnegan score was used to determine need for medical treatment of NAS. FINDINGS: Of the 117 participants, sufficient dosing data were available for 89 women treated with MMT throughout pregnancy; 36 (40.4%) had their dose decreased from a mean pre-pregnancy dose of 73.3 mg [standard deviation (SD) 25.5] to a third-trimester dose of 58.0 mg (SD 26.0). The corresponding figures for those with increased doses (n = 31, 34.8%) were 70.7 mg (SD 25.3) and 89.7 mg (SD 21.0), respectively. The incidence of medically treated NAS did not differ between dosage groups. Antidepressants were dispensed for 29 women (25.7%) during pregnancy, with the rate decreasing from pre-pregnancy to postpartum. Benzodiazepines were prescribed for 43 women (38.0%). CONCLUSION: In the Irish health service, opioid-dependent women frequently have their methadone dose decreased during pregnancy but this does not appear to affect the incidence of the neonatal abstinence syndrome in their babies.

Methadone and perinatal outcomes: a prospective cohort study.

AIMS: Methadone use in pregnancy has been associated with adverse perinatal outcomes and neonatal abstinence syndrome (NAS). This study aimed to examine perinatal outcomes and NAS in relation to (i) concomitant drug use and (ii) methadone dose. DESIGN: Prospective cohort study. SETTING: Two tertiary care maternity hospitals. PARTICIPANTS: A total of 117 pregnant women on methadone maintenance treatment recruited between July 2009 and July 2010. MEASUREMENTS: Information on concomitant drug use was recorded with the Addiction Severity Index. Perinatal outcomes included pre-term birth (<37 weeks' gestation), small-for-gestational-age (<10th centile) and neonatal unit admission. NAS outcomes included: incidence of medically treated NAS, peak Finnegan score, cumulative dose of NAS treatment and duration of hospitalization. FINDINGS: Of the 114 liveborn infants 11 (9.6%) were born pre-term, 49 (42.9%) were small-for-gestational-age, 56 (49.1%) had a neonatal unit admission and 29 (25.4%) were treated medically for NAS. Neonates exposed to methadone-only had a shorter hospitalization than those exposed to methadone and concomitant drugs (median 5.0 days versus 6.0 days, P = 0.03). Neonates exposed to methadone doses ≥80 mg required higher cumulative doses of morphine treatment for NAS (median 13.2 mg versus 19.3 mg, P = 0.03). The incidence and duration of NAS did not differ between the two dosage groups. CONCLUSIONS: The incidence and duration of the neonatal abstinence syndrome is not associated with maternal methadone dose, but maternal opiate, benzodiazepine or cocaine use is associated with longer neonatal hospitalization.