Insanity defense typology.

Much has been written about how to conduct insanity defense evaluations, as well as how to operationalize the legal definitions of insanity. However, the insanity defense has never been categorized by a typology. This article describes a typology of six subtypes of the insanity defense: paranoid self-defense, "but it's mine," erotomanic stalking, deific decree, disorganized, and false report. Knowledge of these subtypes, while not all inclusive, can inform insanity defense evaluations, guide training, and potentially increase the reliability of forensic evaluators' opinions. In addition, such subtypes can generate future research regarding prevalence, interrater reliability, and associated features of the different subtypes.

Contrasting the efficacy of the MMPI-2-RF overreporting scales in the detection of malingering / Contraste de la eficacia de las escalas de validez del MMPI-2-RF en la detección de la simulación

Though it has been the most extensively used instrument for forensic evaluation, the MMPI-2 is being gradually replaced by the MMPI-2-RF version, requiring evidence research to support it. A malingering design was implemented to assess the efficacy of the overreporting validity scales in discriminating between a group of malingerers and the general and clinical populations in a forensic context. Of a total of 878 subjects, 309 were from the general population, 308 from the clinical population, and 261 were instructed to malinger a psychological injury. The results showed that malingerers scored significantly higher than the clinical and general population on the F-r, Fp-r, FBS-r, Fs and RBS scales. As for the classification of cases, the F-r, Fp-r, FBS-r, Fs, and RBS scales classified correctly and significantly between malingerers and honest respondents from the general population, and the F-r and Fp-r scales between malingerers and clinical population. Additionally, the results showed F-r incremental validity over Fp-r, and vice versa. Thus, F-r and Fp-r scales are independent and may be accumulated to detect malingering. Forensic practical implications from the results were derived and discussed (AU)

Aunque el MMPI-2 ha sido el instrumento psicométrico más usado en la evaluación forense, está siendo reemplazado gradualmente por la versión reestructurada, el MMPI-2-RF precisándose de más evidencia científica para ello. Se utilizó un dise˜no de investigación de simulación para evaluar la eficacia de las escalas de validez de evaluación de la simulación en la discriminación entre simuladores y las poblaciones general y clínica en el contexto forense. Participaron en el estudio 878 sujetos, 309 de la población general, 308 casos clínicos y 261 instruidos para simular da˜no psicológico. Los resultados mostraron que los simuladores puntuaban significativamente más alto que los sujetos de las poblaciones general y clínica en las escalas F-r, Fp-r, FBS-r, Fs y RBS. En la clasificación de casos, las escalas F-r, Fp-r, FBS-r, Fs y RBS clasificaban correcta y significativamente entre simuladores y respuestas honestas de la población general, y las escalas F-r and Fp-r entre simuladores y población clínica. Además, los resultados evidenciaron validez incrementada de F-r sobre Fp-r y viceversa. Se discuten las implicaciones para la práctica forense de los resultados (AU)

Aproximación diagnóstica de psicopatía mediante instrumento autoinformado / A diagnose approach to psychopathy using a self-report instrument / Aproximação diagnóstica da psicopatia por meio do instrumento autoinformado

Introducción: Dada la relevancia clínica y social que tiene la psicopatía, resulta útil contar con instrumentos autoinformados para la aproximación diagnóstica a la psicopatía. Objetivos: Evaluar la congruencia interna y la validez convergente del Self Report of Psychopathy-Short Form. Material y métodos: Se evaluaron 208 personas condenadas, alojadas en el Centro de Cumplimiento Penal de la Provincia de Los Andes, Chile. Se utilizaron el SRP-III-SF, el PCL-R y la HCR-20. Resultados: La distribución de valores del SRP-III-SF tuvo una media de 61,6 y fue normal. El Coeficiente de Alfa de Cronbach para el total fue 0,8 y para los factores 1, 2, 3 y 4 fue 0,7, 0, 4, 0,7 y 0,5, respectivamente. La correlación del SRP-III-SF con el PCL-R fue 0,4 (p = 0,01) y con HCR 20, 0,5 (p < 0,001). El riesgo de diagnóstico de psicopatía con el PCL-R aumentó en forma lineal para cada cuartil de la distribución del SRP-SF. El área bajo la curva ROC fue 0,66 (p = 0,05; 95% IC 0,5; 0,8).

Introduction: Given the clinical and social relevance of psychopathy, it is desirable to have self-report instruments for a proper diagnostic approach. Objectives: Assess the internal congruence and convergent validity of the Self Report of Psychopathy Scale III-Short Form. Material and Methods: 208 convicts housed at the “Centro de Cumplimiento Penal” detention center in the Province of Los Andes, Chile, were evaluated using the SRP-III-SF, PCL-R, and HCR-20 schemes. Results: the SRP-III-SF distribution was normal, with a mean of 61.6. The Cronbach’s Alpha Coefficient for the total was 0.8, and 0.7, 0.4, 0.7 and 0.5 for the 1, 2, 3, and 4 factors respectively, while the correlations of SRP-III-SF with PCL-R and HCR 20 were, respectively, 0.4 (p = 0.01) and 0.5 (p < 0,001). The scores of the PCL-R diagnosed psychopathy were linearly higher for each quartile of the SRP-SF distribution. The area under the ROC curve was 0.66 (p = 0.05; 95% IC 0.5; 0.8).

Introdução: Dada a relevância clínica e social que tem a psicopatia, é útil contar com instrumentos autoinformados para a aproximação diagnóstica à psicopatia. Objetivos: Avaliar a congruência interna e a validez convergente do Self Report of Psychopathy-Short Form. Material e métodos: Avaliaram-se 208 pessoas condenadas, alojadas no Centro de Cumprimento Penal da Província dos Andes, Chile. SRP-III-SF, PCL-R e HCR-20 foram usados. Resultados: A distribuição dos valores do SRP-III-SF teve uma média de 61.6 e foi normal. O Coeficiente do Alfa de Cronbach para o total foi 0.8 e para os fatores 1, 2, 3 e 4 foi 0.7, 0.4, 0.7 e 0.5, respectivamente. A correlação do SRP-III-SF com PCL-R foi 0.4 (p = 0.01) e com HCR 20, 0.5 (p < 0.001). O risco do diagnóstico de psicopatia com o PCL-R aumentou em forma linear para cada quartil da distribuição do SRP-SF. A área sob a curva ROC foi 0.66 (p = 0.05; 95% IC 0.5; 0.8).

In search of the psychopathic sexuality taxon: indicator size does matter.

Recent research has suggested that a qualitatively distinct subtype of psychopathic sex offender can be identified via taxometric analyses (Harris et al., 2007). In this study we attempted to replicate the hypothesized psychopathic sexuality taxon in a group of 503 male sexual offenders using data from the Psychopathy Checklist-Revised (PCL-R:Hare, 2003) and five coercive and precocious sexuality items. Ambiguous to dimensional results were obtained when, in a replication of the Harris et al. (2007) study,dichotomized indicators were analyzed with summed input maximum covariance (MAXCOV). Clearly dimensional results, however, were obtained when higher correlating and more valid quasi-continuous indicators were analyzed with traditional (input variables not summed) MAXCOV, and both dichotomous and quasi-continuous indicators were analyzed with mean above minus below a cut (MAMBAC) and latent-mode factor analysis (L-Mode). These results suggest that Harris et al. (2007) may have mistaken the random fluctuations of weakly correlating and poorly differentiating indicators for a taxon. Consistent with the vast majority of earlier research,our results suggest that psychopathy (with or without coercive and precocious sexuality) is a dimensional construct.

Kraepelin and degeneration theory.

Emil Kraepelin's contribution to the clinical and scientific field of psychiatry is recognized world-wide. In recent years, however, there have been a number of critical remarks on his acceptance of degeneration theory in particular and on his political opinion in general, which was said to have carried "overtones of proto-fascism" by Michael Shepherd [28]. The present paper discusses the theoretical cornerstones of Kraepelinian psychiatry with regard to their relevance for Kraepelin's attitude towards degeneration theory. This theory had gained wide influence not only in scientific, but also in philosophical and political circles in the last decades of the nineteenth century. There is no doubt that Kraepelin, on the one hand, accepted and implemented degeneration theory into the debate on etiology and pathogenesis of mental disorders. On the other hand, it is not appropriate to draw a simple and direct line from early versions of degeneration theory to the crimes of psychiatrists and politicians during the rule of national socialism. What we need, is a differentiated view, since this will be the only scientific one. Much research needs to be done here in the future, and such research will surely have a significant impact not only on the historical field, but also on the continuous debate about psychiatry, neuroscience and neurophilosophy.

Principios éticos y legales en la práctica pericial psiquiátrica / Ethical and legal principles at the psychiatric expert practice

Se plantea un análisis ético de la práctica pericial psiquiátrica, realizando una reflexión crítica a partir de las referencias clásicas de la bioética y la deontología, aplicadas a la relación clínica convencional. Se concluye con una selección de los principios éticos que, adaptados a la especificidad de la psiquiatría forense, podrían servir de referencia para la excelencia en la práctica de esta rama de la medicina legal

An ethical analysis of psychiatric expert practice has been raised, carrying a critical thought out from classic references of bioethics and deontology, applied to conventional clinical relation. Concluding with a selection of the ethical principles which, adapted to the specifity of forensic psychiatry, could make use of reference superbly to the practice of this subspeciality of legal medicine