Behavioral Sciences & the Law

Techniques commonly used to increase truth-telling in most North American jurisdiction courts include requiring witnesses to discuss the morality of truth- and lie-telling and to promise to tell the truth prior to testifying. While promising to tell the truth successfully decreases younger children's lie-telling, the influence of discussing the morality of honesty and promising to tell the truth on adolescents' statements has remained unexamined. In Experiment 1, 108 youngsters, aged 8-16 years, were left alone in the room and asked not to peek at the answers to a test. The majority of participants peeked at the test answers and then lied about their transgression. More importantly, participants were eight times more likely to change their response from a lie to the truth after promising to tell the truth. Experiment 2 confirmed that the results of Experiment 1 were not solely due to repeated questioning or the moral discussion of truth- and lie-telling. These results suggest that, while promising to tell the truth influences the truth-telling behaviors of adolescents, a moral discussion of truth and lies does not. Legal implications are discussed.

The original article to which this erratum refers was published in Behavioral Sciences & the Law 17(4) 1999, 435-443

This obituary of Dr. Grant Harris describes his life and the outstanding contributions he made to the field of correctional and forensic psychology. Copyright © 2015 John Wiley & Sons, Ltd.

Fourteen non-terrorist attackers of public figures in Germany between 1968 and 2004 were intensively studied, with a particular focus on warning behaviors, attack behaviors, and the relationship between psychiatric diagnosis, symptoms, and motivations for the assault. A large proportion of the attackers were severely mentally ill, and most likely to be in the potentially lethal rather than the non-lethal group. A new typology of seven warning behaviors was applied to the data, and all were present, most frequently fixation and pathway warning behavior, and least frequently a direct threat. Psychiatric diagnosis could be closely linked to motivation when analyzed at the level of symptom and content of thought, often delusional. Most of the attacks were directed at political figures, and the majority occurred after 1995.

Unlike the minority groups covered by civil rights laws in the past, the disabled population is a heterogeneous group. Because of differences in the nature and onset of health conditions, it is important to study the labor market experiences of different impairment groups separately, rather than treating "disabled workers" as a single group. This article uses data from the 1984 and the 1990 panels of the Survey of Income and Program Participation to analyze trends in the employment and wages of six impairment groups in the years immediately preceding the ADA. The results confirm the diversity of labor market experiences within the disabled population and suggest that policies designed to improve labor market outcomes for workers with disabilities in response to the ADA should be targeted to the different needs of different impairment groups.

Recent legislative and regulatory developments have focused attention on older adults' capacity for involvement in health care decision-making. The Omnibus Budget Reconciliation Act of 1987 (OBRA 87) focused attention on the rights of nursing home residents to be involved in health care decision-making to the fullest extent possible. This article uses data from the 1987 National Medical Expenditure Survey (NMES) to examine rates of incapacity for health care decision-making among nursing home residents. Elements of the Oklahoma statute were used to operationalize decision-making incapacity: disability or disorder, difficulty in decision-making or communicating decisions, and functional disability. Fifty-three percent of nursing home residents had a combination of either physical or mental impairment and an impairment in either self-care or money management. The discussion focuses on the policy and practice implications of significant rates of incapacity among nursing home residents.

Young sex offenders (YSOs) attract significant public and professional concern. YSOs might be perceived as more psychologically deviant or dangerous than other offenders. This study focused on how often YSOs subjected to forensic psychiatric investigation (FPI) were declared medico-legally insane as compared to young non-sex offenders and adult sex offenders. Logistic regression models were applied to data from all major FPIs performed in Sweden between 1988 and 1995 (N=4354) to explore factors affecting the likelihood of receiving a medico-legal insanity declaration. When we adjusted for the statistical effects of age, sex offender status, and psychopathology, YSOs (n=47) were three to four times more likely to be declared insane in the medico-legal sense. The results indicate that YSOs in Sweden constitute a medico-legally distinct subgroup of forensic psychiatric examinees.

The family group conference is an innovation introduced into New Zealand law as a means of resolving child protection and youth justice cases. The law requires the conference to include the offender, the victim, the extended family, and other relevant parties. This article reviews New Zealand research and commentary, and publications reporting on experiences with the methods in other countries. The discussion emphasizes problems in adapting a method based on one culture to a different culture and social organization. The article also considers the law from the viewpoint of therapeutic jurisprudence. Although the research is sparse, the FGC has strong promise for resolving problems, enhancing the sense of community and participation, and empowering families.

The Americans with Disabilities Act (ADA) of 1990 is the most comprehensive federal civil rights law addressing discrimination against one-fifth of the American population. This article is meant to contribute to the emerging dialogue on ADA implementation by presenting information from a longitudinal investigation of employment integration and economic opportunity under the employment provisions of the ADA, set forth in Title I of the act. The broader relevance of the investigation to emerging questions under Title I law is described. Thereafter, the investigation's seven core findings are presented, and then the implications for future investigation of the ADA are examined.

This article reviews and evaluates publications during 1991-1995 with relevance for assessments of competence to stand trial. The review focuses specifically on articles that provide new concepts or data supported by research or case analyses. The studies are reviewed under the following headings: (a) the systemic context of competence to stand trial (CST) evaluations, (b) conceptual definitions of CST, (c) research on CST assessment methods, (d) characteristics of incompetent defendants, (e) interpretation and communication of CST evaluation data, (f) issues in CST assessment of special populations (juveniles, persons with mental retardation), and (g) treatment to restore competence. Suggestions are offered for further research to advance the quality of clinical evaluations for competence to stand trial.

This article reviews and evaluates publications during 1996-2000 with relevance for assessments of competence to stand trial (also known as adjudicative competence). The review focuses specifically on articles that provide new concepts or data supported by research or case analyses. The studies are reviewed under the following headings: (i) the systemic context of evaluations of adjudicative competence (AC); (ii) conceptual guidelines for AC evaluations; (iii) research on AC assessment methods; (iv) empirical correlates of AC judgments and psycholegal abilities; (v) quality of AC evaluations and reports; (vi) interpretation of AC evaluation data; (vii) issues in AC assessment of special populations (e.g., juveniles, persons with mental retardation, and women); and (viii) treatment to restore competence. Suggestions are offered for further research to advance the quality of clinical evaluations of adjudicative competence.

This article examines the evolution of musculoskeletal (MSK) disability and its impact on mortality and work patterns in the late 19th century in America, in the context of the Civil War disability policy scheme. The study was conducted on 17,702 Union Army (UA) Civil War veterans. Of these, 10,789 were examined and diagnosed with major MSK conditions, rheumatism, sciatica, and spinal curvature, between 1862 and 1907. Analyses examine MSK (i) prevalence rates by birth cohort and age group; (ii) fatality rates as compared with other disabilities; (iii) risk rates by occupation type; and (iv) lifespan for MSK patients. MSK conditions are commonly claimed disabilities within the Civil War data set, with prevalence rates increasing with age. Regression studies show that working in clerical and professional (relative to manual labor) occupations decreases the likelihood of being examined for and diagnosed with MSK conditions. MSK patients examined at older ages tended to have longer lifespan than those examined at younger ages. The findings suggest that changes in age, environmental, and occupational conditions during the late 19th century affected MSK condition prevalence and the average lifespan of MSK patients. Implications for contemporary disability policy are discussed.

In a thoughtful critique in the article preceding this one, many arguments are presented about the veracity of assumptions and conclusions I made in my 1998 publication concerning the sexual recidivism base rates for certain incarcerated sex offenders. This article responds to some of the issues raised. First, the ultimate conclusion of the preceding critique is assessed. Even when assuming the accuracy of all points made in the preceding article, an analysis described herein still demonstrates that the current U.S.A. civil commitment referral procedures "under-predict" sexual recidivism rates. Second, an inference made in the preceding critique, read as a possible implication from my article, is strongly contested. Finally, the remaining discussion responds to various other concerns that were raised. While scientific exploration of issues is typically expected to lead to occasional professional differences, a significant lack of agreement with the preceding critique is found.

Since the terrorist attacks of September 11, 2001, 1,348,405 citizens have been deployed to combat in Operation Iraqi Freedom (OIF), Operation New Dawn in Iraq, and Operation Enduring Freedom in Afghanistan (OEF). During this same period 266,810 (20%) of these individuals have been diagnosed with a traumatic brain injury (TBI). The majority of these were Army soldiers, with 155,282 (58%) receiving the diagnosis. Mild TBI comprised 82% of the total, with the remainder being moderate to severe. Over this same period the Department of Defense (DoD) has invested $374.9 million to enhance access and quality of care services, including 57 TBI treatment centers in the combat theater and throughout the U.S. The Army's medical research division, the Medical Research and Material Command (MRMC), has invested an additional $700 million to TBI research during this time. The effort has faced a number of challenges, including limited human subject basic and translational research, limited epidemiological data on combat-related injuries, limited capacity and standards for data acquisition, and a lack of standardized evidenced-based protocols for treatment. All these areas have undergone significant growth and development, leading to the comprehensive system of care present today. A further challenge in this patient population has been the clinical co-morbidity of TBI, post-traumatic stress disorder, and chronic pain syndrome. The Army and the DoD have created treatment programs that are interdisciplinary in clinical approach, targeting particular neuropsychological domains of dysfunction rather than diagnostic category or etiology of injury. This article presents the history of this effort, the challenges to accurate and adequate diagnosis and care that remain, and the future of brain injury clinical and research efforts in the military. Copyright © 2013 John Wiley & Sons, Ltd.

This article reviews and evaluates publications during 2001-2010 with relevance for assessments of competence to stand trial, referred to in this article as adjudicative competence. The review focuses specifically on articles that provide new concepts or data supported by research or case analyses. The studies are reviewed under the following headings: (i) systemic issues, (ii) conceptual guidelines for AC evaluations, (iii) AC assessment methods, (iv) empirical correlates of AC judgments and psycholegal abilities, (v) quality of AC evaluations and reports, (vi) interpretive issues, (vii) special populations (defendants who are elderly, defendants with intellectual disabilities), (viii) AC evaluations of juveniles, and (ix) treatment of incompetent defendants. Suggestions are offered for further research to advance the quality of clinical evaluations of adjudicative competence. Copyright © 2013 John Wiley & Sons, Ltd.

The present study investigated the empirically based factors that predicted success on conditional release among a sample of individuals conditionally discharged in Louisiana. Not guilty by reason of insanity acquittees and individuals on conditional release/discharge for incompetency to stand trial were included in the study. Success on conditional release was defined as maintenance of conditional release during the study period. Recidivism (arrest on new charges) and incidents were empirically evaluated. Success on conditional release was maintained in over 70% of individuals. Recidivism was low, with only five arrests on new charges. Success on conditional release was predicted by financial resources, not having a personality disorder, and having fewer total incidents in the program. After controlling for the influence of other variables, having an incident on conditional release was predicted by a substance use diagnosis and being released from jail. Individuals conditionally released from jail showed fewer number of days to first incident (67 vs. 575 days) compared with individuals discharged from the hospital. These data provide support for the successful management of forensic patients in the community via conditional release, although they highlight specific factors that should be considered when developing community-based release programming. Conditional release programs should consider empirical factors in the development of risk assessment and risk management approaches to improve successful maintenance of community-based forensic treatment alternatives. Copyright © 2014 John Wiley & Sons, Ltd.

Science can provide more information about the nature of aggressive acts, and therefore the mens rea of criminal offenses, than is commonly assumed. For example, progress has been made in classifying aggression as impulsive or premeditated within the context of the role of conscious experience in controlling behavior. This review of the status of the scientific ability to distinguish conscious from unconscious acts and more specifically impulsive from premeditated aggressive acts is organized around four themes: (i) How is aggression defined and measured in general? (ii) How does the distinction between impulsive and premeditated aggression relate to the legal concept of mens rea? (iii) How do various scientific disciplines contribute to the mind/body discourse? (iv) What risk factors are associated with impulsive and premeditated aggression respectively? The authors conclude that the most promising approach to researching the nature of behavioral intention and motivation is to apply a discipline neutral model that integrates the data from multiple disciplines, collectively designated the cognitive neurosciences.

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.

Congressional enactment of Federal Rules of Evidence 413-415 changed centuries of the law which had excluded evidence by the state that the defendant had committed other bad acts and was therefore the sort of person who would be more likely to commit the act charged. The passage of Rules 413-415 opens the door to this type of character evidence in sexual assault and child molestation cases and requires trial judges to assess the probative value of this propensity evidence offered. Yet, neither these rules nor their legislative history offer much guidance in this assessment. This article offers guidance to trial judges and lawyers to assess the probative value of propensity evidence offered under these rules.

Public opinion about neonaticide (the killing of a newborn within the first 24 hours of life) has varied across time and cultures. Some nations have passed legislation on behalf of maternal offenders with the assumption that childbirth, a time of unique biological change, may lead to mental disturbance. The United States, however, makes no such distinction; offenders are prosecuted under general homicide laws. Nevertheless, U.S. courts often consider a mother's emotional and physical condition prior to and during delivery. This study includes 44 female offenders and 45 infant deaths and highlights society's ambivalence toward neonaticide offenders. The authors suggest that this ambivalence may be attributed to: (1) the perception that an offender's emotional and physical turmoil during the birth and homicide reduces her culpability; (2) the sentiment that neonaticide offenders are more "redeemable" than other offenders; and (3) the uncertainty about the personhood of a fetus or newborn.

Participants were 45 violent California male prison inmates scoring 30 or more on the Psychopathy Checklist-Revised (PCL-R; Hare, 1991, 2003). Inmates were evaluated using Rorschach and neuropsychological test data. The participants' intellectual functioning was within the low-average range and displayed a lack of flexibility. Rorschach data were not suggestive of chronic narcissism and anger as in other psychopathic samples. This group resembled Exner's normative sample of high Lambda adults. Consistent with previous studies, psychopaths demonstrated poor emotional modulation, diminished reality testing, little interest in people, and virtually no attachment capacity. Most utilized a simplistic, avoidant, and concrete style. This appeared to be consistent with the concrete thinking and fragmentation attributed to the criminal personality. Concrete thinking is based upon literal interpretations of events. Fragmentation is associated with attitudes that are situation specific and self-serving.

Sanity evaluations are high-stake undertakings that explicitly examine the defendant's culpability for a crime and implicitly explore clinical information that might inform a plea agreement. Despite the gravity of such evaluations, relatively little research has investigated the process by which evaluators form their psycholegal opinions. In the current study, we explore this process by examining 5175 sanity evaluations conducted by a cohort of forensic evaluators in Virginia over a ten-year period. Our analyses focus on (i) the clinical, criminal, and demographic attributes of the defendant correlated with opinions indicative of insanity; (ii) the clinical content of the evaluations and the legal criteria referenced as the basis for the psycholegal opinion; (iii) the process and outcome differences in the sanity evaluations conducted by psychologists versus psychiatrists; and (iv) the consistency in these opinions over a ten year period. Analyses predicting an opinion of insanity indicate a positive relationship with psychotic, organic, and affective diagnoses and previous psychiatric treatment. Analyses also indicate a negative relationship with prior criminal history, drug charges, personality disorder diagnosis, and intoxication at the time of the offense. Modest racial disparities were observed with evaluators offering opinions that the defendant was insane more often for white than for minority defendants despite comparable psychiatric and criminal characteristics.

In Germany, preventive detention can be imposed if a repeat offender shows a proclivity to commit further significant criminal acts. The courts require expert opinion to provide information about personality traits relevant for this disposition. However, currently, consensus about this topic is lacking. On the basis of a standardized examination, the relevance of Hare's concept of "psychopathy" for expert opinion is discussed in the context of preventive detention. Copyright (C) 2010 John Wiley & Sons, Ltd.

This paper describes a 7.5 year retrospective study of all patients discharged from inpatient forensic services to forensic community team (FCT) follow-up from the Auckland Regional Forensic Psychiatry Service. Patients' files were studied for clinical, criminal, and risk data, type of service delivered, and final level of function achieved in the community. Rearrest, re-hospitalization, and reimprisonment data were obtained from clinical, court, and prison records. 105 patients were included. The most common diagnosis was a psychotic disorder, and index offending behaviour was typically violent. The median period of inpatient stay was 36 months and mean subsequent FCT follow-up 21.7 months (SD 17.8). The majority of patients were from Maori and Pacific Island ethnic groups. At the end of the study, half were in independent living, half were in some form of employment, and 19% were readmitted to a forensic hospital. One patient was rearrested but not reimprisoned whilst under forensic community team care. However, 9 of the 48 who were discharged to general mental health services were rearrested and 5 reimprisoned. Only two offences were as serious as the original index offence. Broad based assertive, mandated, and committed forensic rehabilitation can achieve high quality outcomes. These levels of function may not be sustained under less assertive care. Copyright

Evaluations of competence to stand trial (CST) are the most common type of criminal forensic evaluation conducted, and courts tend to defer to clinician opinions regarding a defendant's competence. Thus, it is important to study the ways in which clinicians arrive at opinions regarding adjudicative competence and the data they consider in forming their opinions. We reviewed 8,416 evaluations conducted by forensic evaluators in Virginia over a 12 year period, and examined (a) the clinical, demographic, and criminal characteristics of a defendant as related to opinions regarding competence, predicted restorability, and impairment on "prongs" of the Dusky standard, (b) process and outcome differences in evaluations conducted by psychiatrists versus psychologists and inpatient versus outpatient evaluators, and (c) the consistency of incompetence base rates over a 10 year period. Overall, clinicians opined that 19% of defendants were incompetent and considered 23% of these unlikely to be restored to competence. Not surprisingly, psychotic and organic/intellectual disorders were most strongly associated with findings of incompetence. However, there were some notable differences between evaluations by psychologists versus psychiatrists and between evaluations conducted in inpatient versus outpatient settings.

This study systematically compared parents in abducting families with families litigating custody. Findings indicate that risks for parental abduction of children are multidetermined by: (1) a heightened concern about very young children being exposed to neglectful, endangering, or criminal environments by the other parent; (2) unsubstantiated allegations of sexual abuse; (3) heightened distrust of and less respect for law and authority; and (4) a reluctance to seek help from the courts. Abducting families were also predominantly socially and economically disadvantaged: parents were less likely to have been married to one another; they had lower incomes, were more poorly educated, and were disproportionately members of minority racial and ethnic groups. The social policy dilemmas of identifying these differences as risk factors are discussed together with suggestions for risk management.

Criminal defendants adjudicated incompetent to stand trial are typically hospitalized for competence restoration in state institutions. Prolonged restoration hospitalizations involve civil rights concerns and increasing financial costs, and there remains interest in determining which individuals are likely to be successfully restored. We retrospectively reviewed hospital records of 455 male defendants admitted to a forensic treatment center for competence restoration in an effort to determine whether psychiatric diagnoses, demographic factors, or psycholegal abilities were predictive of successful or failed restoration. At varying stages of restoration efforts, psychotic disorder, mental retardation, and previous state hospitalization predicted unsuccessful restoration, while substance use and personality disorders were predictive of successful restoration. Psycholegal abilities were predictive of successful restoration and appeared to form a continuum, with basic behavior and outlook, factual legal understanding, and rational attorney assistance factors demonstrating progressively increased importance in successful restoration. Copyright © 2012 John Wiley & Sons, Ltd.

A set of measures assessing abilities related to legal standards for competence in the adjudicative process were administered to mentally-disordered criminal defendants with diagnoses of schizophrenia, affective disorder, other psychiatric disorders, and to criminal defendants without diagnosed mental disorder. Mentally-disordered defendants were recruited from two groups: those who had been committed for restoration of competence and those who had been identified by jail personnel as mentally ill. Significant impairments in competence-related abilities were found for approximately half of the defendants with schizophrenia. Defendants with schizophrenia scored lower on measures of understanding, reasoning, and appreciation related to the adjudication process. The association between symptoms and competence-related abilities was explored within diagnostic groups. Conceptual disorganization was found to be inversely correlated with performance on all measures in both defendants with schizophrenia and those with affective disorders. For other psychotic symptoms, differing patterns of correlations were found in the two major diagnostic groups. The implications for policy designed to safeguard the rights of defendants to be tried while competent are discussed.

With the increasing popularity in the use of brain imaging on antisocial individuals, an increasing number of brain imaging studies have revealed structural and functional impairments in antisocial, psychopathic, and violent individuals. This review summarizes key findings from brain imaging studies on antisocial/aggressive behavior. Key regions commonly found to be impaired in antisocial populations include the prefrontal cortex (particularly orbitofrontal and dorsolateral prefrontal cortex), superior temporal gyrus, amygdala-hippocampal complex, and anterior cingulate cortex. Key functions of these regions are reviewed to provide a better understanding on how deficits in these regions may predispose to antisocial behavior. Objections to the use of imaging findings in a legal context are outlined, and alternative perspectives raised. It is argued that brain dysfunction is a risk factor for antisocial behavior and that it is likely that imaging will play an increasing (albeit limited) role in legal decision-making.

The author advances a taxonomy of expert evidence in relation to the responses of sexually abused children to their assaults. He analyses a series of Australian and New Zealand cases in the context of Summit's publicly stated recent views on the use to which Child Sexual Abuse Accommodation Syndrome ("CSAAS") can be put. He argues that expert evidence that goes further than dispelling myths or disabusing triers of fact of misperceptions generally held within the community should not be permitted. He contends that CSAAS is an illegitimate description of such information and that such "syndrome evidence" should not be permitted, particularly before juries. He maintains, moreover, that further rigour will be (and should be) required of prosecutors and mental health professionals alike if such counterintuitive evidence is to be admitted. This will entail proof of the existence of community misunderstanding of the phenomenon, establishment that the field of expertise from which child sexual abuse accommodation evidence emanates is sufficient for the purpose, as well as proof of the expert's expertise in the field. However, he argues against abandoning attempts to use counterintuitive evidence merely on the basis of a number of adverse Australasian determinations, whose reasoning is dependent on the quality of the evidence hitherto advanced and the overly limited perceptions of the evidential framework within which such evidence should be evaluated.

Understanding jurors' perceptions of juvenile defendants has become increasingly important as more and more juvenile cases are being tried in adult criminal court rather than family or juvenile court. Intellectual disability and child maltreatment are overrepresented among juvenile delinquents, and juveniles (particularly disabled juveniles) are at heightened risk for falsely confessing to crimes. In two mock trial experiments, we examined the effects of disability, abuse history, and confession evidence on jurors' perceptions of a juvenile defendant across several different crime scenarios. Abused juveniles were treated more leniently than nonabused juveniles only when the juvenile's crime was motivated by self-defense against the abuser. Jurors used disability as a mitigating factor, making more lenient judgments for a disabled than a nondisabled juvenile. Jurors also completely discounted a coerced confession for a disabled juvenile, but not for a nondisabled juvenile. In fact, compared with when it was portrayed as voluntary, jurors generally discounted a juvenile's coerced confession. Implications for public policy and directions for future research are discussed.

Litigation surrounding family matters can have a significant impact on children well into their adult years. Because their interests may differ from those of their parents or other caretakers, it is crucial that the legal system provide a mechanism to ensure that children's interests are both protected by and appropriately communicated to the family court. The legal community has not reached a consensus regarding how children's interests can best be protected--or the appropriate role for attorneys involved in such cases. In fact, a number of professional organizations have proposed standards that impose differing obligations upon attorneys. In this article, the strengths and limitations of various practice standards are compared and contrasted, with the focus being on how children's interests can best communicated to, and protected by, the court.

As reports of child sexual abuse (CSA) have risen, greater attention has been focused on how clinicians evaluate allegations of abuse. A common theme in the CSA assessment literature is to encourage comprehensive, multimodal assessments. This recommendation, however, is rarely accompanied by suggestions regarding how clinicians might integrate and differentially weight the information gathered. The present article is designed to address the issue of which sources of information clinicians should rely upon when conducting CSA assessments. Specifically, the commonly used indicators and procedures for assessing allegations of abuse are identified and then examined in light of their respective empirical literatures. It is concluded that medical examinations and the child's report are among the best sources of information, and should therefore be most heavily relied upon to arrive at accurate decisions. Clinicians are encouraged to adopt the mind set of a scientist conducting an a priori, hypothesis-driven research investigation. This approach should help clinicians avoid the temptation of post hoc analyses that reflect personal biases more than the actual data.

The relationships between family history of substance use, executive functions, impaired decision making, and current substance dependence are the focus of this study. Thirty-eight substance-dependent inpatients were compared with 30 community controls on performance on the Wisconsin Card Sorting Test, Trail-Making Test-B, the Stroop Color Word Test, the Wais-II Digit Span, and the Iowa Gambling Task. Recent alcohol use, depressive symptoms, and impulsivity were also assessed. As hypothesized, individuals with substance dependence exhibited poorer executive functioning. Family history status was modestly related to impaired performance on tests designed to measure the integrity of the dorsolateral prefrontal cortex. In particular, substance-dependent, family history positive individuals performed less well on the Wisconsin Card Sorting Test than substance-dependent individuals without a family history. Digit Span performances were worse among family history positive controls when compared with family history negative controls. Impulsive personality traits--specifically, difficulty thinking before acting (Urgency)--were related, as hypothesized, to executive functioning. Results indicate that family history status confers an increased risk of impairment beyond that conferred by recent substance abuse, and that impulsive personality traits are related to performance on tests of executive functions. Implications for criminality are discussed.

The use of anatomically detailed dolls in child sexual abuse validation interviews is based on a number of underlying assumptions and beliefs. However, only over the last 12 years have researchers begun to evaluate the validity of these assumptions and beliefs systematically. This consideration of the existing AD doll empirical literature reveals that the support for some of the assumptions underlying the use of the dolls, as well as the surrounding beliefs, is available. However, for other assumptions and beliefs support is less firm, frequently contradictory, and sometimes absent. The evidence of support for these assumptions and beliefs is discussed and future research needs are identified.

The scientist-practitioner model is presented as a format for conducting child sexual abuse evaluations. This model bases conclusions on empirically established relationships between data and the behavior of interest, rather than on subjective opinions. Using empirically derived evidence, the scientist-practitioner defines child sexual abuse as a life event rather than a clinical syndrome, relies on base rates of behavior for distinguishing and understanding differences between nonsexually abused and sexually abused children, and considers issues of instrument sensitivity and specificity when utilizing assessment tools in child sexual abuse evaluations. This model enlists safeguards to keep the evaluator from inappropriately forming cause and effect associations between a child's single response (e.g., behavioral and emotional symptoms, interactions with anatomically detailed dolls, drawing genitalia) and the occurrence of an event (e.g., sexual abuse).

Based on limited research, clinical and forensic experience and observations, factors hypothesized to be potentially useful in forensic evaluation of claims of decades-delayed discovery of childhood sexual abuse are delineated. Factors considered include: (1) alleged victim factors, (2) memory factors, (3) therapist/examiner factors, (4) external influences on the abuse account, (5) evidential patterns. Differences among a limited sample of cases seen by the author are described. Present knowledge does not provide a basis for reliable determination of whether a specific recollection is true or false, based only upon the claimant's account. At this time, there is no empirically validated method for discriminating valid from invalid cases. Experts testifying for either side must exercise caution and restraint as it may be premature and even unethical in many cases to propound opinions about the validity or invalidity of the memories.

Confidentiality is widely considered to be of great importance in psychotherapy. With few exceptions, the breaching of confidentiality is an ethical violation and grounds for litigation. One such exception is the mandated reporting of known or suspected child abuse, representing a legally sanctioned limitation of confidentiality. Because clients generally expect unlimited confidentiality in therapeutic relationships, many therapists have begun to "forewarn" clients as a matter of informed consent. This research report: (a) briefly reviews issues surrounding mandatory reporting and confidentiality as they relate to forewarning, (b) defines and discusses forewarning as contrasted with "informing," (c) examines state statutes, case law and ethical guidelines relevant to forewarning, and (d) presents a survey of 428 mental health providers (MHPs) on their forewarning practices in which 36.9% forewarned all clients, 36.4% informed clients only upon suspicion of abuse, and 20.6% informed only after receiving a disclosure of abuse. The implications of these findings are discussed.

Baseline data from a study of jail diversion services and in-jail behavioral health services were used to examine the differences in clients served by these two models of responding to people with co-occurring mental health and substance abuse problems in the criminal justice system. Clients of the diversion service had more acute psychiatric symptoms and were more likely to have a diagnosis of psychosis NOS. Clients of the in-jail service were more likely to have been on probation or parole in the past and to have received substance abuse treatment. Different service models may attract and serve different populations of clients. Diversion services may cast a wider net that includes clients who may not have otherwise been involved in forensic services.

All 51 jurisdictions in the United States require physicians to report suspected child abuse. In most jurisdictions, reporting requirements override both confidentiality and privilege associated with the physician-patient relationship. The authors review the literature relevant to the conflict between privacy and reporting abuse and report the results of a national survey of therapists at sex offender treatment units. They discuss ethical problems experienced under these statutes by therapists who attempt to provide treatment for sex offenders, and by therapists who are required to report past instances of child abuse even when there is no evidence of ongoing abuse.

This study examined gender differences in a range of lifetime psychiatric disorders in a sample of 272 offenders newly admitted to a prison substance abuse program. Although these men and women did not differ in severity of substance use in the six months prior to incarceration, women were significantly more likely than men to report a lifetime psychiatric disorder and a lifetime severe disorder. Furthermore, gender differences emerged in the pattern of lifetime psychiatric comorbidity. Women reported greater lifetime major depression, posttraumatic stress disorder, eating disorder, and borderline personality disorder; men were more likely than women to meet criteria for antisocial personality disorder. Additionally, female offenders were found to have a higher degree of internalizing disorders than male offenders, but there were no gender differences in degree of externalizing disorders. The study concluded that women offenders newly admitted to a prison substance abuse program present with a greater psychiatric vulnerability and a different pattern of psychiatric comorbidity than their male counterparts.

Criminal justice populations, including arrestees, probationers, inmates and parolees, have become increasingly involved with drugs of abuse. These numbers have seriously impacted the criminal justice system from enforcement to the courts, corrections, and subsequent legal supervision agencies. Prevalence of substance abuse in these populations is reported, as well as the effectiveness of community-based and corrections-based treatment in effecting behavioral changes to reduce drug demand. The characteristics of successful intervention programs are described and an ideal model proposed for better integrating community treatment and criminal justice intervention efforts.

Statutory management of juvenile sexual offenders demands reliable, valid methods for assessing the risk posed by these youth. This study examined the predictive validity of the J-SOAP-II using samples of adolescent and pre-adolescent boys who were wards of the Massachusetts Department of Social Services. The base rate for sexual recidivism among the adolescents (14-16%) is generally in line with what has been reported. The equivalent base rate for the pre-adolescents (25-28%), however, was notably higher. Although the J-SOAP-II was developed for adolescents, the scale also worked with the pre-adolescents in predicting sexual recidivism over 7 years, with AUC values of 0.77, 0.74, 0.77, and 0.80 for Scales 1, 3, 4, and Total among the pre-adolescents and AUC values of 0.80, 0.82, and 0.83 for Scales 1, 4, and Total among the adolescents. Discussion focuses on extant J-SOAP research and sample dependent variability, as well as social policy implications.

This article traces the phenomenon of facilitated communication (FC) from its introduction to the United States in 1990 to its use in recent court proceedings. FC is an alleged breakthrough technique that enables nonverbal individuals with developmental disabilities to communicate via a form of assisted typing. Widespread use of FC resulted in miraculous communications and surprising allegations of abuse. The growing importance and notoriety of FC attracted the interest of the scientific community which rejected the technique after numerous controlled studies were undertaken. Despite the rejection of FC by the scientific community, however, some courts have accepted this unproven technique by evading their state's test of scientific admissibility. It is asserted that court decisions admitting FC evidence are pretextural, and it is argued that FC should not be admitted into court proceedings. In addition, this report analyzes the future of FC in those states that have adopted the newer Daubert standard for scientific evidence.

One of the issues that commonly arises in custody disputes is whether one parent or the court may obtain access to the records of the other parent's mental health treatment. The answer to this question varies across jurisdictions given that states do not treat the medical/psychological therapeutic privilege uniformly. These differences demonstrate the competing interests whenever a party's mental health records become an issue in a custody proceeding, and the attempt to balance the interests when the therapeutic privilege is asserted. This article will examine the balancing challenge, review the scope and function of the psychotherapist-patient privilege, discuss different states' approaches to the balancing challenge, and propose that preserving the privilege creates the most effective, long-term balance. The article concludes with strategies on addressing privilege issues in custody cases.

The Americans with Disabilities Act (ADA), and Sections 504 and 508 of the Rehabilitation Act, prohibit discrimination against people with disabilities in all aspects of daily life, including education, work, and access to places of public accommodations. Increasingly, these antidiscrimination laws are used by persons with disabilities to ensure equal access to e-commerce, and to private and public Internet websites. To help assess the impact of the anti-discrimination mandate for educational communities, this study examined 157 website home pages of Iowa public high schools (52% of high schools in Iowa) in terms of their electronic accessibility for persons with disabilities. We predicted that accessibility problems would limit students and others in obtaining information from the web pages as well as limiting ability to navigate to other web pages. Findings show that although many web pages examined included information in accessible formats, none of the home pages met World Wide Web Consortium (W3C) standards for accessibility. The most frequent accessibility problem was lack of alternative text (ALT tags) for graphics. Technical sophistication built into pages was found to reduce accessibility. Implications are discussed for schools and educational institutions, and for laws, policies, and procedures on website accessibility.

This case study examines efforts by Microsoft Corporation to enhance the diversity of its workforce and improve the accessibility and usability of its products and services for persons with disabilities. The research explores the relation among the Americans with Disabilities Act of 1990, corporate leadership, attitudes and behaviors towards individuals with disabilities, and dynamics that shape organizational culture at Microsoft. Implications for Microsoft, other employers, researchers, and the disability community are discussed.