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Month: July 2017

Qualifications Of Agreement Of Phychiatric Diagnosis Revisited

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Abstract

Eighteen years ago in this journal, Spitzer and colleagues1 published "Quantification of Agreement in Psychiatric Diagnosis," in which they argued that a new measure, Cohen's k statistic,2 was the appropriate index of diagnostic agreement in psychiatry. They pointed out that other measures of diagnostic reliability then in use, such as the total percent agreement and the contingency coefficient, were flawed as indexes of agreement since they either overestimated the discriminating power of the diagnosticians or were affected by associations among the diagnoses other than strict agreement. The new statistic seemed to overcome the weaknesses of the other measures. It took into account the fact that raters agree by chance alone some of the time, and it only gave a perfect value if there was total agreement among the raters. Furthermore, generalizations of the simple k statistic were already available. This family of statistics could be used to assess...

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Liability of the Psychiatrist for Improper Commitment

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An important category of cases of alleged psychiatric malicious practice involves actions for false and improper commitment of a person to a mental institution, an action sometimes based upon statute but more often arrived at by a common law false imprisonment or malicious prosecution action. This consideration poses an interesting concrete question: If a psychiatrist conspires with a patient's relative to commit the patient to an institution because of alleged insanity, and writes to a court requesting confinement of the patient, is the psychiatrist liable for damages where the court later finds the patient was not insane and orders him released ?

Malicious Prosecution
The answer to this intriguing query is to be found in Loweii vs Hilton (351 P 2d 881), decided by the Supreme Court of Colorado in I960. In that case the plaintiff brought a suit for malicious prosecution against his brother and a psychiatrist. He charged that they had conspired to institute lunacy proceedings against him. The plaintiff's brother had signed...

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Human Mate Poaching: Tactics And Tempations For Infiltrating Existing Mateships

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Abstract

The authors explored the psychology of romantically attracting someone who is already in a relationship--what can be called the process of human mate poaching. In Study 1 (N = 236), they found that attempts at poaching were relatively common and were linked with distinctive personality dispositions. Study 2 (N = 220) documented that the perceived costs and benefits of poaching differed somewhat for men and women and depended on whether short-term or long-term poaching outcomes were targeted. Study 3 (N = 453) found support for 5 evolution-based hypotheses about the perceived effectiveness of poaching tactics. Study 4 (N = 333) found that poaching effectiveness was influenced by the type of relationship being encroached on-marital, dating, long distance, highly committed, just beginning, or about to end. Discussion focuses on the importance of placing mate poaching within the broader context of human sexual strategies...

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Concealment of Psychopathology in Forensic Evaluations: A Pilot Study of Intentional and Uninsightful Dissimulator

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Both clinical and forensic psychiatrists recognize that individuals whom they evaluate may be unreliable historians. Clinical psychiatrists are diligent in attending to the possibility that patients may not be forthcoming with all of their symptoms, beliefs, or personal history. For example, consider a clinician’s skepticism about the claims of a delusional paranoid schizophrenic brought to a clinic by his concerned family members or about the denials of suicidal intent of a depressed patient brought to the emergency room for a drug overdose. Clinicians approach cases such as these recognizing that patients may withhold critical information about their psychopathology, whether because of paranoid fears, in response to voices they hear, covert suicidal intent, desires to appear “normal,” or other motives. Forensic practitioners approach evaluations with a somewhat different focus, colored chiefly by inclusion of strategies to detect the possibility of malingering. It is certainly reasonable to be skeptical of a forensic evaluee’s claimed symptoms and complaints in light of the secondary gain attached to the outcome of the evaluation, whether it involves obtaining financial compensation or evading or minimizing...

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Common Psychosexual Disorders: Presentation And Management

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Introduction

During the last decade effective, short term treatment of the major psychosexual disorders has become a reality. For the general practitioner, who seeks to provide developing standards of patient-care, this may bring new expectations and responsibilities, for which he or she may feel ill equipped by virtue of training. In this paper we will be considering the main categories of dysfunction, in terms of established characteristics and principles of treatment. It is hoped that this outline will provide a source of information to the GP, who may wish to participate in aspects of management, in suitable cases, or refer when special expertise is required. Psychological and relationship aspects of aetiology will be considered first on account of their prominence as causative factors. The discussion will, again, be limited to heterosexual problems in couples. Classification of psychosexual disorders is, broadly speaking, either by function (eg. erectile impotence, premature ejaculation) or by phase (e.g. desire, excitement, orgasm) affected. A simplified representation of the main disorders, with outlines...

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Offender Profiling and Investigative Psychology

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Abstract

The origins of ‘Offender Profiling’ in the advice given by police medical advisors and other experts to criminal investigations are briefly outlined. The spread of such advice to police inquiries across the United States in the early 1970s, culminating in its uptake by Special Agents of the FBI in the mid-1970s and the widespread promotion of their services through the fictional writings of Thomas Harris and others is noted. The development beyond the early application to serial killer investigations, and the focus on psychopathological explanations, to cover the full gamut of crime from, for instance, arson and burglary to terrorism, is briefly reviewed. The consideration of the social psychological processes inherent in criminality as well as the characteristics of individual offenders also broadens out the concerns of the field. The linking of crimes to a common offender as well as predicting their future actions further widens the range of issues to be dealt with. The many psychological and practical questions raised by these ‘profiling’activities are

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