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Are Psychiatric Diagnoses Defamatory Statements?

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Abstract

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:

To evaluate evidence from randomised controlled trials (RCTs) for the efficacy of different communication strategies used by clinicians to inform patients about the diagnosis and outcome of schizophrenia, compared with treatment as usual

To compare efficacy between different communication strategies.

Background

Description of the condition

Schizophrenia, a serious mental illness, is a group of heterogeneous disorders typically characterised by the presence of delusions, hallucinations, disorganised speech, disorganised behaviour, and negative symptoms (avolition, apathy, anhedonia, alogia, affective blunting). The two major classification systems, the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD-10), have different requirements of symptoms duration for the diagnosis of schizophrenia. While the DSM requires a total duration of a minimum of six months, the ICD-10 warrants a minimum duration of one month.

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Munchausen’s Syndrome and Other Factitious Disorders in Children

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Abstract

There has been increasing recognition in the pediatric literature for the past 20 years that illness falsification by caregivers must be included in the differential diagnosis of children presenting with persistent, unexplained symptoms or laboratory findings. However, there is considerably less awareness that pediatric symptoms can also be intentionally falsified by child and adolescent patients, and this unique group has remained virtually invisible. There have been reports that many children with factitious disorders also suffer from other mental disorders, particularly personality disorders. We report an unusual case of Munchausen's syndrome in a 15-year-old patient with sickle cell disease. We also review other reported pediatric factitious disorders in literature. Our purpose is to make clinicians aware of this less known disorder in children and to discuss the similarities and differences these disorders have in children compared to adults with the same disorders.

Introduction

Adult patients who present with symptoms of factitious disease are...

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What Is the Difference Between Malingering and Factitious Disorder?

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Factitious disorder is the term used to describe a pattern of behavior centered on the exaggeration or outright falsifications of one’s own health problems or the health problems of others. Some people with this disorder fake or exaggerate physical problems; others fake or exaggerate psychological problems or a combination of physical and psychological problems. Factitious disorder differs from a pattern of falsified or exaggerated behavior called malingering. While malingerers make their claims out of a motivation for personal gain, people with factitious disorder have no such motivation.

Factitious Disorder Basics

People with factitious disorder do several things that are unexpected for patients who present themselves for medical treatment, or for individuals seeking treatment for others in their care. First, they commonly exaggerate or lie about problems in their medical histories or the histories of others. They also present their doctors with symptoms that don’t legitimately ....

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Factitious Disorder Imposed on Another (Munchausen by proxy)

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Practice Essentials

Factitious disorder imposed on another (formerly factitious disorder by proxy) has as its cardinal characteristic the production or feigning of physical or psychological symptoms in another person, usually a child or adult under the care of the person with the disorder. It is currently understood as including the condition commonly known as Munchausen syndrome by proxy (MSBP). Signs and symptoms

Common presentations of factitious disorder imposed on another (including MSBP) include the following:

•Bleeding •Seizures •Recurrent apparent life-threatening events •Poisoning •Apnea •Central nervous system (CNS) depression •Diarrhea and vomiting •Fever, either feigned (via falsification of chart records) or actual •Rash •Hypoglycemia •Hyperglycemia •Hematuria or guaiac-positive stools •Multiple infections with varied and often unusual organisms

Warning signs that raise the possibility of this disorder include the following:

Unexplainable, persistent, or recurrent illnesses Discrepancies among the history, clinical findings, and child’s general health

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Presentation of the Steroid Psychoses.

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Abstract

This study suggests that patients receiving daily doses of 40 mg of prednisone or its equivalent, are at greater risk for developing steroid psychosis. Psychotic reactions were twice as likely to occur during the first 5 days of treatment as subsequently. Premorbid personality, history of previous psychiatric disorder, and a history of previous steroid psychosis did not clearly increase the patient's risk of developing psychotic reaction during any given course of therapy. Steroid psychoses present as spectrum psychoses with symptoms ranging from affective through schizophreniform to those of an organic brain syndrome. No characteristic stable presentation was observed in these 14 cases reported here. The most prominent symptom constellation to appear some time during the course of the illness consisted of emotional lability, anxiety, distractibility, pressured speech, sensory flooding, insomnia, depression, perplexity, agitation, auditory and visual hallucinations, intermittent memory impairment, mutism, disturbances of body image, delusions, apathy, and hypomania. Phenothiazines...

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The Problem of Bank Robbery

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Bank robberies are relatively uncommon: only about 2 of every 100 robberies are of a bank.1 Although violence is rare, employees and customers are at some risk of injury.† If nothing else, being victimized can be terrifying. In addition, bank robberies can invoke fear in the community at large, as most are well-covered by the media. And in fact, a distinctive bank robbery such as the fatal 1998 shoot-out between police and two bank robbers armed with assault weapons in Los Angeles can influence public images of crime for many years.

Injuries occur in about 2 percent of bank robberies in the United State s and in 6 percent of robberies in Australia (Maguire and Pastore, 1997; Pastore and Maguire, 2005; Borzycki, 2003). A death occurs in about 30 percent of U.S. bank robberies (Pastore and Maguire, 2005).

Because of the...

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Extreme Hatred: Revisiting the Hate Crime and Terrorism Relationship to Determine Whether They Are “Close Cousins” or “Distant Relatives”

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Abstract

Existing literature demonstrates disagreement over the relationship between hate crime and terrorism with some calling them “close cousins,” whereas others declare them “distant relatives.” We extend previous research by capturing a middle ground between hate crime and terrorism: extremist hate crime. We conduct negative binomial regressions to examine hate crime by non-extremists, fatal hate crime by far-rightists, and terrorism in U.S. counties (1992-2012). Results show that counties experiencing increases in general hate crime, far-right hate crime, and non-right-wing terrorism see associated increases in far-right hate crime, far-right terrorism, and far-right hate crime, . We conclude that hate crime and terrorism may be more akin to close cousins than distant relatives.

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The Psychopath As Pimp

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ABSTRACT

Although the study of psychopathy has become a significant area for research in recent years, relatively little attention has been paid to examining the role of psychopa-thy in offenders who live off the avails of prostitution (i.e., “pimps”). It may be argued that this dearth in the literature is surprising given that psychopathy is defined by a unique set of interpersonal and affective characteristics that theoretically should facilitate the business of pimping. As such, the present investigation attempted to profile characteristics of perpetrators who engage in pimping. As expected, psychopathy was an important feature of these perpetrators: over one-third of the 22 perpetrators examined met the diagnostic cut-off of 30 on the Psychopathy Checklist-Revised. To expand our understanding of pimps and their actions, other important perpetrator characteristics were also examined. The implications of these findings are discussed in relation to criminal justice factors

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Notice regarding the solicitation “Strengthening the Medical Examiner-Coroner System Program”

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Program-Specific Information

The National Science and Technology Council’s Fast-Track Action Committee on Strengthening the Medicolegal-Death-Investigation System’s (FTAC-SMDIS) report titled Strengthening the Medicolegal-Death-Investigation System: Improving Data Systems notes that death investigations performed by ME/C offices are vital to criminal justice by investigating violent deaths. Of the estimated 2.6 million deaths annually, ME/C offices investigate nearl 500,000 cases in approximately 2,400 jurisdictions. FTAC-SMDIS found that the ME/C community lacks adequate personnel and resources to address the country’s medicolegal death investigation (MDI) needs. In addition, FTAC-SMDIS reports that there are systemic issues with death investigation data quality and infrastructure, inadequate facilities, and inconsistent expertise levels.3 Other reports such as the 2009 National Academy of Sciences Report, Strengthening Forensic Science in the United States: A Path Forward have also asserted a need to address deficient facilities, equipment, staffing, education, and training for MDI.

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Sexual Homicide of Elderly Females

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Both Bureau of Justice Statistic studies and the National Crime Survey reflect that crimes against the elderly tend to be more serious in nature than those against younger persons (Bureau of Justice Statistics, 1994). Older victims of violent crimes are more likely to be attacked by total strangers (Ken-nedy & Silverman, 1990; Muram, Miller, & Cutler, 1992) and are most likely to be victimized in their own homes. They are less likely to try to protect themselves during a crime and are more likely to sustain injuries. These findings are confirmed by numerous studies that discuss the general problem of victimization of the elderly and by specific research addressing violent offenses (Antunes, Cook, Cook, & Skogan, 1977; Faggiani & Owens, 1999;Fox & Levin, 1991; Lent & Harpold, 1988; Nelson & Huff-Corzine, 1998).These studies also demonstrate that in particular ways elderly women are inherently more vulnerable to crime than younger women. First,...

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The Varieties of Homicide and Its Research Proceedings of the 1999 Meeting

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ABSTRACT

Any scholar attempting to trace historic trends in homicide must grapple with the issue of missing data, some of which are yet to be uncovered, but others of which have disappeared forever. This paper shows the utility of multi-source “capture-recapture” (or “dual enumeration”) methods for estimating the number of unrecorded murders, using newspaper and archives data for the state of South Carolina, 1877-1878. Results are dramatic. In comparison with the capture-recapture estimate of total homicides, at least 58% of the state’s murders for the 2 years are not to be found in the South Carolina State Department of Archives and History; the major newspaper of the state missed at least 30%; and the combined sources missed at least 20%. Clearly, any historical trend study based on the 2 sources alone would face a formidable under count problem. The 19th century Southern culture and social structure, and the ruralness of the state,...

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Attorney General’s Opinion

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Is the state or a county responsible for the payment of the costs of (1) a report required before a court may consider suspension of a defendant’s sentence, where the defendant has been convicted of a lewd or lascivious act on a minor under 14, (2) an examination of a defendant’s mental competency, (3) an examination of a defendant, who has been convicted of a felony, to determine whether an involuntary civil commitment should be made due to narcotics addiction, (4) an examination of a person, in the absence of a criminal proceeding, to determine whether a civil commitment should be made due to narcotics addiction, (5) an examination and testimony in connection with an involuntary civil commitment of a person believed to be imminently dangerous to others, (6) evaluations and counsel regarding a civil commitment due to an inmate being a sexually violent predator, and (7) an examination of a...

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Journal of Experimental Psychology

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Dogs which had 1st learned to panel press in a harness in order to escape shock subsequently showed normal acquisition of escape/avoidance behavior in a shuttle box. In contrast, yoked, inescapable shock in the harness produced profound interference with subsequent escape responding in the shuttle box. Initial experience with escape in the shuttle box led to enhanced panel pressing during inescapable shock in the harness and prevented interference with later responding in the shuttle box. Inescapable shock in the harness and failure to escape in the shuttle box produced interference with escape responding after a 7-day rest. These results were interpreted as supporting a learned "helplessness" explanation of interference with escape responding: Ss failed to escape shock in the shuttle box following inescapable shock in the harness because they had learned that shock termination was independent of responding.

Overmier and Seligman (1967) have shown that the prior exposure of dogs

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Distinguishing Between True and False Confessions

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The impact of a confession on a jury in a capital case is so powerful that a defense attorney who does not attempt to suppress it risks charges of providing inadequate counsel. While there are legal safeguards afforded a defendant at trial to refute the voluntariness or trustworthiness of a professed confession, a false confession should be recognized long before it is entered into evidence against an innocent defendant. Ultimately there responsibility of determining whether a confession is true or false falls upon the investigator who obtained it.A widely known critic of police interrogation addressed an audience and stated that in his years of reviewing confessions he has seen both non-coerced reliable confessions and confessions from innocent people who were convinced by the police that they were guilty. He went on to state that if he distributed ten of those confessions to everyone in the audience and had them place the confessions into two piles, five of which were true confessions and five of which were false...

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Misdiagnosing Normality: Psychiatry’s Failure To Address The Problem Of False Positive Diagnoses Of Mental Disorder In A Changing Professional Environmen

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Abstract

BACKGROUND:

In psychiatry's transformation from primarily an asylum-based profession to a community-oriented profession, false positive diagnoses that mistakenly classify normal intense reactions to stress as mental disorders became a major challenge to the validity of psychiatric diagnosis. The shift to symptom-based operationalized diagnostic criteria in DSM-III further exacerbated this difficulty because of the contextually based nature of the distinction between normal distress and mental disorder, which often display similar symptoms. The problem has particular urgency because the DSM's symptom-based criteria are often applied in studies and screening instruments outside of the clinical context and by non-mental-health professionals.

AIMS:

To consider, through selected examples, the degree of concern, systematicity and thoroughness - and the degree of success - with which recent revisions of the DSM have attended to the challenge of avoiding false positive diagnoses.

METHOD:

Conceptual analysis of selected criteria sets, with a focus on possible counterexamples...

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Mental Health Training In Emergency Homeless Shelters.

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Abstract

The prevalence of mental illness among homeless persons points to the importance of providing mental health training to emergency shelter staff. The authors report on their own work and argue that such training offers the potential to significantly improve shelter staffs ability to respond to the needs of shelter residents with mental illness, and to the behavioral problems some of these individuals may pose for shelter operation. Mental health care providers should take into consideration organizational dynamics when planning and implementing such training...

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