Extreme emotional disturbance: Legal frameworks and considerations for forensic evaluation.

A significant minority of jurisdictions in the United States offer extreme emotional disturbance (EED) as a partial defense to murder. The form of this defense, as established by statute and case law, varies widely among jurisdictions. Empirical research on EED is scant with little guidance to forensic mental health professionals on how to approach and conceptualize potential EED cases. This paper addresses these issues by being the first known published work to (1) set forth a contemporary map of the varying definitions and scope of EED across the United States, (2) translate legal terminology into constructs accessible to forensic evaluators, and (3) provide legal and clinical analyses of sample EED cases to highlight key differences in the form of the defense and the admissibility of evidence between jurisdictions.

Diffusion Tensor Imaging Correlates of Resilience Following Adolescent Traumatic Brain Injury.

BACKGROUND: Traumatic brain injury (TBI) is associated with considerable mortality and morbidity in adolescents, but positive outcomes are possible. Resilience is the concept that some individuals flourish despite significant adversity. OBJECTIVE: To determine if there is a relationship between resilience-promoting factors that are known to promote resilience and white matter (WM) microstructure 1 year after complicated mild TBI or moderate or severe TBI that is sustained by adolescents. METHOD: We examined the relationship between performance on a self-report measure of resilience-promoting factors and WM integrity assessed by diffusion tensor imaging in a group of adolescents who had sustained either a TBI (n = 38) or an orthopedic injury (OI) (n = 23). RESULTS: Immediately following injury, the individuals with TBI and the OI controls had comparable levels of resilience-promoting factors; however, at 1 year post injury, the TBI group endorsed fewer resilience-promoting factors and exhibited WM disruption compared with the OI controls. The individuals with TBI who had more resilience-promoting factors at 1 year post injury exhibited increased WM integrity, but the OI controls did not. Findings were particularly strong for the following structures: anterior corona radiata, anterior limb of the internal capsule, and genu of the corpus callosum-structures that are implicated in social cognition and are frequently disrupted after TBI. Relationships were notable for caregiver and community-level resilience-promoting factors. CONCLUSION: The current findings are some of the first to indicate neurobiological evidence of previously noted buffering effects of resilience-promoting factors in individuals with TBI.

Development of a measure of mental health stigma including police behaviors.

Various stigmatizing notions are associated with mental illness, resulting in negative personal (e.g. employment discrimination) and societal (e.g. public treatment of the mentally ill as 'dangerous' and/or 'criminal') outcomes. This study develops and validates a new multi-scale assessment tool to assess several dimensions of mental illness stigma, including perceived dangerousness, self-care, social distance, treatment amenability and predicted police behavior. A total of 641 undergraduate students from various American universities completed the new stigma measure along with two other existing measures. The results indicate that the new stigma measure has an acceptable three-factor solution consisting of self-care, dangerousness and police behavior. The self-care and dangerousness factors were found to have concurrent validity with the corresponding scales of the existing measures. Future research involving different populations, as well as the policy implications of the new police behavior factor, are discussed.

Examining Employment Outcomes of Offender and Nonoffender Vocational Program Graduates.

Researchers have found providing employment opportunities for ex-offenders through job training programs to be effective at reducing recidivism. Examining various community-based programs for ex-offenders can be beneficial as they may be able to provide more stable and consistent programming without relying on the justice system. This study examined employment outcomes of graduates with and without criminal histories ( n = 617) from a community-based vocational training program. Results showed that ex-offender graduates obtained employment at equal rates to nonoffender graduates and received equal pay to their nonoffender counterparts. This could indicate that for the vocationally educated ex-offender, employment outcomes may be able to equal those of other job-searching individuals with similar backgrounds but without a criminal history. Community-based programs for ex-offenders may be able to provide effective programming to improve vocational attainment within this group, thereby potentially easing the burden on criminal justice institutions as the sole provider of offender rehabilitation.

The role and reliability of the Psychopathy Checklist-Revised in U.S. sexually violent predator evaluations: a case law survey.

The civil commitment of offenders as sexually violent predators (SVPs) is a highly contentious area of U.S. mental health law. The Psychopathy Checklist-Revised (PCL-R) is frequently used in mental health evaluations in these cases to aid legal decision making. Although generally perceived to be a useful assessment tool in applied settings, recent research has raised questions about the reliability of PCL-R scores in SVP cases. In this report, we review the use of the PCL-R in SVP trials identified as part of a larger project investigating its role in U.S. case law. After presenting data on how the PCL-R is used in SVP cases, we examine the reliability of scores reported in these cases. We located 214 cases involving the PCL-R, 88 of which included an actual score and 29 of which included multiple scores. In the 29 cases with multiple scores, the intraclass correlation coefficient for a single evaluator for the PCL-R scores was only .58, and only 41.4% of the difference scores were within 1 standard error of measurement unit. The average score reported by prosecution experts was significantly higher than the average score reported by defense-retained experts, and prosecution experts reported PCL-R scores of 30 or above in nearly 50% of the cases, compared with less than 10% of the cases for defense witnesses (κ = .29). In conjunction with other recently published findings demonstrating the unreliability of PCL-R scores in applied settings, our results raise questions as to whether this instrument should be admitted into SVP proceedings.