ABSTRACT
There are few studies of sovereign citizens undergoing competency-to-stand-trial evaluations and little has been written about African-American or urban sovereign citizens. In this study, we examined competency-to-stand-trial reports of 36 New York City defendants who declared themselves to be sovereign citizens during their evaluations. All were men and 33 were African American. The majority denied recent or remote histories of psychiatric hospitalizations or substance use. Sixty-nine percent were deemed competent. Compared with those deemed competent, those deemed not competent were significantly more likely to have diagnosed psychotic disorders and to have reported histories of psychiatric hospitalizations. The 36 who declared themselves sovereign citizens were compared with 200 who did not, from a study conducted in the same forensic clinic. The sovereign citizens were significantly more likely to be male, African American, and high school graduates and were significantly less likely to report a history of psychiatric hospitalization or substance use. Compared with the nonsovereign citizens, they were less likely to receive a diagnosis of psychotic or mood disorders during the competency evaluation and were more likely to be deemed competent. Included are suggestions to assist forensic examiners conducting evaluations of these difficult cases.
Subject(s)
Black People , Criminal Law/legislation & jurisprudence , Mental Competency/legislation & jurisprudence , Mental Disorders/diagnosis , Adult , Comprehension , Female , Forensic Psychiatry/organization & administration , Humans , Male , Middle Aged , New York City , Urban PopulationABSTRACT
Data were examined from an archival sample of Competency to Stand Trial (CST) reports of 200 consecutive New York City pre-trial defendants evaluated over a five-month period. Approximately a fourth of defendants in the present study were immigrants; many required the assistance of interpreters. The examiners conducting the CST evaluation diagnosed approximately half of the defendants with a primary diagnosis of a psychotic disorder and deemed over half not competent. Examiners reached the same conclusion about competency in 96% of cases, about the presence of a psychotic disorder in 91% of cases, and affective disorder in 85% of cases. No significant differences between psychologists and psychiatrists were found for rates of competency/incompetency opinions. Compared to those deemed competent, defendants deemed not competent had significantly higher rates of prior psychiatric hospitalization and diagnosis of psychotic illness at the time of the CST evaluation but lower rates of reported substance abuse.
Subject(s)
Cultural Diversity , Emigrants and Immigrants/legislation & jurisprudence , Emigrants and Immigrants/psychology , Mental Competency/legislation & jurisprudence , Mental Competency/psychology , Mental Disorders/diagnosis , Mental Disorders/ethnology , Urban Population , Adolescent , Adult , Aged , Demography , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Intellectual Disability/diagnosis , Intellectual Disability/ethnology , Interdisciplinary Communication , Intersectoral Collaboration , Interview, Psychological , Male , Middle Aged , Observer Variation , Patient Care Team/legislation & jurisprudence , Psychotic Disorders/diagnosis , Psychotic Disorders/ethnology , Translating , United States , Young AdultABSTRACT
Zolpidem is the most commonly prescribed medication for the short-term treatment of insomnia. Adverse reactions include nightmares, confusion, and memory deficits. Reported rare adverse neuropsychiatric reactions include sensory distortions such as hallucinations. Previous research has identified 4 factors that may place a patient at increased risk of zolpidem-associated psychotic or delirious reactions: (1) concomitant use of a selective serotonin reuptake inhibitor (SSRI), (2) female gender, (3) advanced age, and (4) zolpidem doses of 10 mg or higher. In this article, 2 cases are presented in which individuals killed their spouses and claimed total or partial amnesia. Neither individual had a history of aggressive behavior. Both had concomitantly taken 10 mg or more of zolpidem in addition to an SSRI (paroxetine).
ABSTRACT
Studies have reported a wide range in lifetime prevalence of sleep paralysis (SP). This variation may stem from cultural factors, stressful life events and genetic differences in studied populations. We found that recurrent SP was more common among African-American participants, especially those with panic disorder. Recurrent SP was reported by 59% of African Americans with panic disorder, 7% of whites with panic disorder, 23% of African-American community volunteers and 6% of white community volunteers. Significantly more early life stressors were reported by African Americans than whites. Higher levels of psychosocial stressors, including poverty, racism and acculturation, may contribute to the higher rates of SP experienced by African Americans.
Subject(s)
Black or African American/statistics & numerical data , Panic Disorder/ethnology , Sleep Paralysis/ethnology , Adult , Female , Humans , Panic Disorder/epidemiology , Prevalence , Sleep Paralysis/epidemiologyABSTRACT
Research has demonstrated an association between direct exposure to traumatic events and the exacerbation of mental illness. This report describes the case of a man who had a preexisting mental illness with psychotic symptoms and no history of psychiatric hospitalization who was evacuated from the World Trade Center area after the terrorist attack of September 11, 2001. He did not receive any intensive, specialized treatment during the ensuing months as his mental state deteriorated, and he eventually required psychiatric hospitalization for a full-blown psychotic episode. Given the continuing threat of terrorist attacks, recognition of preexisting psychiatric conditions and early, specialized interventions for those at risk are essential in providing effective treatment and preventing decompensation.
Subject(s)
Psychotic Disorders/diagnosis , Schizophrenia/diagnosis , Schizophrenic Psychology , September 11 Terrorist Attacks/psychology , Adult , Delusions/diagnosis , Delusions/psychology , Diagnosis, Differential , Follow-Up Studies , Hospitalization , Humans , Male , New York City , Psychotic Disorders/psychology , Recurrence , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/psychologyABSTRACT
The present study assessed consistency of recollections of personal circumstances of the 9/11 World Trade Center attack and events of the day before (9/10), and the day after (9/12), in a sample of 100 New York City college students. The day before 9/11 represented an ordinary event. A questionnaire was administered twice, 1 wk. and 1 yr. after the 9/11 attack. Students were asked to describe their personal circumstances when hearing about the news of the World Trade Center attack and for the same time of day for 9/10 and 9/12. 18 students returned the follow-up questionnaire. Consistency of initial and follow-up responses for the central categories for both 9/11 and 9/12 of where, who, and activity was very high (9/11: "Where"--100%, "Who"--100%, "What"--94%; 9/12: "Where"--100%, "Who"--100%, "What"--80%). Recollections of 9/10 were significantly less consistent ("Where"--79%, "Who"--71%, "What"--71%). Analysis indicated that students formed vivid, consistent recollections during the events of both 9/11 and 9/12. It is likely that the events of 9/12 also became flashbulb memories, vivid recollections of traumatic events, because the emotional impact of the stressful events, i.e., police and military presence, disrupted schedules, relating to the 9/11 attack endured beyond the day of the attack.
