Research Progress and Application Prospect of Facial Micro-Expression Analysis in Forensic Psychiatry.

Research on facial micro-expression analysis has been going on for decades. Micro-expression can reflect the true emotions of individuals, and it has important application value in assisting auxiliary diagnosis and disease monitoring of mental disorders. In recent years, the development of artificial intelligence and big data technology has made the automatic recognition of micro-expressions possible, which will make micro-expression analysis more convenient and more widely used. This paper reviews the development of facial micro-expression analysis and its application in forensic psychiatry, to look into further application prospects and development direction.

Changes in Gray Matter Density, Regional Homogeneity, and Functional Connectivity in Methamphetamine-Associated Psychosis: A Resting-State Functional Magnetic Resonance Imaging (fMRI) Study.

BACKGROUND Using regional homogeneity (ReHo) blood oxygen level-dependent functional MR (BOLD-fMRI), we investigated the structural and functional alterations of brain regions among patients with methamphetamine-associated psychosis (MAP). MATERIAL AND METHODS This retrospective study included 17 MAP patients, 16 schizophrenia (SCZ) patients, and 18 healthy controls. Informed consent was obtained from all patients before the clinical assessment, the severity of clinical symptoms was evaluated prior to the fMRI scanning, and then images were acquired and preprocessed after each participant received 6-min fRMI scanning. The participants all underwent BOLD-fMRI scanning. Voxel-based morphometry was used to measure gray matter density (GMD). Resting-state fMRI (rs-fMRI) was conducted to analyze functional MR, ReHo, and functional connectivity (FC). RESULTS GMD analysis results suggest that MAP patients, SCZ patients, and healthy volunteers show different GMDs within different brain regions. Similarly, the ReHo analysis results suggest that MAP patients, SCZ patients, and healthy volunteers have different GMDs within different brain regions. Negative correlations were found between ReHo- and the PANSS-positive scores within the left orbital interior frontal gyrus (L-orb-IFG) of MAP patients. ReHo- and PANSS-negative scores of R-SFG were negatively correlated among SCZ patients. The abnormal FC of R-MFG showed a negative correlation with the PANSS score among MAP patients. CONCLUSIONS The abnormalities in brain structure and FC were associated with the development of MAP.

Role of CACNA1C gene polymorphisms and protein expressions in the pathogenesis of schizophrenia: a case-control study in a Chinese population.

The study aimed to investigate the correlations of CACNA1C genetic polymorphisms and protein expression with the pathogenesis of schizophrenia in a Chinese population. This research included 139 patients diagnosed with schizophrenia (case group) and 141 healthy volunteers (control group). Case and control samples were genotyped using denaturing high-performance liquid chromatography (DHPLC). Haplotypes of rs10848683, rs2238032, and rs2299661 were analyzed using the Shesis software. A mouse model of schizophrenia was established and assigned to test and blank groups. Western blotting was used to detect CACNA1C protein expression. The genotype and allele distribution of rs2238032 and rs2299661 differed between the case and control groups. TT genotype of rs2238032 and G allele of rs2299661 could potentially reduce the risk of schizophrenia. The distribution of rs2238032 genotype has a close connection with cognitive disturbance and the results of the general psychopathology classification exam. The distribution of rs2299661 genotypes was closely related to sensory and perceptual disorders, negative symptom subscales, and the results of the general psychopathology classification exam. CTC haplotype increased and CTG decreased the risk of schizophrenia in healthy people. In the brain tissues of mice with schizophrenia, the CACNA1C protein expression was higher in the test group than in the blank group. Our study demonstrated that CACNA1C gene polymorphisms and CACNA1C protein expression were associated with schizophrenia and its clinical phenotypes.

Aggressive behaviors and treatable risk factors of preschool children with autism spectrum disorder.

Aggressive behaviors of children with autism spectrum disorder (ASD) are common. We conducted this study to describe the aggressive mode of preschool children with ASD and examine the associations between specific aggressive behaviors and two treatable factors: sleep problems and attention deficit hyperactivity disorder (ADHD) symptoms. In total, 577 typically developing (TD) children and 490 children with ASD were investigated in this study. The Institute for Basic Research - Modified Overt Aggression Scale (IBR-MOAS) was used to assess aggressive behaviors. Children's social impairments, sleep problems and ADHD symptoms were also measured with specific scales. The total IBR-MOAS score was significantly higher (worse) in the TD group [4.47 (5.36)] than in the ASD group [3.47 (5.63), P = 0.004]. The aggressive modes differed between groups: when compared with each other, the TD group received higher scores on Verbal and Physical Aggression Toward Others (all P < 0.01), while the ASD group had higher scores on Physical Aggression Against Self (P = 0.006). The linear regression model demonstrated that the aggressive behaviors of children with ASD were significantly associated with two treatable factors: sleep problems and ADHD symptoms. These findings have substantial clinical implications: treatment of these two risk factors may be helpful in managing aggressive behavior in children with ASD. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1155-1162. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

[Personality Change due to Brain Trauma Caused by Traffic Accidents and Its Assessment of Psychiatric Impairment].

OBJECTIVE: To explore the main performance of personality change in people with mild psychiatric impairments which due to the brain trauma caused by traffic accidents and its value in assessment of psychiatric impairment. METHODS: The condition of personality change of patients with traumatic brain injury caused by traffic accident was evaluated by the Scale of Personality Change Post-traumatic Brain Injury (SPCPTBI). Furthermore, the correlation between the personality change and the degrees of traumatic brain injury and psychiatric impairment were explored. Results In 271 samples, 239 (88.2%) with personality changes. Among these 239 samples, 178 (65.7%), 46 (17.0%), 15 (5.5%) with mild, moderate and severe personality changes, respectively. The ratio based on the extent of personality changes to the degree of brain trauma was not significant (P > 0.05), but the total score difference between the groups was significant (P < 0.05). There was no statistical significance between the medium and high severity brain trauma groups. The higher degree of personality changes, the higher rank of mental disabilities. The total score difference of the scale of personality change among the different mild psychiatric impairment group was significant (P<0.05). The difference between other psychiatric impairment levels had statistical significance (P < 0.05) except level 7 and 8. CONCLUSION: The occurrence of personality change due to traumatic brain injury caused by traffic accident was high. Correlations exist between the personality change and the degree of psychiatric impairment. Personality change due to brain trauma caused by traffic accident can be assessed effectively by means of SPCPTBI, and the correlation between the total score and the extent of traumatic brain injury can be found.

[Relevance between writing characteristic and therapeutic effect in schizophrenia].

OBJECTIVE: To explore the relevance between writing characteristic and therapeutic effect in schizophrenia and to discuss the influence of aggressive behavior on writing characteristic. METHODS: Recoding the casual and fixed writing in admission, one week, two weeks, four weeks, eight weeks after treatment and rating Positive and Negative Syndrome Scale (PANSS) and Modified Overt Aggression Scale (MOAS). Choosing two characteristics, "relationship between font and grid lines" and "having big strokes or not", and comparing before and after treatment. RESULTS: Eight weeks after treatment, the score of PANSS decreased. The condition of patients and the writing characteristic improved as well. The differences of writing characteristics were statistically significant in patients with aggressive behavior before and after treatment (P < 0.05). CONCLUSION: The writing characteristic has relation with therapeutic effects and improved with therapeutic effects in aggressive patients.

The comparison of disposal attitudes towards forensic psychiatric patients among police officers, psychiatrists and community members in China.

OBJECTIVE: To understand disposal attitudes towards forensic psychiatric patients among police officers, psychiatrists and community members in China. METHOD: 118 community members, 121 psychiatrists and 105 police officers completed a questionnaire regarding disposal attitudes towards forensic psychiatric patients. RESULT: Surveyed respondents (87.4%) believed patients with mental disorders experienced discrimination, and 97.4% were in favor of providing livelihood security for them. Police officers (89.5%) agreed that patients with mental illness were more violent than the general population, which was significantly higher than 74.4% of psychiatrists (X(2) = 14.29, P = 0.000). Among three groups, the most preferred disposal option for those found not guilty by reason of insanity (NGRI) was to treat them in the custody of a forensic psychiatric hospital, such as an Ankang Hospital (86.9%). The respondents agreed (96.8%) that an independent review board should be established for disposing decisions for forensic psychiatric patients. The percentage who agreed that police officers, prosecutors, and judges should be included in the review board was significantly higher among police officers than among community members (x(2) = 6.60, P = 0.01; x(2) = 9.74, P = 0.002; x(2) = 7.38, P = 0.007). When asked, "who has the legal right to determine whether offenders with mental disorders should bear criminal responsibility", forensic psychiatrists and judges were the top two responders (79.5% and 63.4%, respectively). CONCLUSION: This study suggested that the majority of those surveyed, especially police officers, held that patients with mental illness were violent and should receive violence risk assessments. Although psychiatrists paid more attention to the rights of patients, they also lacked legal knowledge, similar to community members and police officers. Therefore, it is necessary to inform the public regarding mental health, and to provide legal knowledge.

[Development of competency to stand trial rating scale in offenders with mental disorders].

OBJECTIVE: According with Chinese legal system, to develop a competency to stand trial rating scale in offenders with mental disorders. METHODS: Proceeding from the juristical elements, 15 items were extracted and formulated a preliminary instrument named the competency to stand trial rating scale in offenders with mental disorders. The item analysis included six aspects, which were critical ratio, item-total correlation, corrected item-total correlation, alpha value if item deleted, communalities of items, and factor loading. The Logistic regression equation and cut-off score of ROC curve were used to explore the diagnostic efficiency. RESULTS: The data of critical ratio of extreme group were 18.390-46.763; item-total correlation, 0.639-0.952; corrected item-total correlation, 0.582-0.944; communalities of items, 0.377-0.916; and factor loadings, 0.614-0.957. Seven items were included in the regression equation and the accuracy of back substitution test was 96.0%. The score of 33 was ascertained as the cut-off score by ROC fitting curve, the overlapping ratio compared with the expertise was 95.8%. The sensibility and the specificity were 0.938 and 0.966, respectively, while the positive and negative likelihood ratios were 27.67 and 0.06, respectively. CONCLUSION: With all items satisfied the requirement of homogeneity test, the rating scale has a reasonable construct and excellent diagnostic efficiency.

[Applicability of capacity of sexual self-defense assessment scale in psychiatric patients without mental retardation].

OBJECTIVE: To explore the applicability of Capacity of Sexual Self-defense Assessment Scale (CSSAS) in psychiatric patients without mental retardation. METHODS: Eighty-seven cases required for assessment of the capacity of sexual self-defense were collected and evaluated by trained professionals according to CSSAS, and the results were compared to the experts' opinions. RESULTS: The scores of three grades of capacity of sexual self-defense (none, limited and whole) were 5.97 +/- 5.83, 32.22 +/- 10.15 and 61.60 +/- 13.02, respectively, which were statistically significant among them (P < 0.01). The correlation coefficients between items and total score were 0.59 to 0.91, the Cronbach's alpha value was 0.96, the spilt half Cronbach's alpha value were 0.94 and 0.91, respectively, and the relation coefficient between them was 0.94. According to the original cut off scores, the Kappa value between scale results and experts' opinions was 0.32 (P < 0.01). By redefining the cut off scores, the Kappa value was improved to 0.84 (P < 0.01). Two factors were extracted by means of the factor analysis. The explanation rates of variance were 46.15% and 28.93%, respectively. The accuracy of retrospective cumulative square was 94.30%. CONCLUSION: The CSSAS could be applied in the psychiatric expertise of the capacity of sexual self-defense in psychiatric patients without mental retardation; however, the cut off scores and the factor weight should be redefined.

[Disability identification for cases with clinical diagnosis of diffuse axonal injury due to traffic accidents: a study of 89 cases].

OBJECTIVE: To study the disability identification for cases with clinical diagnosis of diffuse axonal injury (DAI) due to traffic accidents, and to explore the possible effects of DAI on identification results. METHODS: Five hundred and fifty-six cases of cerebral injury due to traffic accidents were collected, including 467 cases diagnosed with cerebral contusion or laceration and 89 cases diagnosed with DAI. The identification results of different groups with diagnosis of DAI diagnosis, diagnosis of DAI with cerebral contusion (laceration), and diagnosis of cerebral contusion or laceration without DAI were compared and statistically analyzed, based on the results of CT and MRI re-review. RESULTS: The disability identification levels in DAI group (20 cases), DAI group (69 cases) with cerebral contusion (laceration) and DAI group (467 cases) not complicated by cerebral contusion (laceration) were 7.72 +/- 1.09, 7.78 +/- 1.11, and 8.86 +/- 0.66, respectively. The disability levels of the two groups diagnosed with DAI were higher than those of the group without DAI diagnosis (P < 0.05). CONCLUSION: Patients with DAI diagnosis might have more severe cerebral injury. In the identification process, one should pay attention to the possible missed diagnosis and misdiagnosis, and meanwhile avoid relying on those evidences provided only by CT and MRI.

[Progress in standard assessment on competency to stand trial of mentally disordered offenders].

Competency to stand trial relates directly to legal rights of the appraised individual as well as whether criminal procedure can be carried out smoothly. Foreign scholars have conducted a large number of theoretical researches, and developed a series of standardized evaluation tools. However, the assessment on competency to stand trial has mainly focused on medical criteria in China for a long time, and most cases were judged by forensic psychiatrists' experience. Recently, Chinese scholars have started the initial research on standardized evaluation. This paper reviews the notion of competency to stand trial, the evaluation criteria, and the assessment tools domestically and abroad. The main focus is on foreign assessment tools, which included three categories. First category includes checklist, self-report questionnaires and sentence-completion tasks. Second category is the interview-based instruments without criterion-based scoring. Last category is the interview-based instruments with criterion-based scoring. This literature may be helpful for further research and standardization on assessment tools of competency to stand trial of mentally disordered offenders.

[Reliability of the Violence Risk Scale of Chinese version].

OBJECTIVE: To introduce and revise the Violence Risk Scale (VRS) for assessing violence risk and risk change, and to examine the reliability of Violence Risk Scale of Chinese version(VRS-C). METHODS: The original English version of the VRS was translated into Chinese according to established translation procedures. To examine the scorer reliability the 14 cases assessed by 3 assessors separately. One hundred and twenty-five patients with mental disorders from 3 different institutions in Sichuan province (Refined Control Ward in Ankang Hospital, Department of Forensic Psychiatry, Institute of Forensic Science and Mental Health Center of West China Hospital) were collected to examine the reliability of VRS-C. RESULTS: The results showed moderately good scale reliability of the VRS-C, with 0.80 of ICC for scorer reliability. All items have significant consistence with Cronbach's alpha coefficient as 0.921, split-half reliability as 0.906 and item total correlation as 0.246-0.849. CONCLUSION: The reliability of the VRS-C version is acceptable.

[Correlation between the eicosapentaenoic acid, docosahexaenoic acid and the aggressive behavior in mice].

OBJECTIVE: To explore the correlation between the eicosapentaenoic acid(EPA), docosahexaenoic acid (DHA) and the aggressive behavior in mice. METHODS: Seventy-two male Kunming mice were divided into control group, fish oil group, simvastatin group and aggressive reference group randomly. The control group, fish oil group and simvastatin group were given normal saline, fish oil and simvastatin by irrigation respectively for 3 months consecutively, each mouse was raised isolatedly. The latent period of assault, the frequencies of tail swing and assault, and the cumulative time of assault were recorded at the beginning and the end of the intervention. Finally, the EPA and DHA in brain were analyzed by gas chromatography-mass spectrometry (GC-MS). The aggressive reference group was raised without intervention and was evaluated as aggressive reference only. RESULTS: (1) Before intervention, the latent period of assault, the frequencies of tail swing, the frequencies of assault, and the cumulative time of assault were not significantly different from each other group. After intervention, the differences were significant (P<0.05). (2) After the intervention, the content of EPA and DHA in mice brain was the most in the fish oil group, and the least in the simvastatin group. (3) The content of EPA was negatively related with the four indexes (P<0.05) before and after the intervention. The content of DHA was negatively related with the frequencies of tail swing and assault (P<0.05). CONCLUSION: There is a correlation between the EPA, DHA and aggressive behavior in mice under stress.

[The application of criminal responsibility rating scale for suspects with mental retardation].

OBJECTIVE: To explore the feasibility of the criminal responsibility rating scale for suspects with mental retardation. METHODS: Ninety six suspects with mental retardation were evaluated by trained professionals according to the scale, and the results were compared to the expert's opinion. RESULTS: The scores of three groups (no, diminished, and responsibility group) were 12.25 +/- 2.06, 28.62 +/- 4.57, 44.41 +/- 5.17 respectively and were significant different among them. All items had statistical correlation with the total score of the scale. Five factors were extracted by means of the factor analysis and they could explain 70.919% of the variation. The accuracy of retrospective cumulative square was 92.7%. CONCLUSION: The Criminal Responsibility Rating Scale has good reliability and validity, and can be used as a reference in assessment of criminal responsibility.

[Progress on neuropsychology and event-related potentials in patients with brain trauma].

With the development of information technology, as one of the research frontiers in neurophysiology, event-related potentials (ERP) is concerned increasingly by international scholars, which provides a feasible and objective method for exploring cognitive function. There are many advances in neuropsychology due to new assessment tool for the last years. The basic theories in the field of ERP and neuropsychology were reviewed in this article. The research and development in evaluating cognitive function of patients with syndrome after brain trauma were focused in this review, and the perspectives for the future research of ERP was also explored.

[Preliminary study on civil capacity rating scale for mental disabled patients].

OBJECTIVE: To create civil capacity rating scale for mentally disabled patients, and explore its feasibility during the forensic psychiatric expertise. METHODS: The civil capacity-related items were determined after discussion and consultation. The civil capacity rating scale for mentally disabled patients was established and the manual was created according to the logistic sequence of the assessment. The rating scale was used during the civil assessment in four institutes. RESULTS: There were 14 items in civil capacity rating scale for mentally disabled patients. Two hundred and two subjects were recruited and divided into three groups according to the experts' opinion on their civil capacities: full civil capacity, partial civil capacity and no civil capacity. The mean score of the three groups were 2.32 +/- 2.45, 11.62 +/- 4.01 and 25.02 +/- 3.90, respectively, and there was statistical differences among the groups. The Cronbach alpha of the rating scale was 0.9724, and during the split-reliability test, the two-splited part of the rating scale were highly correlated (r = 0.9729, P = 0.000). The Spearman correlative coefficient between each item and the score of the rating scale was from 0.643 to 0.882 (P = 0.000). There was good correlation between the conclusion according to the rating scale and the experts' opinion (kappa = 0.841, P = 0.000). When the discriminate analysis was used, 7 items were included into the discrimination equation, and 92.6% subjects were identified as the correct groups using the equation. CONCLUSION: There is satisfied reliability and validity on civil capacity rating scale for mentally disabled patients. The rating scale can be used as effective tools to grade their civil capacity during the forensic expertise.

[Progress on relationship between omega-3 polyunsaturated fatty acids and violent-aggressive behavior].

The relationship between omega-3 polyunsaturated fatty acids (PUFAs) and violent-aggressive behavior has been payed attention since 1980s. Their correlation was explored by many epidemiological investigations, and the effect of PUFAs on prevention or reduction of violent-aggressive behavior in different groups were also affirmed by some intervention studies. This article summarized the previous studies and reviewed the history of epidemiological or intervention studies on PUFAs and its relationship with violent-aggressive behavior. It also presented the possible influencing factors in these studies and possible mechanisms.

[The application of diminished criminal responsibility rating scale to mental retardation offenders].

OBJECTIVE: To explore the application of Diminished Criminal Responsibility Rating Scale (DCRRS) to mental retardation offenders. METHODS: The DCRRS was used to 121 cases of mental retardation offenders who were divided into three groups according to the degree of their diminished criminal responsibility. RESULTS: There were significant differences in rating score among the three groups (mild group 22.12+/-4.69, moderate group 25.50+/-5.48, major group 27.59+/-5.69), and 17 items had good correlation with the total score of the scale with the correlation coefficient from 0.289 to 0.665. Six factors were extracted by the factor analysis, and 69.392% variation could be explained. CONCLUSION: The DCRRS has rational items, its total score could show the difference among the three degree diminished criminal responsibility of mental retardation offenders.

[Advanced investigation of testamentary capacity of the mentally disordered].

Testamentary capacity is one of the civil competences, it means that a natural person enjoys the capacity or qualification to establish testament and deal with his property. Recently, the cases of testamentary capacity assessment of the mentally disordered are increasing. This article firstly introduces the concepts of the testament as well as the testamentary capacity, and then summarizes the assessment standard of the testamentary capacity, by using the Banks v. Goodfellow case as a basis to make the standard criteria including: the understanding of the nature of a will and codicil, the knowledge of the general extent of one's assets, the knowledge of the natural object of one's bounty, the understanding of the impact of the distribution of the assets of the estate, and the absence of a delusion specifically affecting the distribution of the estate. The impact factors of the testamentary capacity, including dementia, mood disorder, schizophrenia, alcohol, drug, and undue influence, etc., are summarized. Lastly, the related assessment tools such as the Mini-Mental State Examination, the Clock-Drawing Test, and the Testament Definition Scale are introduced briefly.

[Civil competence assessment of the mental disorders involved in contract dispute].

OBJECTIVE: To search the criteria for evaluating the civil competence of the mental disorders involved in contract dispute. METHODS: Data on the interviewee's mental status and the forensic expertise were collected retrospectively. And 6 indexes were selected and graded: awareness of situation, factual understanding of issues, appreciation of likely consequences, rational manipulation of information, functioning in one's own environment and communication of choice. All of the data were analyzed by SPSS. RESULTS: Fifty six cases were included and interviewee's civil competence was graded to three levels: full civil competence, diminished civil competence, and no civil competence. These cases included two types of contract: the real estate related contract (38 cases) and the labor related contract (14 cases). All of the 6 indexes were well correlated to the forensic expertise. The related coefficient was from 0.703 to 0.834, and the interrelated coefficient of the 6 items was also high, from 0.712 to 0.877. CONCLUSION: It is feasible to divide the civil competence of the mental disorders into three grades. As the basis, these 6 indexes mentioned above are representative and can be applied in further standardized and quantified assessment of civil competence.