Inhomogénéité des évaluations de durée d’incapacité totale de travail. Comparaison d’évaluations des durées d’incapacité totale de travail entre les médecins légistes,les médecins généralistes et les urgentistes

Setting a total length for time off work is a forensic act that all physicians must be able to perform. Given the importance of the legal consequences of this evaluation, it seems desirable that this practice is mastered by all practitioners. However, in practice there is often a disparity between forensic assessments and evaluations provided by other practitioners. To assess this difference in evaluation, we conducted a retrospective study, looking at 4 years of archives, of victims of Marseille's forensic service (CHU Timone), and highlighted a disparity between medical examiners, GPs and emergency physician's assessments. In both comparisons between medical examiners versus GPs (n = 367) or medical examiners versus emergency physicians (n = 511), were found in one third of cases of forensic requalification. The majority of checks on where GP's (80%) determined on over 8 days leave were reassessed under this limit by a medical examiner. This trend is reversed for the majority of (61%) requalification cases of emergency assessments (assessment over eight days by medical examiners. This study, proving a fact long suspected, raises many questions about these disparities evaluation we have discussed.     

Issues associated with repeated neuropsychological assessments

Distinguishing practice effects from other factors in repeated neuropsychological assessments are discussed in the context of research studies and clinical/forensic assessments. Potential methodological procedures for reducing the impact of practice effects in research settings are outlined. In contrast, the potential clinical utility and interpretation of practice effects in clinical assessments and forensic evaluations are highlighted.     

A survey of psychological test use patterns among forensic psychologists

Clinical psychologists are frequently called on to testify in court regarding mental health issues in civil or criminal cases. One of the legal criteria by which admissibility of testimony is determined includes whether the testimony is based on methods that have gained "general acceptance" in their field. In this study, we sought to evaluate the psychological tests used in forensic assessments by members of the American Psychology-Law Society Division of the American Psychological Association, and by diplomates in the American Board of Forensic Psychology. We present test results from this survey, based on 152 respondents, for forensic evaluations conducted with adults using multiscale inventories, single-scale tests, unstructured personality tests, cognitive and/or intellectual tests, neuropsychological tests, risk assessment and psychopathy instruments, sex offender risk assessment instruments, competency or sanity-related instruments, and instruments used to evaluate malingering. In addition, we provide findings for psychological testing involving child-related forensic issues.     

Standardisierte Dokumentation als Methode der Qualit?tssicherung

Quality assurance is one of the recurrent topics in forensic psychiatry and the first methods used were systematic documentation and the development of structured assessment and documentation instruments. In German speaking countries the forensic psychiatric documentation system (FPDS) was derived essentially from the AMDP (working group for methods and documentation in psychiatry) system used in clinical psychiatry and consisted of a modular instrument with a basic module and additional ones for the assessment of violent offenders or of sex offenders for risk assessment etc. The development of comparable instruments became especially popular for risk assessment in different settings and for different offender populations. Even more important was that it initiated a platform for scientific exchange, producing a reliable data base, structured training in forensic psychiatry and evaluation of expert reports. Systematic documentation using instruments was often criticized for reducing information and overlooking the complexity of the problems encountered in forensic psychiatry. The critics, however, often do not seem to be aware of the real quality of forensic assessments and reports, of the variety or of the minimal information they often contain. Systematic documentation serves to find a common language among the experts and the courts to improve the assessment of reliability and validity of the information provided, to establish minimal requirements for the formulation of reports and to prove professionally correct handling of cases in litigation against an expert.     

Ethical dilemmas in forensic evaluations

Ethical issues emerging from forensic assessments are addressed from clinical and research perspectives. The relevance of agency, forensic identification, and attitudes toward defendants are explored within the framework of ethical practice. Finally, the ethical role of mental health professionals in the courtroom, the scope and basis of their testimony, and the rendering of conclusory opinions are discussed within a psycholegal context.     

Ethical Issues in Accounting and Economics Experimental Research: Inducing Strategic Misrepresentation

Forensic psychologists face a variety of ethical issues in conducting evaluations. One such issue is attorney presence during a forensic evaluation. In forensic evaluations, it is necessary to use standardized procedures while also attending to the rights of the individuals being assessed. This article examines the neuropsychological literature on extraneous influences in evaluations including effects of attorney presence. Then the article discusses the limited knowledge about attorney presence during forensic evaluations, addresses attorney motivations for being present during an evaluation, and considers attorney presence in the context of ethical mandates. Finally, suggestions are offered for forensic clinicians confronted with attorneys who wish to be present during assessments.     

Forensic evaluations of adolescents: psychosocial and clinical considerations

The forensic evaluation of an adolescent who has been arrested or is facing adjudication has important ramifications for the youth's present and future welfare. This paper reviews the knowledge base pertinent to forensic evaluations of adolescents, including the legal, social, developmental, and psychological factors underpinning such assessments. It then outlines an approach to assessment that employs a tripartite model of history, interviews and observations, and psychological tests. The manner in which information is reported to decisionmakers is also scrutinized.     

The use of a screening device to assess psychopathy in young offenders

The aim of this research was to determine to what extent a psychopath screening device (the APSD) is useful in forensic assessments to predict general and violent offending. For this purpose, a cross-sectional study was done and 238 young people serving a sentence were assessed. The gold standard instrument used to measure psychopathy was the Psychopathy Checklist: Youth Version (PCL:YV; Forth, Kosson & Hare, 2003). The results indicate that the association found between the screening device scores and several indicators of risk is low if compared with those obtained with the PCL:YV, suggesting that it is less useful as a tool in order to predict offending or violent offences. However, an Area Under the Curve of .784 and a validity index of 62.5 support its use as a screening device or as a preliminary approach to assess psychopathy in this population. The usefulness of this instrument to make assessments with young people in the forensic setting is discussed.     

An analysis of competency to stand trial: an integration of case law and clinical knowledge

In the past three decades competency to stand trial has emerged as a central issue in mental health law and forensic psychology. This article combines legal and clinical frameworks for a more integrated understanding of competency to stand trial. The legal framework focuses on Supreme Court decisions beginning with Dusky and reviews several legal theories of competence. The empirical framework is investigated within Grisso's (1986) conceptualization of legal competencies. In addition, the efficacy of specialized forensic assessments is evaluated, including the newly developed MacArthur Structured Assessment of the Competencies of Criminal Defendants (MacSAC-CD). The article concludes with observations of competency as a construct and their implications for forensic practice. © 1998 John Wiley & Sons, Ltd.     

The role of corroborative evidence in child sexual abuse evaluations

Published studies of forensic child sexual abuse (CSA) evaluations by mental health and medical professionals and paraprofessionals (MHPs) were analysed in order to evaluate two widely held assumptions. These related assumptions are (1) evidence that corroborates children's reports of sexual abuse is rare in forensic CSA evaluations; and (2) in the vast majority of evaluations, MHPs base their judgements about whether or not sexual abuse allegations are true on their assessments of children's reports of sexual abuse and other psychosocial data. Data from five chart review studies of a combined total of 894 forensic CSA evaluations provided sufficient information to assess the validity of these assumptions. Corroborative evidence was present in 36% of the 894 evaluations and in 54% of evaluations in which MHPs judged the allegations likely to be true, contradicting the first assumption. In the evaluations in which corroborative evidence was present, the presence or absence of a child's report of sexual abuse was only weakly associated with MHPs' judgements about the validity of the allegations (allegations in almost all corroborated cases were judged likely to be true, even in the absence of a child's report), partially contradicting the second assumption. Implications of this analysis for research and policy are discussed. Copyright © 2010 John Wiley & Sons, Ltd.     

Empathy in Forensic Evaluations: a Systematic Reconsideration

This paper reexamines the Shuman seminal paper arguing against empathic behaviors in forensic evaluations. Shuman concluded that empathy by examiners seduces evaluees into believing a therapeutic relationship exists. We reconsider empathy as an element of rapport and a helpful supplement in a successful assessment. Actively avoiding empathy could lead to cold and callous examiner self‐presentation, which may in turn produce biased and negative results. In this paper we assert that ethical forensic professionals may use moderate empathy during an assessment. Examiners should consider it not as a component of subjectivity and pseudotherapy, but rather as a potentially useful tool for effective assessments. Copyright © 2012 John Wiley & Sons, Ltd.     

Standards nichtstrafrechtlicher psychiatrischer Begutachtung

The introduction of the certificate for forensic psychiatry of the German Association of Psychiatry, Psychotherapy, Psychosomatics (DGPPN) in 2000 was a significant contribution to raising awareness of the formal and substantive requirements for forensic psychiatric evaluations and to develop a systematic quality improvement in forensic psychiatric expert services. By the special dominance of the certification in the field of penal law assessment, this proved to be problematic for many predominantly non-penal experts. This led to a requirement to develop a qualification for the non-penal expert opinions. In particular the increasing specialization of the psychiatric disciplines and the diversity of the legal issues and framework require a continuing education in the field of non-penal psychiatric assessments. Substantive and formal requirements are discussed and a continuous process of quality improvement and assurance is outlined. Last but not least a plea is made for close interdisciplinary exchange with the jurisprudence and the courts in the context of quality circles.     

Videoconferencing and forensic mental health in Australia

Videoconferencing is in common use in Australian forensic mental health services. It provides opportunities to link remote prisons, courts, and psychiatric clinics with distant specialist services, and enables a range of activities including assessment, treatment and feedback, expert testimony, education, and inter-service planning. These functions are acceptable to patients and clinicians, and in Australia videoconferencing minimizes disruption to small services and their patients, who might otherwise face lengthy journeys. In particular, marginalized patient groups, including indigenous people and prisoners, may receive better services. The evidence base supports use of videoconferencing despite a number of practical, legal, and clinical issues that may reduce its effectiveness compared with face-to-face assessments. Videoconferencing technologies are critical to effective forensic mental health services in Australia.     

Zur Qualitätssicherung zivilrechtlicher Begutachtungen

Quality assurance in forensic psychiatry must take into account the different requirements for assessment in criminal, civil and social law. For civil law assessments the following measures are recommended: a reading list of articles reflecting the expert consensus, guidelines, a list of approved expert supervisors, an exemplary curriculum, modification of the present certificatation by the German Society for Psychiatry and Psychotherapy, Psychosomatic and Neurology (DGPPN) with more emphasis on civil law and a continuous process of education and recertification. Besides an interdisciplinary statement defining minimum requirements for civil law assessments, measures for continuous quality improvement should also be established in cooperation with representatives of the judicature.     

Communicating the Risk of Violent and Offending Behavior: Review and Introduction to this Special Issue

How to communicate risk of recidivism in correctional and forensic contexts has been a subject of scholarly discussion for two decades. This emerging literature, however, is sparse compared with studies on the assessment of risk for violent and offending behavior. In this special issue of Behavioral Sciences and the Law, we have gathered together empirical and review papers exemplifying promising directions and methodologies. We begin with a review of the state of the field, and lessons that can be drawn from research into medical risk assessment and risk communication, finding that many of the same principles apply to the forensic context. How risks are framed, and how numerate assessors are, affects how risk information is understood and applied. We discuss the existing research bearing on these issues, as well as the conceptual, practical, empirical, and legal implications of communicating risk using numerical or categorical risk terms. Along with the seven articles in this volume, we suggest directions for future research on measuring and communicating change, understanding and managing the statistical literacy of those who use and communicate risk assessments, and developing a theoretical framework for forensic risk communication research. We hope this volume will help integrate and invigorate research into forensic risk communication. Copyright © 2015 John Wiley & Sons, Ltd.     

Are Citizens “Receiving the Treatment”? Assessing a Key Link in Contextual Theories of Public Opinion and Political Behavior

The theorization and empirical exploration of contextual effects is a long‐standing feature of public opinion and political behavior research. At present, however, there is little to no evidence that citizens actually perceive the local contextual factors theorized to influence their attitudes and behaviors. In this article, we focus on two of the most prevalent contextual factors appearing in theories—racial/ethnic and economic context—to investigate whether citizens' perceptions of their local ethnic and economic contexts map onto variation in the actual ethnic composition and economic health of these environments. Using national survey data combined with Census data, and focusing on the popular topics of immigration and unemployment, we find that objective measures of the size of the immigrant population and unemployment rate in respondents' county and zip code strongly predict perceived levels of local immigration and assessments of the health of one's local job market. In addition to demonstrating that citizens are “receiving the treatment,” we show that perceptions of one's context overwhelmingly mediate the effect of these objective contextual factors on relevant economic and immigration attitudes. The results from our analyses provide scholars with unprecedented evidence that a key perceptual process presumed in various contextual theories of political attitudes and behavior is, in fact, valid.     

Recursive Partitioning to Identify Potential Causes of Differential Item Functioning in Cross-National Data

Differential item functioning (DIF) assessment is key in score validation. When DIF is present scores may not accurately reflect the construct of interest for some groups of examinees, leading to incorrect conclusions from the scores. Given rising immigration, and the increased reliance of educational policymakers on cross-national assessments such as Programme for International Student Assessment, Trends in International Mathematics and Science Study, and Progress in International Reading Literacy Study (PIRLS), DIF with regard to native language is of particular interest in this context. However, given differences in language and cultures, assuming similar cross-national DIF may lead to mistaken assumptions about the impact of immigration status, and native language on test performance. The purpose of this study was to use model-based recursive partitioning (MBRP) to investigate uniform DIF in PIRLS items across European nations. Results demonstrated that DIF based on mother's language was present for several items on a PIRLS assessment, but that the patterns of DIF were not the same across all nations.     

What is the Right to Exclude Immigrants?

It is normally taken for granted that states have a right to control immigration into their territory. When immigration is raised as a normative issue two questions become salient, one about what the right to exclude is, and one about whether and how it might be justified. This paper considers the first question. The paper starts by noting that standard debates about immigration have not addressed what the right to exclude is. Standard debates about immigration furthermore tend to result either in fairly strong cases for open borders or in denials that considerations of justice apply to immigration at all, which results in state discretion positions. This state of debate is both theoretically unsatisfactory and normatively implausible. The paper therefore explores an alternative approach to the right to exclude immigrants from the perspective of recent debates about the territorial rights of states. The right to exclude claimed by states is analysed and it is shown to differ both conceptually and normatively from rights to impose political authority within a territory. The paper finally indicates how this analysis might broaden the focus of debates about immigration and suggest alternative regimes of migration regulation the possibility of which is obscured by traditional justice approaches.     

Avoiding Type II error in assessing lead toxicity plaintiffs

This article discusses statistical parallels between excessive conservatism and insufficient conservatism in rendering forensic opinions. The elements of a tort are reviewed and their relation to psychological and psychiatric opinions is also discussed, as are psychometric and clinical approaches to assessment of impairment and causation in individual lead poisoned children. It is argued that assessments in lead poisoning cases consisting solely of cranial nerve examinations result in considerable Type II Error. Sources of Type II Error in research using analysis of covariance techniques to study the toxic effects of lead include variance stealing, use of excessive numbers of covariates, lack of attention to interactions, and use of covariates that are actually substitute measures of lead ingestion. When experts cite nonsignificant findings of studies of low-level lead exposure, it inappropriately negates lead effects in more severely lead poisoned plaintiffs. In true experimental studies where there is no ambiguity regarding causation, the destructive effects of lead are quite clear. © 1998 John Wiley & Sons, Ltd.