Fixing forensic patients: Psychiatric recommendations for treatment in pretrial settings

This article is concerned with psychiatric recommendations for treatment at the Metropolitan Toronto Forensic Service (METFORS), a clinical assessment agency providing both 1-day and 30-day evaluations of criminal defendants in Toronto, Canada. Analysis of both psychiatric reports and quantitative research instruments demonstrated the saliency of treatment as a central forensic issue at METFORS. Among a sample of 592 defendants, 134 were considered in need of outpatient care. Persons recommended for hospitalization were most likely to exhibit histories of mental health rather than criminal justice contacts; to be arrested for nonviolent offenses; to manifest psychotic behavior while at METFORS; to be found unfit for bail, incompetent to stand trial, in need of further assessment and dangerous to self; and to experience higher rates of hospitalization, but lower levels of criminalization during the two years following their initial forensic assessment. Psychiatric reports at METFORS tended to merge recommendations for treatment and assessment; to suggest prison or probation as means for securing clinical treatment; and to provide little written support for judgments about the need for intervention. Along with competency and dangerousness, treatment is a key issue in forensic practice, and warrants further attention in the psycholegal literature.     

Treatment recommendations for mentally disordered offenders: More than roulette?

Clinical judgments on the treatability and prognosis of mentally disordered offeenders (MDO) may strongly influence legal dispositions and the availability of treatment resources. This study examined 1,238 discharge summaries for MDOs referred for court assessments. Psychiatrists evidenced marked variability in how often they recommended treatment and how frequently they judged patients to have a poor prognosis. Two logit analyses suggested that diagnosis and consultation by other clinicians were associated with (a) treatment recommendations (i.e., Axis I diagnosis and social work consultations) and (b) prognosis (i.e., Axis II diagnosis and psychology consultations).     

Predicting diagnosis performance with measures of cognitive style

This study examines the relationship between performance on a context-independent fault diagnosis task and two dimensions of cognitive style: field dependence/independence (D-I) and focusing/scanning (F-S). The effects on diagnosis performance of training and the ability of both dimensions of style jointly to predict fault-finding ability were considered. The results showed that field independents and focusers were superior fault diagnosticians. Training, in the form of verbal feedback messages, was uniformly effective for the D-I dimension although field independents maintained a superior level of performance, over field dependents. In general, for the F-S dimension, training had little effect on either the focusers or scanners. A combination of scores on the F-S and D-I dimensions significantly enhanced the proportion of the variance in testing efficiency that could be accounted for during fault-finding. Finally it is argued that the F-S and D-I dimensions should be recognized as measures of ability, not style. Future research should be directed at identifying between subject differences on fault diagnosis tasks with reference to theories of information processing.     

Procedural Justice and Culture

The past fifteen years have seen the development of a considerable research literature on the social psychology of procedural justice (see Lind & Tyler, 1988, for a review). Procedural justice research reveals some serious shortcomings in the exchange theories that have traditionally dominated Western analyses of the social psychology of groups, and in so doing, the procedural justice literature has important ramifications for cross-cultural psychology. Results from a number of studies conducted in the United States and Western Europe show that individualistic, self-interest based models of human behaviour are insufficient to explain procedural justice phenomena. Instead, procedural justice effects frequently reveal strong group-oriented concerns and motivations even in cultural contexts generally thought to be characterized by individualistic orientations. The research literature also shows that if a group's procedures are judged to be fair, people are more likely to show group-oriented behaviour and to hold more favourable attitudes toward the group and its leaders. These findings have led to the development of a theory of justice judgments—the Lind and Tyler group-value theory—which is based on group norms and relations rather than on social exchange theory. We describe a general model of social behaviour that integrates group- and individually-oriented behaviour, and we discuss the implications of the model for social and cross-cultural psychology.     

On estimating processing variance: commentary and reanalysis of Kail's "Developmental functions for speeds of cognitive processes".

A recent paper by Kail (1988) in this journal appears to contain a significant error in the data analysis. The "goodness-of-fit" coefficients reported which suggest that overall about 94% of the variance can be accounted for by the model seem to be a substantial overestimation as a result of inappropriate procedures for statistical modeling. Using the data made available to us by Kail, we have reanalyzed these results. The corrected values range from 0.9 to 92.1% for the individual tasks with an overall average between 40 and 60%. We suggest that the support for the original conclusions is considerably weaker than reported.     

Journal Reviews

Astor , J. (London). ‘A conversation with Dr Michael Fordham.’Journal of Child Psychotherapy Astor , J. (London). ‘Adolescent states of mind found in patients of different ages seen in analysis.’Journal of Child Psychotherapy Blomeyer , R. (Berlin) ‘Der Umgang des Analytikers mit der Analyse’ (The interrelationship between the analyst and the analysis). Analytische Psychologie Blomeyer , Rudolf (Berlin). ‘Analytische Psychologie und Ich-Psychologie’. (Analytical Psychology and Ego-Psychology). Analytical Psychology Rudolf Blomeyer . ‘Anmerkungen zur Typologie’ (Comment on typology). Analytische Psychologie Corbett , L. Kugler , P. ‘The self in Jung and Kohut’ in Progress in self Psychology Dehing , J. ‘Jung aus der Sicht der anderen: anlässlich einiger Kritiken von Seiten der Freudianer.’ (Jung as others see him: some Freudian criticisms.) Analytische Psychologie Erlenmeyer , A. ‘Das kannabalische Phantasma—eine Annäherung’ (Cannibalistic fantasy—an appraisal). Analytische Psychologie Giera -Krapp , Margitta (Berlin). ‘Constellation of the good/bad mother archetype in the treatment of early disturbances.’Analytische Psychologie Lyard , D. (Paris). ‘Le corps et la “redonne” archetypique de l'adolescence.’ (The body and archetypal rebirth in adolescence) in Cahiers jungiens de psychanalyse Noschis , K. (Geneva). ‘La maison du jour et de la nuit’ (The house by day and by night). Le Journal des Psychologues “Le langage de notre intérieur” (The language of our interior). Les Cahiers Médicosociaux Erenest L. Rossi . ‘Mind Body Therapy: methods of ideodynamic healing in hypnosis.’ Norton Professional Books. New York. Samuels , A. (London). ‘Pluralism and the post-Jungians: A reply to Peter Bishop.’ Spring. Samuels , Andrew . (London). ‘A relation called father—Part I: The father in depth psychology.’British Journal of Psychotherapy Steinberg , Warren . (New York). ‘The Fear of Success’. Quadrant Thibaudier , Vivane (Paris). ‘La notion de Grande Mère dans l'optique Jungienne’Cahiers Jungiens de Psychanalyse     

Cardiovascular reactivity and interpersonal influence: active coping in a social context

Previous studies have demonstrated that effortful attempts to secure positive outcomes or avoid negative outcomes produce significant increases in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR). Although these effects of active coping on cardiovascular reactivity are central in current psychosomatic theories, virtually all of the research to date has used impersonal, asocial tasks. Our two studies examined the cardiovascular effects of effortful attempts to influence other people. In Study 1, male subjects attempting to influence the opinions of their discussion partner to improve their own chances of winning money displayed significantly greater SBP, DBP, and HR reactivity. In Study 2, we obtained similar effects on SBP and DBP reactivity in men and women, while both preparing an influence attempt and making that attempt. Furthermore, reactivity levels were larger as the magnitude of incentive for successful persuasion increased. Implications of this interpersonal equivalent of active coping for the development of cardiovascular disease are discussed.     

Predicting Contraceptive Efficacy: A Discriminant Analysis of Three Groups of Adolescent Women1

The relationship of knowledge and attitudes to adolescent contraceptive efficacy was investigated in a multivariate study, with demographic and sexual history variables covaried. Subjects were unmarried, sexually active 15- to 19-year-old women. Two studies were conducted: one using a large and representative sample and the second using a smaller, high socioeconomic status sample that is more typical of samples generally used in earlier research. Subjects were classified as effective, ineffective, or nonusers of contraception, based on both frequency of use and effectiveness of the method(s) they used. Two discriminant function analyses were performed to determine (a) whether knowledge and attitudes contributed to discrimination among the groups over and above discrimination attributable to demographic and sexual history variables, and (b) which variables distinguished ineffective users from both other groups. The results of both studies indicate that attitudes, particularly attitudes toward contraception, are strong predictors of patterns of contraceptive use. Ineffective users were distinguished from nonusers by their greater knowledge of contraception, and from both other groups by their greater sexual activity and more positive attitudes toward intercourse. The discussion focuses on the theoretical implications of the results, the usefulness of the effective/ineffective/nonuser categorization, and applications of these findings to design of interventions.     

A reappraisal of Teresa of Avila's supposed hysteria

This essay offers a reassessment of Teresa's severe seizures which were such a characteristic feature of her mysticism. The diagnosis of hysteria is no longer viable, at the very least given its abandonment by clinicians. An alternative analysis is developed by phenomenologically comparing Teresa's seizures to parallel experiences of subjects in LSD-assisted psychotherapy. Using Stanislav Grof's categories, it is argued that Teresa's seizures are perinatal symptoms. As such, they represent the emergence and reintegration of extremely primitive psychological systems and might be described as the growing pains of transpersonal consciousness. They reflect not degenerative psychopathology but progressive movement toward higher states of consciousness.He has published articles in the fields of metaphor and the psychology of mysticism. An earlier version of this paper was presented at the national meeting of the American Academy of Religion in New York in 1982.