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).     

Common response processing and psychological refractoriness

This experiment examined whether structural considerations, that is the functional closeness of limb control centres (Kinsbourne and Hicks 1978), have a role to play in common processing models of psychological refractoriness. A typical double stimulation paradigm was used (Kantowitz 1974). On experimental trials, subjects responded with the right hand (RT1) to an auditory signal (0.80 probability). After a varied interstimulus interval (ISI) of 100, 200, 300 or 700 msec, one of three lights corresponding to one of the other limbs provided the signal for the second response (RT2). Control trials for RT1 and RT2 involved both stimuli, but subjects were required to make only one response. Results indicated that experimental RT1 was lengthened considerably over control values. While typical double stimulation effects were found at short ISIs, that is RT2 was lengthened, RT2 at long ISIs was actually faster than double stimulation control values. Although the RT results were not in a pattern that would be predicted by functional distance (Kinsbourne and Hicks 1978), within subject correlations of RT1 and RT2 by limb condition suggest that structural considerations may have a role to play. While within subject correlations were positive at all levels of ISI, they decreased as the interval between the two signals increased. The implications of these results for common processing models are discussed.