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).     

Different patterns of cognitive slowing produced by Alzheimer's disease and normal aging

Aging has previously been shown to produce a generalized proportional slowing of all cognitive operations. In contrast, the present results suggested that Alzheimer's disease produces a disproportionate reduction in the speed with which patients carry out one or more mental operations. The tasks that demented patients found particularly difficult involved either a self-directed search of their lexicon or the use of familiarity information.     

Central clinical states: An examination of the Profile of Mood States and the Eight State Questionnaire

Two multidimensional mood-state inventories, the Profile of Mood States (POMS) and the Eight State Questionnaire (8SQ), were administered to 289 Australian college undergraduates. Intercorrelations for the combined 14 subscales were subjected to a higher-order factor analysis in order to elucidate the central clinical states within the mood-state sphere. Results suggested four major state dimensions pertaining to Neuroticism, Hostility/Anger, Vigor, and a combined Extroversion/Arousal-Fatigue entity. Both three- and five-factor solutions were taken out for comparative purposes. Furthermore, separate higher-order factorings of the POMS on normative samples of 350 male and 650 female psychiatric outpatients were conducted, corroborating three of the four central state dimensions, at least in the case of females. The implications of these findings for behavioral assessment are discussed.This study was supported by a Research Development Grant awarded to the author by the University of Melbourne.     

Professional liability (malpractice) coverage of humanist scholars functioning as clinical medical ethicists

In contrast to theoretical discussions about potential professional liability of clinical ethicists, this report gives the results of empirical data gathered in a national survey of clinical medical ethicists. The report assesses the types of activities of clinical ethicists, the extent and types of their professional liability coverage, and the influence that concerns about legal liability has on how they function as clinical ethicists. In addition demographic data on age, sex, educational background, etc. are reported. The results show that while nearly one third (28.9%) of the ethicists regularly make recommendations about patient care, only 10.8% of them regularly make entries in the medical record; only approximately half (53.0%) of them are covered by professional liability (malpractice) insurance; and the vast majority (84.3%) of them say that concerns about legal liability do not influence the way they function as clinical ethicists.