The use of animals for therapeutic benefit is well-established. For example, for individuals with a disability such as blindness, trained service dogs can enhance the ability to live independently and participate fully in society. An emotional support animal (ESA) is an untrained animal that is used to support a person disabled by an emotional or mental disorder. For an animal to qualify as an ESA

Sexually violent predator (SVP) statutes are unique in that these laws allow for the indefinite civil psychiatric commitment of sex offenders after their criminal sentences have been served. In addition to the high cost of psychiatric hospitalization, recently observed low base rates of sexual recidivism of sex offenders released from custody suggest that, in select SVP cases, a collaborative justice

Since 2004, Connecticut has had two different mechanisms for involuntary medication of defendants hospitalized for restoration of competence to stand trial. In this article, we first describe the development of these two mechanisms and compare their procedural elements. The first procedure required a hearing in criminal court, in a process parallel to the subsequent U.S. Supreme Court holding in Sell

We analyze and comment on a legal case (Edward Gatherer v. Drexel Gomez, 1989) from Barbados. We theorize that in this kind of case a forensic psychiatrist consultant could helpfully advise the principals regarding pitfalls to avoid in resolving their conflict. Use of the consultant has certain advantages over taking such disputes to courts of law. In this case the rector of an Anglican Church in Barbados

This article summarizes the evolution of the U.S. Supreme Court's standard for assessing defendants' competency for execution. In Ford v. Wainwright (1986), the Court categorically exempted insane defendants from execution but failed to agree on how to define insanity. In Panetti v. Quarterman (2007), the Court ruled that defendants may be executed only if they rationally understand why they are being

Popular media and the lay public have long expressed concerns about the association between violent video games and violent behavior. The current scientific literature exploring this connection focuses primarily on the relationship between violent video games and aggression in healthy populations. We are unaware of prior publications exploring the effect of such games on aggression in institutional

In their article about countertransference and vicarious trauma in work with sexual offenders, Barros and colleagues highlight the importance of awareness of risk for vicarious trauma in forensic psychiatrists and psychologists. This commentary supports the need for more research related to the risk of vicarious trauma and posttraumatic stress disorder (PTSD) in forensic experts. Also, forensic mental

The available categorical constructs within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, do not allow forensic psychiatrists to distinguish easily between the varieties of delusion-like belief. This dilemma is especially challenging when seemingly delusional beliefs are shared online. Although the term "extreme overvalued belief" has been proposed to aid with such distinctions

Bestiality, or sexual contact between humans and nonhuman animals, is a poorly understood aspect of sexual behavior. There is a dearth of scientific research on the prevalence of bestiality, the motivations for individuals to engage in the behavior, and the risk that such individuals pose for interpersonal sexual and nonsexual violence. This study is a descriptive analysis of bestiality in all individuals

An extreme overvalued belief is shared by others in a person's cultural, religious, or subcultural group. The belief is often relished, amplified, and defended by the possessor of the belief and should be differentiated from a delusion or obsession. Over time, the belief grows more dominant, more refined, and more resistant to challenge. The individual has an intense emotional commitment to the belief

This article examines criticism from the scholarly community and findings from the military's Judicial Proceedings Panel that training in the U.S. Department of Defense Sexual Assault Prevention and Response program biases panel members during courts-martial. The topic is examined from the perspective of psychological science. Studies on jury bias, stereotypes, decision-making dynamics, and behavioral

Artificial intelligence is rapidly transforming the landscape of medicine. Specifically, algorithms powered by deep learning are already gaining increasingly wide adoption in fields such as radiology, pathology, and preventive medicine. Forensic psychiatry is a complex and intricate specialty that seeks to balance the disparate approaches of psychiatric science, which strives to explain human behavior

Women of reproductive age may experience pregnancy and mothering in a correctional environment designed for men. Rates of incarceration for women in the United States are high by international standards, and they continue to rise. Mothers were often single mothers prior to incarceration, and they are often separated from their children for the first time upon entering prison. Pregnancy, delivery, lactation

Sarah Jane Whiteling was accused of fatally poisoning her husband and two children in Philadelphia in 1888. The case prompted public outrage over the appearance that Ms. Whiteling's motive was to collect life insurance. It was evident, however, that she was disturbed, raising a question of culpability. Dr. Alice Bennett, the first female physician in charge of an asylum, provided the defense with expert

The RePresent games are online video games that are publicly available and designed to educate people about legal self-representation in civil court. This study was part of a project to examine use of the RePresent games in Connecticut, Massachusetts, Maine, and New Hampshire from January 2018 to May 2018. Data on game use across the four states were analyzed, and an online survey was conducted to

Caffeine is the most commonly ingested psychoactive substance in the world. Although caffeine-use disorder is not recognized as a formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, five disorders related to caffeine use are enumerated therein. An evolving literature suggests that caffeine is one of many licit substances that may cause psychotic symptoms in

This study aimed to examine the associations between countertransference induced by sex offenders, defense mechanisms, and manifestations of vicarious trauma in forensic psychiatrists and psychologists. A cross-sectional study using a mixed-methods design was performed with 56 Brazilian forensic psychiatrists and psychologists from October 2016 to May 2017. Countertransference, defense mechanisms,

In this issue of The Journal, MacIntyre and Appel have reviewed state laws and medical boards' policies to ascertain which states require reporting of sexually exploitive psychiatrists, specifically when the patient reveals the exploitation during treatment. They highlight the competing ethics duties faced by physicians who are in a position to report such conduct and provide guidance for future development

Supreme Court rulings supporting the constitutionality of sexually violent predator (SVP) statutes require that evaluators determine whether the rapist has a mental disorder (which justifies psychiatric commitment) or is just a common criminal (who cannot be preventively detained psychiatrically), but they offer no guidelines on making this crucial distinction. Until recently, state evaluators ignored

Bloom and Kirkorsky discuss three models of special commitment procedures in use today in California, Oregon, and Ohio, regarding the management of individuals found incompetent to stand trial, not restorable (IST/NR) and considered dangerous. They suggest that a fourth model, one merging the population of dangerous IST/NR individuals into the system of insanity acquittees, would offer this group the

The use of antisocial personality disorder (ASPD) as a qualifying mental disorder for a sexually violent predator (SVP) or a sexually dangerous person (SDP) commitment continues to arouse controversy. Two common questions arise. Is ASPD considered a qualifying mental disorder in statutory or case law definitions? Can ASPD be the sole qualifying mental disorder? We review case law for guidance as to

The capacity of arrestees to comprehend their Miranda rights adequately and to waive them intelligently remains largely unexamined by most defense attorneys and forensic practitioners. Although much is now known about Miranda comprehension, only recently has forensic research emerged on Miranda reasoning. This archival study utilizes an extensive dataset of 847 pretrial detainees who were administered

This article focuses on the preferred disposition for an individual charged with a serious crime against another person, adjudicated incompetent to stand trial and not restorable to competence, whose original criminal charges are dismissed without prejudice, and who is regarded by the state as dangerous to the general public. Three current models used today in California, Oregon, and Ohio are described

Incarcerated individuals have high rates of mental disorders and substance use disorders compared with the general population, yet correctional facilities in the United States have difficulty recruiting mental health professionals. This has led to shortages in the availability of clinicians who can provide psychiatric care in these settings. During training and in practice, mental health professionals

Individuals with a history of offending behavior show high rates of mental disorder as well as fetal alcohol spectrum disorder (FASD). Neurocognitive impairments are common in both mental disorders and FASD and may interface with offending behavior. Understanding these impairments could effectively inform clinical considerations among this population. The purpose of this study was to characterize the

When a patient reports a sexual relationship with a prior provider during treatment, a psychiatrist or therapist must balance conflicting ethics principles of autonomy, confidentiality, and social justice in deciding whether to report this behavior to the proper authority. Many states have statutes regarding such reporting that are unclear or ambiguous; others lack laws entirely. We surveyed state

The use of the Cultural Formulation Interview (CFI), a 16-item, semistructured, patient cultural assessment, in a forensic mental health setting has not been examined. Using a mixed-methods approach, we performed a pilot test of the CFI in an inpatient service that treats both forensic and nonforensic adult patients. Clinicians' attitudes toward adoption of the CFI was assessed quantitatively with

The relative contributions of mental illness and substance use disorders to criminal recidivism have important clinical and policy implications. This study reviewed 36 months of postrelease data for nearly 10,000 New Jersey state inmates released in 2013 to ascertain the rearrest rate of those diagnosed with mental illness, substance use disorders, both, or neither. We also examined whether certain

Competency restoration in jails has grown steadily over the past decade, driven primarily by cost considerations and long wait times for inpatient restoration programs. Although jail-based programs may offer an attractive temporary solution to the shortage of beds, a longer-term solution involves enhancing the continuum of competency restoration services available outside of the correctional system

The strong association between firearms, domestic violence (particularly intimate partner homicide), and additional victimization suggests that prioritization of measures to decrease access to firearms to perpetrators of domestic violence may also reduce the incidence of mass shootings. The majority of mass shootings are associated with domestic violence. The current study by Kivisto and Porter examines

Humans have been persecuted for the crime of blasphemy since biblical times. Today, about one quarter of the world's countries and territories, most of them Muslim-majority nations, still have anti-blasphemy laws. Pakistan is among the countries where blasphemy is punishable by death. In many instances, the accused are killed by mobs before legal proceedings even begin. Often, it is people with mental

Since the landmark case of Roper v. Simmons in 2005, the U.S. Supreme Court has ruled in a series of cases on sentencing for juvenile criminal offenders. Emphasizing that children are different for the purposes of criminal punishment, the Court has incrementally held that it violates the Eighth Amendment's prohibition against cruel and unusual punishment to impose death or life without parole for most

The American Academy of Psychiatry and the Law (AAPL) has been devoted to the teaching of forensic psychiatry, and as AAPL celebrates its 50th Anniversary, it seems fitting to examine the history and the current status of forensic psychiatry teaching in general psychiatry residencies and forensic psychiatry fellowships. After a brief review of the history of AAPL and forensic psychiatry training, this

Recent years have seen a renaissance of research into the use of psychedelic compounds to address various psychiatric conditions. The study of these substances went dormant in 1970 when the United States government passed the Controlled Substances Act, which categorized lysergic acid diethylamide, commonly known as LSD or acid, as a Schedule I drug. The rise of psychedelics in research settings raises

Despite a growing body of research on the association between psychosis and homicide and between psychosis and sexual offending, research on psychosis and sexual homicide is limited. The objective of this review was to estimate the prevalence of psychosis in sexual homicide and to explore the extent to which prior research has investigated symptoms of psychosis as a motivating or causal variable leading

This study reports on restoration outcomes of a sample of pretrial defendants (n = 877, 69% male) who were found incompetent to stand trial and underwent restoration services in a large urban county. Each male defendant was initially assigned to restoration in one of four settings on a continuum of services of varying intensity (ie, outpatient, jail general population, dedicated jail-based restoration

In March 2015, a co-pilot flying Germanwings Flight 9525 deliberately pointed his airplane into a descent, killing himself, five other crew members, and 144 passengers. Subsequent investigation and review teams examined the incident and considered potential lessons to maximize air safety. In this article, aviation industry clinical leaders, including the U.S. Federal Air Surgeon and Chief Psychiatrist

Domestic homicides account for more than one in four homicides in the United States and frequently involve multiple victims. This study examined the prevalence of firearm use in domestic homicides in the United States and the associated risk of a multiple homicide event. We used weighted negative binomial regression to model the effects of firearm use on the number of additional victims in domestic

Psychiatrists without specialty forensic training routinely encounter forensic questions and treat justice-involved patients, which underscores the importance of adequate forensic training in general psychiatry residency. Some programs may face challenges providing adequate forensic instruction due to a lack of local forensic psychiatrists or other forensic resources. Novel training approaches are

The relationship between autism spectrum disorder (ASD) and violence is poorly understood. Several violence risk factors are either modified by or are unique to ASD; clinicians conducting violence risk assessment of people with ASD must consider these factors. An ASD-specific risk assessment tool is clearly needed. In the absence of this, clinicians often use risk assessment tools designed for other

Developed over 30 years ago, the Crisis Intervention Team model is arguably the most well-known approach to improve police response to individuals experiencing mental health crisis. In this article, we comment on Rogers and colleagues' review (in this issue) of the CIT research base and elaborate on the current state of the evidence. We argue that CIT can be considered evidence based for officer level

The Historical Clinical and Risk Management scale (HCR-20) is a structured clinical judgment tool used to assess risk of violence in secure settings. But the scale does not account for difficulties typical of patients with autism spectrum disorder, which are thought to contribute to their engagement in violent behaviors. The present study is a preliminary investigation of the association between risk

Approximately 1,000 people in the United States were fatally shot by police officers during 2018, and people with mental illness were involved in approximately 25 percent of those fatalities. Crisis Intervention Team (CIT) training is a specialized police curriculum that aims to reduce the risk of serious injury or death during an emergency interaction between persons with mental illness and police

Treatment with antipsychotics is a mainstay of trial competency restoration, particularly given that most defendants deemed incompetent to stand trial have psychotic illnesses. We explored the association between competency restoration and antipsychotic type in a retrospective sample of defendants diagnosed with psychotic disorders and deemed incompetent to stand trial. Using regression models, we

Current approaches to monitoring patients' mental status rely heavily on self-reported symptomatology, clinician observation, and self-rated symptom scales. The limitations inherent in these methodologies have implications for the accuracy of diagnosis, treatment planning, and prognosis. Certain populations are particularly affected by these limitations because of their unique situations, including