Antisocial Personality Disorder

Assessments of partial culpability of adolescents are difficult in individual cases; however, the courts are moving away from mandatory sentencing to individual determinations, even for the most heinous crimes.

Traumatic brain injury (TBI) in children and adolescents is a major public health problem. Psychiatrists have a crucial role in the management of young persons who have a TBI.

If we, as a people, continue to sacrifice genuine security for a false sense of freedom, we shall find ourselves in a nation neither secure nor free.

"You turn on the television, and violence is there. You go to a movie, and violence is there."

Boys with ADHD can present with different cognitive and behavioral patterns than girls with ADHD. Despite these factors, girls with ADHD remain at significant psychosocial risk into adulthood.

In this review, we discuss the established medications as well as experimental therapeutic options that may emerge as future medications for alcohol intoxication, withdrawal, and/or long-term abstinence maintenance or harm-reduced drinking.

As we are faced with a growing population of older adults, a better understanding of the issues that they confront is crucial.

The California Supreme Court’s decision in the Tarasoff case over 30 years ago has become a standard part of mental health practice. This case influenced the legal requirements governing therapists’ duty to protect third parties in nearly every state in the US.

In this guest blog, Dr Deirdre D'Orazio responds to a recent commentary by Dr Allen Frances on conducting evaluations of potential sexually violent predators.

Here, Mr Hazelwood answers questions about serial murderers that are commonly posed to him. The term serial murderer (or serial killer) was not even a part of the forensic lexicon until the 1970s . . .

Terrence Malick’s The Tree of Life is not easy entertainment, but for psychiatrists who might welcome an encounter with a brilliant, uncompromising mind, The Tree of Life is enthralling.

Depression, PTSD, panic disorder, and abuse of alcohol and drugs are more insidious, quieter forms of illness that can cause the same desperation and disability as psychotic disorders.

Those of you who have been following the SVP controversy know that "Paraphilia NOS, nonconsent" (PNOS) is a fake diagnosis that is losing traction as justification for committing rapists to psychiatric hospitals.

During the past year, I have been involved as an expert witness for the defense in 14 SVP cases (tried in California, Washington, and Iowa). My role has been to clarify what is meant by the wording of the Paraphilia section in DSM-IV. And it certainly does badly need explaining.

Here’s why it is painful to see a man cry: he's not supposed to. Emotions are arresting when society tells us they should not be expressed. In the case of a grown man crying, there are some thousands of years of cultural training laying down the prohibitive regulations.

Rape is always a heinous, ugly, violent, and cruel crime. But the violence and cruelty that are part of all rapes should not be confused with the specifically motivated violence and cruelty that distinguish sexual sadism...

When my clinic manager told me that prison may be the best place to practice psychiatry nowadays, I didn’t believe him. After all, prisons often seem like a world apart, often in isolated rural areas or in windowless, nondescript urban buildings.

In previous blogs and papers, I have done my level best to skewer the misuse of the misdiagnosis "Paraphilia NOS." I regard it as no more than a flimsy justification, concocted to allow the psychiatric incarceration of rapists who would otherwise have to be released from prison to the street.

I was asked three interesting questions by a psychologist with 15 years experience evaluating sexually violent predators. She has testified often--both for the prosecution and for the defense in the hearings that determine the legitimacy of involuntary psychiatric commitment under SVP statutes.

Every case of patient violence against clinicians provides lessons to be learned in safety management. Here: some key points that can enhance physician safety and help minimize the risks.

One of the impulse-control disorders, Intermittend Explosive Disorder includes serious acts of aggression against person or property that are completely out of proportion to any provocation.

Charles Moser, PhD, MD, has forwarded an interesting suggestion to solve the problem of weak diagnoses that have received a free ride through previous revisions of DSM. His is a middle way intended to steer between the contrasting risks of continuing questionable diagnoses and the risks of eliminating them.

A DSM critic, Andrew Hinderliter sent this perceptive email questioning the wisdom of the most fundamental decision we made in preparing DSM IV-- ie, our goal of keeping the system stable.

The doctor’s role is to go beyond the obvious and to detect subtle determinants. Good diagnosticians have been trained to look beneath the loud symptom and consider underlying factors.

Dr Allen Frances pleads for the United States Supreme Court to “step up to the plate” and halt the “disturbing misuse” of the “makeshift” psychiatric diagnosis of Paraphilia NOS (nonconsent).