Detecting Malingered Psychotic Symptoms With the Rorschach Projective Technique

Problem. Criminal defendants may be strongly motivated to avoid prosecution by appearing mentally ill, and the malingering of psychotic symptoms is of special concern in legal proceedings. Much research has been conducted to determine accurate methods to detect malingering. These include clinical interviews, structured personality tests, intelligence tests, and projective techniques. This present study investigated the ability of specific variables on the Rorschach Projective Technique to detect malingered protocols. Method. The 83 subjects in this study were restricted to male pre-trial defendants in the Federal Judicial system who were placed into three categories by diagnosis: (1) malingering psychotic symptoms, (2) psychotic disorders, and (3) all other diagnoses. The following Rorschach variables were investigated in this study: (1) the total number of responses, (2) the number of Popular responses, (3) the lambda ratio, which examines the frequency of pure form responses to all responses, (4) conventional form, (5) the Schizophrenia Index, (6) the weighted sum of six special scores, (7) the deviant verbalizations added to the deviant responses, and (8) confabulated responses added to inappropriate logic responses. Results. The results of the study indicated that only the number of Popular responses statistically differentiated the malingerer group from the other two groups. Subjects from the malingerer group provided from 0 to 9 popular responses with a mean of 4.487. This was significantly lower than the means obtained by the psychotic group (mean = 5.8), the control group (mean = 5.9), and the mean of 6.9 which Exner (1989) reported for non-patient males. When the variability in the number of responses was controlled for, nothing was found to be significant. Using discriminant analysis, 73.9% of the malingerers were accurately classified. Conclusions. Detecting malingered psychotic symptoms with the Rorschach is difficult. Suggestions for further research include identifying each subject\u27s knowledge of psychiatric disorders and behaviors exhibited by those with mental disorders, and investigating other Rorschach variables

Book Review: Psychiatric Justice

In an era in which extensive judicial emphasis has been placed on due process of law in criminal proceedings, both in the federal courts and in the state courts, Dr. Szasz\u27s book serves as a jarring reminder that in at least one vital area of the concept of due process, much remains to be done. The emerging definition of due process has enunciated the rights guaranteed the individual by the Fourth, Fifth, Sixth, and Fourteenth Amendments; and viewed within that framework, this book, although published in 1965, remains particularly timely, for Szasz, speaking as a psychiatrist, endeavors to demonstrate how the criminal procedure in virtually every jurisdiction in the United States operates to use psychiatry as a weapon against the individual. This injustice is accomplished through the application of two procedures: the involuntary pretrial psychiatric examination of the accused to determine his fitness to stand trial and the coerced plea of not guilty by reason of insanity induced when the accused is found fit to stand trial. Either of these procedures, the author maintains, effectively denies the accused his Sixth Amendment right to trial

Chronic pain and substance use disorders among older HIV-infected sexual minority men: implications for engagement in care

Accepted versio

Pentoxifylline for heart failure: A systematic review

Background. Recent trials have indicated a beneficial effect of pentoxifylline on measures of inflammation and markers of cardiac dysfunction in people with heart failure. However, it is uncertain whether pentoxifylline should be used routinely in the management of heart failure. Objective. To determine the effectiveness of pentoxifylline in heart failure. Design. Systematic review of randomised controlled trials. Methods. We searched MEDLINE (1 January 1966 - 20 November 2004), the Cochrane Controlled Trials Register (issue 4, 2004), and reference lists of related papers, for randomised controlled trials of pentoxifylline in the treatment of heart failure. Prospective, randomised, double-blind controlled trials were sought for inclusion in the study. The two reviewers independently assessed trial quality and extracted data, which were analysed using RevMan statistical software. The following outcome measures were evaluated: (i) New York Heart Association (NYHA) functional class; (ii) left ventricular ejection fraction (LVEF); (iii) frequency of hospitalisation; and (iv) death from all causes. Results. Four studies with a total of 144 participants met the inclusion criteria. Statistical pooling (or meta-analysis) was not performed owing to the significant clinical heterogeneity and differences in reporting of the outcomes in the included studies; instead, the trials were analysed separately for the outcomes of interest. The four studies tested the use of pentoxifylline versus placebo in patients with heart failure of varying aetiology (idiopathic dilated cardiomyopathy, 3 studies; ischaemic cardiomyopathy, 1 study). In 2 of the idiopathic dilated cardiomyopathy studies, patients were classified as NYHA class II or III, while the study population in another idiopathic cardiomyopathy study was in NYHA class IV. The trial of patients with ischaemic cardiomyopathy included patients in NYHA functional classes I - IV. The use of pentoxifylline was associated with significant improvement in symptoms (i.e. NYHA functional class) and cardiac function (i.e. LVEF) in 3 out of 4 studies. The beneficial effect on symptoms of heart failure and cardiac function was seen in all grades of severity of heart failure and in patients with ischaemic and idiopathic dilated cardiomyopathy. All 4 studies showed a trend towards reduction of mortality, but this effect was not statistically significant. The effect of pentoxifylline on the frequency of hospitalisation has not been tested in randomised controlled trials. Interpretation. Pentoxifylline may have a beneficial effect on NYHA functional class, ejection fraction and mortality in heart failure, but published trials are too small to provide conclusive evidence. There is a need for large, placebocontrolled trials of pentoxifylline in heart failure, involving a diverse group of patients with regard to cause and severity of heart failure

Beta decay of 71,73Co; probing single particle states approaching doubly magic 78Ni

Low-energy excited states in 71,73Ni populated via the {\beta} decay of 71,73Co were investigated in an experiment performed at the National Superconducting Cyclotron Laboratory (NSCL) at Michigan State University (MSU). Detailed analysis led to the construction of level schemes of 71,73Ni, which are interpreted using systematics and analyzed using shell model calculations. The 5/2- states attributed to the the f5/2 orbital and positive parity 5/2+ and 7/2+ states from the g9/2 orbital have been identified in both 71,73Ni. In 71Ni the location of a 1/2- {\beta}-decaying isomer is proposed and limits are suggested as to the location of the isomer in 73Ni. The location of positive parity cluster states are also identified in 71,73Ni. Beta-delayed neutron branching ratios obtained from this data are given for both 71,73Co.Comment: Accepted for publication in PR

Orbital dependent nucleonic pairing in the lightest known isotopes of tin

By studying the 109Xe-->105Te-->101Sn superallowed alpha-decay chain, we observe low-lying states in 101Sn, the one-neutron system outside doubly magic 100Sn. We find that the spins of the ground state (J = 7=2) and first excited state (J = 5=2) in 101Sn are reversed with respect to the traditional level ordering postulated for 103Sn and the heavier tin isotopes. Through simple arguments and state-of-the-art shell model calculations we explain this unexpected switch in terms of a transition from the single-particle regime to the collective mode in which orbital-dependent pairing correlations, dominate.Comment: 5 pages 3 figure

The Single-Particle Structure of Neutron-Rich Nuclei of Astrophysical Interest at the Ornl Hribf

The rapid nuetron-capture process (r process) produces roughly half of the elements heavier than iron. The path and abundances produced are uncertain, however, because of the lack of nuclear strucure information on important neutron-rich nuclei. We are studying nuclei on or near the r-process path via single-nucleon transfer reactions on neutron-rich radioactive beams at ORNL's Holifield Radioactive Ion Beam Facility (HRIBF). Owing to the difficulties in studying these reactions in inverse kinematics, a variety of experimental approaches are being developed. We present the experimental methods and initial results.Comment: Proceedings of the Third International Conference on Fission and Properties of Neutron-Rich Nucle