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Biomedical subjects

J L Cavanaugh

Publications and source records attributed to J L Cavanaugh.

35 records · Page 2Linked to original sources

Use of the SADS diagnostic interview in evaluating legal insanity.

Examined clinical usefulness of the SADS diagnostic interview in evaluations of criminal responsibility. Findings, based on 78 SADS evaluations from a specialized forensic clinic, indicated that SADS successfully differentiated between sane and insane evaluatees. These differences were found primilarily in the severity of psychotic symptoms and overall level of psychological impairment. In addition, preliminary data on institutionalized and outpatient Ss suggested the potential applicability of the SADS for assessing the general psychological functioning of insane patients in treatment.

Adaptation, Psychological↗

Identification of random responders on MMPI protocols.

In clinical practice, indicators of random or irrelevant responses on MMPI protocols are typically not examined, and, if obtained, assumed to be the result of either gross psychopathology or attempts to malinger. A sample of 40 computer-generated random profiles and 40 profiles of forensic outpatients were compared on validity scales, clinical scales, and scales specially designed to detect randomness (TR index and Carelessness Scale). Results of discriminant analysis indicated differentiating patterns of responses with random profiles generally elevated. Further, the accuracy of several clinical decisions rules were evaluated. The "F greater than 80 and TR greater than 4" rule was found to have the greatest clinical utility at correctly classifying random responders.

Female↗

Scientific inquiry in forensic psychiatry.

Forensic psychiatry and psychology, with an extensive history of clinical practice, is only recently emerging as a new scientific specialty. It is confronted with both general scientific-methodological issues, as well as unique, empirically-based psycholegal applications. Aimed towards a broader, more flexible paradigm for understanding the basis of our scientific inquiry, the paper examines various research and methodological issues. As a model for connecting and understanding these complicated and interrelated issues, Holton's explicit and useful model of scientific structure is provided. The methodology, logical and statistical analysis, and themata are explored with regards to their potential impact on scientific inquiry in forensic psychiatry. This paper argues for several considerations in furthering research. From a methodological basis, the prospective researcher has to consider (1) whether the methodology is, in part, predetermining the results; (2) whether the results are a prediction of the inclusion criteria rather than an independent finding; (3) what balance between specificity and generalizability is designed within the research study; and (4) what is the impact of various methodological artifacts on the results and conclusions of forensic psychiatric research (e.g., demand characteristics, evaluation apprehension, experimenter bias, systems influence). Further, the forensic psychiatric researcher is asked to consider the basis of the "validity" of his research findings in comparison with "objective reality" from the perspective of logical and statistical analysis. Scientists within forensic psychiatry are asked to consider (1) whether to employ "best fit" or complementarity in understanding their results; (2) how to make explicit the steps in data transformation and redefinition within their study; (3) what are the implications of exclusive use of null hypothesis testing in establishing research results; and (4) what is the comparative utility of non-parametric and multivariate statistical procedures in studying and understanding experimental variables. Finally, in acknowledging the non-linear and sometimes self-justifying aspect of science, researchers are invited to examine their basic assumptions, and the self-perpetuating and constraining nature of unacknowledged themata, as well as their impact on forensic psychiatry. This paper is conceptualized as a movement towards articulating both general methodological issues and their unique application to forensic psychiatry. The brief exposition of Holton's model and review of illustrative research in forensic psychiatry constitutes one attempt to strengthen the scientific rigor of forensic psychiatric research.

Forensic Psychiatry↗

A computerized assessment program for forensic science evaluations: a preliminary report.

The development of the innovative use of an on-line, computer-assisted evaluation program is discussed, with a brief review of pertinent literature. The particular applications within a forensic psychiatric center of the Tandem 16 computer system, utilizing both "canned psychological tests" and specialized assessment techniques, are examined and highlighted with a case vignette. A highly relevant problem within forensic psychiatry, malingering or exaggeration of symptoms, is examined in more detail as it relates to computer assessments. The advantages and limitations of a computer-assisted evaluation are described relative to both its clinical and research application.

Adult↗

An empirical approach to insanity evaluations.

Described the development of the Rogers Criminal Responsibility Assessment Scales (RCRAS) as an empirically based testing procedure specifically designed for use in insanity evaluations. A pretest of the RCRAS that employed 10 case vignettes and a preliminary study of 25 patients are reported. Initial results indicated that the RCRAS has satisfactory interrater reliability and successfully discriminated between those patients evaluated as sane and insane. Results of the discriminant analysis, MANOVA, and factor analysis are discussed with reference to the RCRAS' construct validity and the need for further extensive studies.

Diagnosis, Differential↗

The new mental health code.

Explore the source record for details and available documents.

Commitment of Persons with Psychiatric Disorders↗

Career decisions in the early postresidency years.

The author notes that the end of the postresidency military obligation necessitates earlier career decision making for the senior psychiatric resident. This problem is seen to be exacerbated by the eclectic nature of most psychiatric training. Issues for residents include the problem of role models and the "senior resident syndrome," the decision of whether to maintain their university affiliation, the role of private practice, questions of clinical maturity, etc. The author believes that programs must be developed to systematically and objectively present to residents the data that now exist regarding multiple career options.

Administrative Personnel↗

Psychiatric consultation services in the large general hospital: a review and a new report.

Studies are reviewed documenting increased interest in psychiatric consultation services in the general hospital, and disparities between the need for and the availability/utilization of consultation services are examined. The emergence of the eclectrically trained psychiatrist as the most acceptable consultant in the general hospital is discussed. An exploratory attiduinal questionnaire, developed and circulated to a sample of attending physicians in a midwestern university teaching hospital, yielded the following data. Thirty-nine per cent (N=96) of the 244 physicians who received the questionnaire responded. Ninety-nine per cent of the respondents agreed that readily available psychiatric consultation services should be fully operative in all large general hospitals; 88% agreed that psychiatric consultations in the general hospital must be performed by a physician with special training in psychological medicine; 50% indicated a preference for a biologically-oriented psychiatrist, and 26% preferred a family practitioner or internist who had subsequently become a psychiatrist. The majority of respondents indicated that between July 1974 and July 1975, 1-5% of their private hospitalized patients received inhospital psychiatric consultation. Eighty-six per cent of the respondents felt the patients should be billed directly at a rate equal to other medical/surgical consultations. These data are correlated with issues involved in the utilization of psychiatric consultation in the general hospital.

Aftercare↗