Term
| Who developed the concept of an autopsy, where, and why? |
|
Definition
| Litman and colleagues at the the LA Suicide Prevention Center to help understand the role a person played in their demise. |
|
|
Term
| What are the six purposes for psy autopsies? (developed by Jacobs) |
|
Definition
Determine the cause of death
Intention to die thru retrospective deconstruction
Why a person would chose suicide
Why at that particular time
Research tool to aid in understanding & prevention
Therapeutic aid to family of deceased |
|
|
Term
| Who performed the first psy autopsy and when? |
|
Definition
| Robert Litman, in 1958, for the LA coroner's office on a man who jumped off of the SM pier (accident or suicide?). |
|
|
Term
| What does NASH stand for? |
|
Definition
| Dying of natural cause, accident, suicide, or homicide |
|
|
Term
| What does ME/C stand for? |
|
Definition
| Medical examiner or coroner |
|
|
Term
| WHat does equivocal deaths mean? |
|
Definition
| When the manner of death can not be clearly determined; when autopsy may be requested. |
|
|
Term
| What are contested cases? |
|
Definition
| When an autopsy is requested after a coroner has made a ruling (need a lot of substantial evidence). |
|
|
Term
| What determines a suicide? |
|
Definition
| The requirement of death to be self-inflicted and intentional; the most difficult to prove |
|
|
Term
| What was the Cali Supreme Court case of Searle vs. Allstate Life Insurance Company of 1985 about? |
|
Definition
| Contesting the non-payout of death benefits. Wife was concerned about her husband's mental capacity to take his own life. |
|
|
Term
| What was the court's ruling of Seale vs. Allstate? |
|
Definition
| The mental capacity to form the content to attempt suicide and the factors that may have impaired mental capacity (drugs & alcohol or severe mental illness) were not sufficient. The presence of cognitive impairment by itself does not serve as justification. Husband did not have a mental condition consistent with suicide. |
|
|
Term
| When and for who did the USC Institute of Psychiatry and Law start performing autopsies? |
|
Definition
| In 1989 for the coroner's office. |
|
|
Term
| What are the procedures to evaluate in an autopsy? |
|
Definition
| Interviews, medical & legal reccords, and then write a report on whether consistent or inconsistent with suicide. At the end you give a presentation. |
|
|
Term
| What is the case example of the mother who was supposed to have committed suicide? |
|
Definition
| The mother was 44 and divorced w/out child support payments. She was found laying nude at the bottom of her swimming pool. There was a history of depression and daughter developed depression after divorce and wrote a suicide note for herself. The mother accidentally drowned from alcohol intoxication while sunbathing nude. |
|
|
Term
| What is suicide prediction? |
|
Definition
| Prediction of whether suicide will or not occur at some time in the future, base on the presence or absence of factors. |
|
|
Term
| What is suicide risk assessment? |
|
Definition
| The use of clinical judgment by weighing all the available evidence. A systematic process of estimating probabilities over a short period of time is done. |
|
|
Term
| What are the components of suicide assessment? |
|
Definition
A psy interview looking for risk & protective factors
Asking directly about suicide
Determine the level of suicide risk (low, mod, high)
Determine treatment setting & the plan (hospital)
Document assessments |
|
|
Term
| What are the areas to evaluate in a suicide assessment? |
|
Definition
Presence of psy disorders, prior history of suicide attempts, thoughts, family
individual strengths vs. vulnerability (coping skills & response to stress)
psychosocial situation (acute or chronic stressors, support, religious beliefs)
suicidally ( suicide thoughts, hopeless, depressed) |
|
|
Term
| Demographic suicide risk factors |
|
Definition
| male (widowed, divorced, white) |
|
|
Term
| Psychosocial risk factors for suicide |
|
Definition
| Lack of social support, unemployment, drop in socioeconomic status, access to firearms |
|
|
Term
| Psychiatric risk factors for suicide |
|
Definition
| Presence of a mental disorder, esp. if it's comorbid |
|
|
Term
| Physical illness risk factors of suicide |
|
Definition
| Medical problems associated with pain, discomfort, or terminal or advanced illness (cancer, HIV) |
|
|
Term
| Psychological risk factors of suicide |
|
Definition
| Presence of anxiety and hopelessness |
|
|
Term
| Behavioral risk factors of suicide |
|
Definition
| Being impulsive, aggressive, agitated |
|
|
Term
| Cognitive risk factors of suicide |
|
Definition
| Thought constriction, polarized thinking (all or nothing) |
|
|
Term
| Childhood trauma risk factors of suicide |
|
Definition
| Experience of abuse or neglect in childhood |
|
|
Term
| Genetic and familial risk factors of suicide |
|
Definition
| Family history of suicide or mental illness |
|
|
Term
| Protective factors of suicide |
|
Definition
| Having children in the home, postpartum pregnancy, deterrent religious beliefs, positive coping skills, social support |
|
|
Term
| Prior suicide attempts have an odds ratio of? (suicide) |
|
Definition
|
|
Term
| Eating disorders have an odds ratio of? (suicide) |
|
Definition
|
|
Term
| Bipolar and depression have an odds ratio of? (suicide) |
|
Definition
|
|
Term
| For suicide, what % had 3 or more axis I diagnoses? (Out of 229 suicides) |
|
Definition
|
|
Term
For suicide, what % had axis I and II diagnoses?
(Out of 229 suicides) |
|
Definition
|
|
Term
For suicide, what % had an axis 1 and III condition?
(Out of 229 suicides) |
|
Definition
| 50% (only 12% had axis I with no comorbidity) |
|
|
Term
| What is the high risk profile of suicide and mental conditions? |
|
Definition
| Suicide early on in the disorder, moderate history of alcohol abuse, and previously hospitalized for suicide attempts or thoughts |
|
|
Term
| What is the profile of schizophrenia and suicide? |
|
Definition
| Prior suicide attempt, significant feelings of depression (hopelessness), male, poor premorbid functioning, current substance abuse, and recent hospital discharge. |
|
|
Term
| What is the profile of alcohol/substance abuse and suicide? |
|
Definition
| Men have higher rates of alcohol abuse and women have higher rates of drug abuse, increased # of substances used, recent to impending interpersonal lost. (There is a correlation between the number of drugs and successful suicide) |
|
|
Term
| What is the profile of personality disorders and suicide? |
|
Definition
| Borderline personality disorder with depression and alcohol abuse. In those with ASPD is a narticistic injury or impulsivity (found in con men). |
|
|
Term
| What are the family history genetics associated with suicide? |
|
Definition
|
|
Term
| What family psychopathology is associated with suicide? |
|
Definition
| Having a family history of mental illness. |
|
|
Term
| What are the life stressors associated w/ suicide? |
|
Definition
| A recent stressful life even, esp. if already vulnerable (humiliation or embarrassment). |
|
|
Term
| How is firearms correlated to suicide? |
|
Definition
Firearms account for 50-60% of all completed suicides
They increase the risk of suicide for adolescents |
|
|
Term
| What is intent vs. lethality of suicide? |
|
Definition
| The subjective expectation that they will die vs. objective danger to one's life based on the method of suicide. |
|
|
Term
| What is the degree of ambivalence of suicide? |
|
Definition
| Assessing the wish to live vs. wish to die |
|
|
Term
| What are deterrents of suicide? |
|
Definition
| Any factors that prevent them from taking their life (belief, support) |
|
|
Term
| What are the characteristics of a suicide plan? |
|
Definition
| Method, time, and place to commit suicide (evidence of premeditation) |
|
|
Term
| What are the psychiatric symptoms of suicide? |
|
Definition
| HOPELESSNESS, impulsivity/aggression, anxiety, & command hallucinations |
|
|
Term
| What determines the level of risk of suicide? |
|
Definition
| Clinical judgement, consultation/supervision, re-assessment. |
|
|
Term
| What % of inmates are there for drug offenses? |
|
Definition
|
|
Term
| In LA county jail, what % of inmates tested positive for drugs (excluding alcohol)? |
|
Definition
|
|
Term
| What are the 4 categories of psychoactive drugs? |
|
Definition
1. Hallucinogens or psychedelics
2. Stimulants
3. Opiate Narcotics
4. Sedative-Hypnotics or Depressants |
|
|
Term
| What is the purpose of the Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970? |
|
Definition
| Control the distribution, classification, sale, and use of drugs that have the potential for abuse. |
|
|
Term
| What is physiological dependence on drugs? |
|
Definition
| When a person experience physical pain or discomfort when they are forced to go without the drug. |
|
|
Term
| What is psychological dependence? |
|
Definition
| When a person has an overwhelming desire for the drug and need it to regulate their mood. Their thoughts are fixated on the drug. |
|
|
Term
| What is substance dependence? |
|
Definition
| A pattern of substance use, leading to clinically significant impairment or distress, as manifested by 3 or more symptoms in a 12 month period. |
|
|
Term
| What are the 7 symptoms of substance abuse? |
|
Definition
1. Tolerance
2. Withdrawals
3. Taken in larger amounts or over longer periods of time
4. Persistent desire or unsuccessful efforts to cut down and control substance use
5. Great deal of time spent trying to obtain substance
6. Important activities are given up or reduced b/c of substance use
7. Cont. use despite clear, damaging effects |
|
|
Term
| What are the 4 recurrent substance problems within a 12 month period (need 1 or more)? |
|
Definition
1. Recurrent substance use resulting from failure to fulfill major role obligations
2. Recurrent substance use in situations physically hazardous situations (driving)
3. Recurrent substance related legal problems
4. " " use despite personal and social problems caused by use |
|
|
Term
| What is the most commonly used drug and peak usage? |
|
Definition
| Cannabis (weed). A mild hallucinogen with THC. Peak use between 15 and 25, and drops off after age 34. |
|
|
Term
| What % of admitted LA County jail inmates met diagnostic criteria for substance dependence? |
|
Definition
|
|
Term
| What is Phenyclidine (PCP) and who are typical users? |
|
Definition
A synthetic polysubstance that is a depressant, anesthetic, tranquilizer, or hallucination. It can result in hyperactivity, hallucinations, paranoia, and dellusions.
Black males between 20 and 29. |
|
|
Term
| What is Methamphetamine and its typical user? (ice, crystal, crank, glass) |
|
Definition
Its manufactured from pseudoephedrine. It can be injected or smoke and similar to manic and psychotic symptoms. It is associated with violent behaviors.
White males above the age of 26. |
|
|
Term
| What are the psychological effects of amphetamines? |
|
Definition
| Euphoria, gregariousness, hyperactivity, restlessness, hypervigilance, talkativeness, grandiosity, anger and impaired judgment. |
|
|
Term
| What are the physical effects of amphetamines? |
|
Definition
| Tachycardia or bradycardia, pupillary dilation, elevated or lowered BP, perspiration or chills, nausea or vomiting, psychomotor agitation or retardation, weight loss, muscle weakness, confusion, etc. |
|
|
Term
| What withdrawal effects of amphetamines? |
|
Definition
| Fatigue, vivid and unpleasant dreams, insomnia or hypersomnia, increased appetite, psychomotor agitation or retardation. |
|
|
Term
| What is Cocaine and the price? |
|
Definition
| A non-synthetic stimulant that is sniffed, smoked, or injected. Faster through inhaling (freebasing). It is more expensive than meth or crack cocaine ($10,000 to 36,000 per kilogram). Usage is decreasing, but most commonly used by drug offenders during commission of the offense. |
|
|
Term
| What are the psychological effects of cocaine? |
|
Definition
| At high dosages, can lead to hallucinations, delusion, panic, hypersensitivity, and "coke bugs." |
|
|
Term
| What are the physical effects of cocaine (snorting and ingesting)? |
|
Definition
| Snorting can cause to damage nasal septum, loss of smell. Ingesting can cause damage to gastrointestinal tract. CVS= increased heart rate, perspiration and respiration; can lead to death. |
|
|
Term
|
Definition
| A purified, high potency form of freebase cocaine. Inexpensive compared to cocaine. |
|
|
Term
| What are the effects of crack? |
|
Definition
| Effects similar to injected cocaine, but short-lived. Euphoria, followed by depression, irritability and craving for more. Results in rapid heart beat, can lead to seizures or heart failure. |
|
|
Term
| What is the sentencing disparity of crack and cocaine? |
|
Definition
5 years in prison for trafficking 5 grams of crack cocaine and 500 grams of cocaine for 5 years. Targeting black males.
Dec 2007 the US Sentencing Commission passed a retroactive law to reduce penalties for crack. Saves the govt 87 mill dollars. |
|
|
Term
| What is the most heavily used illegal narcotic and cost? |
|
Definition
| Heroin (pain relief, relaxation, peacefulness and sleep). About $100 per gram. |
|
|
Term
| What are concerns of heroin? |
|
Definition
Disease transmission and availability of higher quality from Columbia. There is an increase in snorting and smoking (10-15 min for peak effects).
Not associated directly w/violent offending, but linked to property crime and money-producing crimes to fund their habit. |
|
|
Term
| What are the psychological effects of heroin? |
|
Definition
| Euphoria followed by apathy, psychomotor agitation or retardation, impaired judgement, pupillary constriction, drowsiness, slurred speech, poor attention or memory. |
|
|
Term
| What are the withdrawal effects of heroin? |
|
Definition
| Anxiety, restlessness, "achy" feeling, intense cravings, irritability and increased sensitivity to pain, nausea or vomiting, pupil dilation, piloerection, sweating, diarrhea, fever, insomnia. |
|
|
Term
|
Definition
| The depressants GHB and Rohypnol. They are produced in laboratories and takes 15-30 min to feel effects, which can last 6 hours. Rohy can last 72 hours. They are tastless, odorless, and usually mixed with alcohol; "date rape." |
|
|
Term
| What are the effects of GHB? |
|
Definition
| Can induce dizziness, nausea, poor motor coordination and anterrograde amnesia. At high dosages, can lead to a coma. |
|
|
Term
| What the effects of Rohy? |
|
Definition
Loss of consciousness, loss of muscle control and anterrograde amnesia.
(Manufactured abroad for sleep disorders) |
|
|
Term
| What are the effects of alcohol? |
|
Definition
A depressant, but at low doses is a stimulant that produces feeling of euphoria. At higher doses can result in poor motor coordination, reduced judgement, and impulsivity.
Can increase risk of violence among "violence-prone" individuals. |
|
|
Term
| What is the crime stat about alcohol? |
|
Definition
| Up to 1/3 of all convicted offenders who commit violent crimes consumed alcohol at time of the offense. |
|
|
Term
| What are the psychological effects of alcohol? |
|
Definition
| Can result in aggressiveness, inappropriate sexual behavior, mood lability, impaired judgement, slurred speech, nystagmus, and impairment in memory or attention. |
|
|
Term
| What are the withdrawal effects of alcohol? |
|
Definition
| Sweating or increased pulse rate, insomnia, increase hand tremor, nausea or vomiting, psychomotor agitation, anxiety and grand mal seizures. |
|
|
Term
|
Definition
| Recurrent, intense sexually arousing fantasies, sexual urges or behavior generally involving non-human objects, the suffering or humiliation of oneself or sexual partner, children, or other non-consenting persons over a period of at least 6 months. |
|
|
Term
| Paraphilia usually occur among who and what are some stats? |
|
Definition
| Men and before treatment they have assaulted on average 7 victims. Non incestuous offenders had 280 separate offenses on 150 victims |
|
|
Term
| What is exhibitionism (paraphilia) and who are typical offenders? |
|
Definition
Paraphiliac focus involves the expose of one's genitals to a stranger. Sometimes the person masturbates openly while exposing himself.
Males in their 20s and 30s and onset is typically in adolescence. |
|
|
Term
|
Definition
| Paraphiliac focus involves the use of nonliving objects (female undergarments, shoes). Find fetish sexually arousing and may masturbate while using the fetish. |
|
|
Term
|
Definition
| On set is adolescence. They have a positive with fetish object. It tends to be rater chronic. |
|
|
Term
| Details of study of exhibitionism |
|
Definition
| Abel's study of offenders in a treatment found that 46% also admitted to molesting a child and 25% admitted to committing a rape. |
|
|
Term
| What is transvestic fetishism? |
|
Definition
In a heterosexual male, recurrent intense and sexually arousing fantasies, and sexual urges of behaviors involving cross dressing. May reduce depression in males.
May or may not include gender dysphoria, which is a persistent discomfort with gender role or identity. |
|
|
Term
| What is voyeurism and age of onset? |
|
Definition
The act of observing unsuspicious individuals, usually strangers, who are naked, in the process of disrobing, or engaging in sexual activity. The act of looking is for purpose of achieving sexual excitement. May masturbate.
Onset os around 15 and tends to be chronic. |
|
|
Term
| What is frotteurism and age of onset? |
|
Definition
Touching and rubbing against a non-consenting person. Usually in a crowded place where person can easily escape apprehension (bus, subway). They are content with that level of arousal.
Can be chronic and occurs between 15 and 25. |
|
|
Term
| What is sexual Masochism? |
|
Definition
Recurrent, intense, sexually arousing fantasies, urges or behavior involving the act of being humiliated, beaten or bound or made to suffer.
Rather chronic and find other things unfulfilling |
|
|
Term
|
Definition
It involves acts in which the individual derives sexual excitement from the psychological or physical suffering (including humiliation) or the victim.
Also chronic and could be w/ a non-consenting person and associated w/ an ASPD and can be dangerous. |
|
|
Term
|
Definition
Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges or behavior involving sexual activity w/ a prepubescent child (13 or younger)
Person is at least 16 years old and child is at least 5 years younger |
|
|
Term
|
Definition
Sexually attracted to males (11-13/ rearrest rate is twice that of female attracted ones), females (8-10), or both.
May be limited to incest.
Can be exclusive (only attracted to children-more difficult to treat), or nonexclusive. |
|
|
Term
|
Definition
| Person who has fantasies about sexual relations w/ pre-pubescent children (10 and under) |
|
|
Term
|
Definition
| Person more interested in children who has gone through puberty (13). |
|
|
Term
| What are the 4 types of Pedophilia? |
|
Definition
1. Fixated (immature)
2. Regressed
3. Exploitive
4. Aggressive |
|
|
Term
| Describe the Fixated (immature) type of pedophilia |
|
Definition
Sexually immature w/ adults, passive, & timid.
More comfortable w/ children and engage in contact w/ child once they become acquainted.
Average or above intelligence and a stable work history.
Rarely get married. No dating experience.
No insight or understanding of severity of problem.
Difficult to treat. Rearrest rates. |
|
|
Term
| Describe the Regressed type of pedophilia |
|
Definition
Tends to have normal peer relationships. A lot of heterosexual experiences & at some point experience feelings of indecency.
High rates of alcohol abuse. There tends to be a stressor (pregnant wife, lost job, money issues).
Tend to choose female victims. Remorseful. Best prospect for treatment. |
|
|
Term
| Describe the Exploitive pedophilia type |
|
Definition
Use children to satisfy sexual needs and exploit their weaknesses. May trick the child with threats to get them to comply.
Long criminal history. Poor relationships. Described as impulsive & irritable. Very difficult to treat. |
|
|
Term
| Describe the Aggressive type of pedophilia |
|
Definition
| Use kids to satisfy sexual and aggressive needs. Assault & inflict pain on the child for sexual arousal. Meet criteria for ASPD and psychopathy. Usually target young boys. Responsible for the majority of child abductions, rape, and murders. Dangerous to adults and children. VERy rare and difficult to treat. |
|
|
Term
| What forensic evidence is needed to prove SVP (sexually violent predator)? |
|
Definition
1) Evidence of a mental disorder and have to be a risk of danger. Have a medical disorder that increases it (wide range from ASPD to psychopathy)
2) Exclude those committing incest |
|
|
Term
| What is a Sexually Violent Predator? |
|
Definition
| A diagnosed mental disorder that makes the person a danger to others in that the person is likely to engage in sexually violent predatory behavior upon release. The mental disorder can include a sexual disoder (paraphilia), or personality disorder. |
|
|
Term
| Describe sexual offenses of SVPs |
|
Definition
Sexual acts include rape, lewd or lascivious acts with a child, etc.
The sex offense involved one or more victims (Jessica's Law in 08)
The offense are directed toward a stranger, a personal or casual acquaintance w/ whom no substantial relationship exists or an individual w/ whom a relationship was established or promoted for the primary purpose of victimization. |
|
|
Term
| What is civil commitment for SVP offenders? |
|
Definition
For individuals who are found to be SVP after after the end of their criminal commitment.
Beyond a reasonable doubt; heard by a judge or jury.
For "treatment" not punishment purposes.
2 year civil commitment |
|
|
Term
| Describe civil commitment for SVP offenders |
|
Definition
| Evaluation and the court determines whether a civil commitment is needed. 2 year commitment can be extended by 2 years indefinitely. If hospital can no longer show a danger, then send to court to be released. Past sex offense is legible for SVP commitment. |
|
|
Term
| What is the 4 Constitutional challenges to SVP? |
|
Definition
1) Due Process
2) Equal Protection
3)Double Jeopardy
4) Ex Post Factor
3 & 4 and 4 are heard most often. Law gets around this by treating through civil court, not punishing in civil court. |
|
|
Term
| What is Due Process (SVP)? |
|
Definition
| 14th amendment that challenges the terms like "mentally abnormality," which re vague and violate fundamental fairness |
|
|
Term
| What is Equal Protection (SVP)? |
|
Definition
| That the SVP process differs from other civil commitment schemes. |
|
|
Term
| What is Double Jeopardy (SVP)? |
|
Definition
| The 5th amendment provides that no "person can be subject for the same offense to be twice put in jeopardy of life or limb." |
|
|
Term
| What is Ex Post Factor (SVP)? |
|
Definition
| The imposition of a different or more severe punishment than was permissible when the crime was committed |
|
|
Term
| What is the landmark case of Allen V. Illinois (SVP)? |
|
Definition
| The 1986 case before SVP. Terry Allen was charged w. committing a crime against a minor. 2 psychologist interviewed him. he argued it violated the the 5th amendment (self incrimination). Court said it didn't because the proceeding were civil and not criminal. |
|
|
Term
| What is the Hendricks v. Kansas case (SVP)? |
|
Definition
| The 1997 case. Hendricks molested two 13 yr old boys. He got caught in a civil commitment when he was about to be released from prison. He said he molested several boys and the only way for him to get rid of the urges was for him to die. His attorney claimed that it violated all of his rights. The Supreme Court upheld the constitutionality of the SVP statue. Also said civil and not criminal (treatment). |
|
|
Term
| What is the Kansas V. Crane case (SVP)? |
|
Definition
| The 2002 case that also upheld the constitutionality of the SVP statue. He, as well as others, were diagnosed with ASPD. |
|
|
Term
| What is the outcome data on SVP and sex offenders? |
|
Definition
There is little to do data on SVP outcomes.
There is recidivism among sex offenders.
There is no outcome data to date on re-arrest rates |
|
|
Term
| What was the finding of Milloy's (2003) SVP non civil commitment data? |
|
Definition
Using a WA sample of 97 persons referred for possible SVP commitment, but for whom no petition was filed.
In a 6 year follow-up, 57% had a new felony conviction and sex offense. |
|
|
Term
|
Definition
| A substantial risk of physical harm to other persons as manifested by evidence of homicidal or other violent behavior or evidence that others are placed in reasonable fear of violent and serious harm to them, or other evidence of dangerousness. |
|
|
Term
| What is Substantial Risk (violence)? |
|
Definition
| Defined as a strong personality, as contracted with a remote or significant possibility. |
|
|
Term
| What is Risk Assessment (violence)? |
|
Definition
Assessing the probability that a given individual will engage in harmful behavior.
It is not a prediction of dangerousness, cannot accurately predict violent behavior. |
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|
