Ovarian aging and hormone replacement therapy. Hormonal levels, symptoms, and attitudes of African-American and white women

The purpose of the study was to identify psychiatric symptoms, neurological impairments, and situational factors associated with the emergence of violence and with its persistence. Psychiatric symptoms were assessed in newly admitted physically assaultive psychiatric patients and nonviolent controls. Patients were than evaluated for 4 weeks to determine the persistence or resolution of these physical assaults. Patients who showed marked resolution of assaults were classified as transiently violent (n = 41), and those who remained assaultive throughout were categorized as persistently violent (n = 34). At the end of 4 weeks, all patients received a comprehensive psychiatric and neurological assessment. Physical assaults were associated initially with prominent positive psychotic symptoms. Both transiently and persistently violent patients were more psychotic than the nonviolent controls; however transiently violent patients showed better resolution of these symptoms over the 4 weeks. They also evidenced less frontal lobe impairment on the neurological examination than the persistently violent patients. The two violent groups differed in their susceptibility to environmental influences: the surrounding ward agitation fostered physical assaults in transiently but not in persistently violent patients. This differentiation between transiently and persistently violent patients has major implications for the comprehensive treatment of violent behavior.     

Minors' consent to treatment: A developmental perspective.

Discusses the cognitive and behavioral characteristics of minors in relation to the question of competence to consent to treatment. The legal standard (knowing, intelligent, and voluntary) used to judge the effectiveness of consent is translated into psychological concepts, especially cognitive abilities. A review of developmental psychological research is presented, which examines these concepts as they relate to minors' abilities to satisfy the legal standard. It is suggested that cognitive developmental stages associated with ages below 11–23 yrs might exclude such minors from meaningful consent. In addition to cognitive considerations, certain results suggest that the tendency toward deference in early adolescence is so normative that capacity for voluntary consent is questionable through age 14, but existing evidence provides no psychological grounds for maintaining the general legal assumption that minors at age 15 and above cannot provide competent consent. (63 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prospects for remediating juveniles' adjudicative incompetence.

With the application of adjudicative competence requirements to adolescent defendants, there is a growing need for interventions to enhance the legal capacities of adolescents who are found to be incompetent. By reviewing developmental, clinical, and educational research, the authors discuss whether it is possible to enhance youths' legal capacities and, if so, what the most promising approaches may be. Psychoeducational interventions for youth are discussed, as well as the possibility of changing the demands of the juvenile justice system to try borderline-competent youth in juvenile court. The authors conclude that there is evidence to believe it may be challenging to enhance youths' legal capacities, particularly when youth have limited rational understanding and/or legal reasoning capacities, and when these deficits stem from developmental immaturity and/or mental retardation. A research agenda is proposed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training in law and psychology: Models from the Villanova conference.

Although the domain of law and psychology is a burgeoning and popular field of study, there has never been a concerted effort to evaluate current training models or to develop newer, more effective ones. 48 invited participants attended a national conference held at Villanova Law School to remedy this deficiency. Working groups addressed issues of education and training for the undergraduate level; for doctoral-level programs in law and social science; for forensic clinical training; for joint-degree (JD/PhD–PsyD) programs; for those in practica, internships, and postdoctoral programs; and for continuing education. This article delineates levels and models of training in each of these areas. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life event stress and the association with spontaneous abortion in gravid women at an urban emergency department.

In this study, the authors hypothesized that life event stress is associated with an increased risk of spontaneous abortion. Using a nested case-control design in an emergency department (N?=?970), stress was measured using a life event inventory and a sample drawn from R. B. Ness et al's (1999) Early Pregnancy Study. Gestational age at time of fetal loss served as a marker of chromosomal status. Women experiencing more than one life event used more alcohol and public assistance. Spontaneous abortion at 11 weeks or greater was associated with more life event stress (adjusted odds ratio 2.9, 95% confidence interval 1.4–6.2), whereas spontaneous abortion at any gestational age was not, implying that life event stress increases the risk of chromosomally normal spontaneous abortion. An analysis of confounders showed tobacco use was associated with an increased risk of spontaneous abortion, whereas prenatal care was only associated with fetal loss at 11 weeks or greater. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On being ethical in legal places.

Comments that many ethical pitfalls may await psychologists who participate as expert witnesses in the legal process. This article describes the ethical problems and examines their origin in light of important differences in purpose between psychological practice and legal process. Special attention is given to problems of objectivity in the assessment process, ethical issues in the interpretation of data in the courtroom, and the client's psychological welfare. Suggestions for maintaining ethical practice in the role of expert witness are provided. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Characteristics of institutionalized delinquents in conflict about their release.

Results suggest that among male delinquents about to be released from an institution, Ss scoring high on an index of conflict about release (i.e., having a less definite preference for home vs institution) may exhibit increased misbehavior which postpones release and thereby temporarily reduces the conflict. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Law and professional psychology: An introduction.

Presents an overview of a special issue on law and psychology that includes solicited articles focusing on (a) psychology applied to legal issues, and (b) the legal control of professional activities. The stated goal of the issue is to provide insight into complex legal issues faced in day-to-day practice, stimulate concern for the many problems that the legal system creates for psychologists, and encourage continuing input into the psychology-law interface. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tube feeding preferences among nursing home residents

OBJECTIVE: To determine the preferences of nursing home residents regarding the use of tube feedings and to characterize the clinical, functional, and psychosocial factors that are associated with preferences. DESIGN: In-person survey. SETTING: Forty-nine randomly selected nursing homes. PATIENTS/PARTICIPANTS: Three hundred seventy-nine randomly selected, decisionally capable, nursing home residents. MAIN RESULTS: Thirty-three percent of participants would prefer tube feedings if no longer able to eat because of permanent brain damage. Factors positively associated with preferences for tube feedings include male gender. African-American race, never having discussed treatment preferences with family members or health care providers, never having signed an advance directive, and believing that tube feeding preferences will be respected by the nursing home staff. Twenty-five percent of the participants changed from preferring tube feedings to not preferring tube feedings on learning that physical restraints are sometimes applied during the tube feeding process. CONCLUSIONS: Demographic and social factors are associated with preferences for tube feedings. The provision of information about the potential use of physical restraint altered a proportion of nursing home residents' treatment preferences.