Mitigating the Risk of Digital Financial Exploitation.

The article by Zhang and colleagues in this issue of The Journal calls attention to an important but underrecognized problem facing today's seniors and their loved ones. The risk of digital financial exploitation, particularly in the wake of the COVID-19 pandemic, has risen considerably in recent years and continues to rise today. Zhang provide a helpful analysis of assessment tools currently available to forensic psychiatrists for the evaluation of financial capacity.

Considerations in Forensic Evaluations by Telepsychiatry.

The COVID-19 pandemic has increased demand for telepsychiatric services. Forensic psychiatrists can expect to receive more requests for assessments conducted via videoconferencing technology in the years to come. Under current rules of evidence in the United States, the testimony of expert witnesses is introduced as a form of scientific evidence and may be challenged by opposing counsel through hearings.

The Mental Status Exam at the Movies: The Use of Film in a Behavioral Medicine Course for Physician Assistants.

Objective: This study evaluated student satisfaction with an educational exercise using feature films to learn about performing a psychiatric mental status examination.

Methods: Following the completion of an educational exercise designed by the first author, students in a behavioral medicine course completed surveys regarding their satisfaction with the exercise as a tool for learning how to perform a mental status examination. The educational exercise involved an initial didactic lecture followed by group exercises and individual presentations, utilizing feature films as tools for understanding the mental status examination.

Homicide and the Internet.

The Internet and social media have grown increasingly relevant in homicide cases in recent years. Although several recent studies have analyzed the relationship between homicide and the Internet, there is a dearth of rigorous scientific research on the subject to date. Although a statistically rare event, Internet-related homicide may be increasing, and forensic mental health professionals may experience growing demand for consultations in cases where the Internet and social media play a salient role.

The Notion of Truth and Our Evolving Understanding of Sexual Harassment.

The notion of truth and its determination in legal proceedings is contingent on the cultural setting in which a claim is argued or disputed. Recent years have demonstrated a dramatic shift in the public dialogue concerning sexual harassment. This shift reflects changing cultural mores and standards in the workplace and society as a whole, particularly with respect to the validity of women's voices.

New Technologies, New Problems, New Laws.

Forensic psychiatrists in the 21st century can expect to encounter technology-related social problems for which existing legal remedies are limited. In addition to the inadequate protection of adolescents using social media as outlined by Costello et al., current laws are often poorly suited to remedy problems such as cyberharassment, sexting among minors, and the publication of threatening or harmful communications online.

Outpatient Psychiatrists' Practices for Requesting Prior Treatment Records.

Patients' treatment records often contain information critical to risk assessment. We sought to determine whether psychiatrists treating outpatients agree about the standard of care (SOC) for requesting records from a patient's past clinicians. This web-based survey invited psychiatrists to review a hypothetical outpatient clinical vignette and to indicate whether they would request a release of information (ROI) from the patient for treatment records from past clinicians.

Gender bias and judicial decisions of undue influence in testamentary challenges.

Allegations of undue influence constitute a common basis for contests of wills. Legal research from the 1990s suggests that gender bias factors significantly into judicial decision-making regarding alleged undue influence and testamentary intent. In this study, we sought to assess whether this bias is present today and to identify any factors that may be associated with it.

Adulthood animal abuse among men arrested for domestic violence.

Learning more about intimate partner violence (IPV), perpetrators could aid the development of more effective treatments. The prevalence of adulthood animal abuse (AAA) perpetration and its association with IPV perpetration, antisociality, and alcohol use in 307 men arrested for domestic violence were examined. Forty-one percent (n = 125) of the men committed at least one act of animal abuse since the age of 18, in contrast to the 1.

The implications of the ADA Amendments Act of 2008 for residency training program administration.

The Americans with Disabilities Act (ADA) is rarely invoked by medical residents in training. Dr. Martin Jakubowski, a family medicine resident with Asperger's disorder, was dismissed for communicating poorly with patients, peers, and supervisors and for issuing dangerous medical orders.

Restraint and seclusion in psychiatric treatment settings: regulation, case law, and risk management.

Changing federal regulations, civil rights and malpractice cases, and new treatment methods have influenced the use of restraint and seclusion (R&S) in inpatient psychiatric treatment settings, such that restraint and seclusion today are among the most highly regulated practices in psychiatry. Despite increased pressure from regulatory bodies and litigation, the use of R&S remains controversial and risky. These procedures can compromise safety if performed incorrectly or monitored inadequately, but intervention by restraint or seclusion may be necessary to maintain safety on the treatment unit, especially during emergencies.

Psychiatric residents' experience conducting disability evaluations.

Objective: The increasing frequency and societal cost of psychiatric disability underscore the need for accuracy in evaluating patients who seek disability benefits. The authors investigated senior psychiatric residents' experiences performing disability evaluations, their self-assessment of competence for this task, and whether they perceived a need for more training.

Methods: Seventy-nine third- and fourth-year psychiatric residents in Massachusetts and Rhode Island training programs were surveyed from May to June in 2008.

The mental status examination in the age of the internet.

The Internet has grown increasingly relevant in the practice of forensic psychiatry. To a psychiatrist conducting a forensic evaluation, the evaluee's Internet use can be relevant in nearly all aspects of the analysis. An evaluee's Internet presence may help to confirm, corroborate, refute, or elaborate on the psychiatrist's general impression of the person.

Examining the interface between substance misuse and intimate partner violence.

There is considerable theoretical and empirical support for a link between substance misuse and perpetration and victimization of intimate partner violence. This review briefly summarizes this literature and highlights current research that addresses the interface between treatment for substance abuse and intimate partner violence. Suggestions for future research and clinical implications are provided.

Clinical practice guidelines as learned treatises: understanding their use as evidence in the courtroom.

It is important for forensic experts to understand how clinical practice guidelines may enter the courtroom, what role they may play in a trial, and how they relate to expert testimony. Guidelines enter the record in several different ways and in several types of cases, typically with the assistance of an expert witness. A common vehicle for their introduction is the learned-treatise exception to the hearsay rule.

Resource document on the use of restraint and seclusion in correctional mental health care.

This resource document discusses the use of seclusion or restraint for purposes of mental health intervention in correctional facilities. Correctional mental health standards essentially state that seclusion or restraint, when used for health care purposes, should be implemented in a manner consistent with current community practice. The community practice was significantly impacted and revised during July 1999, after the Health Care Financing Administration defined rules for the use of seclusion and restraint in facilities that participate in Medicare and Medicaid.

Ethics of medical records and professional communications.

In child and adolescent psychiatry, medical records and professional communications raise important ethical concerns for the treating or consulting clinician. Although a distinction may be drawn between internal records (eg, medical records and psychotherapy notes) and external communications (eg, consultation reports and correspondence with pediatricians), several ethical principles apply to both types of documentation; however, specific considerations may vary, depending upon the context in which the records or communications were produced. Special care is due with regard to thoroughness and honesty, collaboration and cooperation, autonomy and dignity of the patient, confidentiality of the patient and family members, maintaining objectivity and neutrality, electronic communications media, and professional activities (eg, political advocacy).

Liability and risk management in outpatient psychotherapy supervision.

Supervision of outpatient psychiatry residents plays the dual role of protecting the public by monitoring care and improving the educational experience of residents. The responsibility of supervisors may leave them vulnerable to liability under several legal theories. They may be vicariously liable for residents' negligence or may be directly liable for their own negligence in supervision or administration.

Managing risk when considering the use of atypical antipsychotics for elderly patients with dementia-related psychosis.

In 2005, responding to several studies, the FDA issued a black box warning on atypical (second generation) antipsychotic medications, noting that the drugs may increase the risk of cerebrovascular adverse events in elderly patients with dementia-related behavior disturbances. The black box warning has raised concern for clinicians, among whom atypical antipsychotics have gained favor for having a more tolerable side-effect profile than many other pharmacological treatment options. Complicating this concern are studies suggesting that other medications may have similar risks and a dearth of unbiased head-to-head studies comparing different treatment options.