Dinah, ClinkShrink, & Roy produce Shrink Rap: a blog by Psychiatrists for Psychiatrists, interested bystanders are also welcome. A place to talk; no one has to listen.
Sunday, October 26, 2008
What I Learned Part 3
ClinkShrink is blogging from AAPL meeting she is attending.
Click HERE for Part 1 (she'll even tell you what AAPL stands for).
Click Here for Part 2.
So, the clinical vampirism presentation taught me one main lesson: I'll never understanding how the program committee chooses which presentations to accept. The speaker presented an overview of the historical role of blood in ancient cultures and religions (remember our blog posts about Moche indian culture?), then he presented his own proposed typology of blood-seeking behaviors, then he presented two cases to illustrate that typology. The first case was your basic Goth who drank his girlfriend's blood (consensually) then beat her to death. The second case was a sad one about a psychotic killer who decapitated his mother, her bird and the family dog. (Note to future speakers: please warn your audience if you're going show autopsy photos during the time slot right before lunch.) I really don't think we need a new classification system to understand these behaviors, but there you are.
One of the next presentations was a nicely done study of violent female offenders in one Connecticut prison. These women essentially all had very early onset of conduct disordered and antisocial behavior with high levels of substance abuse and childhood trauma. I'm not sure it says as much about the women themselves as it does about the criminal justice system: in order for a woman to get sent to prison they have to be really really pathological, at least compared to men.
Next up was an update about human subject research in correctional psychiatry. The Institute of Medicine is in the process of reviewing the Code of Federal Regulations as it applies to prisoner research. As it stands now the regulations are restrictive to the point that inmates are being denied necessary research into the best practices for correctional health care. New IRB regulations will help ensure that projects are designed to give a clear risk-benefit analysis to proposals (as opposed to doing generic research on 'systems' issues or institutional issues).
Then I went to the Computers in Forensic Psychiatry presentation, an annual tradition that I as a geek always enjoy. Once again, computers don't always behave in public the way the geeks plan. After some fiddling and tweaking I saw some fun new gadgets, including a pen that electronically records everything you write and uploads it to organizing software through a USB port. Pretty wild. It can also record up to 100 hours of audio.
Last but not least, I went to an update on the US v Hamdan case. Hamdan was Osama Bin Laden's chaffeur, and was the subject of the landmark US Supreme Court case in which Sandra Day O'Connor declared that a "state of war is not a blank check for the President." In other words, that the President could not unilaterally create his own separate legal system. Hamdan has been a Guantanimo Bay detainee since shortly after start of the Afghanistan war (except for one month spent in a suspected secret CIA facility in northern Afghanistan). Anyway, two of Hamdan's lawyers spoke as well as the forensic psychiatrist who spent 120 hours evaluating him. While the legal issues were pretty egregious, in the back of my mind I kept wondering how I could testify, if placed in a similar position, that this person would not participate in future terrorism. I mean, what in psychiatric training would really qualify one to testify to that? If there was clear evidence that he was not a central conspirator, as they suggest, then why would they really need a mental health expert to testify to that fact? It seemed to be a situation where political ideology dragged mental health into a realm that it was never designed for. If AAPL feels strongly that mental health professionals should not assist or participate in interrogations (a position I agree with) then perhaps they should also encourage members not to express opinions about the future dangerousness of suspected terrorists---an area for which data is lacking, to say the least.
So that was my third day.
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I am amazed at the content of your conference. These are topics it would never occur to me to think about.
On NPR today, however, I hear the term sanguivore to mean an animal that lives on blood, plus a discussion of the dying of the bat population. The cases you described did not seem to warrant new categories to me, as you said.
Did the US v. Hamden case stir up any hot political debates?
The Sandra Day O'Connor quote makes me want to insert my own rant on the subject, but I'll refrain. Just wondering if this is a controversial issue among the forensic psych crowd, or whether there is a tendency toward consensus?
I think it's interesting that the pendulum has swung so far away from the past history of using prisoners as medical guinea pigs toward not allowing them to participate in clinical trials at all. Hopefully, common sense will eventually prevail on this issue.
TP: Yup, it's my favorite conference because of that.
Anon: No political debates at all. The Hamdan case has been presented at two of these conferences with essentially no controversy or debate. That may be because of the nature of the defendant, who is sort of a 'wrong place at the wrong time' kind of guy as opposed to a central Al Qaeda figure.
What did you learn about people who make false confessions? I've always been curious about that, because I can't imagine doing it myself (but maybe I'd break down easier than I think).
It occurred to me on the way home that I forgot to mention that great luncheon speaker, Dr. Richard Leo. He basically gave an overview of the Reid police interrogation method. I was already familiar with this, but it was still a good review. He said that the actual rate of false positive confessions will never be known, and he encouraged the use of videotaped interrogations and the importance of corroboration with external evidence.
Get some sleep already. I hear you need new canned food.
Wow, Leo's list of papers is really impressive! I'll bet that was a great presentation.
I was surprised by how structured and detailed the Reid police interrogation method is, but a little alarmed at one of the conclusions they drew:
D. Tears at this stage positively indicate the suspect’s guilt.
I would be crying from the second I set foot in the room. Definitely not planning a life of crime at this point.
BTW, have you seen the show "Real Interrogation," that actually shows taped interviews with suspects? I'm a nut for that sort of thing. Next time I'll have a copy of the Reid paper with me for comparison purposes.
Thanks for sharing your experiences!
Anon: Yes, the method does raise eyebrows, doesn't it? He was as impressive to listen to as he is to read. I haven't seen the television show you mentioned though.
Anon #1: Going to sleep now.
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