Forensic assessment

法医评估
  • 文章类型: Journal Article
    目标:人口贩运或当代奴役是以武力或欺骗手段招募和转移人员,劳动或其他类型的剥削。虽然暴力,贩运所带来的虐待和剥夺对其受害者的健康构成威胁,在西班牙,这方面的临床或法医数据很少。在加泰罗尼亚法律医学和法医学研究所(IMLCFC),成立了一个专门对这些受害者进行法医评估的单位。这项工作的目的是描述一系列贩运受害者的法医案件。
    方法:在2023年6月30日前在IMLCFC登记的涉嫌贩运人口罪的司法案件中对受害者进行回顾性研究。
    结果:登记了57名不同的受害者。大多数是妇女(71.9%)。平均年龄为30.5岁(s.d.10.31)。所有的受害者都是外国人,主要来自拉丁美洲(45.5%)。剥削主要是性剥削(61.4%)。性剥削的受害者与其他人之间存在一些社会人口统计学差异以及贩运的条件和后果。在评估时,所有受害者的心理健康问题都非常普遍(87.5%)。
    结论:贩运对健康的影响,尤其是心理健康,在司法程序中,对受害者的法医评估是有价值的。有必要加深我们对环境中现象的了解。
    Human trafficking or contemporary slavery is the recruitment and transfer of people by force or deception for sexual, labour or other types of exploitation. Although the violence, abuse and deprivation that trafficking entails are a threat to the health of its victims, in Spain the clinical or forensic data available in this regard is scarce. At the Institute of Legal Medicine and Forensic Sciences of Catalonia (IMLCFC), a unit specialized in the forensic assessment of these victims was created. The objective of this work was to describe a series of forensic cases of trafficking victims.
    Retrospective study of victims in judicial cases opened for an alleged crime of human trafficking registered in the IMLCFC until 06/30/2023.
    57 different victims were registered. The majority were women (71.9%). The average age was 30.5 years (s.d. 10.31). All the victims were foreigners, mostly from Latin America (45.5%). The exploitation was mainly sexual (61.4%). There were some sociodemographic differences and in the conditions and consequences of trafficking between victims of sexual exploitation and the rest. Mental health problems were very common in all victims at the time of the assessment (87.5%).
    The consequences of trafficking on health, especially mental health, are notable and the forensic assessment of victims is valuable in judicial proceedings. It is necessary to deepen our knowledge of the phenomenon in our environment.
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  • 文章类型: Journal Article
    被发现没有能力接受审判(IST)的刑事被告只有在认为恢复成功的情况下,并且可以在“合理”的时间内实现这一目标时,才可以进行能力恢复。在这项研究中,我们在293例裁定IST并承诺住院恢复的男性患者样本中,评估了标准化智力测试对不可恢复性分类的预测有效性和测试准确性.90天,17.0%的FSIQ评分在平均值的一个标准差内的病例未恢复,未恢复率随着FSIQ标准差的每增加增加到29.5%,38.8%,和59.5%。事件发生时间分析发现,尽管FSIQ评分为56或更高的患者中有一半预计将在64天内恢复,FSIQ评分≥55分的患者的中位恢复时间为145天.与可能的FSIQ评分范围相关的阳性预测值在建模的未恢复患病率为5%时一致较低,15%,25%,很少超过机会水平。我们得出的结论是,尽管FSIQ分数与不可恢复性的预测相关,特别是当分数低于平均值至少三个标准差时,单个基于FSIQ的不可恢复性预测的准确性有限.
    Criminal defendants found incompetent to stand trial (IST) may only be committed for competency restoration if their restoration success is considered likely and when this aim can be met within a \"reasonable\" period of time. In this study, we evaluated the predictive validity and test accuracy of standardized intelligence testing on the classification of nonrestorability in a sample of 293 male patients adjudicated IST and committed for inpatient restoration. At 90 days, 17.0% of cases with FSIQ scores within one standard deviation of the mean were unrestored, and nonrestoration rates increased with each additional FSIQ standard deviation decrement to 29.5%, 38.8%, and 59.5%. Time-to-event analyses found that whereas half of patients with FSIQ scores of 56 or higher would be predicted to be restored within 64 days, the median restoration timeline was 145 days for patients with FSIQ scores of 55 or below. Positive predictive values associated with the range of possible FSIQ scores were uniformly low at modeled nonrestoration prevalence rates of 5%, 15%, and 25%, rarely exceeding chance levels. We conclude that although FSIQ scores are relevant to predictions of nonrestorability, particularly when scores are at least three standard deviations below average, the accuracy of individual FSIQ-based predictions of nonrestorability are limited.
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  • 神经科学对犯罪行为的关注正在迅速增长,研究表明,神经生物学因素对解释犯罪的心理和社会因素的理解具有附加价值。有证据表明,神经技术可用于刑事司法,可能与法医精神病学和心理学评估有关。然而,问题是神经生物学因素的科学知识是否适用于法医评估的日常实践。基础技术的整合,例如,心理生理学(心率,皮肤电导,可穿戴设备),荷尔蒙措施(皮质醇,睾酮),神经心理学测试可能很明显,因为它们可以相对容易地应用。此外,大量研究表明,这些技术在这一领域具有附加价值。此外,第一步是将这些技术应用于个人诊断,治疗,和风险评估。复杂的神经技术,如功能磁共振成像(例如,大脑阅读)和脑电图显示出适用于刑事司法的潜力,一旦知道这些指数为个别病例提供了哪些额外信息。
    The attention for neuroscience in relation to criminal behavior is growing rapidly, and research shows that neurobiological factors have added value to the understanding of psychological and social factors in explaining delinquency. There is evidence that neurotechnology can be used in criminal justice and may be of relevance for forensic psychiatric and psychological assessment. However, the question is whether scientific knowledge of neurobiological factors is applicable in daily practice of forensic assessment. Incorporation of basic technologies, e.g., psychophysiology (heart rate, skin conductance, wearables), hormonal measures (cortisol, testosterone), and neuropsychological testing might be evident, since they can be applied relatively easy. Moreover, a body of research shows the additive value of these technologies in this field. In addition, first steps are taken to apply these technologies in individual diagnostics, treatment, and risk assessment. Complex neurotechnologies like functional MRI (e.g., brain reading) and EEG show potential to be applicable in criminal justice, once it is known what additional information these indices offer for individual cases.
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  • 文章类型: Journal Article
    本文详细介绍了我的精神分析过程,以评估难民的庇护申请。它着重于在主体间矩阵中出现无代表的内容和卑鄙的状态,从而导致合作创作创伤故事。这种个人内和个人间的相遇是由更大的社会组织的,政治,和支持的文化背景,limit,结构,擦除,并确定可以知道和告知的内容。对创伤铭文的了解需要在幸存者和证人以及能够容忍悲伤的接受社会中适应非语言情感状态,承认暴力期间受害者和受害者的堕落和堕落,吸收幸存者悲伤的道德故事。
    This paper details my psychoanalytic process evaluating refugees as part of their application for asylum. It focuses on the emergence of unrepresented content and abject states within the intersubjective matrix that lead to collaborative creation of a story of trauma. Such intra- and inter-personal encounters are structured by the larger social, political, and cultural contexts that support, limit, structure, erase, and determine what can be known and told. Knowledge of traumatic inscription necessitates attunement to nonverbal affective states in both survivor and witness as well a receptive society that is able to tolerate grief, acknowledge the degradation and depravity unleashed in victim and victimizer during violence, and absorb survivors\' mournful morality tales.
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  • 文章类型: Journal Article
    在美国各地,法院关于受审能力(CST)评估和能力恢复服务的命令的增长速度远远超过各州提供这些服务的速度,引发了所谓的“国家能力危机”。“提供及时的能力恢复服务面临的挑战是,在几个司法管辖区,促使能力评估发生变化。评估人员通常需要解决更广泛的临床问题,例如建议安置或解决住院的紧迫性,而不仅仅是解决CST。这标志着法医评估实践的发展,这使评估人员超越了非常狭窄的法医能力问题,并进入了更传统的临床建议。我们描述了几个改变实践的州示例,以突出最初的障碍,和潜在的好处,为了解决能力评估中的其他临床问题,在国家能力危机中。
    Across the United States, court orders for competence to stand trial (CST) evaluations and competence restoration services have been increasing much more rapidly than states can provide these services, prompting what has been called a national \"competency crisis.\" The challenge in providing timely competence restoration services has, in several jurisdictions, prompted a change in competence evaluations. Evaluators are more often required to address broader clinical issues-such as recommending placement or addressing the urgency of hospitalization-rather than addressing only CST. This marks an evolving practice in forensic evaluation, which moves evaluators beyond the very narrow forensic question of competence and into more traditionally clinical recommendations. We describe several state examples of changing practice in order to highlight the initial barriers, and potential benefits, to addressing additional clinical issues in competence evaluations, amid a national competence crisis.
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  • 文章类型: Systematic Review
    心理尸检(PA)已广泛用于许多不同领域。然而,很难确定一个标准模型。在这次系统审查中,我们专注于PA研究,评估精神疾病是自杀的主要危险因素.这项研究,在Scopus上表演,Embase,和Pubmed覆盖过去20年导致321份报告,其中15份符合纳入标准。结果证实精神疾病是自杀的主要危险因素,其次是具体的社会人口因素和生活事件。方法学分析描绘了一个仍然高度异构的场景,特别是关于数据收集和包括的变量。然而,关于精神病学评估,PA模型的初步标准化过程出现了。总之,这种方法是在进化中,和新的指导方针是必要的,以促进PA的应用作为一个基本的工具,告知自杀预防工作,并协助法医审查员在法庭上。
    Psychological Autopsy (PA) has become widespread to the point of being applied in many diverse fields. However, it is difficult to identify a standard model. In this systematic review, we focused on PA studies assessing mental illness as a major risk factor for suicide. The research, performed on Scopus, Embase, and Pubmed to cover the last 20 years led to 321 reports of which 15 met the inclusion criteria. Results confirmed mental illness as the main risk factor for suicide, followed by specific socio-demographic factors and life events. The analysis of methodologies depicted a still highly heterogeneous scenario, especially regarding data collection and variables included. However, concerning psychiatric evaluations, an initial standardization process of PA models emerged. In conclusion, the approach is in evolution, and novel guidelines are needed to promote the application of PA as a fundamental tool to inform suicide prevention efforts and to assist forensic examiners in court.
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  • 文章类型: Journal Article
    这项研究旨在描述神经心理学过程,这些过程支撑了接受审判能力(CST)的心理法律概念。因此,我们回顾性研究了在安全性最高的精神病院接受治疗的被告的能力或无能的临床判断与认知和社会智力以及陈述性记忆的神经心理学测量之间的关系.结果表明,两组(有能力和无能力)的抑郁认知智力水平相似,韦克斯勒的全面智商水平落在边界范围的上端。与被临床判定为不称职的被告相比,被推荐为有能力的被告在社会智力和情景记忆方面的得分明显更高,最明显的优势发生在语言记忆测试上,对编码提出了很高的要求,合并,和检索听觉呈现的叙事材料。社会智力和情景记忆领域的认知能力可能在开发CST的启发式神经心理学模型中起关键作用。对这些领域的评估为评估提供了影响,restoration,以及对CST的理解。
    This study sought to delineate the neuropsychological processes that undergird the psycho-legal concept of competency to stand trial (CST). Accordingly, we retrospectively examined the relationship between clinical judgments of competence or incompetence of defendants committed to a maximum-security psychiatric facility and neuropsychological measures of cognitive and social intelligence and declarative memory. Results indicated that both groups (competent and incompetent) showed similar levels of depressed cognitive intelligence with Wechsler full-scale IQ levels falling in the upper end of the borderline range. Compared with defendants clinically judged as incompetent, defendants recommended as competent scored significantly higher on measures of social intelligence and episodic memory, with the most pronounced advantage occurring on tests of verbal memory that place heavy demands on encoding, consolidation, and retrieval of aurally presented narrative material. Cognitive capacities in areas of social intelligence and episodic memory may play critical roles in developing a heuristic neuropsychological model of CST. The evaluation of these domains offers implications for the assessment, restoration, and understanding of CST.
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  • 文章类型: Journal Article
    在本文中,我们描述了一部小说,集成的概念模型,将结构化工具中的核心要素聚集在一起,评估未来暴力的风险,保护因素,以及法医心理健康环境中治疗和康复的进展。我们认为,这种模型的价值在于其提高临床效率和简化评估方案的能力。促进患者有意义地参与评估和治疗计划活动,并增加这些信息的主要使用者对临床评估的可及性。模型中出现的四个领域(治疗参与,疾病和行为的稳定性,洞察力,以及专业和个人支持)进行了描述,并说明了法医背景下每个领域的常见临床表现。最后,我们讨论了验证概念模型所需的研究类型,例如此处介绍的模型以及对临床实践和实施的影响。
    In this paper we describe a novel, integrated conceptual model that brings together core elements across structured tools assessing risk for future violence, protective factors, and progress in treatment and recovery in forensic mental health settings. We argue that the value of such a model lies in its ability to improve clinical efficiencies and streamline assessment protocols, facilitate meaningful participation of patients in assessment and treatment planning activities and increase the accessibility of clinical assessments to principal users of this information. The four domains appearing in the model (treatment engagement, stability of illness and behavior, insight, and professional and personal support) are described, and common clinical manifestations of each domain within a forensic context are illustrated. We conclude with a discussion of the types of research that would be needed to validate a concept model such as the one presented here as well as implications for clinical practice and implementation.
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  • 文章类型: Journal Article
    拘留嫌疑人必须被告知他们的米兰达权利(米兰达诉亚利桑那州,1966年)在警察讯问之前。自从这个具有里程碑意义的决定以来,学者们对包括智障人士(ID)在内的弱势群体中的米兰达理解和推理进行了严格的研究。然而,对身份证的关注使被捕者的认知能力有限(即,智商在70到85之间的LCC)完全被忽视了。当前的数据集使用大量(N=820)完成了对米兰达能力的标准化评估(SAMA)的审前被告样本来解决这一问题。传统的(即,首先分析ID和no-ID)标准组,并去除测量标准误差(SEM)。第二,一个细微差别的三组框架包括LCC的被告.结果表明,LCC被告容易受到米兰达理解受损的影响(即,对米兰达警告的有限召回和米兰达相关词汇知识的缺陷)。毫不奇怪,他们的豁免决定往往受到关键误解的损害(例如,看到调查人员站在他们一边)。强调了这些调查结果对这一至关重要的群体的宪法保障的实际影响,他们似乎从刑事司法系统的裂缝中堕落了。
    Custodial suspects must be informed of their Miranda rights (Miranda v. Arizona, 1966) prior to police questioning. Since this landmark decision, scholars have rigorously studied Miranda comprehension and reasoning among vulnerable groups including those with intellectual disabilities (ID). However, the focus on ID has left arrestees with limited cognitive capacities (i.e., LCCs with IQs between 70 and 85) entirely overlooked. The current dataset addressed this oversight using a large (N = 820) sample of pretrial defendants who had completed the Standardized Assessment of Miranda Abilities (SAMA). Traditional (i.e., ID and no-ID) criterion groups were first analyzed with the standard error of measurement (SEM) removed. Second, a nuanced three-group framework included defendants with LCCs. Results indicate that LCC defendants are vulnerable to impaired Miranda comprehension (i.e., limited recall of the Miranda warning and deficits in Miranda-related vocabulary knowledge). Not surprisingly, their waiver decisions were often impaired by crucial misconceptions (e.g., seeing the investigating officers as beneficently on their side). The practical implications of these findings were underscored with respect to Constitutional safeguards for this critically important group, who have appeared to fall through the cracks in the criminal justice system.
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  • 文章类型: Journal Article
    在过去十年中,使用视频会议技术远程进行法医精神病学和法医心理评估的情况已大大增加。本评论阐述了Recupero关于使用远程技术进行法医精神病学评估的许多观点。这些要点包括支持心灵感应的研究及其对法医评估的普遍性,与远程法医评估相关的错误率,以及它在该领域的普遍接受度。评注还考虑将心理测试和专门的法医措施纳入法医评估,并描述了考虑可以合理地纳入远程进行的法医评估的测试和措施的标准。
    The use of videoconferencing technology to conduct forensic psychiatric and forensic psychological evaluations remotely has grown considerably in the last decade. This commentary addresses a number of points made by Recupero regarding the use of remote technology to conduct forensic psychiatric evaluations. These points include the research supporting telepsychiatry and its generalizability to forensic assessment, the error rate associated with remote forensic assessment, and its general acceptance in the field. The commentary also considers the inclusion of psychological testing and specialized forensic measures in forensic assessment and describes criteria for considering tests and measures that can reasonably be included in a remotely conducted forensic assessment.
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