Postcards from the Id

Alleged Rapist Placed On House Arrest

Wow.  Just, wow.

BTW, I like one commenter's suggestion - put the guy in the judge's house...

Over At Marginal Revolutions...

Tyler Cowen has a new book out, Create Your Own Ecomony, and he is making a special offer if you buy his book today.  I enjoyed his book Discover Your Inner Economist, which I blogged about here.  My hunch is that I'll enjoy this book as well.

In addition, Cowen has an interesting post regarding John Calvin's underrated reputation as a thinker, and he gingerly steps into the debate regarding high speed rails (in this case, building them in Texas).

Defense Challenges Statements Based on Mental Health Diagnosis

Caught this article, which examines the argument by a defense attorney that his client’s statements to police should not be admitted due to his Bipolar diagnosis.  The prosecution is arguing that the defendant’s presentation at the time of his statements was within normal limits; therefore, his mental health condition is not a factor.  From the article:

Kevin Porter's statement and admission to police should be blocked from being introduced into evidence because of those mental health problems, lawyer John Tardif said during a hearing to suppress evidence.

And:

Porter, who is being held on $250,000 bail, is bipolar and on several medications to treat that condition, Tardif said.

He told Judge Lloyd Macdonald that Porter's mental condition and the fact he had not taken his medication for hours prior to being questioned by police were evidence Porter could not legally volunteer to make a statement.

Prosecutor Marian Ryan argued that Porter acted in a manner typical of someone trying to deflect blame and was also extremely detailed in describing the events of that day.

This gets to the issue of competency to waive Miranda rights, one of several different types of competency.  While I don’t know much about the specifics of this case, a couple of thoughts do come to mind:

1) Most mental health issues ought to be considered on a continuum, rather than either/or, in terms of their impact on functioning.  The presence of a particular disorder, such as Bipolar I Disorder, is a necessary but not sufficient condition for a lack of competency.  Until such a level of functioning is established, the diagnosis alone, generally speaking, is only one step in the process of determining whether the defendant was competent at that time.  What is truly unfortunate is that this vagueness is not limited to lay people - plenty of records I’ve received over the years will have the generic “Bipolar” listed as a diagnosis, which becomes problematic when sorting out what symptoms the person has actually experienced.

2) It is often extremely frustrating when partial diagnoses such as “Bipolar” are thrown around.  There are multiple diagnostic issues related to Bipolar-type disorders, which address many areas, including severity.  As a primary example, Bipolar I Disorder is often a significantly debilitating disorder when untreated; Bipolar II Disorder, in contrast, might disrupt functioning to some degree, but would generally not impair an individual’s competency.

3) The diagnosis of “Bipolar” is fast becoming a diagnosis assigned to people who have engaged in impulsive behavior, often reckless or short-sighted, and based on an environmental trigger which escalated a particular emotion.  Generally speaking, this is not Bipolar.  This doesn’t mean that people with Bipolar disorder cannot be impulsive as well; the problem is that individuals with certain personality characteristics (often with the additional influence of alcohol or drugs), will typically engage in unhealthy behaviors whenever their emotions shift.  This is not a Bipolar Disorder.  A Bipolar Disorder is a mood disorder, which means that is experienced as a longer term, qualitative shift in emotion that lasts almost all day, every day, for the duration of the disturbance.  Full mania is debilitating, in that it often results in significant incapacitation and incredibly reckless behavior based on psychotic belief systems that develop as the mood elevates to extreme levels.  As an example of mood versus affect (or short-term emotional state), a Major Depressive Mood episode must last a minimum of two weeks to be considered “depression.”  A full manic episode must last a minimum of one week (often much longer when untreated), and represent a significant shift in functioning.  Someone who acts out whenever something happens that changes how they feel in the moment may be impulsive, but this is not manic.  Hopefully, the DSM-V will address this diagnostic trend, but I’m not optimistic; I fear the next round make actually make the issue worse. 

Anyway, back to this case.  The real issues in front of the judge are: 1) does the individual have a diagnosis that meets the state’s criteria for the minimum mental health issue that must be present; 2) Was the diagnosis, if present, active at the time of the statements; 3) if the symptoms were active, then to what degree were they active, and did they impair the individual’s understanding of his rights, and how making statements might impact his legal standing.  Transcripts will certainly be important (how and what the defendant said during those sessions can go a long way towards determining whether he was experiencing any mania during the time frame in question).  Even better would be a video recording of the interview, which is more and more common as a result of these types of issues being raised.  Also of import would be the defendant’s actions prior to, and following, his statements.

Depression In College Students Increases Likelihood Of Dropping Out

I came across this article, which discusses the impact of depression, and to a lesser extent anxiety, on both the completion rate and academic performance of college students.  While it makes intuitive sense that students with depression might struggle with college more than those without depression, what I like about this research is its exploration of the types of depression involved.  In terms of academic performance, it is the loss of motivation, rather than the experience of depressed affect, which impairs the student’s academic performance.  From the article:

There are two core symptoms of depression---loss of interest and pleasure in activities, or depressed mood---but only loss of interest is associated with lower grade point averages.

"The correlation between depression and academic performance is mainly driven by loss of interest in activities," Eisenberg said. "This is significant because it means individuals can be very depressed and very functional, depending on which type of depression they have. I think that this can be true for many high achieving people, who may feel down and hopeless but not lose interest in activities.

"Lots of students who have significant depression on some dimension are performing just fine, but may be at risk and go unnoticed because there is no noticeable drop in functioning."

The article also discusses how comorbid anxiety (very common, as anxiety and depression tend to go together) increases the degree of academic impairment:

"If you take a student at the 50th percentile of the GPA distribution and compare them to a student with depression alone, the depressed student would be around the 37th percentile---a 13 percent drop," Eisenberg said. "However, a student with depression and anxiety plummets to about the 23rd percentile, a 50 percent drop."

There are some important insights to be gained from research like this.  First, depending on the type of depression one experiences, a change in behavior may not necessarily be evident.  Just because someone continues to maintain a certain degree of functioning does not mean they are not experiencing depression.  However, depression ought to be screened should a change in functioning occur, especially absent some other apparent cause.  It seems like colleges are dramatically improving in their ability to assess, recognize, and intervene with students who are experiencing mental health difficulties, which often emerge, or increase, during young adulthood.  This is especially important because the individuals who would normally be most familiar with a change in presentation - family members - are often no longer seeing their child on a regular basis.  The ability of school employees and fellow students to be informed and make educated observations can help pick up the slack.

Impact of Tech on Custer’s last Stand

Over at Wired, a nice blog review of the impact technology might have played in Custer’s fall at Little Big Horn.  My only real knowledge of this event is from reading Ambrose’s Crazy Horse and Custer (which I enjoyed), so I like coming across posts like this.  Seems like the numeric advantage was overwhelming, so the rifle differences probably only hastened the eventual outcome.  On the other hand, if Custer had brought Gatlin guns, who knows?  Interesting stuff, worth a read.

Baby-Boomers and Online Social Networking Needs

Interesting article about online social networking, and how baby boomers have different expectations than younger people.  In particular, and not surprisingly, two areas of concern are privacy, and attention-seeking.  From the article:

According to a study to be published in HCI2009 conference 55-65 year-old Finns consider social network sites unsecure. In addition, they consider the behaviour at these sites often inappropriate. According to researchers Vilma Lehtinen, Jaana Näsänen and Risto Sarvas young people, for instance, usually find it natural to publish a personal pictures on the web, but many Finnish baby-boomers consider that inappropriate as self-assertion.

Another idea brought up in the article, related to the above, is that boomers were brought up in a less photo-intensive world, which contributes to the discomfort with the frequent visual images regularly displayed by younger networkers.  Given the importance of social networking in general, and the potential benefits of online sites in facilitating social contact, addressing these issues with respect to boomers would likely provide a number of benefits, whether it be educating older users on security issues, tweaking existing sites for older users, or developing boomer-friendly sites.  I know there are sites out there that market themselves as “40+ sites,” but I’m not sure whether they address the concerns noted in this article.

Correctional Psychology - Book Quote on "Correctional Movement"

As noted in an earlier post, one book I like for the purpose of a basic introduction to correctional psychology is the Handbook of Correctional Mental Health.  The chapters focus on various aspects of providing mental health services in correctional settings, and the authors often touch on aspects of working in a correctional environment that may not seem like a big deal to someone who is used to a prison atmosphere, but may be quite informative to a person who has not spent much time in a correctional setting.

One such description is in the second chapter of this book, entitled “Practicing Psychiatry in a Correctional Culture,” by Kenneth Appelbaum, M.D.  He discusses the impact of security on movement within a prison, providing a great overview:

“Containment and security are central to the mission of all correctional facilities, and the environment reflects this priority.  Prisons are fortresses that carefully control who gets in and, more importantly, who gets out.  Without proper clearance and identification, outsiders will not make it past the “front trap.”  Like the entryway of a castle, the front trap is the passage through the razor-wire-topped outer perimeter walls.  A correctional officer in a separate control station regulates entrance to and exit from the trap through the security doors on either end of the passageway.  At least one door is always closed, literally trapping, at least temporarily, all traffic as it transits through the trap.  Another officer assigned to the trap may search visitors and staff when entering or leaving the facility.  Additional inner traps control movement within the facility.  Officers control all movement.  The psychiatrist usually does not have a key.

Although the distance between two points in a prison may be short, transit time can vary considerably.  Many factors affect the ease of movement.  For example, delays can occur when visitors in the trap require more extensive searching and processing.  Sometimes the control officer or the trap officer is temporarily distracted by other tasks.  At other times, a freeze on all movement within the institution occurs because of a medical emergency, a fight, or another disturbance.  These delays cannot be avoided, but even during normal operations, the speed of movement may be directly proportional to the quality of the relationship the psychiatrist has with the officers in charge.  Good rapport with officers can go a long way toward improving a psychiatrist’s efficiency, and as described later in this chapter, rapport can be critical in the efficacy of psychiatric assessments and interventions.”

Monitoring movement within a prison, in addition to into and out of a prison, is an important aspect of the correctional environment.  Obviously, this priority increases proportional to the security level of the facility.  Safety not only for the staff, but also the inmates, is enhanced through the effective monitoring and control of inmate movement; therefore, it is a priority that non-correctional staff should respect.  Regulations are in place for a reason, and often the reason is the result of a past issue or breach.  With respect to the rapport issue described above, I’ve seen a number of non-correctional staff (including mental health professionals) burn bridges through chronic complaining about security-related procedures, passive-aggressive noncompliance with said procedures, and even verbal arguments with correctional staff regarding priorities.  Obviously, there will be times where correctional procedures may come into conflict, to some degree, with optimal mental health practices; in these cases, there is nothing wrong with asserting mental health priorities in the context of a correctional environment.  But, there is a correct way to do this (i.e. seeing oneself as part of the correctional team, and working with custody staff), and a wrong way (i.e. condescension, griping, discounting of correctional concerns).  In the latter case, you may win the battle, but lose the war, which is unfortunate, given the importance correctional staff play in the assessment and monitoring of mentally ill inmates.

Personally, I try to approach custody-related tasks not just from a neutral perspective, but from a positive, pro-custody manner.  I want the correctional staff to not necessarily see me as an officer, but as someone who “gets it.”  In that vein, I will help out whenever possible when correctional disturbances occur (breaking up fights, searching for reported contraband, etc.), volunteer for extra custody posts during time periods when there is a shortage of available correctional staff (for example, during annual training, when all staff attend a week’s worth of training on correctional principles), regular conversations with custody staff (to include “keeping them in the loop,” asking for feedback on individuals, and simple banter), and attending correctional staff events.  I’m generally disappointed with the low participation in staff activities by medical, mental health, and other non-custody staff (i.e. Staff Christmas Party).  Do I always feel like going?  No.  But I do think it’s important to demonstrate through actions that you don’t think you’re better than anyone else, you respect the work of the other staff, and that they can count on you in an emergency.  In return, I generally have a good relationship with many of the officers and other staff at the facility, which not only makes for a better work environment, but also helps out with my job in many little ways.   

Psychologist Helps Inmate Escape

Ugh.  I hate to see stories like this, especially when it involves a mental health professional.  Well, at least this one occurred in Canada (even though the psychologist in question is Amercian).  In this case, a psychologist aided the escape of an inmate convicted of murder.  Worse, she helped as a result of an inappropriate relationship with the inmate:

Police believe Danto and Wood have a romantic relationship and that she was involved with his escape plans from the beginning, Sun Media's Whig Standard has learned.

“We do understand that a staff member was involved,” said Stephanie Fullerton, a spokeswoman for Corrections Canada at its regional headquarters in Kingston. “Currently this is under investigation by CSC as well as the police so it would be inappropriate for me to comment on specifics.”

In corrections, we go over this stuff again and again - why these relationships are destructive, how it puts others at risk, and what warning signs to look for in terms of relationships becoming inappropriate.  And yet, despite these efforts, this stuff comes up again and again.  I really am amazed at just how often this does occur, especially considering the consequences.  Not sure what the penalty is for this type of conduct in Canada, but it will be interesting to see how it plays out.

Instigating Geek Wrath!!!

Funny little post here about how to raise the hackles of a geek.  Normally these gentle creatures are passive (or at least passive-aggressive), content to while away hours working on various tech gadgets, playing games, and watching sci-fi.  However, the author warns that asking certain questions might awaken the Geek-Rage within!  My favorite is actually one left in the comments section - “Why didn’t Frodo just fly the Ring into Mordor, rather than only escape by flying out?”  Really?  Someone really needs an explanation for that...?

On the other hand, some of the stuff they are talking about I just flat out either don’t know, understand, or care about.  So, I guess I’m “the Diet Coke” of geekiness, huh? 

Over at Omnivoracious...

A few links to posts on their site: 

1) First, here is someone as excited about Terry Teachout’s next book as me.

2) A review of The Human Disguise, and a short interview with the author.  I now want to read this book, a lot!

3) A tribute to the awesomeness that is Tolkien...