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Biomedical subjects

C L Stokman

Publications and source records attributed to C L Stokman.

5 recordsLinked to original sources

Incompetent misdemeanants--pseudocivil commitment.

Prior to Jackson v. Indiana, psychiatric hospitalization of those found to be incompetent to stand trial often led to an inordinately long confinement, a particularly invidious consequence if the patient had been accused only of a misdemeanor. After a highly publicized murder perpetrated by a patient originally in this category, New York State instituted a rather cumbersome set of procedures designed to assure several layers of review, including involvement of the legal system, prior to increasing privileges or discharging someone committed pursuant to a criminal court order. The effect of this new law on patient care is examined by looking at the hospital course of 52 incompetent misdemeanants at one state facility. They are demographically and clinically quite similar to a control group of persons civilly committed, except for an increased length of inpatient stay. When compared with those sent to the county penitentiary after conviction, the study population differs on several important parameters. Looking like a patient, the incompetent misdemeanant is, however, treated more as a criminal with no indication that public safety is thereby increased or that individual therapeutic objectives are enhanced.

Adult

Dangerousness and violence in hospitalized mentally ill offenders.

Clinical judgments of dangerousness depend not only on patient characteristics, but are greatly influenced by the perspective of the rater and the context for which the assessments are made. Similarly, institutional violence is determined not only by patient characteristics, but is also a function of contextual variables such as physical milieu, important clinical events not under the control of the patient, etc. To increase the predictive validity of assessments of dangerousness it is essential to specify the vulnerabilities and strengths of the patient, the current life stressors, and the contextual triggers to which the patient is likely to react violently. The momentary contextual triggers may be useful to predict the type and severity of violence and perhaps the most likely victims as well. Analyses of previous violent incidents may provide markers for contextual triggers, e.g., type of weapon, victim, severity of violence, etc.

Antisocial Personality Disorder