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Biomedical subjects

R Barnum

Publications and source records attributed to R Barnum.

14 recordsLinked to original sources
PubMed2001

Massachusetts Youth Screening Instrument for mental health needs of juvenile justice youths.

OBJECTIVE: This report describes the development of the Massachusetts Youth Screening Instrument-Second Version (MAYSI-2), a brief screening measure to identify youths with potential mental, emotional, or behavioral problems at entry points in the juvenile justice system. METHOD: This 52-item self-report measure, with content relevant to common mental health problems in delinquent populations, was administered to 1,279 male and female youths, aged 12 to 17, in Massachusetts juvenile justice facilities. A subsample of youths also received the Millon Adolescent Clinical Inventory (MACI) and the Youth Self-Report (YSR). The instrument was subsequently administered to 3,804 male and female youths in California Youth Authority custody. RESULTS: Factor analyses of the 52 items identified seven scales that were conceptually associated with various mental, emotional, and behavioral problems of youths, which were generally confirmed by separate factor analyses with the California sample. The scales manifested adequate internal consistency and test-retest reliability. Most scales were substantially correlated with conceptually similar scales in the MACI and YSR, and they identified most youths who scored at clinically significant levels on those instruments. CONCLUSIONS: The MAYSI-2 shows promise as a reliable and valid screening tool to assist juvenile justice staff in identifying youths who may need an immediate response to mental or emotional problems.

Adolescent↗
PubMed1997

A suggested framework for forensic consultation in cases of child abuse and neglect.

Child abuse and neglect is a central issue in several kinds of legal proceedings in which forensic psychiatry consultants may be involved. Thorough and responsive consultation in these cases calls for the consultant to be aware of a broad range of issues, some of which may not be explicitly raised in referral questions. These issues include: (1) determining the history of abuse or neglect; (2) assessing the resulting harm to the child; (3) assessing a parent's current capacity to provide for a child; and (4) predicting future risk and treatment response for children and parents. Each of these questions calls for different clinical assessment approaches and clinical expertise.

Child↗
PubMed1994

Maternal and child posttraumatic stress disorder in cases of child maltreatment.

The purpose of this study was to examine the rates of posttraumatic stress disorder (PTSD) among a sample of severely maltreated children and their mothers, and to investigate the age of onset of documented maltreatment in these children. The sample consisted of 109 pairs of women and their children who were before a juvenile/family court due to maltreatment of sufficient severity to warrant removal of the child from parental custody. Children were examined using the PTSD Section of the Diagnostic Interview for Children and Adolescents, Revised 6th Version (DICA-6-R). The PTSD Module of the Structured Clinical Interview for DSM-III-R (SCID) was administered to all mothers. Clinical psychiatric interviews were also administered to all children and mothers. From the sample of 109 cases, 15.6% of the mothers met SCID criteria for a current presentation of PTSD, while 36.7% had a past history of PTSD. Of the 109 evaluated children, 35.8% met current DICA criteria for PTSD. Posttraumatic stress disorder is significantly overrepresented in the children of mothers diagnosed with PTSD (p = .001). The average age of maltreatment onset was 46.4 months among the children diagnosed as PTSD, and was 61.3 months in the group of seriously maltreated children who did not develop PTSD (p = .038). The onset of maltreatment is significantly earlier among children whose mothers meet PTSD criteria than among other maltreated children (p = .025). Intergenerational transmission of violence and developmental effects of traumatic experiences upon the young child are discussed.

Adult↗
PubMed1993

An agenda for quality improvement in forensic mental health consultation.

Recent developments in quality assurance in health care have embraced the total quality management approach to industrial quality control. Setting a goal of "continuous quality improvement" for medical care, this approach features special attention to the process and systems of care provision. Applying this approach to the specialty of forensic mental health consultation yields a variety of potential ways of improving care, by articulating common problems in the consultation process that might respond to the total quality management approach. These problems include the setting of appropriate goals for forensic evaluation, and selecting cases for attention on the basis of those goals; determining appropriate standards for thoroughness and validity in the use of evaluation techniques; and establishing clear expectations regarding the provision of mental health services beyond the consultation process itself. Creating interdisciplinary teams at various levels of administration of trial courts and mental health agencies can provide contexts for reviewing cases, with the aim of discovering problems in these areas, educating professionals across boundaries about sources of problems, and developing clearer and more consistent standards of practice to reduce problems and improve quality of service.

Commitment of Persons with Psychiatric Disorders↗
PubMed1992

Differences in neuropsychological and academic achievement between adolescent delinquents and status offenders.

OBJECTIVE: This study sought to determine whether neurocognitive factors could discriminate delinquents brought before a juvenile court in a large urban area from nondelinquent status offenders brought before the same court. METHOD: Psychological tests were administered to 216 adolescents, aged 13-15 years, presenting to a large urban juvenile court. One hundred ten delinquents (65 male and 45 female) were compared to 106 high-risk nondelinquents (65 male and 41 female) on the WISC-R subtests, the Wide Range Achievement Test, and the Memory for Designs Test. RESULTS: Discriminant analysis revealed that the male delinquents could not be discriminated from the comparison group of male status offenders on the basis of scores on any of the measures. Among the female subjects, scores on reading, arithmetic, digit span, and picture completion subtests and the Memory for Designs Test differed significantly between groups, with some of the findings favoring status offenders and others favoring delinquents. CONCLUSIONS: Overall, the findings did not support the hypothesis that inferior intelligence is an independent risk factor for delinquent behavior.

Achievement↗
PubMed1991

The designated forensic professional program: a state government-university partnership to improve forensic mental health services.

As the law/mental health field has expanded and matured in the last 20 years, the sophistication required by mental health professionals in order to respond appropriately to legal questions has grown significantly. Courts and legislatures define a growing number of legal competencies. Judges and attorneys are more familiar with mental health law than they were 10 or 20 years ago.

Credentialing↗
PubMed1990

Self-incrimination and denial in the juvenile transfer evaluation.

Clinical evaluation of alleged juvenile delinquents regarding possible transfer to adult court must be conducted before adjudication of the facts of the case. This requirement leads to problems for the juvenile court and for the psychiatric consultant in managing certain potentially incriminating information that the defendant may reveal in the evaluation process. Both explicity self-incriminating information, and also denial of involvement in the alleged offense, present problems in this regard. Explorations of procedural protections for dealing with explicity self-incriminating information, and of the clinical and forensic problems in interpreting defendants' denial of culpability in these circumstances, do not yield fully satisfying answers to the problems. The author suggests some procedural compromises, and discusses the dilemma at the boundary of juvenile court jurisdiction that underlies these problems.

Adolescent↗
PubMed1989

Clinical evaluation of juvenile delinquents: who gets court referred?

This study examines which alleged delinquents in a large urban juvenile court are selected for referral to the court's psychiatric clinic. A number of demographic factors, probation officer impressions, index charges, and past delinquency record variables were examined for all minor delinquency cases referred in a six-month period and for a random selection of nonreferred cases. In general, referral was associated with lower socioeconomic status (SES), and with a variety of probation impressions of child and family dysfunction. Little relation to index charge or past record was found. The authors interpret these results as showing that probation referrals appear to be made more on the basis of high risk than on the basis of favorable prognosis for treatment.

Adolescent↗
PubMed1987

Patient warnings in court-ordered evaluations of children and families.

The rules covering disclosure of information generated by court-ordered clinical evaluations in Massachusetts require that patients be warned that the patient-psychotherapist privilege does not apply to the evaluation interview. The nature of the warning required ("the Lamb warning") is not perfectly clear and is especially uncertain when those being warned are children and families. Comparing the Lamb warning to the Miranda warning offers some insight but is not conclusive. To reach conclusions regarding the type and degree of procedural protections for children required by the Lamb warning, it is necessary to analyze the stakes, interests, and capacities involved for children in juvenile court. This analysis suggests that in most situations a relatively informal procedure is sufficient to provide the required warning. However, there are some exceptional circumstances in which more formal and thorough warnings should be required. These include juvenile transfer hearings and some situations involving child abuse and neglect.

Adolescent↗
PubMed1986

Court-ordered removal in severe child maltreatment: an association to parental major affective disorder.

The authors report on a study of psychiatric diagnoses in parents whose children had been removed from their custody by court order because of child abuse and neglect. Compared to a similar group of parents who had not had children removed, the subject parents had a significantly greater lifetime incidence of affective disorders by Research Diagnostic Criteria (RDC) prior to their court involvement. Very few of these disorders had been rigorously diagnosed before or treated psychiatrically.

Adult↗
PubMed1975

Patient rehabilitation through hospital work under Fair Labor Standards.

Payment of patients for hospital work assignments has become a matter of great concern for mental health institutions since the 1973 federal court ruling requiring the Department of Labor to enforce the 1966 amendments to the Fair Labor Standards Act. A work program in compliance with Fair Labor Standards has been operating at Binghamton (N.Y.) Psychiatric Center since 1971. Certificates from the labor department permit the hospital to pay less than the minimum wage for patients in occupational training or in sheltered employment in a regular job. The authors believe that work therapy has important clinical and rehabilitative functions, and that patients should not be denied the opportunity for such work because of the court ruling.

Persons with Disabilities↗