Biomedical subjects

Thomas Grisso

Publications and source records attributed to Thomas Grisso.

At least 19 recordsLinked to original sources

PubMed2005

The empirical limits of forensic mental health assessment.

This article introduces a special issue of Law and Human Behavior, including five articles describing the limits of forensic mental health assessments of (a) risk of violence in female adolescents, (b) sexually violent predators, (c) dangerousness in capital murder cases, (d) child sexual abuse, and (e) PTSD litigants. Knowing the limits of forensic mental health assessment methods is essential in order to recognize their strengths, increase the credibility of forensic mental health assessment, and drive research that will enhance the value of assessments for the courts.

Adolescent↗

PubMed2005

An actuarial model of violence risk assessment for persons with mental disorders.

OBJECTIVES: An actuarial model was developed in the MacArthur Violence Risk Assessment Study to predict violence in the community among patients who have recently been discharged from psychiatric facilities. This model, called the multiple iterative classification tree (ICT) model, showed considerable accuracy in predicting violence in the construction sample. The purpose of the study reported here was to determine the validity of the multiple ICT model in distinguishing between patients with high and low risk of violence in the community when applied to a new sample of individuals. METHODS: Software incorporating the multiple ICT model was administered with independent samples of acutely hospitalized civil patients. Patients who were classified as having a high or a low risk of violence were followed in the community for 20 weeks after discharge. Violence included any battery with physical injury, use of a weapon, threats made with a weapon in hand, and sexual assault. RESULTS: Expected rates of violence in the low- and high-risk groups were 1 percent and 64 percent, respectively. Observed rates of violence in the low- and high-risk groups were 9 percent and 35 percent, respectively, when a strict definition of violence was used, and 9 percent and 49 percent, respectively, when a slightly more inclusive definition of violence was used. These findings may reflect the "shrinkage" expected in moving from construction to validation samples. CONCLUSIONS: The multiple ICT model may be helpful to clinicians who are faced with making decisions about discharge planning for acutely hospitalized civil patients.

Actuarial Analysis↗

PubMed2005

Between a rock and a soft place: developmental research and the child advocacy process.

Developmental researchers face a perilous path as they set out to perform research with child advocacy potential. We offer our observations regarding how researchers can navigate the path between science (the "rock") and advocacy (the "soft place"), based on our recent experience as directors of the MacArthur Juvenile Adjudicative Competence Study. Scientific research can be extraordinarily effective in the child advocacy process, but science and advocacy are very different endeavors. Scientific credibility demands impartiality, whereas advocacy is never impartial. For psychological scientists to be effective in conducting research relevant to child advocacy, it is important to maintain our identity as scientists and resist any efforts on the part of others to label this work as advocacy.

Biomedical Research↗

PubMed2004

Validity and structure of a self-report measure of youth psychopathy.

An interest in early identification of youth who may be at risk of psychopathy has generated measures for age-appropriate screening and assessment. This study examines the structural, concurrent, and divergent validity of the Psychopathy Content Scale, a 20-item self-report instrument derived from the Millon Adolescent Clinical Inventory (MACI). Data for 481 youths who had taken the MACI, the Child Behavior Checklist Youth Self-Report (YSR), and the Massachusetts Youth Screening Instrument, Second Version (MAYSI-2), were analyzed. Results showed that the PCS is best described by a two-factor model and that analyses of the two factors offer limited support for convergent and divergent validity. High scores on both factors were associated with high YSR and MAYSI-2 scales, suggesting that the measure identified youth who were distressed on several measures of emotional, psychological, and behavioral disorder.

Adolescent↗

PubMed2004

Therapeutic misconception and the appreciation of risks in clinical trials.

Studies repeatedly have shown that clinical research subjects have trouble appreciating the implications for their clinical care of participating in a clinical trial. When this failure is based on a lack of appreciation of the impact on individualized clinical care of elements of the research design, it has been called the "therapeutic misconception". Failure to distinguish the consequences of research participation from receiving ordinary treatment may seriously undermine the informed consent of research subjects. This article reports results concerning appreciation of the risks of trial participation from intensive interviews with 155 subjects from 40 different clinical trials at two different medical centers in the USA. Working from transcripts of the interviews, every statement of a risk or disadvantage of trial participation was identified and coded into one of 5 different categories. Totally, 23.9% of subjects reported no risks or disadvantages in spite of being explicitly asked about them. Another 2.6% reported only incidental disadvantages such as having to drive a long way to get to the experimental site. In all 14.2% reported only disadvantages associated with the standard treatment (usually side effects). Another 45.8% told the interviewer about disadvantages and risks associated with the experimental intervention (usually side effects). Only 13.5% could report any risks or disadvantages resulting from the research design itself, such as randomization, placebos, double-blind designs and restrictive protocols. The results of this research suggest that subjects often sign consents to participate in clinical trials with only the most modest appreciation of the risks and disadvantages of participation.

Academic Medical Centers↗

PubMed2003

Five year research update (1996-2000): evaluations for competence to stand trial (adjudicative competence).

This article reviews and evaluates publications during 1996-2000 with relevance for assessments of competence to stand trial (also known as adjudicative competence). The review focuses specifically on articles that provide new concepts or data supported by research or case analyses. The studies are reviewed under the following headings: (i) the systemic context of evaluations of adjudicative competence (AC); (ii) conceptual guidelines for AC evaluations; (iii) research on AC assessment methods; (iv) empirical correlates of AC judgments and psycholegal abilities; (v) quality of AC evaluations and reports; (vi) interpretation of AC evaluation data; (vii) issues in AC assessment of special populations (e.g., juveniles, persons with mental retardation, and women); and (viii) treatment to restore competence. Suggestions are offered for further research to advance the quality of clinical evaluations of adjudicative competence.

Adolescent↗

PubMed2003

Subtypes of adolescent offenders: affective traits and antisocial behavior patterns.

Etiological models of life-course persistent offending often emphasize behavioral explanations. Suggestions that persistent offenders have psychopathy ignore the distinct non-behavioral features of the psychopathy disorder. Using a three-factor model of the PCL-YV and cluster analysis with 259 incarcerated adolescents, we identified four distinct juvenile subtypes on the basis of affective, interpersonal, and behavioral dimensions. Prospective and retrospective comparisons of antisocial behavior patterns found the cluster comprising all three psychopathy dimensions to be the most chronic and severe. Impulsive features alone were strongly associated with severe antisocial behaviors retrospectively, but not prospectively. Findings rebut the proposal that disruptive behavioral and impulsive symptoms can identify "fledgling psychopaths." Assessments that disregard callous-unemotional traits will likely result in high false positive rates among serious adolescent offenders. Implications for developmental models of chronic offending are discussed in light of the need for further follow-up into adulthood.

Adolescent↗

PubMed2003

Juveniles' competence to stand trial: a comparison of adolescents' and adults' capacities as trial defendants.

Abilities associated with adjudicative competence were assessed among 927 adolescents in juvenile detention facilities and community settings. Adolescents' abilities were compared to those of 466 young adults in jails and in the community. Participants at 4 locations across the United States completed a standardized measure of abilities relevant for competence to stand trial (the MacArthur Competence Assessment Tool--Criminal Adjudication) as well as a new procedure for assessing psychosocial influences on legal decisions often required of defendants (MacArthur Judgment Evaluation). Youths aged 15 and younger performed more poorly than young adults, with a greater proportion manifesting a level of impairment consistent with that of persons found incompetent to stand trial. Adolescents also tended more often than young adults to make choices (e.g., about plea agreements) that reflected compliance with authority, as well as influences of psychosocial immaturity. Implications of these results for policy and practice are discussed, with an emphasis on the development of legal standards that recognize immaturity as a potential predicate of incompetence to stand trial.

Adolescent↗

PubMed2003

Applicability of traditional and revised models of psychopathy to the Psychopathy Checklist: screening version.

Recently, psychopathy has become virtually synonymous with the Psychopathy Checklist (PCL) measures. However, the "gold standard" 2-factor model that underlines these measures has been questioned for its uncertain empirical support and emphasis on antisocial behavior that is not specific to psychopathic personality deviation. This study (N = 870 civil psychiatric patients) compares the fit of the traditional 2-factor model with that of a revised 3-factor model of psychopathy. The revised model better describes the structure of the Screening Version of the PCL (PCL:SV) than the traditional model. Although the revised model's exclusion of some items that assess antisocial behavior reduces the PCL:SV's power in predicting patient violence, this model arguably assesses psychopathy in a more specific, theoretically coherent fashion that may reduce misapplications of the construct. Implications for future research are discussed.

Adult↗

PubMed2003

Mental health assessments in juvenile justice: report on the consensus conference.

OBJECTIVE: At national, state, and local levels, there is increasing recognition of the importance of identifying and responding to the mental health needs of youths in the juvenile justice system, as policymakers and practitioners struggle to find ways to address causes and correlates of juvenile crime and delinquency. The proposed guidelines for mental health assessment provide explicit information about how, why, and when to obtain mental health information on justice youths at each important juncture in processing. METHOD: A national group of expert researchers and practitioners convened in April 2002. Experts derived six recommendations, following the expert consensus method, for conducting mental health assessments in juvenile justice settings. Experts had broad experience creating collaborations between juvenile justice, mental health, and child welfare systems and understood the policy and health implications of conducting such assessments in juvenile justice settings. RESULTS: Consensus Conference recommendations regarding screening for emergent risk, screening and assessment of mental health service needs, comprehensive mental health assessment components, assessment before community re-entry, need for periodic reassessment, and staff training are presented. CONCLUSION: Deriving specific recommendations that can be implemented systematically is a necessary first step toward policy changes that will optimize the standard of care for this vulnerable population.

Adolescent↗

PubMed2002

Adolescent development and the measurement of juvenile psychopathy.

Researchers are currently seeking antecedents of psychopathy among children and adolescents. Instruments developed for this purpose are likely to be used in the future in ways that may have serious implications for youths in delinquency and criminal cases. In this regard, and because the concept and measurement of psychopathy have been developed in reference to adults, there is reason to be concerned about potential developmental sources of false positives when measuring psychopathic traits in juvenile offenders. We provide the basis for our concern, as well as standards regarding the types of research evidence that should be provided before psychopathy measures are accepted for use in juvenile forensic assessments.

Adolescent↗

PubMed2002

Research ethics for mental health science involving ethnic minority children and youths.

In response to U.S. Public Health Service projects promoting attention to disparities in the outcomes of mental health treatments, in July 2001, the American Psychological Association, the National Institute of Mental Health, and the Fordham University Center for Ethics Education convened a group of national leaders in bioethics, multicultural research, and ethnic minority mental health to produce a living document to guide ethical decision making for mental health research involving ethnic minority children and youths. This report summarizes the key recommendations distilled from these discussions.

Adolescent↗

PubMed1995