Psychiatric Disorders That May Be Mistaken for Malingering

Factitious disorders and somatoform disorders share common elements with malingering (Cunnien 1997 Eisendrath 1996). Thus, clinicians should be familiar with these conditions when examining suspected cases of malingering. Both malingering and factitious disorders involve the intentional production of physical or psychological symptoms (American Psychiatric Association 2000, p. 513). However, the motivation for behavior associated with factitious disorders is a desire to assume the sick role in...

Case Vignette

J, a 36-year-old chief financial officer of a large corporation, was returning home aboard a jet aircraft when it skidded off the runway in a snowstorm. The aircraft entered a bordering harbor and came to a stop in 5 feet of icy water. Ms. J was momentarily dazed when her head struck the seat in front of her. She was terrified that she would drown, as she had never learned to swim. She escaped the aircraft by sliding down an emergency chute and was able to walk ashore. Ms. J twisted her...

Contracting With Clients

Utilizing business practices common to attorneys minimizes problems involved with collecting fees. Psychiatrists are generally unfamiliar with writing contracts for their services. In contrast, attorneys typically work on a contractual basis. Psychiatrists undertaking forensic work should be familiar with comparable acceptable and desirable billing practices that facilitate the ethical provision of forensic psychiatric services. Mr. W, the gentleman who contacted Dr. M to contract for a...

Subject Index

Page numbers printed in boldface type refer to tables or figures. fellowships in forensic psychiatry and, 64 forensic psychiatry for children and adolescents, 484 recognition of forensic psychiatry as subspecialty, 4 Achievement tests, 625, 628-629 Act for the Safe Keeping of Insane Persons Charged With Offences (1800), 18 Actuarial measures, and risk assessment, 384, 540 Actuarial prediction, and forensic evaluations in correctional settings, 398, 404 Actuarial risk assessment instruments...

Anxiety Disorders

A particular event or accident may not affect some individuals much at all, whereas it may cause others to become quite anxious. The individual who responds with anxiety can develop an anxiety disorder, the signs and symptoms of which are elucidated in DSM-IV-TR. The history of a plaintiff's responses to prior stress with anxiety can be helpful in determining whether a current anxiety disorder exists or is impairing. A plaintiff who has no history or no significant history of responding to...

Vignette 1 Malingered PTSD

A Vietnam-era veteran was admitted to a PTSD partial hospitalization program upon referral from an outpatient clinician. Shortly after entering the program, he reported symptoms such as hearing the voice of his dead comrades during group therapy sessions. However, psychologists conducting group therapy sessions began to be concerned about the patient berating other veterans in the program. In group sessions, he chided the other patients as follows Y'all aren't here to get help like me because...

Role of Psychiatrists

The guidelines of the National Council of Negotiation Associations advise that negotiation teams consider establishing a consultative relationship with a mental health professional. The mental health professional should serve as a team advisor and not as a negotiator, participate in negotiation team training, respond to team call outs as requested, focus on behavioral assessment of the subject and assist in team debriefing after a critical incident (National Council of Negotiation Associations...

Case Vignette 2

Police responded to a call from Mr. and Mrs. H concerning a domestic dispute. The H's reported that the couple living in the apartment next door, Mr. and Mrs. J, had been fighting all night. Mr. and Mrs. H were concerned because they had overheard Mrs. J screaming, Get away from me. Don't hurt me. Mr. J had been drinking heavily since losing his job as a computer programmer in a recent company downsizing. The J's were experiencing serious financial problems and had received an eviction notice....

Dimensional Diagnosis in Litigation Subthreshold Posttraumatic Stress Disorder

Subthreshold PTSD is an example of a disorder with dimensional features that has not received official diagnostic recognition yet clearly exists and frequently causes significant functional impairment. Subthreshold PTSD can be conceptualized as a dimensional entity that manifests categorical characteristics (defined symptoms causing impairment) and is a good example of such a model (Frank et al. 1998 Maser and Patterson 2002 Ruscio et al. 2002). The diagnosis of PTSD may present clinically with...

The Value of a Business Plan

Most business schools advocate developing a formal business plan when getting started in any business. For complex forensic practices, for example, those that involve a partnership or employment relationship between forensic service providers from multiple disciplines as well as support staff, a formal business plan may be useful and necessary (Granacher 2004). In contrast, a formal business plan is probably not going to be of assistance in achieving practice goals for a solo practitioner who...

References

Adams K, Alpert GP, Dunham RG, et al Use of force by police overview of national and local data, in National Institute of Justice Research Report, jointly published with the Bureau of Justice Statistics, October 1999. U.S. Department of Justice, Office of Justice Programs. Available at Accessed June 27, 2009. Alpert GP, Dunham RG The force factor measuring and assessing police use of force and suspect resistance, in Use of Force by Police Overview of National and Local Data. National Institute...