Search

Resting-state network research is extremely influential, yet the functions of many networks remain unknown. In part, this is due to typical (e.g., univariate) analyses testing the function of individual regions and not the full set of co-activated regions that form a network. Connectivity is dynamic and the function of a region may change based on its current connections. Therefore, determining the function of a network requires assessment at the network-level. Yet popular theories implicating the default mode network (DMN) in episodic memory and social cognition, rest principally upon analyses performed at the level of individual brain regions. Here we use independent component analysis to formally test the role of the DMN in episodic and social processing at the network level. As well as an episodic retrieval task, two independent datasets were employed to assess DMN function across the breadth of social cognition; a person knowledge judgement and a theory of mind task. Each task dataset was separated into networks of co-activated regions. In each, the co-activated DMN, was identified through comparison to an a priori template and its relation to the task model assessed. This co-activated DMN did not show greater activity in episodic or social tasks than high-level baseline conditions. Thus, no evidence was found to support hypotheses that the co-activated DMN is involved in explicit episodic or social processing tasks at a network-level. The networks associated with these processes are described. Implications for prior univariate findings and the functional significance of the co-activated DMN are considered.

Patients with semantic dementia have degraded conceptual knowledge, accompanied by atrophy of ATL; however, the organisation of ATL is less well-understood, due to signal loss/distortions in ATL in fMRI. We used MBME acquisition and the HCPex-Glasser parcellation to investigate how parcels within ATL respond across different types of semantic content (emotional, contextual, associative, feature) in generative and matching tasks. Areas closer to auditory cortex activated more for associative and emotion-based semantics. An intermediate area nearer to visual cortex was more multi-modal, with equal recruitment across judgments (associative/feature) and generation (emotion/context). The parcel closest to vision activated more for context than emotion. Recruitment was stronger for initial generation than switching to a second association, regardless of content, across ATL parcels. Left ATL activated more than right ATL across content and process (except aSTG). Our results are consistent with the graded-hub-perspective, showing graded transitions from both dorsal and medial ATL towards vATL.

The human dorsolateral prefrontal cortex (DLPFC; approximately corresponding to Brodmann areas 9 and 46) has demonstrable roles in diverse executive functions such as working memory, cognitive flexibility, planning, inhibition, and abstract reasoning. However, it remains unclear whether this is the result of one functionally homogeneous region or whether there are functional subdivisions within the DLPFC. Here, we divided the DLPFC into seven areas along rostral-caudal and dorsal-ventral axes anatomically and explored their respective patterns of structural and functional connectivity. In vivo probabilistic tractography (11 females and 13 males) and resting-state functional magnetic resonance imaging (fMRI; 57 females and 21 males) were employed to map out the patterns of connectivity from each DLPFC subregion. Structural connectivity demonstrated graded intraregional connectivity within the DLPFC. The patterns of structural connectivity between the DLPFC subregions and other cortical areas revealed that the dorsal-rostral subregions connections were restricted to other frontal and limbic areas, whereas the ventral-caudal region was widely connected to frontal, parietal, and limbic cortex. Functional connectivity analyses demonstrated that subregions of DLPFC were strongly interconnected to each other. The dorsal subregions were associated with the default mode network (DMN), while middle dorsal-rostral subregions were linked with the multiple demand network (MDN). The ventral-caudal subregion showed increased functional coupling with both DMN and MDN. Our results suggest that the connectivity of the DLPFC may be subdivided along a dorsorostral-ventrocaudal axis with differing (albeit graded) patterns of connectivity reflecting the integrative executive function of the DLPFC.SIGNIFICANCE STATEMENTResearch has shown that the dorsolateral prefrontal cortex (DLPFC) plays a role in various executive functions. By dividing the DLPFC into seven areas along rostral-caudal and dorsal-ventral axes anatomically, we explored their patterns of structural and functional connectivity. The patterns of connectivity within DLPFC subregions demonstrated graded intraregional connectivity. There were distinctive patterns of connectivity with other cortical areas in dorsal-rostral and ventral-caudal DLPFC subregions. Divisions across DLPFC subregions seem to align with their structural and functional connectivity. Our results suggest that DLPFC may be subdivided by the diagonal axis of the dorsal-ventral axis and rostral-caudal axis, supporting the framework of a functional organization along the anterior-posterior axis in the lateral PFC.

The parietal cortex (PC) is implicated in a confusing myriad of different cognitive processes/tasks. Consequently, understanding the nature and organization of the core underlying neurocomputations is challenging. According to the Parietal Unified Connectivity-biased Computation model, two properties underpin PC function and organization. Firstly, PC is a multidomain, context-dependent buffer of time- and space-varying input, the function of which, over time, becomes sensitive to the statistical temporal/spatial structure of events. Secondly, over and above this core buffering computation, differences in long-range connectivity will generate graded variations in task engagement across subregions. The current study tested these hypotheses using a group independent component analysis technique with two independent functional magnetic resonance imaging datasets (task and resting state data). Three functional organizational principles were revealed: Factor 1, inferior PC was sensitive to the statistical structure of sequences for all stimulus types (pictures, sentences, numbers); Factor 2, a dorsal–ventral variation in generally task-positive versus task-negative (variable) engagement; and Factor 3, an anterior–posterior dimension in inferior PC reflecting different engagement in verbal versus visual tasks, respectively. Together, the data suggest that the core neurocomputation implemented by PC is common across domains, with graded task engagement across regions reflecting variations in the connectivity of task-specific networks that interact with PC.

Highlights • Semantic task demands affect activity and connectivity at different processing stages. • Earliest task modulations occurred in posterior visual brain regions. • ATL, PTC and IFG effects reflect task-relevant retrieval of multimodal information. • ATL effects are left-lateralised for activation but bilateral for functional connectivity. • Dynamic evoked and connectivity data are essential to study semantic networks., How does brain activity in distributed semantic brain networks evolve over time, and how do these regions interact to retrieve the meaning of words? We compared spatiotemporal brain dynamics between visual lexical and semantic decision tasks (LD and SD), analysing whole-cortex evoked responses and spectral functional connectivity (coherence) in source-estimated electroencephalography and magnetoencephalography (EEG and MEG) recordings. Our evoked analysis revealed generally larger activation for SD compared to LD, starting in primary visual area (PVA) and angular gyrus (AG), followed by left posterior temporal cortex (PTC) and left anterior temporal lobe (ATL). The earliest activation effects in ATL were significantly left-lateralised. Our functional connectivity results showed significant connectivity between left and right ATL, PTC and right ATL in an early time window, as well as between left ATL and IFG in a later time window. The connectivity of AG was comparatively sparse. We quantified the limited spatial resolution of our source estimates via a leakage index for careful interpretation of our results. Our findings suggest that the different demands on semantic information retrieval in lexical and semantic decision tasks first modulate visual and attentional processes, then multimodal semantic information retrieval in the ATLs and finally control regions (PTC and IFG) in order to extract task-relevant semantic features for response selection. Whilst our evoked analysis suggests a dominance of left ATL for semantic processing, our functional connectivity analysis also revealed significant involvement of right ATL in the more demanding semantic task. Our findings demonstrate the complementarity of evoked and functional connectivity analysis, as well as the importance of dynamic information for both types of analyses.

The posterior lateral temporal cortex is implicated in many verbal, nonverbal and social cognitive domains and processes. Yet without directly comparing these disparate domains, the region’s organisation remains unclear; do distinct processes engage discrete subregions, or could different domains engage shared neural correlates and processes? Here, using activation likelihood estimation meta-analyses, the bilateral posterior lateral temporal cortex subregions engaged in seven domains were directly compared. These domains comprised semantics, semantic control, phonology, biological motion, face processing, theory of mind, and representation of tools. Whilst phonology and biological motion were predominantly associated with distinct regions, other domains implicated overlapping areas, perhaps due to shared underlying processes. Theory of mind recruited regions implicated in semantic representation in the left hemisphere, tools engaged semantic control areas, and faces engaged subregions for biological motion and theory of mind. This cross-domain approach provides insight into how posterior lateral temporal cortex is organised and why.

This paper examines two episodes in the history and philosophy of phallometry and cervimetry in the second half of the 20th century. Phallometry is the measurement of the human penis with special devices (phallometers) in a psychophysiological context, while cervimetry is the measurement of the cervix in laboring women (by hand or by cervimeter). Despite decades of efforts to standardize these measuring practices, we still have only non-standard ways of measuring the dynamics of the cervix during labor as well as penile tumescence during arousal. We adopt the lens of "messiness" as an analytic tool in order to trace historical actors' methodological assumptions, goals, and decisions that were involved in their measuring practices. It will be argued that, far from being an a priori attribute, the "messiness" of biomedical phenomena (and how to best respond to it) depends on the actors' methodological priorities. What is "messy" is actively shaped (and re-shaped) by researchers' instrumental assumptions and theoretical commitments, as demonstrated in their method of measuring. This paper also offers a preview of early findings from our current research on the history of cervical measurement (Jackson) and phallic measurement (Wassermann). Drawing on primary source material we have analyzed, the argument will be developed in two parts. First, in the context of phallometry research: Two different and eventually diametrically opposed methodological approaches developed when confronted with "messy" human bodies and minds, a divergence which still exists today. Second, in the case of cervimetry research: "messiness" emerged when researchers tried to standardize the measurement of the human cervix, to no avail. Ironically, today's "messy" practice of measuring the cervix by hand has been continually justified by knowledge gained in the continued pursuit (and failure) of standardized replacements of this method.

The functional heterogeneity of the ventromedial prefrontal cortex (vmPFC) suggests it may include distinct functional subregions. To date these have not been well elucidated. Regions with differentiable connectivity (and as a result likely dissociable functions) may be identified using emergent data-driven approaches. However, prior parcellations of the vmPFC have only considered hard splits between distinct regions, although both hard and graded connectivity changes may exist. Here we determine the full pattern of change in structural and functional connectivity across the vmPFC for the first time and extract core distinct regions. Both structural and functional connectivity varied along a dorsomedial to ventrolateral axis from relatively dorsal medial wall regions to relatively lateral basal orbitofrontal cortex. The pattern of connectivity shifted from default mode network to sensorimotor and multimodal semantic connections. This finding extends the classical distinction between primate medial and orbital regions by demonstrating a similar gradient in humans for the first time. Additionally, core distinct regions in the medial wall and orbitofrontal cortex were identified that may show greater correspondence to functional differences than prior hard parcellations. The possible functional roles of the orbitofrontal cortex and medial wall are discussed., peer-reviewed

We examined the usefulness of scores on the Personality Assessment Inventory (PAI; Morey, 1991) in predicting treatment program violations among 76 sexual offenders civilly committed as sexually violent predators. Scores on the Borderline Features scale (area under the curve [AUC] = .69, p = .005) and Negative Relationships subscale (BOR-N: AUC = .71, p < .001) were the strongest predictors of misconduct, outperforming scores on scales designed to predict poor treatment amenability and antisocial behavior. Incremental validity analyses indicated that BOR scores made a significant contribution to the prediction of misconduct after controlling for scores on measures of overall self-reported distress (e.g., Mean Clinical Elevation, Negative Impression), which were also predictive of program violations. Overall, our findings point to the potential utility of integrating components of treatment for borderline personality disorder into sex offender treatment.

The temporal lobe has been associated with various cognitive functions which include memory, auditory cognition and semantics. However, at a higher level of conceptualisation, all of the functions associated with the temporal lobe can be considered as lying along one major axis; from modality-specific to modality-general processing. This paper used a spectral reordering technique on resting-state and task-based functional data to extract the major organisational axis of the temporal lobe in a bottom-up, data-driven fashion. Independent parcellations were performed on resting-state scans from 71 participants and active semantic task scans from 23 participants acquired using dual echo gradient echo planar imaging in order to preserve signal in inferior temporal cortex. The resulting organisational axis was consistent (over dataset and hemisphere) and progressed from superior temporal gyrus and posterior inferior temporal cortex to ventrolateral anterior temporal cortex. A hard parcellation separated a posterior (superior temporal and posterior fusiform and inferior temporal gyri) and an anterior cluster (ventrolateral anterior temporal lobe). The functional connectivity of the hard clusters supported the hypothesis that the connectivity gradient separated modality-specific and modality-general regions. This hypothesis was then directly tested by performing a VOI analysis upon an independent semantic task-based data set including auditory and visually presented stimuli. This confirmed that the ventrolateral anterior aspects of the temporal lobe are associated with modality-general processes whilst posterior and superior aspects are specific to certain modalities, with the posterior inferior subregions involved in visual processes and superior regions involved in audition.

This study investigated raters’ personality traits in relation to scores they assigned to offenders using the Psychopathy Checklist—Revised (PCL-R). A total of 22 participants, including graduate students and faculty members in clinical psychology programs, completed a PCL-R training session, independently scored four criminal offenders using the PCL-R, and completed a comprehensive measure of their own personality traits. A priori hypotheses specified that raters’ personality traits, and their similarity to psychopathy characteristics, would relate to raters’ PCL-R scoring tendencies. As hypothesized, some raters assigned consistently higher scores on the PCL-R than others, especially on PCL-R Facets 1 and 2. Also as hypothesized, raters’ scoring tendencies related to their own personality traits (e.g., higher rater Agreeableness was associated with lower PCL-R Interpersonal facet scoring). Overall, findings underscore the need for future research to examine the role of evaluator characteristics on evaluation results and the need for clinical training to address evaluators’ personality influences on their ostensibly objective evaluations.

This study is the first of its kind to evaluate attorneys' perception of motive and defense strategies when presented with a fictional filicide case. A vignette-based survey was designed to elicit data regarding perception of motive and willingness to use various defenses. Participants were more likely to agree that jealousy and retaliation were motivating factors when the perpetrator was male, but agreed more strongly that mental illness was a motivating factor when the perpetrator was female. Male perpetrators were more likely to be encouraged to accept a 15-year prison term, while attorneys were more willing to use insanity and mistake as mitigating defenses when the offender was female. Gender of participants also affected the perception of motive and defense strategies used. Results suggest that female attorneys are more likely to use defenses aimed to negate mens rea and female defendants are more likely to be encouraged to use such a defense.

Evaluations of sex offenders in the context of civil commitment occur both pre- and post-commitment. Pre-commitment evaluations must address the relevant prongs of the state's civil commitment statute including the presence of a mental disorder or abnormality, likelihood of future sexual violence, and the volitional link between the two. Post-commitment evaluations must assess treatment progress and readiness for release. A thorough understanding of assessment and diagnostic issues relating to sexual offender civil commitment are essential in conducting both pre- and post-commitment evaluations. The high stakes nature of sex offender civil commitment demands rigorous and empirically based evaluations.

Psychopathy is an important clinical construct in clinical, community, and forensic populations. In forensic populations, it has been found to be a consistent predictor of recidivism and aids in offender management and treatment decisions. Research supports routine assessment of the construct within criminal populations. As routine assessment with the “gold standard” PCL-R can be difficult due to institutional constraints, the need for a quick yet reliable measure has surfaced. The PSCAN, a 90 item rating scheme designed for use by non-psychologists, was developed to meet this need. This study examined the psychometric properties of the PSCAN as well as its relationship to the PCL-R and its utility as a screen for psychopathy. PSCANs were rated by master and doctoral level psychologists for residents in a sex offender civil commitment program. Results suggest the PSCAN has high reliability and may serve as an effective screening tool for psychopathy when administered by raters of various educational backg...

The anterior temporal lobe (ATL) makes a critical contribution to semantic cognition. However, the functional connectivity of the ATL and the functional network underlying semantic cognition has not been elucidated. In addition, subregions of the ATL have distinct functional properties and thus the potential differential connectivity between these subregions requires investigation. We explored these aims using both resting-state and active semantic task data in humans in combination with a dual-echo gradient echo planar imaging (EPI) paradigm designed to ensure signal throughout the ATL. In the resting-state analysis, the ventral ATL (vATL) and anterior middle temporal gyrus (MTG) were shown to connect to areas responsible for multimodal semantic cognition, including bilateral ATL, inferior frontal gyrus, medial prefrontal cortex, angular gyrus, posterior MTG, and medial temporal lobes. In contrast, the anterior superior temporal gyrus (STG)/superior temporal sulcus was connected to a distinct set of auditory and language-related areas, including bilateral STG, precentral and postcentral gyri, supplementary motor area, supramarginal gyrus, posterior temporal cortex, and inferior and middle frontal gyri. Complementary analyses of functional connectivity during an active semantic task were performed using a psychophysiological interaction (PPI) analysis. The PPI analysis highlighted the same semantic regions suggesting a core semantic network active during rest and task states. This supports the necessity for semantic cognition in internal processes occurring during rest. The PPI analysis showed additional connectivity of the vATL to regions of occipital and frontal cortex. These areas strongly overlap with regions found to be sensitive to executively demanding, controlled semantic processing.SIGNIFICANCE STATEMENTPrevious studies have shown that semantic cognition depends on subregions of the anterior temporal lobe (ATL). However, the network of regions functionally connected to these subregions has not been demarcated. Here, we show that these ventrolateral anterior temporal subregions form part of a network responsible for semantic processing during both rest and an explicit semantic task. This demonstrates the existence of a core functional network responsible for multimodal semantic cognition regardless of state. Distinct connectivity is identified in the superior ATL, which is connected to auditory and language areas. Understanding the functional connectivity of semantic cognition allows greater understanding of how this complex process may be performed and the role of distinct subregions of the anterior temporal cortex.

This chapter takes the position that virtually all “mental health” and related evaluations of sexual offenders are, in fact, forensic evaluations, in that they almost always involve the appraisal of “justice-involved clients.” Most so-called clinical evaluations, involving treatment planning or related to dispositional status, are conducted in the context of the justice system and are most accurately regarded as forensic evaluations. The purpose of this chapter is to describe relevant principles, methods, and other considerations in conducting adequate and informed forensic evaluations of sexual offenders (e.g., most evaluations of sexual offenders) and to discuss a set of domains and procedures (interviews, tests, questionnaires, and rating scales) for collecting relevant, reliable, and admissible information for assessing and appraising the various psycho-legal questions that the judicial system might pose regarding sexual offenders. The notions of a “forensic ethic,” which distinguishes traditional clinical evaluations from forensic ones, are delineated: the primary forensic task of critically or skeptically examining an individual appraised within a particular psycho-legal context and advocating for the “data” and conclusions of the evaluation and not necessarily the evaluatee in any capacity. Various principles and procedures identified as defining forensic mental health evaluations are identified that lead to informed, well-founded opinions that acknowledge the key multiple sources of information available to the forensic evaluator. Central elements of forensic evaluations are presented and applied to appraisals of sexual offenders, including record review, issues in the direct evaluations of individuals (including the relative value of interviews with alleged or identified sexual offenders), structured psychological assessment, and report writing (developing and documenting opinions and their bases as applied to the particular psycho-legal issues).

In the United States, the civil commitment of recidivist sexual offenders concerns the indeterminate detention for the purpose of public safety (to reduce or prevent future sexual offending) of a small, select subset of sexual offenders (those deemed at particularly higher risk by virtue of certain psychological and/or psychiatric (“mental” or “personality”) characteristics). Almost all such sexual offenders are persons who have completed one or more incarcerations in the criminal justice system, typically with their most recent crime being a sexual offense. Such action necessarily involves the balancing of liberty interests or freedom of those select recidivist sexual offenders with public safety concerns about their potential for persisting dangerousness, specifically the likelihood of future sexual offending. Managing sexual offenders who have committed multiple and/or extreme sexual offenses as the result of some sets of psychological or psychiatric conditions has long been a concern for Western society. Over the past 100 years, in the United States, public policy has shifted among different approaches to dealing with recidivistic sexual offenders perceived as still at elevated risk for sexual offending, sometimes emphasizing enhanced criminal commitment sanctions, sometimes opting to offer a hypothesized therapeutic approach via civil commitment, and sometimes utilizing both increased criminal and civil commitments. The purpose of this chapter is to consider the current civil commitment of recidivistic, the characteristics of sexual offenders, typically referred to as sexually violent offenders or “predators” (CCSVP). In doing so, an overview is provided of the key elements of so-called sexually violent predator (SVP) statutes, the assessment components of evaluations of those sexual offenders selected for consideration under such statutes, characteristics of sexual offender currently the assessment and evaluation practices committed under these statutes and aspects of the civil commitment programs for such individuals.

At this study's commencement, 17 states had enacted sex offender civil commitment legislation. Although each statute outlines broad criteria that must be met, civil commitment evaluators are given considerable latitude in how to conduct their assessment. Forty-one experts who conduct sex offender civil commitment evaluations were surveyed to identify the usual practice of these evaluators. A great deal of agreement exists across experts regarding the conduct of sex offender civil commitment evaluations. However, these patterns appear quite different from the usual practice outlined in other types of forensic evaluations. Experts in sex offender civil commitment endorsed documentation as the core method for evaluation. The majority of evaluators reported the assessment of paraphilias, substance abuse, other Axis I disorders, Axis II disorders, and psychopathy as essential to the evaluation. Virtually all survey respondents utilized actuarial risk assessment measures, primarily the Static-99, in assessing for risk of future sexual violence. Although several approaches to assessing volitional impairment were described, the majority of respondents reported that a history of sex offending combined with a personality disorder or a paraphilia established the necessary link between mental abnormality and risk of future sexual violence. An overwhelming majority of experts indicated that it was essential for evaluators to report their ultimate opinion as to whether criteria had been met for civil commitment. Future research regarding the use and incorporation of documentation should be conducted to determine whether the heavy reliance on documentation is unique to sex offender civil commitment evaluations, or whether it is commonly used in other forensic evaluations.

The utility of psychopaths’ self-reports have consistently been questioned in the literature. Extant literature attempts to assess the degree to which individuals with psychopathic tendencies can and do identify in themselves those traits associated with psychopathy. Typically, self-report measures are more highly correlated with Factor 2 of the PCL-R than Factor 1. This pattern suggests that psychopaths are better able to reliably assess their behavior than their personality or emotional traits. Unexplored is whether psychopaths perceive their personality differently than observers’ when using the same measure. The current study assesses the congruence of offenders’ self-report of personality and the personality ratings provided by their primary therapists using a uniform measure of personality, the NEO-PI-R. Results suggest that offenders’ ability to accurately report on their personality characteristics is hampered by their emotional and affective deficits (psychopathy Facet 2). Implications for FFM-psychopathy research and psychopathy self-reports are discussed.

The clinical assessment of malingering requires the systematic application of empirically validated detection strategies. Prior investigations of the Structured Interview of Reported Symptoms (SIRS) and the Minnesota Multiphasic Personality Inventory-2 have not fully addressed whether individual scales represent well-defined dimensions. The first phase of this study reexamined the original SIRS normative sample via maximum-likelihood factor analysis with promax rotation and subjected the resulting two-factor model to confirmatory factor analysis. The second phase was a cross-validation of the two-factor model on combined data from correctional-mental health and forensic settings. With one modification, the two-factor model was confirmed. The two dimensions (Spurious Presentation and Plausible Presentation) are theoretically relevant to the assessment of malingering.

Forensic evaluations must systematically assess malingering and related response styles. In the criminal forensic domain, competency to stand trial evaluations are the most common referrals. Effective screens for feigned incompetency would be valuable assets for forensic evaluations. This study evaluates the effectiveness of the Miller Forensic Assessment of Symptoms Test (MFAST) as a screen for feigned incompetency. Using a simulation design, the MFAST was tested on jail and competency-restoration samples. Most notably, recommended MFAST cut score (> or =6) was useful for the identification of feigning cases in competency evaluations. Recommendations for forensic practice, including the advantages and disadvantages of systematic screens, are discussed.

A critical issue for public policy and professional forensic practice is whether Sexually Violent Predator commitment is an empirically-validated determination. Utilizing a mixed factorial design, forensic psychologists and graduate students were asked to make predictions about offenders' likelihood of future sexual violence and their appropriateness for Sexually Violent Predator commitment. Forensic psychologists demonstrated adequate application of the relevant psycholegal standard, but made accurate predictions approximately one half of the time. Surprisingly, graduate students demonstrated a greater ability to discriminate between types of violent behavior (nonsexual versus sexual), but applied the relevant legal standard with less precision than forensic psychologists. Finally, the current results suggest that emotionallyevocative information in the form of victim statements biased psychologists' and students' predictions of future sexual violence and resulted in students' increased support for the o...

Psychological assessments of competency-to-stand-trial (CST) referrals must consider whether the defendants' impairment is genuine or feigned. This study addressed feigning on the Evaluation of Competency to Stand Trial--Revised (ECST-R), a standardized interview designed for assessing dimensions of CST and screening for feigned CST. In particular, this study examined the effectiveness of the ECST-R's Atypical Presentation (ATP) scales as screens for feigned incompetency. It examined ATP scales for (a) jail detainees (n=96) in simulation and control conditions and (b) inpatient competency cases (n=56) in clinical comparison and probable malingering groups. Comparisons of ATP scales yielded very large effect sizes for feigners when compared with jail controls (mean d=2.50) and genuine inpatient competency cases (mean d=1.83). Several cut scores were established with very few false negatives and robust sensitivity estimates. In summary, the ECST-R ATP scales appear to be homogenous scales with established clinical use as feigning screens in CST evaluations.

The Schedule of Affective Disorders and Schizophrenia-Change Version (SADS-C; Spitzer & Endicott, 1978b) is a brief, highly reliable structured interview with clinical applications to diverse populations. This investigation involved reanalyses of data from 2 earlier studies (Rogers, Grandjean, Tillbrook, Vitacco, & Sewell, 2001; Ustad, Rogers, & Salekin, 1998). Focusing on 2 clinical samples from a metropolitan jail, we investigated its subscales via exploratory and confirmatory factor analysis. A good model fit was found (comparative fit index =.92; robust comparative fit index =.94) for 4 subscales (Dysphoria, Psychosis, Mania, and Insomnia) with good interrater reliability (M intraclass coefficient =.95) and clinical relevance. As a preliminary screen for feigned mental disorders, 2 detection scales (Symptom Combinations and Symptom Selectivity) were moderately successful. By maximizing negative predictive power, the SADS-C detection strategies proved effective at ruling out feigning for mentally disordered offenders with a high likelihood of genuine disorders.

Four decades of forensic research have left unanswered a fundamental issue regarding the best conceptualization of competency to stand trial vis-à-vis the Dusky standard. The current study investigated three competing models (discrete abilities, domains, and cognitive complexity) on combined data ( N = 411) from six forensic and correctional samples. Using the Evaluation of Competency to Stand Trial–Revised (ECST-R), items representative of the Dusky prongs were used to test the three models via maximum-likelihood confirmatory factor analyses (CFA). Of the three, only the discrete abilities model evidenced a good fit, indicating that competency to stand trial should consider separately each defendant’s factual understanding of the proceedings, rational understanding of the proceedings, and ability to consult with counsel. ECST-R competency scales, based on the current CFA, have excellent alphas (.83 to .89) and interrater reliabilities (.97 to .98).

Psychopathy is an important clinical construct in explaining criminal behavior, determining the likelihood of treatment response, and evaluating risk assessment. The majority of past research has focused on male offenders or male forensic patients. Psychopathy in females is relatively unexplored. The current study was designed to further investigate the underlying dimensions of psychopathy in females. Utilizing a sample of 119 female inmates from a large metropolitan area jail, a series of confirmatory factor analyses was undertaken. Previous research and clinical tradition suggest the use of a two-factor conceptualization of psychopathy. More recent research suggests that a three-factor model may better capture the underlying dimensions of psychopathy. Two-factor models of psychopathy were not confirmed. However, the three-factor model reproduced the data extremely well. Clinical and research implications of this finding are addressed.

Psychopaths frequently con and manipulate others in an attempt to achieve their own objectives. In the current literature, correlational research has generally found that psychopathy has (a) an inverse relation with social desirability and (b) a positive relation with malingering. Although instructive, these correlational data do not address whether the assessment of psychopathy is vulnerable to specific response styles. This study examined 2 response styles among adolescent offenders in the context of pending adjudication: social desirability and social nonconformity. On 3 measures of psychopathy (i.e., Psychopathy Checklist: Youth Version, Psychopathy Screening Device, and Self-Report of Psychopathy-Second Edition), a simulation design was employed with a realistic scenario, incentives for successful deception, and appropriate manipulation checks. Results indicated moderate to large effect sizes for social desirability and large effect sizes for social nonconformity. The implications of these results for the clinical assessment of psychopathy are discussed.

Emotional memories tend to be strengthened ahead of neutral memories during sleep-dependent consolidation. In recent work, however, we found that this is not the case when emotion pertains to the contextual features of a memory instead of its central constructs, suggesting that emotional contexts are influenced by distinct properties of sleep. We therefore examined the sleep-specific mechanisms supporting representations of emotional context and asked whether these differ to those already implicated in central emotional memory processing, such as rapid eye movement sleep (REM). Participants encoded neutral foreground images that were each associated with an emotionally negative or neutral background (context) image. Immediate and delayed tests for the emotionality of the foreground/background image association were separated by a 4-h consolidation period, which consisted of either total wakefulness or included a 2-h polysomnographically monitored nap. Although memory for negative contexts was not associated with REM, or any other parameter of sleep, sleep spindles (12–15Hz) predicted increased forgetting and slowed response times for neutral contexts. Together with prior work linking spindles to emotional memory processing, our data may suggest that spindles provide multi-layered support to emotionally salient memories in sleep, with the nature of such effects depending on whether the emotionality of these memories pertains to their central or contextual features. Therefore, whereas spindles may mediate a direct strengthening of central emotional information, as suggested in prior work, they may also provide concurrent indirect support to emotional contexts by working to suppress non-salient neutral contexts.

Management of infected Achilles tendon repair poses a significant reconstructive problem. Thorough debridement is most important and resection of non-viable tendon substance is required. Reconstruction of such tendon defects requires vascularized soft-tissue coverage that is stable and that offers the possibility of functional restoration. Gracilis free-tissue transfer is an effective means of providing stable, durable, well-vascularized, soft-tissue coverage in an infected Achilles tendon repair. The microsurgical anastomoses are technically straightforward. Cybex II dynomometer measurements, performed 6 months following free-tissue transplantation, revealed strength (torque) and power, at an angular velocity of 45 degrees per second, of: 59 percent and 52 percent, respectively, compared to the uninjured side. Endurance was assessed at an angular velocity of 120 degrees per second over a 15-second test interval, and was noted to be 81 percent, compared to the normal ankle. Excellent functional results and acceptable soft-tissue contour can be expected with this technique.

The original consulting microsurgeon should be present to assist in the identification and protection of the vascular pedicle during secondary procedures on microvascular transplants. Flap elevation, trimming, and bone graft placement should be completed during a single tourniquet time, whenever possible. Flaps can easily be resutured on the original bed while the tourniquet is still inflated. Although proximal pedicle transection is possible, it should be avoided by careful planning, because the transplanted tissue cannot be predictably expected to survive, especially with muscle transplants. The distal muscle should be transected only in situations in which the muscle inset is extremely complex. Transection in the extramuscular portion of the main pedicle may require prompt microsurgical repair in immature muscle transplants. The safest approach is to avoid the pedicle whenever additional secondary procedures are necessary following free microvascular tissue transplantation. Placement of vascular pedicles such that the anterior crest of the tibia is avoided if the Ilizarov technique is required permit uncomplicated distraction osteosynthesis. Simultaneous Ilizarov fixation and microvascular tissue transfer are safe, practical procedures for limb salvage. Placement of the Ilizarov fixator at the time of microvascular transplantation provides stable fixation and eliminates the need for a subsequent anesthetic for fixator placement. This form of stabilization, when performed at the time of microvascular tissue transfer, allows the orthopedic surgeon direct visualization of the fracture site as the fixator is placed and eliminates the need for placement of the fixation device through the transplanted tissue. Tissue expansion or suction lipectomy are sometimes needed to optimize the clinical result.

During the past 20 years, 972 microvascular transplantations have been performed for 783 patients, with an overall failure rate of 6.2 percent. Fifty-four of the 60 failed transplantations were available for long-term follow-up and were retrospectively reviewed with respect to the original indications for transplantation, the number, and the type of salvage procedures performed following transplant failure. This study illustrates that the choice of salvage procedures performed following transplant failure depends on the original indications, the location, and the severity of the resultant wound. Failure following transplantation for coverage of contour defects or unstable wounds can often be managed by non-microsurgical methods. In contrast, when the indications for transplantation included the transfer of specialized tissues for thumb or digit reconstruction, the restoration of motor or sensory function, or the coverage of a limb-threatening wound, requirements for reconstruction could be satisfied only by a second successful tissue transplant. Eighteen of the 54 cases underwent an additional transplantation, with an 89 percent success rate.

Indentation hardness tests were performed on thick, fine-grained, electro-formed deposits of copper and nickel using Knoop, Vickers, and Berkovich indenters. The latter type of indenter was used for shallow penetrations (85–1750nm), and results are reported in terms of nanoscale hardness (NH) numbers. Knoop and Vickers indenters were used with applied loads of between 0.15 and 0.98 N, and at the lowest load, produced indentation depths comparable to the larger ones obtained with the Berkovich indenter. The NH numbers became very sensitive to penetration depth when the penetration depth was less than certain critical values. NH numbers for Cu and Ni were higher than those for Knoop and Vickers testing at comparable penetration depths. Applying indenter area function corrections to calculate hardness numbers (i.e., considering projected area versus facet contact area) resulted in a closer correlation between microhardness and nanohardness scales; however, changes in the tip shape because of wear or other imperfections can lead to inaccurate calculation of NH numbers at the lowest loads. Results also suggest that the interconversion of lowload hardness numbers from one scale to another can be material-dependent.

Sexual sadism continues to be a diagnosis fraught with controversy concerning its reliability and validity. The current study examined the offense behavior of 39 civilly committed sexual offenders diagnosed with sexual sadism compared to a group of similarly committed individual diagnoses with Paraphilia Not Otherwise Specified (NOS)— Nonconsent. In addition, offense elements common across studies of sadism were identified. Specifically, offense behaviors including victim abduction and confinement, beating the victim during a sexual assault, and using restraints were indicative of sexual sadism across studies. In addition, this study found the use of noncontingent threats as well as gestures of mutuality to be more common among sadists. Results overall suggest that sadistic acts may be more characterized by humiliation of the victim through the exercise of power and control than by the use of violence. Differential diagnosis between Sexual Sadism and Paraphilia NOS—Nonconsent, may be aided by close inspection of offense behavior.