Showing papers by "John Monahan published in 2008"

Alternative Pathways to Violence in Persons with Schizophrenia: The Role of Childhood Antisocial Behavior Problems

Abstract: Violence in schizophrenia patients may result from many factors besides the symptoms of schizophrenia. This study examined the relationship between childhood antisocial behavior and adult violence using data from the NIMH CATIE study. The prevalence of violence was higher among patients with a history of childhood conduct problems than among those without this history (28.2% vs. 14.6%; P < 0.001). In the conduct-problems group, violence was associated with current substance use at levels below diagnostic criteria. Positive psychotic symptoms were linked to violence only in the group without conduct problems. Findings suggest that violence among adults with schizophrenia may follow at least two distinct pathways-one associated with premorbid conditions, including antisocial conduct, and another associated with the acute psychopathology of schizophrenia.

Comparison of antipsychotic medication effects on reducing violence in people with schizophrenia

Abstract: Background Violence is an uncommon but significant problem associated with schizophrenia. Aims To compare antipsychotic medications in reducing violence among patients with schizophrenia over 6 months, identify prospective predictors of violence and examine the impact of medication adherence on reduced violence. Method Participants (n=1445) were randomly assigned to double-blinded treatment with one of five antipsychotic medications. Analyses are presented for the intention-to-treat sample and for patients completing 6 months on assigned medication. Results Violence declined from 16% to 9% in the retained sample and from 19% to 14% in the intention-to-treat sample. No difference by medication group was found, except that perphenazine showed greater violence reduction than quetiapine in the retained sample. Medication adherence reduced violence, but not in patients with a history of childhood antisocial conduct. Prospective predictors of violence included childhood conduct problems, substance use, victimisation, economic deprivation and living situation. Negative psychotic symptoms predicted lower violence. Conclusions Newer antipsychotics did not reduce violence more than perphenazine. Effective antipsychotics are needed, but may not reduce violence unrelated to acute psychopathology.

The MacArthur Violence Risk Assessment Study Revisited: Two Views Ten Years After Its Initial Publication

Abstract: This article presents two views of the results of the MacArthur Violence Risk Assessment Study, which was conducted between 1992 and 1995 in order to ascertain the prevalence of community violence in a sample of people discharged from acute psychiatric facilities. The initial findings, which were published in 1998 in the Archives of General Psychiatry, have been cited by some advocates as proof that discharged psychiatric patients are not more dangerous than other persons in the general population. For the article presented here, Dr. Torrey and Mr. Stanley examined additional articles, book chapters, and a book about the MacArthur Study that have appeared since 1998 in order to ascertain whether the study's original conclusion should be modified and whether additional conclusions can be drawn from the subsequently published data. They present six points on which they disagree with the findings or fault the design of the MacArthur Study. After each point, Dr. Monahan, Dr. Steadman, and other authors of the MacArthur Study Group respond.

The Function of Punishment in the 'Civil' Commitment of Sexually Violent Predators

Abstract: Two experiments find that support for civil commitment procedures for sexually violent predators is based primarily upon the retributive rather than incapacitative goals of respondents. Two discrete samples composed of students (N = 175) and jury-eligible citizens (N = 200) completed experimental surveys assessing their support or opposition to scenarios in which a sexual predator was to be released after completing his criminal sentence. Respondents were sensitive to likelihood of recidivism only when the initial sentence was sufficiently punitive. When initial sentence was lenient, respondents strongly supported civil commitment without regard to future risk. Results are discussed in light of the U.S. Supreme Court's ruling in Kansas v. Hendricks (1997) on the constitutionality of civil commitment laws for sexually violent predators.

Contextual evidence of gender discrimination: the ascendance of “social frameworks”

Abstract: In Dukes v. Wal-Mart, the Ninth Circuit upheld the certification of the largest employment discrimination class in history, with more than 1.5 million women employees seeking over $1.5 billion in damages. A crucial piece of evidence supporting class certification came from a sociologist who testified that he performed a social framework analysis to evaluate Wal-Mart against what social science research shows to be factors that create and sustain bias and found the company wanting. As authority for introducing this analysis, the expert and the Ninth Circuit relied on our prior work introducing the concept of social framework to refer to the use of general social science research to provide a context for the determination of specific factual issues in litigation. In this article, we review and recast the procedures originally proposed for apprising juries of general research results to assist in resolving the case before them. We then apply these updated procedures to the expert testimony in Dukes v. Wal-Mart, which promises to be a template for future employment discrimination litigation.Experience over the past 20 years has shown that that courts will typically allow general contextual information from social science research to be conveyed to the jury by expert witnesses rather than via instructions, as originally envisioned. Where this occurs, we believe it essential that courts limit expert testimony to a description of the findings of relevant and reliable research and of the methodologies that produced those findings, and preclude the witness from linking the general research findings to alleged policies and practices of a specific firm. The landmark class action of Dukes v. Wal-Mart illustrates the centrality of social framework evidence to modern employment litigation, as well as the need for courts to clarify and circumscribe the role of the experts who introduce them.

Mandated Community Treatment: Applying Leverage to Achieve Adherence

Abstract: Treating people with mental disorder without their consent always has been the defining human rights issue in mental health law. For centuries, unwanted treatment took place in a closed institution, a mental hospital. What has changed is that in recent years the locus of involuntary treatment has

Lawyers at Mid-Career: A 20-Year Longitudinal Study of Job and Life Satisfaction

Abstract: This study is the first to our knowledge to simultaneously measure the predictors of lawyers' satisfaction with their careers and the predictors of lawyers' satisfaction with their lives more broadly. One class of the University of Virginia School of Law was studied between their matriculation in 1987 and their graduation in 1990. All 360 living graduates of this class were contacted in 2007, with a response rate of 72.2%. Descriptive information was obtained and empirically validated measures of both career satisfaction and life satisfaction were administered. Respondents were found to have taken many diverse career paths, with most (85%) having changed jobs at least once, and half having changed jobs at least twice. Gender differences in the personal and professional lives of respondents were pervasive. Women graduates were far more likely than men to interrupt or forego full-time employment (39% v 1%), mainly in order to care for children, and were also more likely to have a spouse or partner employed full-time outside the home (77% v 24%). Working conditions at large private law firms emerged as a significant problem for many respondents; half of those who started their careers in large firms left to go to a different type of employer. Finally, both career satisfaction and life satisfaction were found to be high, with 81% of the respondents satisfied with their decision to become a lawyer, and 86% satisfied with their lives more broadly.