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American College of Forensic Psychiatry
21st Annual Symposium
The Lodge at Rancho Mirage (Palm Springs, California)
April 3-6 2003

Wednesday, April 2
4:30 - 6:00 pm Early Registration
Thursday, April 3
7:00 - 7:45 Registration / Continental Breakfast
7:45 - 8:00 Opening Remarks /Announcements
8:00 - 8:45
Disability and personality disorders: treatment and legal implications
Personality disorders in relation to disability, ideal and practical guidelines for ultimate needs in treating the worker, and the legal implications in compensation will be addressed. Attendees will gain a clearer understanding of personality disorders in relation to the work force and the complexity of laws regarding treatment and compensation issues. Marshall S. Cherkas, M.D., Ph.D., Los Angeles
8:45 - 9:45
Veterans with service-connected psychiatric disorders: an increased demand for psychiatric experts
This will be a joint presentation by a psychiatrist and an attorney who have worked together on many cases involving veterans with service-connected psychiatric and medical disorders. Specific cases in which the authors have been involved, and the relationship that needs to develop between attorney and psychiatrist to correctly manage these cases successfully will be described. Eric W. Fine, M.D., Private Practice, Philadelphia; Lawrence D. Levin, J.D., Founder, National Veterans Law Clinic
9:45 - 10:00 Coffee Break
10:00 - 12:00 Two Rooms
Room One
10:00 - 10:40
Atkins v. Virginia: mercy for the mentally retarded&endash;maybe
The recent Supreme Court decision, Atkins v. Virginia affirms that execution of the mentally retarded is prohibited by the Eighth Amendment, raising numerous issues for forensic mental health practition-ers and jurists. Attendees will be made aware of possible procedural implementation of Atkins hearings, what definition courts are likely to rely on to decide mental retardation and what evidence will be needed in an Atkins hearing. Alan A. Abrams, M.D., J.D., Private Practice; Chief Psychiatrist, Centinela State Prison, Imperial, CA
10:40 - 11:20
The forensic evaluation of a mentally retarded criminal in a capital case
While the Supreme Court offers no guidance on how the diagnosis of mentally retardation should be properly defined for purposes of capital punishment, their ruling signified that all 20 states which allowed execution of retarded killers would have to develop procedures to determine who is mentally deficient. A capital case in which the speakers consulted, involving an adult who had been diagnosed with mental retardation, will be presented. Timothy J. Michals, M.D., Private Practice, Philadelphia; Steven Samuel, Ph.D., Jefferson Medical College
11:20 - 12:00
Criminal case competence to stand trial evaluations: legal and psychiatric issues
An experienced criminal defense lawyer will revisit the current state of the law and state of the art of criminal case competence-to-stand-trial evaluations. As pointed out in the recently decided United States v. Duhon, the very definition of competence to stand trial has been changing over the past 15 years. Future court decisions are likely to refine the definition further. The state of the law and professional practices will be discussed. John T. Philipsborn, M.Ed., J.D., Attorney at Law, San Francisco
 Room 2
10:00 - 10:45
Sexual aggression and incest by women
The issue of sexual offense by women, specifically mothers who commit incest, will be examined. The epidemiology and prevalence, personality characteristics and psychopathology in these offenders will be explored. The myth of "abused to abuser" cycle is addressed. Treatment procedures and modalities will be reviewed. Jamshid Marvasti, M.D., Private Practice, Manchester, CT
10:45 - 11:25
Somatoform disorder: a forensic case
A 19-year-old female was reported to have given birth to a dead baby and disposed of its remains in a dumpster. This turned out to be a case of false pregnancy and the woman was charged with mischief. Differential diagnoses are discussed. The presentation should stimulate discussion on the diagnosis of the case&endash;somatoform disorder&endash;and its difficulties and dynamics. Emmanuel P.B. Aquino, M.D., East Coast Forensic Hospital, Nova Scotia
11:25 - 12:00
Forensic psychiatric issues related to borderline personality
Borderline patients are at high risk for both suicidal and assaultive behaviors. Relevant forensic psychiatric issues relate to correct diagnosis, appropriate behavioral management, appropriate use of psychotropic medications, management of the suicidal patient, adequacy of safety precautions, premature discharge, termination of treatment and abandonment. Landmark cases and case vignettes will be used to highlight the various issues for risk management, thus preventing malpractice and liability. Richard May, M.D., Virginia Commonwealth University
 12:00 - 1:30 Lunch Break (on your own)
 1:30 - 2:15
Preventing adverse events from materializing: a new role for forensic psychiatrists
Litigation is the endpoint in a long process that emanates from either real or perceived injurious events. Little attention has been paid to the concept of intervening at critical junctures to prevent this process from spiraling to the point where litigation becomes inevitable. Consulting with industry is one means of directly minimizing or preventing legal action. By timely and competent involvement, threat assessment can avert death, physical harm, and extreme emotional distress. Attendees will recognize another unique role for forensic psychiatrists, and will be able to enumerate the actual interventions that can be applied. David N. Glaser, M.D., Clinical and Forensic Psychiatry, Los Angeles
2:15 - 3:00
The role of psychiatric diagnosis in the law
Does or should psychiatric diagnosis play a role in the legal process? In a cautionary statement, the American Psychiatric Associationís Diagnostic and Statistical Manual points out that its categories may not be wholly relevant to legal judgments but, notwithstanding, the DSM is used frequently in the legal process. This discussion is a critique. Ralph Slovenko, J.D., Ph.D., Professor of Law and Psychiatry, Wayne State University Law School, Detroit
3:00 - 3:45
The scientific literature on harm in patient therapist sex: Lysenkoism?
While an expert in an action over therapist sexual misconduct, the author was confronted with literature claiming that harm in such situations was universal, severe and permanent. Hence specific facts of the case regarding disability and appropriate compensation were immaterial. This type of literature is reviewed, much of it methodologically defective, relying upon opinion surveys, anecdote, and psychodynamic speculation. With few exceptions, it is not science but political convenience: Lysenkoism. Knowledge of the defects in the literature will encourage forensic examiners to view carefully the specific facts in a given situation, and to use the literature with discernment, thereby promoting reasonable compensation. F.W. Furlong, M.D., Private Practice, Toronto, Canada
3:45 - 4:30
Psychology of false confessions
Police interrogations in the United States today are almost entirely psychological in nature. Nonetheless, false confessions are routinely discovered by forensic experts as three recent cases will illustrate. These false confessions have been categorized as voluntary, false, coerced compliant, and coerced internalized. The primary reasons for these false confessions will be discussed and suggestions offered for uncovering this type of behavior. John W. Podboy, Ph.D., Kenwood, CA; Albert Kastl, Ph.D., Santa Rosa, CA; Daniel Greenfield, M.D., MPH, Millburn, NJ
5:30 - 7:00 Welcome Reception
Friday, April 4
7:15 - 8:00 Registration / Continental Breakfast
8:00 - 8:45
Homicide due to sudden and intense passion
When homicide occurs in a relationship between lovers or spouses, the issue of "sudden and intense passion" may be raised by the defense. The presenter will review current legal and psychiatric literature on the issue of "sudden and intense passion." A detailed discussion of two forensic cases where such a defense was raised will be used to analyze the forensic psychiatristís contribution to the casesí resolution.Participants will be able to describe the legal definitions for voluntary manslaughter, enumerate psychiatric conditions that commonly lead to homicide due to this behavior, describe and explain the content of forensic psychiatric evaluation in cases of state of mind defense other than sanity. Alexander Obolsky, M.D., J.D., Private Practice, Chicago, IL
8:45 - 12:00
Forensic Skills Workshop
The 3 hour Forensic Skills Workshop will be an interactive session between moderator, panelists and the audience on advanced issues confronting the forensic psychiatrist. Open discussion during the session will begin by focusing on brief vignettes submitted to the panel by other practicing forensic psychiatrists attending the symposium. The vignettes will describe problems and experiences that forensic psychiatrists often confront in their practices and in court. These will include procedural problems, such as ethical or practice issues in performing evaluations, dealing with courts, attorneys, or opposing experts, as well as substantive problems, such as dilemmas that come up in difficult cases, reliability of psychiatric opinion, and legal standards. The Workshop will focus on practical issues in the nexus of civil and criminal law and psychiatric evaluation and testimony. Albert Drukteinis, M.D., J.D., Moderator; Panelists: Clifford E. Haines, J.D., Carla Rodgers, M.D.; Eric Fine, M.D.
10:15 - 10:30 Coffee Break
12:00 - 1:00
Posttraumatic stress dishonesty
PTSD diagnoses are commonly found in personal injury litigation today. While some of these diagnoses are plainly valid, others are more dubious. This presentation will first examine the diagnostic criteria for PTSD set forth in DSM-IV-TR and then explore how some expert witnesses and courts have departed from these criteria in favor of idiosyncratic definitions of PTSD designed to fit a particular case but which do not stand up to scientific scrutiny. Implications for the legal system and forensic practice will be discussed. James J. McDonald, Jr., J.D., Attorney at Law, Fisher & Phillips LLP, Irvine, CA
Saturday, April 5
7:15 - 8:00 Registration / Continental Breakfast
8:00 - 8:45
Performing competency evaluations on geriatric patients
This lecture will focus on how to do competency evaluations on elderly patients who may present as incompetent because of physical illnesses such as cardiovascular disease, diabetes or infection. Distinguishing depression from dementia is also a key issue which will be addressed. The use of collateral data will be discussed. Actual case material will illustrate the various points. Carla Rodgers, M.D., Private Practice, Philadelphia
8:45 - 11:30
Workshop on forensic practice in employment litigation
Mental health issues continue to play a growing role in employment lawsuits, producing an increasing need for forensic psychiatrists to serve as consultants and expert witnesses. This presentation will begin with an overview of lawsuits in which mental health issues may be relevant. It will then address basic and advanced issues of forensic practice in this area, including whether a mental examination is likely to be ordered by the court, whether to use psychological testing, whether and how to write a report; techniques for deposition and trial testimony; how to obtain needed information to conduct a comprehensive and objective evaluation of a plaintiff; how to get paid for services without compromising your objectivity or your relationship with counsel; how Axis II pathology is related to the issues faced by the forensic psychiatrist in an employment case. James J. McDonald, Jr., J.D.
10:00 - 10:15 Coffee Break
11:30 - 12:15
The role of suggestibility in mental damage claims
The subjective nature of mental damage claims in personal injury and workersí compensation litigation allows for extraneous influence by both patient and covert psychological factors. Among these, the role of suggestibility may not be fully appreciated. This presentation will review literature and discuss suggestibility as a sociocultural and psychodynamic phenomenon that influences illness behavior, its connection to secondary gain, iatrogenic and other sources, and effect on legal causation. Attendees will become more aware of the specific influence of suggestibility in mental damage claims and will learn ways to articulate its effect on legal causation when providing expert opinions. Albert M. Drukteinis, M.D., J.D., Dartmouth Medical School
12:15 - 1:30 Lunch Break (on your own)
1:30 - 2:10
"Evidence" for forensic psychiatrists
This lecture will familiarize the attendee with the basic concepts of evidence and their application to the expert in both the courtroom and during deposition. The basic elements of the evidence code will be explained and reviewed. The proper use of tangible evidence (exhibits) at deposition and trial, evidentiary objections, rulings from the bench, and the proper response by the expert witness under a variety of circumstances will be discussed. Steven Pinkert, M.D., J.D., Attorney at Law, Miami, FL
2:10 - 2:50
Practice guidelines and defensive medicine
Healthcare authorities around the world and managed care companies in this country have published all kinds of psychiatric practice guidelines and treatment protocols. Some of these guidelines were motivated by economic reasons, others were based on scientific evidence, frequently outdated due to the rapid advances in neurosciences. As published guidelines can potentially be used to aid in establishing an allegation of negligence as well as for exculpatory purposes, it is important to understand how guidelines are established. This presentation examines some of the dilemmas one faces in adopting the guidelines. Siu Wa Tang, M.D., Head and Chair Professor, The University of Hong Kong
2:50 - 3:30
Informed consent and competency
evaluation for the medically ill patient Elements of the competency evaluation, exceptions to informed consent, legal and medical precedents, and how to write accurate forensic reports on competency issues will be addressed. The difference between legal and ethical standards for capacity and competence, who makes the decision for incapacitated patients, and what standards for decision making are appropriate in cases of temporary or permanent incapacity in previously competent patients, and in never-competent patients will be discussed. Jose R. Maldonado, M.D., Stanford University
Sunday, April 6
7:15 - 8:00 Registration / Continental Breakfast
8:00 - 8:45
Memory for murder: the "I donít remember" defense
Memory complaints are commonplace from the perspective of perpetrators, witnesses, and victims of extreme violence with claims of amnesia reported commonly in cases of homicide. General issues inherent to a forensic psychiatristís retrospective analysis of mental state at the time of a crime, factors associated with claims of amnesia for violent crime, the legal systemís responses to claims of amnesia, and the legal significance of such claims will be presented. Case examples will be given. Timothy J. Michals, M.D.; Steven Samuel, Ph.D.
8:45 - 9:40
Does truth serum always reveal the truth? A videotaped interview
The presentation centers on a 25 minute videotaped interview of a 20-year-old man who presented to hospital with complete psychogenic amnesia. During a sodium amytal interview he regained complete recovery of memory as well as memory of some events that did not happen, i.e., false memories. The implications for clinical and forensic work are discussed. The techniques, risks, benefits and therapeutic utility of the sodium amytal interview are addressed. Kenneth I. Gottlieb, M.D., Private Practice, San Francisco
9:40 - 10:10
The "show and tell" murder case
At age 13, Sandra was interviewed by the author as a private therapy patient after she had witnessed a fatal shooting. Two years later, she was a principal defendant in the brutal murder of a young Canadian male tourist in an isolated desert area near Las Vegas. The relationship of past traumatic events and current criminal behavior, and posttraumatic stress disorder as a criminal psychiatric defense will be explored. Franklin D. Master, M.D., Private Practice, Las Vegas, NV
10:10 - 10:25 Coffee Break
10:25 &emdash; 11:10
Neuropsychiatric sequelae of traumatic brain injury: assessment and forensic applications
There are more than 2 million cases of traumatic brain injury every year. Of these, some 300,000 require hospitalization and approximately 80,000 develop a serious chronic sequelae. This presentation will include discussion of epidemiology, neuroanatomy, and assessment of TBI. Special attention will be paid to the clinical features associated with TBI including the predictors of outcome and the psychiatric consequences of traumatic injury. Forensic aspects of TBI will be discussed. Jose R. Maldonado, M.D., Stanford University
11:10 - 12:00
The psychology of terrorism
Forensic psychiatrists are interested in a variety of behaviors and will increasingly be asked to address the group of behaviors described as "terrorism." Dr. Haroun will present the Psychiatric Evaluation of Suspected Terrorists that he has developed for the Army, a diagnostic instrument to help the psychiatrist analyze the thinking, decision making process, ethical reasoning and mental defenses of these aggressors who exhibit specific forms of violence. Profiling the terrorist, biological and psychological characteristics, cultural determinants, and violence typologies will be addressed. Ansar Haroun, M.D., Superior Court, County of San Diego
The American College of Forensic Psychiatry is accredited by the Accreditation Council for Continuing Medical Education to provide Continuing Medical Education for physicians. The American College of Forensic Psychiatry designates this educational activity for a maximum of 22 Category 1 credits toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.
American College of Forensic Psychiatry
PO Box 1111, Balboa Island, California 92662
Telephone: (111) 111-2222
Fax: (202)-555-0116
Email: mail@forensicpsychiatry.cc