Entries by Sky Esser

fMRI in the Courtroom: A (Very Brief) Overview

On the evening of May 9, 1991, a postdoctoral fellow named Kenneth Kwong ran a new MRI sequence at Massachusetts General Hospital and, remarkably, “saw a bright blob coming out of the visual cortex” (1). This experiment—the first to use blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging (fMRI) in a human subject—led to a […]

Effects of temporary psychiatric holds on length of stay and readmission risk among persons admitted for psychotic disorders

The practice of involuntary psychiatric commitment is central to the acute treatment of persons with severe mental illness and others in psychiatric crisis. Deciding whether a patient should be admitted involuntarily requires weighing respect for autonomy against beneficence, considering the clinical needs of the patient, and navigating ambiguous legal standards. The relative dearth of information […]

Growing and Managing Expert Witness Practice with Mark Levy, MD and Charles Saldanha, MD

On November 11th, 2020, we were joined by Mark Levy, MD and Charles Saldanha, MD, members of Experts.com since 2005, for a really informative discussion on growing and managing your forensic #expertwitness practice. Doctors Levy and Saldanha started Forensic Psychiatric Associates, LP, in 2005. Dr. Levy had been a solo practitioner of clinical and forensic psychiatry for many years before he and Dr. Saldanha decided to partner and build a nationwide forensic #psychiatry and #psychology practice.

The Neuroscience of Real Life Monsters: Psychopaths, CEOs, & Politicians

Why do some people live lawful lives, while others gravitate toward repeated criminal behavior? Do people choose to be moral or immoral, or is morality simply a genetically inherited function of the brain? Forensic psychiatrist Dr. Octavio Choi explores how emerging neuroscience challenges long-held assumptions underlying the basis—and punishment—of criminal behavior.

Off-Label Prescribing & Malpractice

Is Off-Label Prescribing Malpractice? By Dr. Steven H. Berger, MD fpamed Forensic Psychiatrist Off-label prescribing is malpractice if (1) the prescription does not comply with the standard of care and (2) the prescription causes harm.  The standard of care is unique for each patient’s situation.  A prescription being on-label or off-label is irrelevant to the […]

A Case of Biopharmaceutical-Induced Catatonia and the Implication of a Novel Mechanism

Catatonia can be described structurally as a motor dysregulation syndrome with a concomitant behavioral component. However, despite its initial recognition nearly 150 years ago, the exact pathophysiological causes underlying this syndrome are still somewhat unknown and are potentially variable. This report reviews a case of a patient with multiple catatonic episodes precipitated by the use […]

Risk of suicide after discharge from inpatient psychiatric care: a systematic review

The findings of this review suggest that significant suicide predictors both common and unique to those established for suicide in the general population exist and can be utilised in a clinically meaningful way, despite the difficulties inherent in studying this population.KEY POINTSThe risk of suicide after psychiatric hospitalisation is high.Factors that predict suicide after psychiatric […]

Sanity Evaluations: The relationship between the mental state and the criminal behavior.

The insanity defense is a traditional affirmative defense that dates back to biblical times with more relevant application dating back to English common law. Simply defined, the insanity defense determines whether a defendant is capable of being held criminally responsible for his or her actions. How sanity is more specifically defined differs between states and in Clark v. Arizona, 548 […]

Pseudologia Fantastica: An Elaborate Tale of Combat-related PTSD

Pseudologia fantastica (PF), also known as mythomania or pathologic lying, is a well-known yet controversial phenomenon in psychiatry. There is no firm conceptualization of PF, nor are there any widely accepted diagnostic criteria for PF. The condition may be related to low self-esteem, and it shows some overlap with narcissistic personality disorder and other Diagnostic […]

Virtual Forensic Psychiatric Practice: A Lawyer’s Guide

Just because we’re housebound, ​doesn’t mean we’ve stopped working. January 18,2023 Post-Pandemic Update: This article was originally written early in the Covid-19 Pandemic. Since May 5, 2020, much has changed. Many temporary and experimental adaptations to restrictions imposed by the pandemic have become normalized and adopted by lawyers, the courts as well as by forensic […]

Video: The Criminal Brain

Why do some people live lawful lives, while others gravitate toward repeated criminality? Do people choose to be moral or immoral, or is morality simply a genetically inherited function of the brain, like mathematical ability? Research suggests certain regions of the brain influence moral reasoning. Dr. Octavio Choi explores how emerging neuroscience challenges long-held assumptions underlying the basis—and punishment—of criminal behavior.

Psychological and Neuropsychological Assessment of Children and Adolescents

Psychological and neurocognitive assessment can provide empirical data that can be very valuable to the trier of fact in determining the presence, severity, and absence of psychological and neurocognitive damages in children and adolescents. Testing provided by psychologists who are highly trained and experienced with forensic assessment can be extremely helpful for plaintiff and defense […]

Indications for Psychotherapy in Adults in Later Life

Since its inception more than 100 years ago, theories and techniques of psychotherapy have experienced tremendous growth and diversification. There has been a gradual increase in our knowledge of aging as well as in our experience conducting psychotherapy with older adults. Although the core principles of psychotherapy are mostly similar to those pertaining to younger […]

What Neuroscience Can and Cannot Answer | Journal of the American Academy of Psychiatry and the Law

We truly live in the golden age of neuroscience. Advances in technology over the past 20 years have given modern neuro-researchers tools of unprecedented power to probe the workings of the most complex machine in the universe (as far as we know).