Papers by Graham Spruiell
Psychoanalytic Quarterly, Apr 3, 2018
I am not sure, however, that the book delivers on one of its promises: it consists almost entirel... more I am not sure, however, that the book delivers on one of its promises: it consists almost entirely of the six narratives, with little discussion of analytic technique. I also note that the authors frequently engage in what I would call overinterpretation; for example, about one of the sets of twins at the age of seventeen weeks, they write: "The babies begin to communicate formally by making gestures, moving their bodies, and touching. They seem aware of each other. The girl faces her brother as if looking at him. She moves down a little, and he runs his hand over her head" (p. 55). But these are minor flaws, if that, in an illuminating book that is a pleasure to read.
The Journal of clinical psychiatry, 1992
Considerable evidence indicates that the lipophilic beta-blocker propranolol is useful in treatin... more Considerable evidence indicates that the lipophilic beta-blocker propranolol is useful in treating organically based aggression. This study looked at the efficacy of a more hydrophilic beta-blocker, nadolol, to treat aggression in chronic psychiatric inpatients. Forty-one chronic psychiatric inpatients with an average of one aggressive outburst per week (defined by the Overt Aggression Scale [OAS]) were entered into a double-blind, placebo-controlled study lasting 17 weeks. The OAS was used to track aggression on a per-incident basis, while the Brief Psychiatric Rating Scale (BPRS) and the Clinical Global Impressions scale (CGI) were used to track clinical status. Nadolol subjects showed a significant decline in frequency of aggression compared with controls (p = .026) and a significant decline in the BPRS total score (p = .007) and in the subfactors "hostility and suspicion," "negative symptoms," and "signs of hyperarousal/tension." There was no signif...
The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society, 1980
Experientia, 1983
Naloxone (10 mg/70kg, i.v.) was used in normal volunteers to study a possible relationship betwee... more Naloxone (10 mg/70kg, i.v.) was used in normal volunteers to study a possible relationship between endorphins and the depth of hypnotic trance. No effect was found. The drug also failed to modify the subjects' level of alertness.
The journal of the American Academy of Psychiatry and the Law, 2011
Consent to disclosure of confidential information is a cornerstone of the clinician-patient relat... more Consent to disclosure of confidential information is a cornerstone of the clinician-patient relationship; however, changes in the legal, regulatory, and technological landscape affecting patient confidentiality have brought increasing conflict between ethics-based commitments and the realities of practice. In this pilot study, 119 mental-health clinicians completed a questionnaire that measured levels of disapproval of disclosures of confidential information to various third parties. Clinicians were asked to respond as though they were patients whose information was to be disclosed. Clinicians, taking a patient's perspective, most disapproved of disclosures to anyone who wanted the information and to entities that marketed pharmaceutical, medical, or other products. They were progressively less uncomfortable with disclosures to family members, for educational use without consent but with de-identification, to insurance companies, to pharmacists, to journals, for educational purp...
Consent to disclosure of confidential information is a cornerstone of the clinician-patient relat... more Consent to disclosure of confidential information is a cornerstone of the clinician-patient relationship; however, changes in the legal, regulatory, and technological landscape affecting patient confidentiality have brought increasing conflict between ethics-based commitments and the realities of practice. In this pilot study, 119 mental-health clinicians completed a questionnaire that measured levels of disapproval of disclosures of confidential information to various third parties. Clinicians were asked to respond as though they were patients whose information was to be disclosed. Clinicians, taking a patient's perspective, most disapproved of disclosures to anyone who wanted the information and to entities that marketed pharmaceutical, medical, or other products. They were progressively less uncomfortable with disclosures to family members, for educational use without consent but with de-identification, to insurance companies, to pharmacists, to journals, for educational purp...
The Psychoanalytic Quarterly
The Psychoanalytic Quarterly
Journal of the American Academy of Psychiatry and the Law Online, Sep 1, 2004
Journal of the American Academy of Psychiatry and the Law Online, Feb 1, 2003
The expert witness testifies under oath to tell "the whole truth," yet certain aspects of the leg... more The expert witness testifies under oath to tell "the whole truth," yet certain aspects of the legal system itself make this ideal difficult or impossible. The authors present both a philosophical and a practical discussion of the challenges for the expert in attaining this goal. After review of oaths in general and truth-telling in particular, real-life examples are provided to examine the vicissitudes of the whole truth in court. Recommendations are provided for experts, to preserve the truth in the adversary system.
The Journal of Psychiatry & Law, 2011
A correctional policy of medically mandated, constitutionally guaranteed, and legally enforced me... more A correctional policy of medically mandated, constitutionally guaranteed, and legally enforced mental health treatment for persons with mental illness sounds both humane and like good public policy. The widely assumed presumption is that such a framework exists and can be applied in correctional settings. Unfortunately, the piecemeal nature of current programs often interferes in addressing special offender populations such as persons with psychotic illness, sex offenders, psychopaths, substance abusers, domestic violence perpetrators, or any admixture thereof. This article concludes with a review of six cases that illustrate how clinicians, line staff, and administrative personnel in a typical prison milieu manage to finesse treatment under challenging conditions.
The journal of the American Academy of Psychiatry and the Law, 2004
The journal of the American Academy of Psychiatry and the Law, 2003
The expert witness testifies under oath to tell "the whole truth," yet certain aspects ... more The expert witness testifies under oath to tell "the whole truth," yet certain aspects of the legal system itself make this ideal difficult or impossible. The authors present both a philosophical and a practical discussion of the challenges for the expert in attaining this goal. After review of oaths in general and truth-telling in particular, real-life examples are provided to examine the vicissitudes of the whole truth in court. Recommendations are provided for experts, to preserve the truth in the adversary system.
Journal of the …, 2004
As authors of our recent article, The whole truth versus the admissible truth,1 in agreement wi... more As authors of our recent article, The whole truth versus the admissible truth,1 in agreement with the membership of the Program in Psychiatry and the Law, Massachusetts Mental Health Center, Harvard Medical School (hereafter, the Program), we would like to express our ...
The journal of the American Academy of Psychiatry and the Law
Consent to disclosure of confidential information is a cornerstone of the clinician-patient relat... more Consent to disclosure of confidential information is a cornerstone of the clinician-patient relationship; however, changes in the legal, regulatory, and technological landscape affecting patient confidentiality have brought increasing conflict between ethics-based commitments and the realities of practice. In this pilot study, 119 mental-health clinicians completed a questionnaire that measured levels of disapproval of disclosures of confidential information to various third parties. Clinicians were asked to respond as though they were patients whose information was to be disclosed. Clinicians, taking a patient's perspective, most disapproved of disclosures to anyone who wanted the information and to entities that marketed pharmaceutical, medical, or other products. They were progressively less uncomfortable with disclosures to family members, for educational use without consent but with de-identification, to insurance companies, to pharmacists, to journals, for educational purposes in training other clinicians, and for research. They were least disapproving of disclosures to other clinicians. Based on this initial study of clinicians taking a patient's perspective, clinicians will do well to inform patients about disclosure practices at least as fully as they themselves would want to be informed.
The journal of the American Academy of Psychiatry and the Law, 2011
Consent to disclosure of confidential information is a cornerstone of the clinician-patient relat... more Consent to disclosure of confidential information is a cornerstone of the clinician-patient relationship; however, changes in the legal, regulatory, and technological landscape affecting patient confidentiality have brought increasing conflict between ethics-based commitments and the realities of practice. In this pilot study, 119 mental-health clinicians completed a questionnaire that measured levels of disapproval of disclosures of confidential information to various third parties. Clinicians were asked to respond as though they were patients whose information was to be disclosed. Clinicians, taking a patient's perspective, most disapproved of disclosures to anyone who wanted the information and to entities that marketed pharmaceutical, medical, or other products. They were progressively less uncomfortable with disclosures to family members, for educational use without consent but with de-identification, to insurance companies, to pharmacists, to journals, for educational purp...
The journal of the American Academy of Psychiatry and the Law, 2003
The expert witness testifies under oath to tell "the whole truth," yet certain aspects ... more The expert witness testifies under oath to tell "the whole truth," yet certain aspects of the legal system itself make this ideal difficult or impossible. The authors present both a philosophical and a practical discussion of the challenges for the expert in attaining this goal. After review of oaths in general and truth-telling in particular, real-life examples are provided to examine the vicissitudes of the whole truth in court. Recommendations are provided for experts, to preserve the truth in the adversary system.
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Papers by Graham Spruiell