Preventing Suicide in French Prisons

This paper shows that preventing suicide risk in French prison regulations is thwarted in 2 prisons by professional criteria regarding credibility & solidarity, as well as by the balance of power between prisoners & guards, in addition to the realization, on the part of judges responsible for sentencing, of the risk posed by recidivists. The […]

Suicide Prevention and Manipulative Behavior

This article discusses the challenges that face jail officials & staff when an inmate’s behaviour is perceived as being manipulative. Research evidence clearly suggests all threats or acts of self-injury should be treated as potential suicidal behaviour. The case history of an adult female is used to illustrate the dangers of making assumptions about intent. […]

Homicide and Suicide in the Military (IN: Military Psychiatry: Preparing in Peace for war, ed. by F D Jones and L Sparacino et al)

~

Characteristics of False Stalking Reports

~

The use of Personality Assessment Inventory (PAI) in Assessing Offenders

~

Esophageal Foreign Body in a Prison Inmate: Genuine Suicide Attempt or Pursuit of Illness for Secondary Gain?

~

“Iatrogenic Malingering” in VA Substance Abuse Treatment

The authors share some observations from working on 2 inpatient psychiatry wards at a Veteran Affairs hospital. Because admission criteria do not permit hospitalization of patients with substance use disorders alone, patients are prompted to present with ubiquitous complaints such as depression & suicidality. The authors view these willful misrepresentations of symptoms in order to […]

Prevalence of Malingering in Inpatient Suicide Ideators and Attempters

The prevalence of malingering by inpatients admitted to an urban hospital for suicidal ideation or attempt was studied. 4 of 40 patients indicated they had malingered & that external incentives had motivated them to feign either suicidal ideation or a suicide attempt. A psychiatrist & masters-level psychologist, blind to patient responses, rated each patient for […]

Managing the Manipulative Suicidal Inmate in the new Generation Jail: a Management Team Approach

Adding manipulative behaviour to an inmate’s suicidal profile complicates staff supervision, especially when threats are used as a means of controlling staff response. A comprehensive team approach is critical in managing the manipulative/suicidal inmate. While this inmate thrives on creating misinformation & targeting staff to be used to his/her advantage, the team approach dramatically reduces […]

Munchhausen Syndrome and Suicidal Behavior

Controversial Issues in Jail Suicide Prevention

Hayes discusses several controversial approaches to suicide prevention in jails, including: no-suicide contracts, stripping potentially suicidal inmates naked, using closed circuit television monitoring as an alternative to staff observation, & reliance on suicide profiles. Policies that may hinder intervention are reviewed; some of these include: not talking with inmates, presuming death has occurred when no […]

Factors Complicating Cost Containment in the Treatment of Suicidal Patients

The following 5 factors which complicate efforts to contain the cost of treating suicidal patients are outlined & discussed: 1) assessment techniques cannot identify the small number of patients who will complete suicide; 2) parasuicidal & malingering patients who must be hospitalized; 3) “revolving-door” admissions of highly suicidal patients; 4) decreased lengths of stay, managed […]

Factitious HIV Infection: the Importance of Documenting Infection

This article reports on a case-control study which examined risk factors for factitious HIV infection, & a survey of hosptials in the Boston area to determine their practices for documenting HIV infection. Conclusions: limitations of current serologic tests for HIV, use of anonymous HIV testing, & recent reports of factitious HIV disease of immune deficiency […]

Factitious AIDS

Discusses a case of factitious AIDS including both physical & psychological components illustrated by a case report. Calls for more research, awareness, & diagnosis of factitious disorders which often involve costly abuse of the medical system. (21 ref)

Feigned Bereavement: Twelve Cases

12 patients who feigned bereavement are described. Most appeared depessed on admission & in over half bereavement was erroneously believed by staff to be an important cause of their depression. This type of behaviour may be regarded as abnormal illness behaviour, & reasons are given for considering most of the cases as variants of Munchausen […]

Focal Suicide: Malingering and Munchausen Syndrome

Factitious Mourning: Painless Patienthood

Of 20 patients who falsely reported the deaths of loved ones in order to assume the patient role, most presented with depression & suicidal ideation. Many had histories of factitious physical symptoms, manipulative suicide attempts, substance abuse & sociopathy. The authors recommend early & repeated confrontations in a firm but nonjudgmental manner combined with referral […]