Wednesday, May 30, 2012

Face Chewing Update: Excited Delirium

Rudy Eugene (left) attacked Ronald Poppo and
chewed off most of his face this weekend.
Authorities in Miami Dade County are now speculating that the naked man who chewed his victim's face this past weekend was in the midst of an "excited delirium."

The attacker, 31 year-old Rudy Eugene, is suspected to have been under the influence of an LSD-like drug known as "bath salts." He chewed 65 year-old Ronald Poppo's face almost completely off, and authorities are saying much of his face was gone by the time police arrived on the scene.

There is some controversy in the scientific community about whether "excited delirium" actually exists. Typically, a delirium is considered to be an abrupt change in a person's level of consciousness, with a reduced ability to focus or shift attention. It is also accompanied by a change in the person's ability to think, and typically comes with significant confusion and bizarre behavior. Delirium develops rapidly (usually over the course of about a day) and can fluctuate throughout the day. It is also considered a temporary condition, meaning if the person gets proper treatment, he/she can usually go back to normal life.

Excited delirium is said to be just like regular delirium, with the addition of heightened physiological responses. A person's body temperature rises dramatically, blood pressure increases, and the heart starts pounding. Typically, a person in the midst of an excited delirium will shout or growl and will become physically violent toward others. Many people who are experiencing this disturbance will take off their clothes because they are burning up on the inside.

As I mentioned previously, there is disagreement about whether or not "excited delirium" is an actual condition or if it is any different than a run-of-the-mill delirium. However, Miami Dade Police have reported a number of incidents similar to what happened with Mr. Eugene and Mr. Poppo in recent months. Attackers strip naked, become unresponsive, growl, and attack others. It is certainly possible that Mr. Eugene was in the midst of something like an excited delirium when he committed this heinous act.

Thanks for reading-- Max Wachtel, Ph.D.

Monday, May 28, 2012

Monday Update: LSD Is The Likely Cause of the Gruesome Face Chewing Incident

As I guessed yesterday, Miami Dade Police now suspect that a "bad strain of LSD" is what caused the naked man yesterday to attack his victim and chew his face.

The police department reported there have been several incidents where individuals have taken the "bad" LSD, which causes them to strip naked as their body temperature rises. They also have been found growling and trying to chew on others, both of which the attacker from yesterday was witnessed doing.

The details are absolutely horrifying, and I wish the best for the victim of this attack. I also feel for the attacker, as he was probably not a bad person. It certainly highlights the importance of staying away from illegal drugs, as users are never certain exactly what it is they are buying and ingesting.

Thanks for reading-- Max Wachtel, Ph.D.

Sunday, May 27, 2012

Naked Man Killed As He Chewed On Victim's Face

A naked man was shot and killed by Miani police as he was "chewing on another man's face on Saturday."

Here is a link to the story:

I feel terrible for the victim, as reports are saying that he was unidentifiable due to the damage to his face, and he is in critical condition at a local Miami hospital. It will be interesting to learn the details of this gruesome crime as time passes.

I wonder if he was under the influence of a hallucinogen or methamphetamines. A brain tumor could also cause such bizarre behavior. Mental illness is certainly a possibility, but that seems unlikely. Mental illness does not typically cause face chewing.

What do you think happened?

Thanks for reading-- Max Wachtel, Ph.D.

Wednesday, May 23, 2012

Predicting Police Officer Misconduct Using the MMPI-2

Officer Derrick Saunders' mug shot
On the night of June 17, 2010, a Colorado State Patrol Officer was parked on the side of the road. He was looking for speeders, and it was a slow night. But, seemingly out of nowhere, a car blew past him so fast he almost missed it. The officer quickly jumped into action and chased down the car, eventually getting the driver to stop. What he found surprised him.

The officer clocked the car at 143 miles per hour (driving in a 55 mph zone), and the driver was Derrick Curtis Saunders, a Denver police officer. He had a passenger in the car with him, and he was drunk. He ended up pleading guilty to driving while impaired and reckless driving. Mr. Saunders was later reported to have said he merely wanted to test how fast the car would go.

In December of 2011, a mere 18 months after his arrest, Officer Saunders was fired from his job with the Denver Police Department. He appealed the decision, citing it was "disproportionate to the offenses alleged." Within the past week, he was reinstated with the Denver Police Department, and he is back at work.

It takes a special kind of person to be a police officer. In my opinion, being a good cop is one of the hardest jobs in the world. It requires an extensive knowledge of state laws, the US Constitution, police procedures, self-defense, aggressiveness, compassion, and calmness. I truly believe the vast majority of police officers are of the highest caliber, and I am impressed with their performance.

Unfortunately, there are always going to be a few bad cops who ruin it for all the good ones. And the bad ones have the power to do some extraordinarily bad things. The problem is, how do you pick out the bad cops from the good cops before they endanger anyone's life?

It turns out, there is an excellent way to do just this--all police departments put their job applicants through a rigorous pre-employment screening procedure, which includes a psychological assessment. In the last 50 years, there has been a tremendous amount of research into the characteristics of pre-employment screening assessment results and how to use those results to predict bad outcomes.

By far, the most widely used assessment instrument in these psychological evaluations is the Minnesota Multiphasic Personality Inventory, Second Edition (MMPI-2). It was originally developed to detect mental illness, but its use has expanded into many different areas.

The MMPI-2 has a number of "validity scales," or scales that determine whether the person is lying on the test. It also has many clinical and supplemental scales that measure different aspects of a person's personality and emotional make-up.

What research has shown is that officers who lie on the MMPI-2 and score highly on a scale measuring antisocial tendencies usually end up getting into trouble in their careers. Paranoia and mood instability are also good predictors of future misconduct. High anxiety and overcontrolled hostility are also predictors of future misconduct. When the personality traits of antisocial tendencies, paranoia, and overly controlled hostility are combined, it is a recipe for disaster.

I do not know what Mr. Saunders' pre-employment MMPI-2 scores were, but he obviously passed the pre-employment screening conducted by the Denver Police Department (otherwise, he never would have been employed by the DPD). Do you have any guesses about his antisocial, paranoia, mood instability, lying, anxiety, and overcontrolled hostility scores?

One other fact about Mr. Saunders--in 2009, he was arrested for allegedly pulling a gun on a McDonald's employee because he was taking too long to get his food to the officer. Mr. Saunders was eventually cleared of those charges.

Thanks for reading-- Max Wachtel, Ph.D.

Monday, May 21, 2012

Special Monday Post: Is Dharun Ravi's Sentence Fair?

As most of the world already knows, New Jersey Judge Glenn Berman sentenced Dharun Ravi today to 30 days in jail, 3 years of probation, and 300 hours of community service. He is also ordered to pay $10,000 to the probation department, which will use the money to help victims of bias crimes.

Mr. Ravi was found guilty of bias intimidation, witness tampering, and hindering arrest stemming from an incident where he videotaped his roommate, Tyler Clementi, having sex in their dorm room in 2010.

It appears that the judge was unimpressed with Mr. Ravi's demeanor, and many media outlets have described his courtroom behavior as aloof, unapologetic, and arrogant.

Nevertheless, Mr. Ravi's sentence was significantly lighter than the maximum potential penalty for his charges, which would have been 10 years in prison.

Do you think Dharun Ravi's sentence is fair? Why? If not, what would have been a fairer sentence? 

I have posted a polling question on this topic at my Facebook site. Click here to vote:

Thanks for reading-- Max Wachtel, Ph.D.

Sunday, May 20, 2012

Mental Illness And Murder: Who is Most Likely To Kill?

Charles Whitman, who killed and wounded 48 people on the University of Texas campus in 1966,
was depressed and addicted to amphetamines. He was also psychotic at the time of the murders.
The media pays a lot of attention to murder. Plain old murders are exciting enough, but what about when someone with a mental illness is involved? We hear stories of hallucinations, delusions, commands from God or the Devil--the murderer was completely psychotic and thought his mother was poisoning his food. He was hearing the voice of God telling him he was the Chosen One who was brought to Earth to rid the world of evil. He should kill his mother and chop her into bits as a warning to others. Nothing sells better than out-of-your-mind crazy murder.

And, those murders do happen. Jared Loughner is a recent example of an individual with a psychotic thought disorder whose delusions led him to kill a number of people and attempt to kill even more. However, those murders are rare. They seem to happen all the time, but that is mostly because the news is dominated by them for months after they occur--the stories are too juicy to ignore.

What is much more common though is run-of-the-mill murder. The media covers these murders, but they quickly move on to other stories...usually other run-of-the-mill murders.

And who commits these plain old murders? For the most part, it is normal people killing other normal people. Maybe someone with an anger problem. Most likely someone with a substance abuse problem.

In 2008, researchers from the University of Pennsylvania reported on statistics from the Indiana Department of Corrections. They examined prisoners with mental illness who had been convicted of murder. Here are the common characteristics they found:

1. Male
2. White
3. High school education or GED
4. Rage or anger directed toward a family member was the most common motive for murder
5. Raised in dysfunctional homes
6. History of substance abuse
7. History of legal problems
8. Received little treatment for mental health issues and substance abuse disorders prior to the murder
9. Diagnosed with a mood disorder (like Major Depressive Disorder or Bipolar Disorder)

Although it might not make as interesting of a news story, a typical murder takes place when a man who is depressed (and experiencing anger as a symptom of that depression) and drunk (thus lowering his inhibitions) gets angry with a family member or friend and shoots that person. it is much less typical for a person with Schizophrenia to go on a shooting spree, even though those are the murders we hear about over and over again on the news.

Thanks for reading-- Max Wachtel, Ph.D.


Matejkowski, J. C., Cullen, S. W., & Solomon, P. L. (2008). Characteristics of Persons With Severe Mental Illness Who Have Been Incarcerated For Murder. Journal of the American Academy of Psychiatry and Law, 36, pp. 74-86.

Wednesday, May 16, 2012

Ethical Issues: Is It Okay To Spy On A Client?

To what length should psychologists go in
gathering information about their clients?
I recently finished work on a case where I determined an individual was malingering (pretending to have mental and cognitive problems for the purpose of getting into less legal trouble). This defendant's case was complicated, but at first, it appeared that he was being genuine. He seemed to have bona fide mental problems.

The first clue I received that he was lying came from the prosecuting attorney. He called me one day and asked if I had seen the surveillance videos. I had no idea what the attorney was talking about. He explained to me that part of the defendant's charges involved defrauding an insurance company by saying he was more mentally and physically impaired than he actually was. The attorney assured me that the videos would help in my evaluation.

Once I know evidence exists that may or may not be helpful, I cannot ignore it. So, I asked him to send me the videos to review. Sure enough, it was very clear to even the most untrained observer that this guy was faking it. There were videos of him walking normally into a medical building and then transforming himself into a completely disabled individual who could barely navigate on his own and who needed a walker to move. He would finish his doctor's appointment, hobble out of the door, and transform himself back into a normal person and drive away. There was six hours of video documenting scenarios similar to the one I just described.

As a result of that obvious deception, I gave the defendant a number of malingering tests and determined that he was, in fact, lying to me. I don't know if he has mental or cognitive problems, but I do know that he is not as impaired as he tried to convince me he was.

Here is the catch--the defendant did not know he was being videotaped. The insurance company had him under surveillance for months while they were building their case to bring to the police. It was perfectly legal for the insurance company to do that, and once I knew the videos existed, I needed to use them to inform my opinion about the defendant. But, it is generally seen as highly unethical to evaluate clients for the purposes of a psychological assessment without their informed consent.

The ethical issues at play are Autonomy and Nonmaleficence. I will go through them one at a time:

Autonomy: This ethical principle dictates that psychologists give clients the freedom to make fully informed, autonomous decisions about their care. It is important to explain to clients what their treatment or evaluation will be like, how it will be used, and who has access to the information, among other issues. it is only after clients have all of the important information that they can decide whether or not they want to participate. If I were to hire a private investigator to follow my clients as part of my evaluation, they would not be able to make a fully informed decision to engage in the evaluation--it is quite likely they would refuse to participate if they knew they were going to be followed.

Nonmaleficence: This is the principle of "do no harm." If all else fails, it is important to minimize the amount of harm that might befall clients as a result of their work with psychologists. It seems to make sense that covertly following clients in order to get them into more legal trouble falls into the "harm" category. Interestingly, one might argue that writing a report saying the client is a malingerer is harmful to the client. The distinction here is that the client's own behavior led to the diagnosis of malingering, so the client was essentially harming himself.

What makes this particular case trickier is that I did not commission the surveillance. I would never, ever do that as part of a psychological evaluation (although it probably would produce interesting results). But, the videos existed, they were produced legally, and the defendant knew they were entered into evidence by the prosecution. For those reasons, I felt the ethical principles of autonomy and nonmaleficence had been covered and I would be remiss if I did not use the videos as part of my overall evaluation of the defendant.

Thanks for reading-- Max Wachtel, Ph.D.

Sunday, May 13, 2012

Mother's Day Post: Are You Raising A Bad Seed?

Have you ever wondered if your child is bad seed? The defiance, the eye-rolling -- is it normal? Or, should you consider scanning your child's body for the mark of the beast?

There is a quick question you can ask yourself to determine if you are raising a little psychopath. Does your child routinely torture animals?

In 2006, researchers from New South Wales University and Griffith University confirmed what many psychologists already suspected: animal cruelty is closely linked with "lack of empathy" and "callous disregard" in children. These traits are commonly associated with psychopaths, and animal cruelty is a better predictor of these traits than problematic parenting, in fact.

There are a lot of possible explanations for why animal cruelty is such a good predictor of psychopathy in kids. The most convincing, in my mind, is that there is no reason to torture an animal other than to be cruel. Kids may get into fights with other kids, for instance, but there is typically some explanation for the fight (e.g. "He called me a name," or "She was mean to my friend"). The only "justification" for animal cruelty is that the child likes torturing for the sake of torturing.

So, does your kid torture animals? If not, then you can rest easy that he or she is probably not pure evil. Your child may have other behavioral problems, which could be caused by a host of issues. And, just because your kid doesn't torture animals, you still need to be mindful of concerning behavior.

But, if your kid does torture animals, I would suggest locking the door to your room at night.

Thanks for reading-- Max Wachtel, Ph.D.


Dadds, M., Whiting, C., & Hawes, D. (2006). Accosiations Among Cruelty To Animals, Family Conflict, and Psychopathic Traits in Childhood. Journal of Interpersonal Violence, 21(3), 411-429.

Wednesday, May 9, 2012

Expert Witness Credibility: What Makes An Expert Believable?

Can you believe this guy? Being an expert is not enough
when it comes to credibility on the witness stand.

In order for an expert witness's testimony to be helpful in a legal case, it has to fit well into the attorney's overall legal argument. The testimony must clarify or prove certain elements of the attorney's case, and it must be persuasive. It is not enough for an expert to coldly present facts and opinions--The trier-of-fact (either the jury or the judge) also needs to believe the expert witness.

There are plenty of examples of experts who present very good opinions in very bad ways. These experts spend hours pouring over the data, reading relevant research, and forming their opinions. Then, they get on the witness stand and panic. They are tense, they stumble over their words, they look frozen in place. No matter how smart they are, the jury has a hard time believing them.

Stan Brodsky, a psychologist and nationally renowned leader on the topic of expert witness testimony, has written on the topic of expert witness credibility. He and his research partners wanted to know what factors play into whether or not an expert witness is believable on the stand.

In his research, he developed a measure called the Witness Credibility Scale (Brodsky, Griffin, & Cramer 2010), where he identified four factors that underlie the concept of believability: Likability, Trustworthiness, Confidence, and Knowledge.

Except for the factor of Confidence, it appears that the higher an expert's score on the trait, the more believable he/she is in the eyes of the jury. With Confidence, moderate scores are ideal. Apparently, an expert who is overly confident is seen as less believable (and possibly more rigid in his/her thinking) than an expert who displays a moderate level of confidence.

Dr. Brodsky's research is important because we have known for a long time that a credible expert witness is going to have more of an impact on a jury than a non-credible witness. But, we have had difficulty defining exactly what constitutes credibility or believability.

Of course, experts need to formulate well-thought, honest opinions. But, they also need to present them in the most believable way. If, for example, an expert is seen as highly knowledgeable but overly confident and unlikeable, that knowledge may have little effect on a jury. A trustworthy expert who is likeable but not confident may be seen as less than credible.

One of the limitations to Dr. Brodsky's study, which he admitted readily in his conclusions section, is that he is unsure if there are overarching personality styles that may be influencing the four factors his research team identified through the Witness Credibility Scale. One hypothesis I have is that expert witness Preparation may have a strong effect on the witness's Confidence and Knowledge ratings. Although it is not a personality attribute, there are strong indications from the research that witness preparation is one of the most important factors when it comes to effective testimony. I am inclined to believe that witnesses who prepare thoroughly are going to come across on the stand as more confident and more knowledgeable in their opinions. The proper amount of witness preparation may even increase the expert's trustworthiness.

The most highly prepared, trustworthy, and knowledgeable expert can still be a jerk, though. So, likability is probably not associated with case preparation.

Thanks for reading-- Max Wachtel, Ph.D.

Sunday, May 6, 2012

Freud's Birthday, Defense Mechanisms

Sigmund Freud, hard at work avoiding neurosis
Sigmund Freud, born on May 6, 1856, would have been 156 years old today. Although this isn't directly related to the topic of forensic psychology, I thought I would give you a little information about his theory.

Freud referred to anxiety in much of his writing, and he described it as an unpleasant state that people desperately attempt to avoid. He divided anxiety into three different types:

1. Reality Anxiety: A fear of real-world events. For example, you might become scared that you will fall if you are walking very close to the edge of a cliff. It is easy to "cure" yourself of this type of anxiety--just stay away from cliffs.

2. Moral Anxiety: A fear of violating moral principles. If you think it is wrong to have premarital sex, yet you have a strong desire to do so, you will experience this type of anxiety. The "cure," in this case, is probably a very cold shower.

3. Neurotic Anxiety: An unconscious fear that we will lose control of our basic urges, which causes us to punish ourselves for any inappropriate behavior. Whereas you might feel moral anxiety at the thought of violating your principle of avoiding premarital sex, your "id" is constantly telling you to go for it. When you act on those basic urges, you might end up punishing yourself with neurotic anxiety or "neurosis."

In order to protect ourselves from conflict and anxiety, especially the neurotic kind, we use defense mechanisms. These mechanisms can be adaptive--they rid ourselves of anxiety in a healthy way. Or, they can distort reality and become unhealthy.

Anna Freud, one of Sigmund's children, came up with a list of 10 commonly used defense mechanisms:

1. Denial: A refusal to admit that something has happened or is happening ("Our house isn't flooding. I don't know what you are talking about").

2. Repression: Forcing information out of our conscious awareness--this happens unconsciously and you don't know you are doing it (People who have experienced sexual abuse as children sometimes "forget" that it happened).

3. Suppression: Consciously forcing something out of conscious awareness ("That was awful. I am never going to think about it again").

4. Displacement: Taking out our anger on people who are less threatening (When your boss yells at you at work, you go home and kick your dog).

5. Sublimation: Acting out unacceptable impulses in socially acceptable ways (An aggressive person might choose to become a boxer).

6. Projection: Taking qualities we don't like about ourselves and placing them onto others (When a narcissist says, "I don't like Betty, she only thinks of herself").

7. Intellectualization: Thinking about everything in a detached, cold, thoughtful manner ("Death is a natural part of life. No one can avoid it. It is not worth crying over").

8. Rationalization: Explaining unacceptable behavior in a logical manner and ignoring the true reasons for the behavior ("The reason I got so drunk last night was because of my stressful day at work. I never would have had that much to drink if George hadn't been covering my tab").

9. Regression: Giving up on coping strategies and reverting to earlier levels of development ("Now, where did I put that adult-sized diaper?").

10. Reaction Formation: Taking a negative feeling and acting in the exact opposite manner (Treating someone you dislike with a tremendous amount of respect).

Do you recognize any of these processes at work in your life? Do you have a favoriate defense mechanism? Which ones seem healthier than others?

Thanks for reading-- Max Wachtel, Ph.D.

Wednesday, May 2, 2012

Why Do Some Experts Lie to Attorneys?

Some experts are less than truthful with their clients

I recently found myself in a situation where I needed to disappoint a defense attorney. The case is ongoing, so I cannot reveal any specific details. However, the attorney called me, gave me a brief account of what he was looking for, and asked me if I could help him. As it was within my area of expertise, I felt comfortable taking the case. We agreed on an hourly fee, and he mailed me a stack of medical and court records and a big retainer check. I was excited because it sounded like a fascinating case, and from the attorney's description of events, I thought I could be very helpful--my testimony would be the foundation of the client's main defense argument.

Quickly into the review of records, I realized I was not going to be helpful to the defense. In fact, if I were to testify about my professional opinion, it would be harmful to the defense's case. I called the attorney and told him my opinion. I could tell he was shocked and disappointed, and I explained I did not like having to tell him I could not be of help. His response was typical of the vast majority of attorneys I have worked with: he preferred to get truthful, bad news than to be told what he wanted to hear only to be surprised during the trial.

I hate having to give attorneys bad news. I do not think I am the only forensic psychologist who feels this way. One of the reasons many of us get into the field of psychology is to help others and make them feel better. What better way to make an attorney's day than to tell him/her that your data is going to be extremely helpful to the case? Just like most other psychologists, I want to help the people who hire me.

There is also the question of money. The more I work on a case, the more money I make. If I am finding data that supports what the attorney is arguing, I typically end up spending a significant amount of time writing reports, preparing for testimony, and sitting around the courthouse waiting to testify. I get paid for all of that time.

These are just two of the reasons psychologists can find it hard to conduct unbiased forensic assessments. We all need to overcome the urge to agree with whatever the retaining attorney asks of us. It is easy to fall into the trap of telling the attorney what he/she wants to hear. The temptation is that we want to please our "customer," and we want to make money (after all, our families need to eat).

The irony of trying to please attorneys by always agreeing with them is that it does not work. If an expert psychologist only tells attorneys what they want to hear despite evidence to the contrary, those attorneys are not pleased in the end. The psychologist may make money on the case, but he/she will not get hired again by those attorneys. And, those attorneys will tell their colleagues.

I don't know what the disappointed attorney did after we parted ways. He may have used the information I gave him to change his defense strategy. Or, he may have looked for another psychologist who could give him a different, more favorable opinion. But, I felt good knowing that I was objective, honest, and ethical. I informed the attorney at the earliest possible moment that I was not going to be helpful, and I gave him plenty of time to pursue a different strategy.

And, I sent a big refund check to him for the unused retainer money.

Thanks for reading-- Max Wachtel, Ph.D.


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