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Handbook for Working with
Defendants and Offenders with
Mental Disorders
Third Edition
Federal Judicial Center
October 2003
The Federal Judicial Center
Board
The Chief Justice of the United States,
Chair
Judge Pierre N. Leval, U.S. Court of Appeals for the Second Circuit
Judge Pauline Newman, U.S. Court of Appeals for the Federal Circuit
Judge Robert J. Bryan, U.S. District Court for the Western District of Washington
Judge James A. Parker, U.S. District Court for the District of New Mexico
Judge Sarah S. Vance, U.S. District Court for the Eastern District of Louisiana
Chief Judge Robert F. Hershner, Jr., U.S. Bankruptcy Court for the Middle District of Georgia
Magistrate Judge Robert B. Collings, U.S. District Court for the District of Massachusetts
Leonidas Ralph Mecham, Director of the Administrative Office of the U.S. Courts
Director
Judge Barbara J. Rothstein
Deputy Director
Russell R. Wheeler
About the Federal Judicial Center
The Federal Judicial Center is the research and education agency of the federal judicial system. It was
established by Congress in 1967 (28 U.S.C. §§ 620–629), on the recommendation of the Judicial
Conference of the United States.
By statute, the Chief Justice of the United States chairs the Center’s Board, which also includes the
director of the Administrative Office of the U.S. Courts and seven judges elected by the Judicial
Conference.
The Director’s Office is responsible for the Center’s overall management and its relations with
other organizations. Its Systems Innovation & Development Office provides technical support for
Center education and research. Communications Policy & Design edits, produces, and distributes all
Center print and electronic publications, operates the Federal Judicial Television Network, and
through the Information Services Office maintains a specialized library collection of materials on
judicial administration.
The Judicial Education Division develops and administers education programs and services for
judges, career court attorneys, and federal defender office personnel. These include orientation
seminars, continuing education programs, and special-focus workshops.
The Court Education Division develops and administers education and training programs and
services for nonjudicial court personnel, such as those in clerks’ offices and probation and pretrial
services offices, and management training programs for court teams of judges and managers.
The Research Division undertakes empirical and exploratory research on federal judicial processes,
court management, and sentencing and its consequences, often at the request of the Judicial
Conference and its committees, the courts themselves, or other groups in the federal system.
The Federal Judicial
History Office develops programs relating to the history of the judicial branch
and assists courts with their own judicial history programs.
The Interjudicial Affairs Office provides information about judicial improvement to judges and
others from foreign countries and identifies international legal developments of importance to
personnel of the federal courts.
Handbook for Working with
Defendants and Offenders with Mental
Disorders
Third Edition
October 2003
This Federal Judicial Center publication was undertaken in furtherance of the
Center’s statutory mission to develop and conduct education programs for judicial
branch employees. The views expressed are those of the authors and not necessarily
those of the Federal Judicial Center.
Contents
Preface____________________________________________________________ iv
Introduction ________________________________________________________ 1
Chapter 1: Case Management and the Individual with a Mental Disorder ________ 3
Introduction to Mental Disorders _____________________________________ 3
Introduction to Supervision Issues ___________________________________ 11
Major Depression ________________________________________________ 29
Bipolar Disorders (Manic and Manic-Depressive Illness) _________________ 32
Schizophrenia ___________________________________________________ 34
Panic Disorder ___________________________________________________ 38
Phobias ________________________________________________________ 40
Post-Traumatic Stress Disorder______________________________________ 42
Obsessive-Compulsive Disorder _____________________________________ 45
Other Disorders of Impulse Control __________________________________ 46
Paraphilias ______________________________________________________ 49
Paranoid Personality Disorder_______________________________________ 52
Schizoid Personality Disorder_______________________________________ 54
Schizotypal Personality Disorder ____________________________________ 55
Antisocial Personality Disorder _____________________________________ 56
Borderline Personality Disorder _____________________________________ 58
Histrionic Personality Disorder______________________________________ 61
Narcissistic Personality Disorder ____________________________________ 62
Avoidant Personality Disorder ______________________________________ 63
Dependent Personality Disorder _____________________________________ 65
Obsessive-Compulsive Personality Disorder ___________________________ 66
ii
Chapter 2: Co-occurring Disorders _____________________________________ 69
Treatment Issues _________________________________________________ 69
Supervision Issues ________________________________________________ 70
Chapter 3: Child Molesters ___________________________________________ 72
Pedophile or Child Molester? _______________________________________ 72
Reactions After Identification _______________________________________ 81
Appendix A: Frequently Encountered Terminology________________________ 85
Appendix B:
DMS-IV
Classification Axes _______________________________ 96
Appendix C: Antipsychotic Medications _______________________________ 100
Appendix D: National Associations, Agencies, and Clearinghouses __________ 101
Appendix E: Related Web Sites ______________________________________ 103
J-Net Resource _________________________________________________ 103
Nonprofit Organizations __________________________________________ 103
Federal Government Sites _________________________________________ 104
Professional Organizations ________________________________________ 104
Other _________________________________________________________ 104
Appendix F: Commonly Used Abbreviations ____________________________ 105
Professional Degrees and Licenses __________________________________ 105
Diagnoses and Conditions_________________________________________ 105
Treatment _____________________________________________________ 106
Shorthand _____________________________________________________ 106
iii
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