Paul S Appelbaum
Biographic Data
| ID | 331054 |
|---|---|
| NAME | Paul S Appelbaum |
| GIVEN NAMES | Paul S |
| FAMILY NAME | Appelbaum |
| SIGNATURE | APPELBAUM P S |
| AFFILIATIONS | New York State Psychiatric Institute |
| VERIFIED | No |
| TOTAL WORKS | 49 |
| TOTAL CITATIONS | 53 |
| AUTHOR COUNT | 48 |
| EDITOR COUNT | 1 |
| FIRST PUBLICATION YEAR | 1979 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 4 |
Beliefs about genetic influences on prosocial and antisocial behavior in a U.S. sample
Genes are increasingly understood to influence behavior. Research—generally conducted among convenience samples— has suggested that genetic influences tend to be perceived as playing a greater role in positive (e.g. prosocial) behaviors than in negative (e.g. antisocial) behaviors. Several potential bases for this asymmetry have been explored previously. We examined, in a U.S. sample, whether an asymmetry in genetic attributions between prosocial…
Understanding Violent Behavior in Early Psychosis Through the Fluid Vulnerability Theory
Compared to the general population, young adults with early psychosis are at increased risk of violent behavior. Existing research has found contextual similarities between violent behavior and suicidal behavior. Therefore, this study examines the drivers and consequences of violent ideation and behavior among young adults with early psychosis by applying frameworks developed for suicide prevention. This research was conducted at OnTrackNY, a net…
Lessons learned from the translation of the Internalised Stigma of Mental Illness (Ismi) scale into isiXhosa for use with South African Xhosa people with schizophrenia
Internalised stigma is highly prevalent among people with mental illness. This is concerning because internalised stigma is often associated with negative consequences affecting individuals' personal, familial, social, and overall wellbeing, employment opportunities and recovery. Currently, there is no psychometrically validated instrument to measure internalised stigma among Xhosa people in their home language. Our study aimed to translate the I…
Qualitative Evaluation of Acceptability and Feasibility of a Behavioral Intervention to Reduce Violence Among Young Adults with Early Psychosis
Wrestling with Social and Behavioral Genomics
In this consensus report by a diverse group of academics who conduct and/or are concerned about social and behavioral genomics (SBG) research, the authors recount the often‐ugly history of scientific attempts to understand the genetic contributions to human behaviors and social outcomes. They then describe what the current science—including genomewide association studies and polygenic indexes—can and cannot tell us, as well as its risks and poten…
Feasibility and Utility of Different Approaches to Violence Risk Assessment for Young Adults Receiving Treatment for Early Psychosis
The role of causal knowledge in stigma considerations in African genomics research
Choices, attitudes, and experiences of genetic screening in Latino/a and Ashkenazi Jewish individuals
Disability, Ethics, and Health Care in the Covid-19 Pandemic
This article considers key ethical, legal, and medical dilemmas arising for people with disabilities in the COVID-19 pandemic. We highlight the limited application of existing frameworks of emergency planning with and for people with disabilities in the COVID-19 pandemic, explore key concerns and issues affecting the health care of people with disabilities (i.e., access to information and clinician–patient communication, nondiscrimination and rea…
On What We Have Learned and Still Need to Learn about the Psychosocial Impacts of Genetic Testing
Since the start of the program to investigate the ethical, legal, and social implications (ELSI) of the Human Genome Project in 1990, many ELSI scholars have maintained that genetic testing should be used with caution because of the potential for negative psychosocial effects associated with receiving genetic information. More recently, though, some ELSI scholars have produced evidence suggesting that the original ELSI concerns were unfounded, ex…
Asymmetrical genetic attributions for prosocial versus antisocial behaviour
Does genetics matter for disease-related stigma? The impact of genetic attribution on stigma associated with rheumatic heart disease in the Western Cape, South Africa
Deaths of people with mental illness during interactions with law enforcement
Reflections on culture-bound syndromes
This chapter presents a commentary on culture-bound syndromes, as discussed in the previous chapter. It explores how cultural preconceptions can shape the symptomatic manifestations of physical or mental disease, as well as the concept of a gradient of cultural-responsiveness.
The Precision Medicine Nation
The United States’ ambitious Precision Medicine Initiative proposes to accelerate exponentially the adoption of precision medicine, an approach to health care that tailors disease diagnosis, treatment, and prevention to individual variability in genes, environment, and lifestyle. It aims to achieve this by creating a cohort of volunteers for precision medicine research, accelerating biomedical research innovation, and adopting policies geared tow…
Beneficial and detrimental effects of genetic explanations for addiction
BACKGROUND: Addictions are highly stigmatized and increasingly construed as biomedical diseases caused by genes, partly to reduce stigma by deflecting blame. However, genetic explanations may have negative effects, which have been understudied in the context of addiction. How the effects of genetic explanations might differ for substance addictions versus behavioral addictions is also unknown. AIMS: This study examined the impact of genetic expla…
For Their Financial Benefit
More than 17 million disabled Americans receive financial benefits from the U.S. Social Security Administration (SSA) through the Supplemental Security Income or the Social Security Disability Insurance programs, or both. Taken together, 3.5 million disabled adults are appointed a representative payee who receives and manages their SSA benefits because they have been determined not to be financially capable (that is, able to manage or direct the …
Behavioural genetics in criminal court
There Are All Kinds of Rights
Some years ago I received a phone call telling me that my mother, then in her eighties, had been found wandering the street outside her home. It was the first indication my wife and I had of Alzheimer's disease. We arrived to discover that my mother was incoherent, with the house in disorder, bills unpaid, and perishable food in the night table rather than the refrigerator. Having spent much of my career trying to improve the assessment of decisi…
Informed Consent of Research Subjects
An Introduction to Thinking about Trustworthy Research into the Genetics of Intelligence
The advent of new technologies has rekindled some hopes that it will be possible to identify genetic variants that will help to explain why individuals are different with respect to complex traits. At least one leader in the development of “whole genome sequencing”—the Chinese company BGI—has been quite public about its commitment to using the technique to investigate the genetics of intelligence in general and high intelligence in particular. Be…
The Authors Reply
Reply to a commentary by Felicitas Holzer and Ignacio Mastroleoon “Models of Consent to Return of Incidental Findings in Genomic Research.”
Effects of behavioral genetic evidence on perceptions of criminal responsibility and appropriate punishment
Demonstrations of a link between genetic variants and criminal behavior have stimulated increasing use of genetic evidence to reduce perceptions of defendants' responsibility for criminal behavior and to mitigate punishment. However, because only limited data exist regarding the impact of such evidence on decision makers and the public at large, we recruited a representative sample of the U.S. adult population (n=960) for a web-based survey. Part…
Models of Consent to Return of Incidental Findings in Genomic Research
Genomic research-including whole genome sequencing and whole exome sequencing-has a growing presence in contemporary biomedical investigation. The capacity of sequencing techniques to generate results that go beyond the primary aims of the research-historically referred to as "incidental findings"-has generated considerable discussion as to how this information should be handled-that is, whether incidental results should be returned, and if so, w…
Context is Everything
Issues associated with consent to clinical trials have attracted considerable attention recently, spurred in part by controversies over alleged inadequacies in the consent process. Professor Jansen's interesting essay is unusual in two ways. First, it raises issues about the conceptualization of one set of problems in informed consent (which Jansen subsumes under the term “therapeutic error”) and, more critically, about the methods and the data u…
Therapeutic misconception and the appreciation of risks in clinical trials
Disability, Ethics, and Health Care in the Covid-19 Pandemic
This article considers key ethical, legal, and medical dilemmas arising for people with disabilities in the COVID-19 pandemic. We highlight the limited application of existing frameworks of emergency planning with and for people with disabilities in the COVID-19 pandemic, explore key concerns and issues affecting the health care of people with disabilities (i.e., access to information and clinician–patient communication, nondiscrimination and rea…
Legal liability and managed care
Using Research Evidence to Reframe the Policy Debate Around Mental Illness and Guns
Recent mass shootings have prompted a national dialogue around mental illness and gun policy. To advance an evidence-informed policy agenda on this controversial issue, we formed a consortium of national gun violence prevention and mental health experts. The consortium agreed on a guiding principle for future policy recommendations: restricting firearm access on the basis of certain dangerous behaviors is supported by the evidence; restricting ac…
Techniques Used by Assertive Community Treatment (ACT) Teams to Encourage Adherence
Does genetics matter for disease-related stigma? The impact of genetic attribution on stigma associated with rheumatic heart disease in the Western Cape, South Africa
Behavioural genetics in criminal court
Effects of behavioral genetic evidence on perceptions of criminal responsibility and appropriate punishment
Demonstrations of a link between genetic variants and criminal behavior have stimulated increasing use of genetic evidence to reduce perceptions of defendants' responsibility for criminal behavior and to mitigate punishment. However, because only limited data exist regarding the impact of such evidence on decision makers and the public at large, we recruited a representative sample of the U.S. adult population (n=960) for a web-based survey. Part…
Qualitative Evaluation of Acceptability and Feasibility of a Behavioral Intervention to Reduce Violence Among Young Adults with Early Psychosis
Feasibility and Utility of Different Approaches to Violence Risk Assessment for Young Adults Receiving Treatment for Early Psychosis
The role of causal knowledge in stigma considerations in African genomics research
Asymmetrical genetic attributions for prosocial versus antisocial behaviour
For Their Financial Benefit
More than 17 million disabled Americans receive financial benefits from the U.S. Social Security Administration (SSA) through the Supplemental Security Income or the Social Security Disability Insurance programs, or both. Taken together, 3.5 million disabled adults are appointed a representative payee who receives and manages their SSA benefits because they have been determined not to be financially capable (that is, able to manage or direct the …
Impact of Decisional Capacity on the Use of Leverage to Encourage Treatment Adherence
Drugging a Defendant
The therapeutic misconception
Case Studies
Morton E. Winston, Sally M. Winston, Paul S. Appelbaum, Nancy K. Rhoden, Case Studies: Can a Subject Consent to a 'Ulysses Contract'?, The Hastings Center Report, Vol. 12, No. 4 (Aug., 1982), pp. 26-28
Substituted Judgment
Several influential recent court rulings involving treatment\ndecisions by legal guardians for incompetent patients have relied on a\n"substituted judgment" standard, in which the guardian attempts to decide\nvicariously what the ward would choose if competent, rather than a "best\ninterests" standard based on determining what would be preferable for the\nwell-being of the patient. Gutheil and Appelbaum analyze the difficulties\ninherent in apply…
The chronic child patient
Children under state supervision who are identified as needing long-term psychiatric care often do not have the opportunity to benefit from consistent mental health treatment. The difficulties in establishing a consensus about long-term treatment and the problems resulting from an absence of anyone consistently involved with the child over time are illustrated by a case history. Appointment of an "overseer" in such cases is argued for, and guidel…
False Hopes and Best Data
Paul S. Appelbaum, Loren H. Roth, Charles W. Lidz, Paul Benson, William Winslade, False Hopes and Best Data: Consent to Research and the Therapeutic Misconception, The Hastings Center Report, Vol. 17, No. 2 (Apr., 1987), pp. 20-24
Tarasoff and the researcher
Legal liability and managed care
Drug-Free Research in Schizophrenia
of persons with psychiatric disorders. Why this sudden interest in the ethics of psychiatric research, an area that has been quiescent for nearly a decade and a half? This paper explores the context from which much of this interest has grown: drug-free research on schizophrenia. I consider the roots of the controversy, the nature both of the disorder and of the research that lies at the core of the debate, and the ethical issues that have been ra…
Case Study
Trauma and memory
PART I. THE CONTROVERSY OVER THE DELAYED RECALL OF TRAUMATIC MEMORIES 1. Some People Recover Memories of Childhood Trauma That Never Really Happened 2. The Argument for the Reality of the Delayed Recall of Trauma PART II. CURRENT CONCEPTS OF MEMORY 3. Neuroanatomical Correlates of the Effects of Stress on Memory: Relevance to the Validity of Memories of Childhood Abuse 4. Inaccuracy and Inaccessibility Memory Retrieval: Contributions from Cogniti…
[Drug Free Research in Schizophrenia]
Assessing Competence to Consent to Treatment
One of the most challenging tasks facing clinicians today is the assessment of patients' capacities to consent to treatment. The protection of a patient's right to decide, as well as the protection of incompetent patients from the potential harm of the decisions they might make, rests largely on clinicians' abilities to judge patients' capacities to decide what treatment they will receive. Confusing laws and complex ethical questions surrounding …
Violence by People Discharged From Acute Psychiatric Inpatient Facilities and by Others in the Same Neighborhoods
BACKGROUND: The public perception that mental disorder is strongly associated with violence drives both legal policy (eg, civil commitment) and social practice (eg, stigma) toward people with mental disorders. This study describes and characterizes the prevalence of community violence in a sample of people discharged from acute psychiatric facilities at 3 sites. At one site, a comparison group of other residents in the same neighborhoods was also…
A classification tree approach to the development of actuarial violence risk assessment tools
Since the 1970s, a wide body of research has suggested that the accuracy of clinical risk assessments of violence might be increased if clinicians used actuarial tools. Despite considerable progress in recent years in the development of such tools for violence risk assessment, they remain primarily research instruments, largely ignored in daily clinical practice. We argue that because most existing actuarial tools are based on a main effects regr…
Rethinking Risk Assessment
The presumed link between mental disorder and violence has been the driving force behind mental health law and policy for centuries. Legislatures, courts, and the public have come to expect that mental health professionals will protect them from violent acts by persons with mental disorders. Yet for three decades research has shown that clinicians’ unaided assessments of “dangerousness” are barely better than chance. Rethinking Risk Assessment: T…
The Therapeutic Misconception
Background. The therapeutic misconception occurs when a research subject fails to appreciate the distinction between the imperatives of clinical research and of ordinary treatment, and therefore inaccurately attributes therapeutic intent to research procedures. The therapeutic misconception is a serious problem for informed consent in clinical research. Objectives. This paper analyzes the nature and origins of the therapeutic misconception and su…
Therapeutic Misconception in Clinical Research
The article addresses the frequency and risk factors of therapeutic misconceptions in clinical research. When clinical researchers fail to recognize the ways in which research participation may involve the sacrifice of some degree of personal cares they are said to manifest a therapeutic misconception. Growing concern about the validity of consent obtained from many research subjects has led experts to suggest that therapeutic misconception may c…
Therapeutic misconception and the appreciation of risks in clinical trials
Impact of Decisional Capacity on the Use of Leverage to Encourage Treatment Adherence
Assessment of Patients' Competence to Consent to Treatment
A 75-year-old woman has type 2 diabetes mellitus, peripheral vascular disease, and a gangrenous ulcer of her left foot. A below-the-knee amputation is recommended, but she declines, saying that she has lived long enough and wants to die with her body intact. Her internist is concerned about her increasing confusion over the past year and notes that she appears to be depressed. How should her physician determine whether her decision is competent?
A New Brief Instrument for Assessing Decisional Capacity for Clinical Research
CONTEXT: There is a critical need for practical measures for screening and documenting decisional capacity in people participating in different types of clinical research. However, there are few reliable and validated brief tools that could be used routinely to evaluate individuals' capacity to consent to a research protocol. OBJECTIVE: To describe the development, testing, and proposed use of a new practical instrument to assess decision-making …
Techniques Used by Assertive Community Treatment (ACT) Teams to Encourage Adherence
Models of Consent to Return of Incidental Findings in Genomic Research
Genomic research-including whole genome sequencing and whole exome sequencing-has a growing presence in contemporary biomedical investigation. The capacity of sequencing techniques to generate results that go beyond the primary aims of the research-historically referred to as "incidental findings"-has generated considerable discussion as to how this information should be handled-that is, whether incidental results should be returned, and if so, w…
Context is Everything
Issues associated with consent to clinical trials have attracted considerable attention recently, spurred in part by controversies over alleged inadequacies in the consent process. Professor Jansen's interesting essay is unusual in two ways. First, it raises issues about the conceptualization of one set of problems in informed consent (which Jansen subsumes under the term “therapeutic error”) and, more critically, about the methods and the data u…
Psychology (40 works) · Medicine (28 works) · Psychiatry (19 works) · Social Psychology (18 works) · Political science (14 works) · Ethics in Clinical Research (12 works) · Law (12 works) · Computer Science (10 works) · Healthcare Decision-Making and Restraints (9 works) · Poison control (8 works)