posted 01-30-2013 08:21 PM         

Dr. Barland...Ray???

Thanks

posted 01-30-2013 08:56 PM         

This is purely anecdotal, but...

I tested many a skinner behind the walls at the state prison who was prescribed Trazadone.

Didn't seem to make a helluva lot of difference.

That said, there's a huge black market for SSRI drugs in prison, so a lot of sh*tbirds would cry to a sympathetic shrink for a script, then cheek the meds for resale later.

Bottom line: One never knows if the "patient" is taking the drug as prescribed -- especially in a prison setting.

Dan

posted 01-31-2013 12:06 AM         

Barry's response is cogent and on target.

In my day, examiners were encouraged to obtain a PDR as a drug reference. More recently I shelled out over $200 for a massive tome Drug Facts and Comparisons, an annual publication. Now drug apps are available for free or a nominal sum. I would recommend Micromedex Drug Information, a free app.

posted 01-31-2013 09:33 AM            

It is sometimes used in combination with other SSRIs. And it is sometimes used in combination with other meds when doctors are treating a complex array of symptoms.

You may also see it used as a nighttime medication to help assist sleep with normal functioning persons who have insomnia from a sitational (stress related or incident related) adjustment disorder with insomnia or depressive symptoms.

If you see someone taking Trazodone along with other meds you might wonder if you are looking at something more than a simple (major) depressive disorder (if there is such a thing).

These are used in some institutions because people are generally healthier (psychologically and physically) when they sleep better and cause fewer problems when they are healthier.

Prisons will put someone on meds at the slightest complaint because the places are stressful and can tend to exacerbate some pathologies (psychoticism and depressive disorders with psychotic features, suicidal ideation, aggitation, or insomnia). Bottom line: meds are cheap and they help while riots and suicides are expensive and don't help.

They use a variety of SSRIs and NSAIDs (and medical MJ) for pain these days.

My perspective is that as polygraph examiners we should never care about the dosage – although it is interesting to observe when a person takes a very high or very low dosage. There is no decision that a polygraph will ever make around a drug dosoge. That is for their doctors.

Unless we are going to insult and indict the medical professionals who are caring for the person, we should assume that the examinee are properly medicated and the meds are working to help the person function optimally. Some meds have bad side effects that people choose to tollerate to achieve the drug benefits (e.g. Interferon therapy for hepatitis and chemotherapies for cancer patients).

In addition to asking about the name of a medication I find it interesting to ask if they know why they take the med. Some do. Some don't. Some will tell an metaphoric story that their doctor told them.

I don't really care if they know or don't know, but my next question is more important.

Are they having any bad side effects? That is exactly how I ask it "bad side effects?" What I want is for them to be on my recording saying they are not having bad side effects.

That allows us to proceed with the assumption that the meds are not interfering with their functioning and are most likely helping. For most meds, if they say "yes" to "bad side effects" then I would assume they are not yet habituated to the side effects or the med is not yet titrated effectively. I would reschedule the exam. They are not functioning optimally. If they say "no" to “bad side effects,” I may or may not ask if the meds seem to be working. I want them on my recording saying "yes" the meds are working. No excuses.

If they are functioning optimally while taking medications, then it is a reasonable assumption that they will produce test data of optimal interpretable quality.

SSRIs can have anticholinergic effects, and you may or may not see some dampening of EDA activity.

There is no published research or theoretical rationale suggesting that any medications would cause erroneous polygraph examination results. However there may be an increased rate of inconclusive results.

Medication use seems to be very common these days. I would regard most anyone suitable for the polygraph if they take a single medication and are not having “bad” side effects.

The complicated part is when someone takes multiple medications - because medications can sometimes interract with each other. It is not our job to know how meds interract. Doctors and pharmacists spend a lot of time studing this. They will try to use medications that do not interact with others, and ometimes they use meds to exploit the interactions. For example we used to see Benadryl used for sedation if they also wanted to reduce other side effects from neuroleptics. If they didn't want the sedation they would use Cogentin. For intractible depressive disorders we may see Trazodone along with another antidepressant – or we might see trazodone used with Bipolar patients who have unipolar mania. You never know what the docs will do because psychopharacology seems to be half science and half witchcraft. They try things until something works for the patient.

Our job is to conduct the polygraph and then interpret the results in a professionally responsible manner.

One of the common problems we see when polygraph exams are challenged is accusations that an examiner erred (unethical conduct?) in conducting an exam when someone takes multiple medications for documented medical or psychiatric problems - and we write in the report that the person is a "fit subject" for the polygraph. The term "fit subject" is arcane language that was used decades ago. A better term today would be "suitable," meaning we expect the test to work normally because persons are represented in the normative and validation data.

In reality we are not so sure that persons taking multiple medications - persons diagnosed with complex medical or psychiatric conditions - are represented in our validation data and normative data. That does NOT mean that the person is unsuitable, that the polygraph will not work, or that it is unethical to test these persons. I have some biolerplate text that I use in reports with persons taking multiple medications. It has kept me out of trouble on more than one occasion.

The APA (2011) Model Policy for Examinee Suitability says that examiners may choose to report persons taking multiple medications as "marginally suitable" for the polygraph. What this means is that we do not pretend they are normal functioning when their is professional documentation indicating they are not - but we find no reason to regard them as "unsuitable." We cannot ethically test people who are unsuitable. We also cannot ethically regard people as completely normal functioning and represented by our validation data and normative data when they are not. If we want to be viewed as ridiculous and incredulous by judges and other professionals then we should just pretend people are normal and "fit" when it is obvious they are not. The document describes how we conclude that it is ethical and reasonable to test some persons under a variety of conditions and how we are presently attempting to account for the known boundaries of suitability/un-suitability. Examiners will find the policy to reduce their vulnerability to criticism when testing persons who have some complications due to medical or psychiatric issues.
http://www.polygraph.org/files/5_pg_-_model_policy_for_the_evaluation_of_examinee_suitability_for_polygraph_testing.pdf

You do not have to be an APA member or log in to the site to download the document.

As always,

.02

r

------------------
"Gentlemen, you can't fight in here. This is the war room."
--(Stanley Kubrick/Peter Sellers - Dr. Strangelove, 1964)

posted 01-31-2013 06:53 PM         

quote:

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Unless we are going to insult and indict the medical professionals who are caring for the person, we should assume that the examinee are properly medicated and the meds are working to help the person function optimally.

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We can assume best case until hell freezes over. The reality is that there are many quacks, pill-pushers, and faker-patients who are well schooled in the art of doctor shopping.

We don't know what we don't know.

The meds element -- with all of its surrounding issues (tolerance, possible abuse, contraindications, unknown side effects, etc.) adds yet another degree of murkiness to polygraph's terminally troubled waters.

quote:

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You never know what the docs will do because psychopharmacology seems to be half science and half witchcraft.

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Half science and half witchcraft... Where have I heard that before?

quote:

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The term "fit subject" is arcane language that was used decades ago.

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Then, clearly, it's most appropriate for the arcane polygraph, a uniquely storied hodgepodge of tubes, wires, sensors, and readouts designed to assess a person's state of mind. (Or so the story goes.)

Ray, I know you're buzzed on Polygraph Scientology's own blend of Jonestown Kool-Aid, but do you really expect critical thinkers to take this hokum seriously?

Whether or not the "meds are working to help the person function optimally," the result of any polygraph "test" is merely a SWAG -- a scientific wild-ass guess.

Remember:

"Although the degree of reliability of polygraph evidence may depend upon a variety of identifiable factors, there is simply no way to know in a particular case whether a polygraph examiner's conclusion is accurate, because certain doubts and uncertainties plague even the best polygraph exams."
(Justice Clarence Thomas writing in United States v. Scheffer, 523 U.S. 303, 118 S.Ct. 1261, 140 L.Ed.2d 413, 1998.)

posted 01-31-2013 09:53 PM            

Is this Candid Camera? I know I just fixed this (and no, I'm not on pain meds.)

quote:

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Although the degree of reliability of polygraph evidence may depend upon a variety of identifiable factors, there is simply no way to know in a particular case whether a polygraph examiner's conclusion is accurate, because certain doubts and uncertainties plague even the best polygraph exams.

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Remember: the same is true about any evidence offered in a courtroom, and any jury's conclusions. DNA has demonstrated that is the case. You could say the same thing about medical tests, presumptive tests, etc.

quote:

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...the result of any polygraph "test" is merely a SWAG -- a scientific wild-ass guess.

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That's essentially true of any predictive test (minus the drama). We're just fortunate to have one that is on the good end of the spectrum.

With all these surgeries, I've bought a few over the years - I haven't found any that impact my tracings on the polygraph, but I'm an N of 1, and I produce pretty good tracings anyhow. We have no idea what mixing drugs does, and even with a single drug, everybody is different. Some people take stimulants and get tired - and some even take them to sleep; others take them and never sleep. The good part is the drugs don't discriminate between relevant and comparison questions.

Daily trivia: In regard to doctor shopping, it's good to know if you work in a state that keeps all prescription information in one database. My doctors (and pharmacists) know every drug I ever buy anywhere in the state. For those of you who investigate deaths, sometimes that's good to know. (There's a push - I think by DEA - to get all states on board.)

[This message has been edited by Barry C (edited 01-31-2013).]

posted 02-01-2013 07:36 AM         

quote:

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That's essentially true of any predictive test (minus the drama). We're just fortunate to have one that is on the good end of the spectrum.

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The reality is this: We don't know what we have -- and neither does anyone else.

Case in point...

There's an article in the current issue of Polygraph magazine that illustrates how favorably polygraph compares, among other things, with several diagnostic tests used in medicine.

It's a puff piece, plain and simple. The article relies on a 30-year-old study authored by a rabid polygraph champion and well-known industry insider, Norman Ansley.

This kind of circular validation is intellectually flawed and dangerously self-deceiving.

Moreover, comparing the circumstances surrounding medical diagnostics to those that surround a polygraph "test" is ludicrous.

When we have blind,independent studies that vouch for polygraph's efficacy I'll change my tune. But for now, please understand that you aren't fooling anyone but yourselves, some daytime TV fans, and perhaps the occasional dimwit judge.

Somewhere in another thread mention is made of NAS taking another look at polygraph in hopes of seeing if there have been any fundamental changes.

Fundamental changes? Do tell.

I hope they decide to save the taxpayer's money.

posted 02-02-2013 12:21 AM            

quote:

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When we have blind,independent studies that vouch for polygraph's efficacy I'll change my tune.

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Describe, in detail, the research design. Please define "blind," "independent," and "efficacy" when you share this design that may be capable of changing your so-called tune.

posted 02-03-2013 09:47 AM         

You have the indu$try's zealous Polygraph Scientology clerics and their crew of acolyte apologists -- not to mention the tireless turd polishers behind the scenes -- all pointing to the same mother lode of solid gold "empirical evidence" that's in the indu$try's very own statistical alchemy data mine.

And then you have legions of dutiful rank-and-file polygraph operators doing the critical-thinking zombie shuffle like they're dancing to some kind of twisted keep-your-blinders-on conga line.

Throw in the gummint-approved imprimatur of imaginary legitimacy, add enough of the gullible hoi polloi, and it's a winning formula.

Eureka! Polygraph works! It's even safe for children!

I'm not a scientist, so I'll leave the study design to the qualified experts.

But I think the idea I've floated before -- about using convicted sex offenders as subjects and using professional actors in supporting roles to complete the scenario of an alleged child molestation -- would be a very telling laboratory experiment.

NAS should think outside the box and design their own studies (perhaps like CBS did on 60 Minutes) instead of gambling on the same tired old chestnuts supplied by the polygraph industry, where, it appears, the fix is in.

What's wrong with leaving this to a disinterested entity -- e.g., Underwriters Laboratories, Consumer Reports, psych dept at major university -- starting with a blank slate, and striving for as much independence as possible?

[This message has been edited by Dan Mangan (edited 02-03-2013).]

posted 02-03-2013 02:21 PM            

quote:

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I'm not a scientist, so I'll leave the study design to the qualified experts.

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It's odd you present yourself as qualified to criticize studies and the experts, but you aren't qualified to find solutions to the problems as you perceive them.

quote:

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What's wrong with leaving this to a disinterested entity

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posted 02-03-2013 11:45 PM         

My theory: Because polygraph is much more of a religion than it is a science.

No heretics need apply. Don't rock the boat. We have a good thing going here.
__________________________________________

By "disinterested" I refer to parties having no direct or indirect commercial, professional, vocational, academic, intellectual or otherwise self-serving connection (past, current or potential), to polygraph. In other words, true outsiders with nothing to either lose or gain.

posted 02-04-2013 11:25 AM            

.02

r

------------------
"Gentlemen, you can't fight in here. This is the war room."
--(Stanley Kubrick/Peter Sellers - Dr. Strangelove, 1964)

posted 02-04-2013 12:07 PM         

Nothing to be done.

Ray,

Ah yes, the Theater of the Absurd.

I studied Beckett, Ionesco, Albee and other such greats during my first grad school foray in the early 1980s.

Good times.

The genre seems strangely fitting for polygraph "testing," don't you think?

posted 02-04-2013 12:26 PM            

.02

r

------------------
"Gentlemen, you can't fight in here. This is the war room."
--(Stanley Kubrick/Peter Sellers - Dr. Strangelove, 1964)