In preparation for writing this editorial, I re-read the statements about The Journal that appear on pages ii–iii of each issue. On those pages, we define the mission of The Journal, give practical information about the sections of The Journal, and prescribe almost two pages of specific instructions for authors to follow. The Instructions for Authors continuously evolve. Definitions are expanded as dilemmas appear and we find we have not addressed a specific situation that we judge will reappear; instructions made unnecessary are deleted. I searched in vain, however, for a statement of the guiding principle, the central premise emphasized in making editorial decisions.
I define it as respect for the reader.
The person I conjure up as the reader is intellectually curious and scientifically rigorous, and it is our job to make sure nothing stands in the way of that person's understanding of the information that we believe is important to impart. I believe our job is to remove roadblocks to this understanding and to make readers feel rewarded for spending their precious time with The Journal. Below, I reflect on how that principle has been applied during the last 20 years of The Journal's history, in decisions that sometimes were satisfying and sometimes felt inadequate.
When we come to the end of a particularly energetic discussion about an editorial decision that needs to be made, I ask myself if readers will notice what we did or why it meant so much to us to get it right. I conclude, however, that it doesn't matter if anyone notices. In fact, they shouldn't notice because they should not encounter any obstacles to understanding.
The workings of any journal are likely mysterious. I know there is a fantasy that decisions are arbitrary and subject to whether or not the editor had a good breakfast that day. In the editorial process over the past 20 years, Dr. Griffith has insisted that thorny Journal decisions be discussed by a number of people, thus diluting the possibility of one bad breakfast.
The decision process depends on the type of decision to be made. There are many actors: the Editor, the Deputy Editor, the Managing Editor, the Reflections and Narratives Editors, the Legal Digest Editor, the Book Review Editor, the Editorial Board (Associate Editors), copy editors and managers at our publishing company, and, occasionally, wise, experienced writers and former editors. Any of them may have been involved in the situations I discuss.
Style
In researching definitions of style, I found that professionals in the field of writing refer to consistency or a consistent manner of expression. Easy examples are The New York Times typeface, Times New Roman, which now has a place among the most used of typefaces; and the instantly recognizable font of The New Yorker. In addition to fonts, there are paragraph separations, continuations, capitalization, references, and rules on how to state a function or a relationship.
Style considerations range from the tiny to the massive. Another interesting element of The New York Times' style is to capitalize only the first initial of an acronym, which means NAFTA is presented as Nafta, for example. In this way, style can be used to establish the uniqueness of a publication, but that has not been the goal of The Journal.
There is an extensive list of books written on style. Strunk and White's The Essentials of Style1 is a venerable authority. Time Magazine named it in 2011 as one of the 100 best and most influential books written in English since 1923. The Chicago Manual of Style2 and the American Medical Association Manual of Style3 are frequently consulted. The Journal has its own style manual, a record of decisions made in certain recurring situations. There is an International Committee of Medical Journal Editors (ICMJE)4 that promulgates policy on medical publishing.
Most manuals of style are updated often. There have been some changes that have been attributable to the internet. There used to be a firm rule that type with serifs (see Times New Roman) was more readable than type without serifs (see Calibri, Arial). Our eyes now seem to have been trained by the internet, making this rule no longer necessary.
The Journal's redesign in 1999 required many decisions. Among the major ones were the levels of headlines, how content was to be separated so that the reader would know which thoughts were new and which were amplifications or subsets of what preceded. Another style decision that troubles us to this day is how to deal with lists of items. You may have noticed that we indent but do not number the separate items in the list. Our decision was based on the fact that even if a list is the easiest way to express a concept, it is not necessarily the most important part of the article. Further, the items in a list might not represent a progression, as in Step 1, Step 2, etc. The Journal is not a textbook, and it does not necessarily follow that the list presented summarizes the major concepts of the article.
Titles and Headlines
A recent decision of The Journal has been to limit the size of titles. The decision was made for two reasons: appearance and readability. An alternate decision would have been to reduce the size of the font, so lengthy titles would be easier to read. We concluded that the appearance of the current title font was appealing, and that working with authors to make their titles shorter would serve them as well as the readers. While we do not use key words, we do believe in the importance of having the central idea expressed as succinctly as possible.
A major decision that had to be made in the reformatting of The Journal came as a complete surprise. In the font we had chosen for the titles, the “ill” was rendered as three identical letters when the I was capitalized. You can see what we decided at JAAPL, Volume 46, Number 1, page 2 of the printed version.5
Color
As prices have retreated, it has become inexpensive to produce graphics and figures in color in printed publications. With cost less of a factor, we are now facing more momentous editorial decisions about the use of color. How do we decide if color is appropriate or necessary? We know that color draws the eye in a field that is otherwise black and white. Therefore, we have a responsibility to make sure that what is in color is worthy of the extra attention that will be paid to it.
Recent redesigns of journals that have set loose a veritable rainbow of colors seem to me to have no purpose other than to make more visual noise. In my opinion, they do not serve the reader. On the other hand, I have sympathy for the authors we require to re-set their beautiful multicolored graphs in gray scale. But I assure them we have done so to balance the content in their articles so that the important points will be more accessible to readers.
The discussion about the use of color is not over. While writing this editorial, I came across the news that scientists have created a scale that is yellow and blue called CIVDIS.5 It is designed to make figures more appealing to the eye, especially for those who are colorblind. I'm glad The Journal is not alone in its concern about the use of color in an effective way.
Use of Figures
As distracting as color can be, figures in gray scale also represent a break in the flow. Because of production considerations, they cannot always be placed in the optimal location in the copy. On occasion the editors have struggled with the rendition of a graph to make it more understandable, only to conclude that the concept was far better explained in the text of the article and the figure did not, in fact, need to be published.
Writing
Expressing one's ideas, especially if they have come about because of hard work, is an exciting process. The discipline of writing and communicating those ideas in an effective way is harder and less exciting.
When I read nonfiction writers of the first half of the 20th century, I marvel that many of them had only a high school education. Letters to home from soldiers in the Civil War are models of clear and expressive writing. As early as 1946, George Orwell was bemoaning the state of the English language. I wonder what he would think now? I am not planning to contribute my complaints or solve this problem in this editorial. I wish only to emphasize that one's ideas are not worth much if they can't be understood, and these days people seem to receive less training in making concepts understandable.
I invite authors to join The Journal in this endeavor. The goal is to get your work read. The way to get it read is to write in an engaging and clear style. Even scientific work must be written in a style that encourages the reader to continue reading. One of the most effective ways I have found to explain to an author what needs to be changed is to say, “This will not be clear to the reader.” All authors want their work to be clear to the reader.
Writing is different from speaking. In speaking we employ gestures, tones of voice, and facial expressions. None of these is available to readers of an article. There is a tendency to choose a word and put it in quotation marks. The Journal encourages writers to spend some time searching for a better word (or words) that doesn't need to be put in quotes, because if a word needs to be put in quotes, it may not have the same meaning to everyone. It also may not be clear if the author is directly quoting someone or is just employing the word for lack of a better alternative. Quotes are usually used only for direct quotations, but we do find circumstances where we believe we need to permit the author to use quotation marks. The same reasoning applies to our discouraging the use of italics. We review every decision to use quotes or italics.
Another barrier to understanding is the use of filler expressions, such as “as such” and “that said.” Those expressions rarely refer to a single concept or idea.
This is not to imply that all problems are caused by authors. Unique perhaps to forensic psychiatry, competence to stand trial has always been a problem. We have settled on “competence to stand trial” as a noun and “competence-to-stand-trial” as an adjective, and in this case we welcome CST as an alternative. Another point of contention is “decision-making” versus “decisionmaking.” (I have heretofore been on the losing end of that battle.)
Another concern is the use of he, she, and they. The decision to use he only was made after consultation with many people, male and female. The consensus was that switching back and forth from he to she, while perhaps a statement of equality, was more difficult for a reader. We continue to monitor the use of pronouns, and when a consistent, nongender alternative appears, we will no doubt adopt it. In the meantime, we also edit or encourage authors to rewrite sentences so that gendered pronouns are unnecessary, and we avoid the use of plural pronouns to refer to single individuals. While the latter has been accepted by some print sources, its acceptance in spoken, colloquial language has not impressed us as making it thereby suitable for academic scholarship.
Peer Review and Conflict of Interest
Peer reviewers for The Journal are called upon to read complex articles and make thoughtful decisions. They are expected to make suggestions that will improve an article, if possible, rather than find ways to reject it. Dr. Griffith has instilled a culture of respect for the writing and the author. It is a problem when reviewers disagree. If a peer reviewer believes an article should be rejected, but other peer reviewers think it can be improved and published, the dissenting reviewer is still expected to participate in the subsequent review process. In rare instances other reviewers are recruited to contribute their opinions. This is a person-to-person process. The Editor is involved in extensive discussions with peer reviewers and authors, and that probably occupies the most of the retiring Editor's time.
Choosing peer reviewers is sometimes difficult. A topic may be very specialized, with only a few being knowledgeable in the subject. However, respect for the reader demands that nonspecialized reviewers also participate. The article must be understood by all readers. If they are not interested in the topic, they can skip it, but it needs to be something they would at least consider reading.
Editorial policy at The Journal includes a strict process for reviewing articles that are submitted by someone close to The Journal or to the editors so that reviews will be objective. The Editor appoints an ad hoc editor to handle the entire review process, from working with the staff to select reviewers, to corresponding with the author, to producing a finished article. The ad hoc editors, whose names are confidential, are experienced writers, reviewers, editors, and teachers. This is not a perfect process, but it has been as close as we have come to date for ensuring there will be no conflict of interest.
Conclusion
The statement on page ii of every Journal issue that bears repeating is “The Journal … is intended to be a forum for the exchange of multidisciplinary ideas.” Central to the exchange of ideas is the ability to communicate them such that they can be easily understood. In the interests of forensic science, the communicators of those ideas, in this case The Journal and its authors, must strive in small and large ways to place no barriers between the ideas and the readers' understanding of them.
Acknowledgments
The author wishes to thank Kenneth Applebaum, MD, for sharing his unpublished document, “Tools for Writing Better Reports and Papers,” and Sara Elsden, The Journal's Editorial Assistant, whose communication with authors is essential to the success of The Journal.
Footnotes
Disclosures of financial or other potential conflicts of interest: None.
- © 2018 American Academy of Psychiatry and the Law
