What Do Clinicians Expect? Comparing Envisioned and Reported Violence for Male and Female Patients

Just Like a Woman: Gender Role Stereotypes in Forensic Psychiatry

The relationship between violence, gender and mental health is a complex one which is yet to be fully understood. Gender role stereotypes are social constructs that can powerfully influence and regulate human behaviour, including violence; and so it is likely that they also influence the nexus of violence management and mental health which is at the core of forensic psychiatry. In this article, we examine how gender role stereotypes might influence the practice of forensic psychiatry: specifically, in relation to women as violent offenders, as patients in secure psychiatric care and as clinicians working in forensic settings. We identify areas of development in women's forensic mental health services, and examine whether patriarchal influences and gender role stereotypes may have inadvertently impacted upon these changes. We also consider whether these changes may maintain pre-existing barriers to treatment for both men and women.

A meta‐analysis of psychopathy‐, antisocial PD‐ and FFM associations

This research meta‐analytically summarizes the relationships of the Five‐Factor Model (FFM) with psychopathy and Antisocial Personality Disorder (APD). Effect sizes of the associations between psychopathy, APD and the FFM were compiled from 26 independent samples (N = 6913) for psychopathy and 57 independent samples (N = 16 424) for APD. The results revealed predominantly points of similarity and some differences in the FFM associations of both disorders. Symptoms of psychopathy and APD were negatively associated with Conscientiousness and Agreeableness facets and positively with scores on Angry–Hostility (N2), Impulsiveness (N5), Excitement Seeking (E5) and negatively with Warmth (E1). Only psychopathy had a small negative association with Anxiety (N1) and was characterized by stronger negative associations with Agreeableness and Straightforwardness (A2), Compliance (A4) and Modesty (A5) compared to APD. The moderator analyses showed that sample type, use of the NEO‐PI‐R and APD instrument moderated the APD FFM associations, while psychopathy instrument and age group were moderators in the psychopathy MA. Implications of this research for the assessment of APD and psychopathy relying on dimensional models of personality pathology are discussed. Copyright © 2009 John Wiley & Sons, Ltd.

The practitioner proposes a treatment change and the patient declines: what to do next?

OBJECTIVE

This study describes how pain practitioners can elicit the beliefs that are responsible for patients' judgments against considering a treatment change and activate collaborative decision making.

METHODS

Beliefs of 139 chronic pain patients who are in treatment but continue to experience significant pain were reduced to 7 items about the significance of pain on the patient's life. The items were aggregated into 4 decision models that predict which patients are actually considering a change in their current treatment.

RESULTS

While only 34% of study participants were considering a treatment change overall, the percentage ranged from 20 to 70, depending on their ratings about current consequences of pain, emotional influence, and long-term impact. Generalized linear model analysis confirmed that a simple additive model of these 3 beliefs is the best predictor.

CONCLUSION

Initial opposition to a treatment change is a conditional judgment and subject to change as specific beliefs become incompatible with patients' current conditions. These beliefs can be elicited through dialog by asking 3 questions.

The prevalence of domestic violence in primary care patients in Slovenia in a five-year period (2005-2009)

Aim

To estimate the prevalence of exposure to domestic violence in primary care patients in Slovenia and determine the associated factors.

Methods

In a systematic cross-sectional survey, 70 physicians from 70 family medicine practices from urban and rural settings conducted interviews with every fifth patient from January 15 to February 15, 2010.

Results

Of 2075 patients (98.8% response rate), 372 (17.9%) were exposed to psychological or physical violence in the family in the last five years. Factors that increased the chances of exposure to psychological and physical violence were female sex (odds ratio [OR], 3.27; 95% confidence interval [CI], 2.24-4.76; P < 0.001; OR, 4.52; 95% CI, 2.83-7.20; P < 0.001, respectively) and formal divorce (OR, 2.08; 95% CI, 1.35-3.21; P = 0.001; OR, 2.72; 95% CI, 1.73-4.29; P < 0.001, respectively). Factors that decreased the chances of exposure to psychological violence were age of 65 years or above (OR, 0.56; 95% CI, 0.33-0.96, P = 0.035) and single status (OR, 0.43; 95% CI 0.21-0.86, P = 0.016), while age of 65 years or above (OR, 0.43; 95% CI, 0.23-0.79, P = 0.007) and parenting of two children (OR, 0.51; 95% CI, 0.29-0.90, P = 0.020) decreased the chances of exposure to physical violence.

Conclusions

We found the rate of exposure to psychological and physical violence of 17.9%, which indicates that this problem is a serious public health issue that needs to be addressed by adequate measures. The identified risk and protective factors could serve as a valid guidance for family physicians dealing with physical violence.