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Youn S, Guadagno BL, Byrne LK, Watson AE, Murrihy S, Cotton SM. Systematic Review and Meta-analysis: Rates of Violence During First-Episode Psychosis (FEP). Schizophr Bull 2024; 50:757-770. [PMID: 38412435 PMCID: PMC11283196 DOI: 10.1093/schbul/sbae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND Most people with psychotic disorders will never commit an act of violence. However, the risk of violence committed by people with schizophrenia is higher than the general population. Violence risk is also known to be highest during the first episode of psychosis compared to later stages of illness. Despite this, there have been no comprehensive reviews conducted in the past 10 years examining rates of violence during FEP. We aimed to provide an updated review of the rate of violence in people with FEP. STUDY DESIGN Meta-analytical techniques were used to identify pooled proportions of violence according to severity (less serious, serious, severe) and timing of violence (before presentation, at first presentation, after presentation to services). STUDY RESULTS Twenty-two studies were included. The pooled prevalence was 13.4% (95% CI [9.0%-19.5%]) for any violence, 16.3% (95% CI [9.1%-27.4%]) for less serious violence, 9.7% (95% CI [5.4%-17.0%]) for serious violence and 2.7% for severe violence, regardless of time point. The pooled prevalence of any violence was 11.6% (95% CI [6.8%-18.9%]) before presentation, 20.8% (95% CI [9.8%-38.7%]) at first presentation and 13.3% (95% CI [7.3%-23.0%]) after presentation to services. CONCLUSION Overall, rates of violence appear to be lower in more recent years. However, due to the high between-study heterogeneity related to study design, the findings must be interpreted with consideration of sample characteristics and other contextual factors. The prevalence of violence remained high at all-time points, suggesting that more targeted, holistic, and early interventions are needed for clinical FEP groups.
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Affiliation(s)
- Sarah Youn
- Orygen, 35 Poplar Road, Parkville, Melbourne, Victoria 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, Victoria 3052, Australia
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Victoria 3220, Australia
| | - Belinda L Guadagno
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Victoria 3220, Australia
| | - Linda K Byrne
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Victoria 3220, Australia
- Faculty of Psychology, Counselling and Psychotherapy, The Cairnmillar Institute, 391-393 Tooroonga Road, Hawthorn East, Victoria 3123, Australia
| | - Amity E Watson
- Orygen, 35 Poplar Road, Parkville, Melbourne, Victoria 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, Victoria 3052, Australia
| | - Sean Murrihy
- Orygen, 35 Poplar Road, Parkville, Melbourne, Victoria 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, Victoria 3052, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Melbourne, Victoria 3010, Australia
| | - Sue M Cotton
- Orygen, 35 Poplar Road, Parkville, Melbourne, Victoria 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, Victoria 3052, Australia
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Baumann ML. Mental Illness, Gun Access and Carrying: A Test of Competing Hypotheses. Psychol Rep 2024:332941231225169. [PMID: 38185670 DOI: 10.1177/00332941231225169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Access to firearms among individuals with mental health problems has been a source of protracted debate among policymakers, the media, and the public, writ large. At the center of this controversy are questions about the nature and consequences of gun access in the context of mental illness. The lack of substantial empirical evidence, due in part to limited access to quality data, plays a significant role in perpetuating ongoing debate. To address this problem, this study uses data from the National Comorbidity Survey Replication to evaluate the relative importance of several clinical, cultural, and criminological factors in explaining gun access and carrying among adults with and without mental illnesses. Multivariate analyses reveal that, whereas past year disorder (of any type or severity) and other clinical characteristics were unrelated to firearm access, several cultural factors such as childhood rurality (e.g., ORrural vs. urban: 3.59; 95% CI: 2.52, 5.12) and the criminological experience of early intimate partner violence (e.g., ORvictim only vs. noexp: 1.84; 95% CI: 1.50, 2.26) were. None were predictive of carrying. Further, none of the relationships observed were conditioned on any of the clinical characteristics. These results indicate that people with mental illnesses likely own and carry guns for the same reasons and in the same contexts as others. Additional updated and quality data is needed to further explore these issues; however, these finding suggest that suicide and violence prevention efforts targeting people with mental illnesses need to be sensitive to the cultural and personal significance of guns.
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Affiliation(s)
- Miranda L Baumann
- Department of Criminal Justice and Criminology, Andrew Young School of Policy Studies, Georgia State University, Atlanta, GA, USA
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3
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Racine CW, Johnston DN, Quigley KM, Strout TD, Durst LS, Guido BJ, Wolfrum LA. Utilization of the Fordham Risk Screening Tool for violence risk assessment in an emergency department. Acad Emerg Med 2023; 30:927-934. [PMID: 37021603 DOI: 10.1111/acem.14735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND Violence is a critical problem in the emergency department (ED) and patients experiencing mental health crises are at greater violence risk; however, tools appropriate for assessing violence risk in the ED are limited. Our goal was to evaluate the utility of the Fordham Risk Screening Tool (FRST) in reliability assessing violence risk in adult ED patients with acute mental health crises through evaluation of test characteristics compared to a reference standard. METHODS We evaluated performance of the FRST when used with a convenience sample of ED patients undergoing acute psychiatric evaluation. Participants underwent assessment with the FRST and an established reference standard, the Historical Clinical Risk Management-20, Version 3 (HCR-20 V3). Diagnostic performance was assessed through evaluation of test characteristics and area under the receiver operating characteristic curve (AUROC). Psychometric assessments examined the measurement properties of the FRST. RESULTS A total of 105 participants were enrolled. In comparison to the reference standard, the AUROC for the predictive ability of the FRST was 0.88 (standard error 0.39, 95% confidence interval [CI] 0.81-0.96). Sensitivity was 84% (95% CI 69%-94%) while specificity was 93% (95% CI 83%-98%). The positive predictive value was 87% (95% CI 73%-94%) and negative predictive value was 91% (95% CI 83%-86%). Psychometric analyses provided reliability and validity evidence for the FRST when used in the ED setting. CONCLUSIONS These findings support the potential utility of the FRST when used to assess violence risk in adult ED patients experiencing a mental health crisis. Future research with more diverse populations and ED settings is warranted.
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Affiliation(s)
| | | | - Kerry M Quigley
- Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Tania D Strout
- Department of Emergency Medicine, Maine Medical Center, Portland, Maine, USA
| | - Linda S Durst
- Department of Psychiatry, Maine Medical Center, Portland, Maine, USA
| | - Ben J Guido
- Department of Psychiatry, Maine Medical Center, Portland, Maine, USA
| | - Lee A Wolfrum
- Department of Psychiatry, Maine Medical Center, Portland, Maine, USA
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4
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Wiesner M, Capaldi DM, Kerr DCR, Wu W. Bidirectional Associations of Mental Health with Self-Reported Criminal Offending Over Time for At-Risk Early Adult Men in the USA. JOURNAL OF DEVELOPMENTAL AND LIFE-COURSE CRIMINOLOGY 2023; 9:211-237. [PMID: 38846025 PMCID: PMC11156218 DOI: 10.1007/s40865-022-00221-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 11/28/2022] [Accepted: 12/05/2022] [Indexed: 06/09/2024]
Abstract
Criminal offending and mental health problems often co-occur. This study examined competing models to understand bidirectional associations between crime and mental health problems over time among at-risk men in the U.S. It was hypothesized that there would be significant cross-lagged associations of offending and mental health problems in early adulthood. Longitudinal data were drawn from 206 at-risk men enrolled in the Oregon Youth Study. Random intercept cross-lagged models examined bidirectional associations between mental health problems (assessed with the 53-item Brief Symptom Inventory) and self-reported offending in early adulthood across 6 time points from ages 19-20 to 29-30 years. Sociodemographic factors, prior levels, and common risk factors (i.e., parents' criminality, mental health problems, and socioeconomic status, as well as child age, antisocial propensity, and internalizing behaviors) were controlled during analysis. A robust association between mental health problems and offending was found for the early adult period, especially for total and violence offenses. Findings did not support the hypothesized positive cross-lagged effects. Instead, two cross-lagged effects emerged indicating that offending was inversely related to subsequent mental health problems. Childhood antisocial propensity and internalizing behaviors emerged as important predictors of stable between-person level differences in offending and mental health problems, respectively, although results differed as a function of offense categories (total, violence, property, drug). Findings indicate that the relation between mental health problems and offending is unidirectional, temporal, and partially spurious. Preventing child internalizing behaviors and child antisocial behaviors holds promise for reducing early adult mental health problems and offending.
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Affiliation(s)
- Margit Wiesner
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX
| | | | | | - Weiwei Wu
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX
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5
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Leiding D, Kaiser F, Hüpen P, Kirchhart R, Puiu AA, Steffens M, Bergs R, Habel U. Lifetime Prevalence of Victimization and Perpetration as Related to Men's Health: Clinical Insights. Front Psychol 2022; 13:762079. [PMID: 35369152 PMCID: PMC8965285 DOI: 10.3389/fpsyg.2022.762079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
Violence is a known risk factor for health problems. In this epidemiological study across 5,385 male patients, we investigate the prevalence of perpetrated violence, exposure to violence, their overlap and the relationship between violence, mental, and psychosomatic health, as well as adverse health behaviors, such as self-harming behavior and the consumption of drugs. Participants completed an anonymous questionnaire addressing violence experience (i.e., both expose and perpetration), age of victimization/perpetration, frequency, and perceived severity of violence exposure. We considered physical, psychological as well as sexual violence. Information on health status and adverse health behaviors complemented the data. Results showed that 48.4% of the sample reported having experienced violence (perpetration, victimization, or both). The victim-perpetrator overlap formed the largest group, in which the incidence of having experienced multiple types of violence was significantly higher compared to victims and perpetrators. The age-crime curve flattened more slowly with increasing age in this group. Although the perceived severity of exposure to violence is lower in the overlap group, its health status and adverse health behaviors were worse. Interventions should focus on this group since they constitute a burden for the healthcare system.
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Affiliation(s)
- Delia Leiding
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Franziska Kaiser
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Philippa Hüpen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Ramona Kirchhart
- Center for Ambulant Psychotherapy, Röher Parkklinik, Eschweiler, Germany
| | - Andrei Alexandru Puiu
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Marion Steffens
- GESINE Netzwerk Gesundheit.EN/Frauen helfen Frauen EN e.V., Schwelm, Germany
| | - Rene Bergs
- Center for Vocational Training, Berufsförderungswerk Düren GmbH, Düren, Germany
| | - Ute Habel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Jülich Aachen Research Alliance, Translation Brain Medicine, Jülich, Germany
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6
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Turvey CL, Fuhrmeister LA, Klein DM, Moeckli J, Howren MB, Chasco EE. Patient and Provider Experience of Electronic Patient Portals and Secure Messaging in Mental Health Treatment. Telemed J E Health 2022; 28:189-198. [PMID: 33887164 PMCID: PMC8941946 DOI: 10.1089/tmj.2020.0395] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Objective: Electronic health record patient portals were promoted to enhance patient engagement. However, organizations often deny patient access to records of treatment for mental health disorders. This study explores patient and provider experience of patient electronic access to the mental health treatment record and the use of secure messaging. Materials and Methods: Online surveys of a sample of mental health patients (N = 168) and providers (N = 80) addressed their experience using patient portals and secure messaging. Results: Only 29 of the 80 providers (36%) worked at organizations which provided patients electronic access to mental health records. Of these 29 providers, 72% endorsed that patients requested a change in the provider note, 69% endorsed patients asked more questions, 55% endorsed patients reported they experienced significant distress after accessing portal, and 21% reported patients engaged in negative and/or self-destructive behavior toward themselves or others. Of patients with access to mental health notes (N = 37), 86% endorsed that they gained a better understanding of what was discussed in the appointment, 84% trusted their health care provider more, 76% felt comforted or relieved after reading their health information, and 57% reported they were better able to take medications as prescribed. Both patients and providers enjoyed the efficiency of secure messaging. Open-text responses are also presented. Conclusions: The implementation of electronic access to mental health notes requires a transition from viewing the medical record as the exclusive tool of providers to that of a collaborative tool for patients and providers to achieve treatment goals.
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Affiliation(s)
- Carolyn L Turvey
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
- Office of Rural Health Resource Center, Iowa City VA Health Care System, Iowa City, Iowa, USA
- Center for Access Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, Iowa, USA
| | - Lindsey A Fuhrmeister
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Dawn M Klein
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
- Office of Rural Health Resource Center, Iowa City VA Health Care System, Iowa City, Iowa, USA
- Center for Access Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, Iowa, USA
- J P Systems, Clifton, Virginia, USA
| | - Jane Moeckli
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
- Office of Rural Health Resource Center, Iowa City VA Health Care System, Iowa City, Iowa, USA
| | - M Bryant Howren
- Office of Rural Health Resource Center, Iowa City VA Health Care System, Iowa City, Iowa, USA
- Center for Access Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, Iowa, USA
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, Florida, USA
- Florida Blue Center for Rural Health Research and Policy, College of Medicine, Florida State University, Tallahassee, Florida, USA
| | - Emily E Chasco
- Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
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Simonetti A, Kurian S, Saxena J, Verrico CD, Restaino A, Di Nicola M, Soares JC, Sani G, Saxena K. Cortical Correlates of Impulsive Aggressive Behavior in Pediatric Bipolar Disorder. Front Psychiatry 2021; 12:674707. [PMID: 34366914 PMCID: PMC8333699 DOI: 10.3389/fpsyt.2021.674707] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/15/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Impulsive aggression represents a frequent characteristic of pediatric bipolar disorder (PBD). Cortical alterations associated with impulsive aggression and its multiple facets have not been investigated yet in youth with bipolar disorder. Aim: To investigate the relationship between cortical thickness and facets of impulsive aggression in youth with PBD. Materials and Methods: Twenty-three youth with PBD and 23 healthy controls (HC) were administered the aggression questionnaire (AQ) and underwent 3T magnetic resonance imaging scan. Cortical thickness was assessed with FreeSurfer. Canonical correlation analyses were used to investigate the relationship between AQ total and subscale scores and cortical thickness in youth with PBD. Results: Youth with PBD had increased scores in the subscales of AQ-anger and AQ-hostility and cortical thinning in in areas belonging to the affective network (AN), frontoparietal network (FPN) and cingulo-opercular network (CON), i.e., right rostral anterior cingulate, right caudal anterior cingulate, right lateral orbitofrontal, right medial orbitofrontal, left and right inferior parietal, left posterior cingulate, left and right supramarginal left lingual cortices. Greater thickness in these networks positively correlated with the AQ-hostility subscale and negatively correlated with AQ-anger subscale. Conclusions: The opposite patterns observed between areas belonging to AN, FPN, CON, and the two facets of IA, namely anger and hostility, corroborate clinical findings supporting the different nature of these two constructs.
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Affiliation(s)
- Alessio Simonetti
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” Istituto di Ricovero e Cura a Carattere Scientific (IRCCS), Rome, Italy
| | - Sherin Kurian
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
- Department of Psychiatry, Texas Children's Hospital, Houston, TX, United States
| | - Johanna Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
- Department of Psychiatry, Texas Children's Hospital, Houston, TX, United States
| | - Christopher D. Verrico
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Antonio Restaino
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Di Nicola
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” Istituto di Ricovero e Cura a Carattere Scientific (IRCCS), Rome, Italy
| | - Jair C. Soares
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, United States
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” Istituto di Ricovero e Cura a Carattere Scientific (IRCCS), Rome, Italy
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Kirti Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
- Department of Psychiatry, Texas Children's Hospital, Houston, TX, United States
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8
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Shiina A, Sato A, Iyo M, Igarashi Y. Identifying factors associated with criminal responsibility by analyzing court trial verdicts. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2021; 77:101702. [PMID: 33962349 DOI: 10.1016/j.ijlp.2021.101702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
The criminal responsibility of offenders with mental disorders is a key issue in forensic psychiatry. Japan's implementation of the Medical Treatment and Supervision Act and Lay Judge Act in the early 2000s raised public awareness of this issue. To determine how criminal court judges in Japan assess the criminal responsibility of offenders, we examined 453 district court verdicts that mention psychiatric evidence. We extracted elements from each verdict that may be associated with courts' decision-making regarding criminal responsibility and analyzed the relationship between each element and the adjudication of criminal responsibility. We investigated the changes in each element's prevalence over time. A logistic regression analysis revealed that the following were independently associated with the court decisions that offenders' criminal responsibility was intact: understandable motivation for committing the offense, homogeneity of the offense from the defendant's usual behavioral pattern, a coherent process used to commit the offense, alertness while offending, and absence of psychotic symptoms. We observed that recent verdicts are more focused on the offender's perception of illegality and the coherence of the offending process while disregarding the defendant's consciousness and memory while offending. Thus, the courts focus on some specific elements for evaluating the criminal responsibility of each offender.
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Affiliation(s)
- Akihiro Shiina
- Chiba University Center for Forensic Mental Health, Inohana 1-8-1, Chuo-ku, Chiba-shi, Chiba, Japan.
| | - Aiko Sato
- International University of Health and Welfare, Kouzunomori 4-3, Narita-shi, Chiba, Japan
| | - Masaomi Iyo
- Chiba University Center for Forensic Mental Health, Inohana 1-8-1, Chuo-ku, Chiba-shi, Chiba, Japan; Chiba University Graduate School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba-shi, Chiba, Japan.
| | - Yoshito Igarashi
- Chiba University Center for Forensic Mental Health, Inohana 1-8-1, Chuo-ku, Chiba-shi, Chiba, Japan.
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9
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Simonetti A, Kurian S, Saxena J, Verrico CD, Soares JC, Sani G, Saxena K. Cognitive correlates of impulsive aggression in youth with pediatric bipolar disorder and bipolar offspring. J Affect Disord 2021; 287:387-396. [PMID: 33838473 DOI: 10.1016/j.jad.2021.03.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/13/2021] [Accepted: 03/17/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Youth with bipolar disorder (BD) and offspring of individuals with BD (BD-OFF) are characterized by higher levels of impulsive and overt aggression. The cognitive basis underlying these aggressive behaviors are not clarified in this population. The aim of this study was to investigate the relationship between cognitive alterations and aggressive behavior in youth with BD and BD-OFF. METHODS Forty-two youth with BD, 17 BD-OFF and 57 healthy controls (HCs) were administered the Modified Overt Aggression Scale (MOAS), the Cambridge Neuropsychological Test Automated Battery (CANTAB), the Young Mania Rating Scale (YMRS) and the Children's Depression Rating Scale (CDRS). Multiple linear regression analyses were performed in the three groups separately. In each group, tests scores from the CANTAB were predictors. MOAS subscale scores and MOAS total scores were dependent variables. Results are corrected for age, IQ and mood state. RESULTS Both youth with BD and BD-OFF showed positive correlations between impairment in executive functions and levels of verbal aggression. In youth with BD, altered processing of either positive and negative stimuli positively correlated with MOAS total scores, whereas in BD-OFF, such relationship was negative. CONCLUSIONS Impulsive aggressive behaviors in youth with BD arise from a combination of altered affective processing and executive dysfunction. The negative relationship between affective processing and aggression in BD-OFF suggested the presence of possible mechanisms of resilience in this population.
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Affiliation(s)
- Alessio Simonetti
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Neuroscience, Section of Psychiatry; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Italy; Centro Lucio Bini, Rome, Italy.
| | - Sherin Kurian
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry, Texas Children's Hospital, Houston, TX, USA.
| | - Johanna Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry, Texas Children's Hospital, Houston, TX, USA.
| | - Christopher D Verrico
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, USA.
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Italy; Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Kirti Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry, Texas Children's Hospital, Houston, TX, USA.
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Carabellese F, Mandarelli G, Felthous AR, Catanesi R. Forensic psychiatric evaluation of 187 homicidal assailants with and without a schizophrenia spectrum disorder: Clinical, criminological and behavioral characteristics. BEHAVIORAL SCIENCES & THE LAW 2021; 39:190-204. [PMID: 34037268 DOI: 10.1002/bsl.2515] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/24/2021] [Accepted: 02/02/2021] [Indexed: 06/12/2023]
Abstract
Intentional homicide, a declining phenomenon in Italy, represents one of the most extreme forms of violence. A specific subgroup of homicidal assailants is represented by those affected by mental disorders, where the relationship between psychopathology and characteristics of the homicidal attack is not yet fully understood. We analyzed the case files of 187 homicides or attempted homicides, in which the defendant had undergone a forensic psychiatric evaluation within the previous 10 years from a single forensic psychiatric center. We described and analyzed the perpetrator, victim and criminological characteristics of the study cases. A diagnosis of a schizophrenia spectrum disorder, a victim who was the perpetrator's biological child and absence of a personality disorder diagnosis were associated with an increased probability of having been adjudicated as lacking or having substantially diminished criminal responsibility due to a mental disorder. Homicidal assailants with a schizophrenia spectrum disorder showed some differences in criminological characteristics compared with murderers without a schizophrenic spectrum disorder, including a higher incidence of parricide, interruption of pharmacotherapy before the crime and disorganized post-crime behavior.
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Affiliation(s)
- Felice Carabellese
- Section of Criminology and Forensic Psychiatry, Department of Internal Medicine, University of Bari Aldo Moro, Policlinico Universitario, Bari, Italy
| | - Gabriele Mandarelli
- Section of Criminology and Forensic Psychiatry, Department of Internal Medicine, University of Bari Aldo Moro, Policlinico Universitario, Bari, Italy
| | - Alan R Felthous
- Forensic Psychiatry Division, Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Roberto Catanesi
- Section of Criminology and Forensic Psychiatry, Department of Internal Medicine, University of Bari Aldo Moro, Policlinico Universitario, Bari, Italy
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11
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J O'Brien A, Thom K, Gordon S, McKenna B, Kidd J, Quince K, Exeter DJ. The nature of police shootings in New Zealand: A comparison of mental health and non-mental health events. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2021; 74:101648. [PMID: 33412476 DOI: 10.1016/j.ijlp.2020.101648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/29/2020] [Accepted: 11/05/2020] [Indexed: 06/12/2023]
Abstract
The use of firearms by police in mental health-related events has not been previously researched in New Zealand. This study analysed reports of investigations carried out by the Independent Police Conduct Authority between 1995 and 2019. We extracted data relating to mental health state, demographics, setting, police response, outcome of shooting, and whether the individual was known to police, mental health services, and with a history of mental distress or drug use. Of the 258 reports analysed, 47 (18%) involved mental health-related events compared to 211 (82%) classified as non-mental health events. Nineteen (40.4%) of the 47 mental health events resulted in shootings, compared to 31 (14.8%) of the 211 non-mental health events. Of the 50 cases that involved shootings 38% (n = 19) were identified as mental health events compared to 62% (n = 31) non-mental health events. Over half of the mental health events (n = 11, 57.9%) resulted in fatalities, compared to 35.5% (n = 11) of the non-mental health events. Cases predominantly involved young males. We could not ascertain the ethnicity of individuals from the IPCA reports. Across all shooting events, a high proportion of individuals possessed a weapon, predominantly either a firearm or a knife, and just under half were known to police and had known substance use. Of the 19 mental health events, 47.4% (n = 9) of individuals were known to mental health services and in 89.5% (n = 17) of cases whānau (family) were aware of the individual's current (at the time of the event) mental health distress and/or history. These findings suggest opportunities to prevent the escalation of events to the point where they involve shootings. Lack of ethnicity data limits the accountability of the IPCA and is an impediment to informed discussion of police response to people of different ethnicities, and Māori in particular, in New Zealand.
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Affiliation(s)
- Anthony J O'Brien
- Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand.
| | - Katey Thom
- Law School, Auckland University of Technology, Auckland, New Zealand
| | - Sarah Gordon
- Service User Academic, Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
| | - Brian McKenna
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand; Auckland Regional Forensic Psychiatry Services, Waitemata District Health Board, Auckland, New Zealand; Centre for Forensic Behavioural Science, Swinburne University of Technology, Victoria, Australia
| | - Jacquie Kidd
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Khylee Quince
- School of Law, Auckland University of Technology, Auckland, New Zealand
| | - Daniel J Exeter
- School of Population Health, The University of Auckland, New Zealand
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Tsai CH, Kao YC, Lien YJ. The Relationship between Individual-Level and Context-Level Factors and Social Distancing from Patients with Depression in Taiwan: A Multilevel Analysis of National Surveys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197109. [PMID: 32998328 PMCID: PMC7579483 DOI: 10.3390/ijerph17197109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 11/17/2022]
Abstract
Background: Research on social distancing from patients with depression has primarily focused on individual-level factors rather than context-level factors. This study aimed to investigate the relationship between individual-level and context-level factors and social distancing from depressive patients. Methods: Sample data were collected via computer-assisted telephone interviews with 800 Taiwanese adults aged 20 to 65 years in 2016. All effects were tested using multilevel analysis. Results: With regard to individual-level variables, male sex, older age, people with more perceived dangerousness and those with more emotional reaction of fear were associated with greater social distancing from depressive patients. After controlling for individual-level variables, a positive association was found between the degree of urbanization and social distancing. We also found the interaction between the density of psychiatric rehabilitation services and perceived dangerousness to be associated with social distance. This finding revealed that persons with more perceived dangerousness and living in a region with higher density of psychiatric rehabilitation services were associated with greater social distance. Conclusions: We found that social distancing from depressive patients is not only determined by individual-level factors but influenced by the surroundings. This study provides useful directions for the implementation of optimal anti-stigma interventions for patients with depression.
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Affiliation(s)
- Chi-Hsuan Tsai
- Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Heping East Road Section 1, Taipei 106, Taiwan;
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Chenggong Rd., Neihu District, Taipei 114, Taiwan;
| | - Yin-Ju Lien
- Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Heping East Road Section 1, Taipei 106, Taiwan;
- Correspondence:
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Gulati G, Kelly BD. Domestic violence against women and the COVID-19 pandemic: What is the role of psychiatry? INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2020; 71:101594. [PMID: 32768101 PMCID: PMC7264022 DOI: 10.1016/j.ijlp.2020.101594] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 05/21/2023]
Abstract
A heightened risk of domestic violence has been associated with infection-reducing measures undertaken by governments during the COVID-19 pandemic. Psychiatric services can play a key role in addressing this issue by (a) addressing certain risk factors for perpetration of domestic violence through, for example, assertive identification and management of substance misuse; (b) providing support, advocacy and treatment services for victims of domestic violence; and (c) multi-agency working to strengthen medical and social responses to domestic violence. At a time like this, it is important that multi-disciplinary mental health services are strengthened, rather than depleted, in order to address the pressing issues at hand.
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Affiliation(s)
- Gautam Gulati
- School of Medicine, University of Limerick, Limerick, Ireland.
| | - Brendan D Kelly
- Department of Psychiatry, Trinity College Dublin, Trinity Centre for Health Sciences, Tallaght University Hospital, Dublin 24 D24 NR0A, Ireland
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Dierenfeldt R, Scott S, Iles G, Smith M. Examining College Student Perceptions of Criminal Justice Outcomes Among Persons With Mental Illness. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2020; 64:1027-1049. [PMID: 31989848 DOI: 10.1177/0306624x19899642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
An extensive body of literature has documented punitive responses to mental illness in the United States that have coalesced around arrest and incarceration. Similarly, studies have highlighted the lack of treatment options available to persons with mental illness, as well as the fact the persons with mental illness are particularly susceptible to offering false confessions. Research on perceptions of these realities is, however, comparatively limited. This study contributes to the literature through the use of survey methodology to examine the perceptions of college students at a mid-sized university in the Southeastern United States as they relate to criminal justice outcomes among persons with mental illness. Results of multinomial regression models suggest that these perceptions are shaped by factors such as political orientation, semester standing, and punitiveness.
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Affiliation(s)
| | | | - Gale Iles
- University of Tennessee at Chattanooga, USA
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Younis T, Jadhav S. Islamophobia in the National Health Service: an ethnography of institutional racism in PREVENT's counter-radicalisation policy. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:610-626. [PMID: 31849069 DOI: 10.1111/1467-9566.13047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In 2015, the UK government made its counter-radicalisation policy a statutory duty for all National Health Service (NHS) staff. Staff are now tasked to identify and report individuals they suspect may be vulnerable to radicalisation. Prevent training employs a combination of psychological and ideological frames to convey the meaning of radicalisation to healthcare staff, but studies have shown that the threat of terrorism is racialised as well. The guiding question of our ethnography is: how is counter-radicalisation training understood and practiced by healthcare professionals? A frame analysis draws upon 2 years of ethnographic fieldwork, which includes participant observation in Prevent training and NHS staff interviews. This article demonstrates how Prevent engages in performative colour-blindness - the active recognition and dismissal of the race frame which associates racialised Muslims with the threat of terrorism. It concludes with a discussion of institutional racism in the NHS - how racialised policies like Prevent impact the minutia of clinical interactions; how the pretence of a 'post-racial' society obscures institutional racism; how psychologisation is integral to the performance of colour-blindness; and why it is difficult to address the racism associated with colourblind policies which purport to address the threat of the Far-Right.
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Affiliation(s)
- Tarek Younis
- Department of Psychology, Middlesex University, Middlesex, UK
| | - Sushrut Jadhav
- Division of Psychiatry, University College London, London, UK
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Hotzy F, Kerner J, Maatz A, Jaeger M, Schneeberger AR. Cross-Cultural Notions of Risk and Liberty: A Comparison of Involuntary Psychiatric Hospitalization and Outpatient Treatment in New York, United States and Zurich, Switzerland. Front Psychiatry 2018; 9:267. [PMID: 29973889 PMCID: PMC6020767 DOI: 10.3389/fpsyt.2018.00267] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 05/31/2018] [Indexed: 01/01/2023] Open
Abstract
Involuntary hospitalization is a frequently discussed intervention physicians must sometimes execute. Because this intervention has serious implications for the citizens' civil liberties it is regulated by law. Every country's health system approaches this issue differently with regard to the relevant laws and the logistical processes by which involuntary hospitalization generally is enacted. This paper aims at analyzing the regulation and process of involuntary hospitalization in New York (United States) and Zurich (Switzerland). Comparing the respective historical, political, and economic backgrounds shows how notions of risk and liberty are culture-bound and consequently shape legislation and local practices. It is highly relevant to reconsider which criteria are required for involuntary hospitalization as this might shape the view of society on psychiatric patients and psychiatry itself. Furthermore, this article discusses the impact that training and experience of the person authorized to conduct and maintain an involuntary hospitalization has on the outcome.
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Affiliation(s)
- Florian Hotzy
- Department for Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Jeff Kerner
- Montefiore Medical Center, Bronx, NY, United States.,Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York, NY, United States
| | - Anke Maatz
- Department for Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Matthias Jaeger
- Department for Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Andres R Schneeberger
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York, NY, United States.,Psychiatrische Dienste Graubünden, Chur, Switzerland.,Universitäre Psychiatrische Kliniken Basel, Universität Basel, Basel, Switzerland
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