Accounting for the fear of schizophrenia

Research over the last three decades has demonstrated that a substantial minority of both professional and lay people have negative and rejecting attitudes towards the mentally ill. We argue that these attitudes may, in part, be a function of a tendency to perceive the mentally ill as somehow inherently dangerous and liable to violence. The evidence for the association between schizophrenia and violence suggests that although people with schizophrenia may be somewhat more likely to act violently than members of the general public, the magnitude of the differential is not sufficient to explain the perceived association. Alternative explanations for the correlation are therefore considered. Specifically, the influences of the media, errors in information processing and the process of stereotyping in accounting for the development of a perceived association between schizophrenia and violence are examined. Finally, the implications for enhancing the acceptance of people with schizophrenia into the community are discussed.     

The relationship of mental illness to targeted contact behavior toward state government agencies and officials

Research in the burgeoning field of threat assessment has illuminated the importance of mental illness factors when considering risk of targeted violence-particularly related to government agencies and officials. The authors analyzed 127 cases investigated by a state law enforcement agency regarding threatening or other contacts toward public officials or state agency employees prompting security intervention. Univariate and discriminant analysis indicated that mentally ill subjects were significantly more likely to engage in more contacts as well as to make specific demands during such contacts. Mentally ill subjects were also more likely to articulate help-seeking concerns and employ religious themes, as opposed to using insulting, degrading, or ominous language toward the target or issuing complaints regarding policy issues. Contrary to other research, the mentally ill subjects within this sample were not significantly more likely to engage in approach behavior, a threshold for higher risk of violence. Implications for threat assessment activity are discussed.     

Impact of a television film on attitudes toward mental illness

The possible impact of a prime time television film portraying a mentally ill killer was investigated. Groups of college students were shown the film with and without a film trailer reminding viewers that violence is not characteristic of mentally ill persons. A third group viewed a film not about mental illness. Postfilm responses to the Community Attitudes toward the Mentally Ill scale indicated that those who saw the target film expressed significantly less favorable attitudes toward mental illness and community care of mentally ill persons than did those who saw the control film, regardless of whether of not they received the trailer along with the target film. Results support concerns that media depictions add to mental illness stigma and also suggest that corrective information alone may be sufficient to counteract the stigmatizing impact of such audience-involving mass media portrayals.     

Homicide-suicides in Fiji: offense patterns,situational factors,and sociocultural contexts

Although there is growing literature on lethal violence in developing nations, homicide-suicides have rarely been studied. Addressing this issue, this paper analyzes all homicide-suicides that occurred in Fiji between 1982 and 1992. The study's results are consistent with prior research in Western developed nations, demonstrating that homicide-suicides constitute a minuscule proportion of all homicides, occur primarily between intimate relations, are precipitated by intrafamilial discord, and occur in the domestic setting. Contrary to prior research, however, perpetrators of homicide-suicide were equally divided between men and women and no firearms were utilized.     

Mad Scientist: The Unique Case of a Published Delusion

In 1951, entomologist Jay Traver published in the Proceedings of the Entomological Society of Washington her personal experiences with a mite infestation of her scalp that resisted all treatment and was undetectable to anyone other than herself. Traver is recognized as having suffered from Delusory Parasitosis: her paper shows her to be a textbook case of the condition. The Traver paper is unique in the scientific literature in that its conclusions may be based on data that was unconsciously fabricated by the author’s mind. The paper may merit retraction on the grounds of error or even scientific misconduct “by reason of insanity,” but such a retraction raises the issue of discrimination against the mentally ill. This article asks what responsibilities journals have when faced with delusions disguised as science, what right editors have to question the sanity of an author, and what should be done about the Traver paper itself. By placing higher emphasis on article content than author identity, scientific integrity is maintained and a balance is struck between avoiding discrimination against the mentally ill and not preventing patients from seeking needed treatment.     

The violence of prediction: The uneasy relationship between social science and social policy

Neither the suggestion that certain categories of people be prevented from childbearing nor the suggestion that involuntary commitment of mental patients be made easier is justified by scientific analysis. Assertion that the high rate of violence in the United States is “caused by” inadequate socialization of biologically susceptible children raised by single parents is unjustified by available data. Similarly, results of recent studies predicting violence among the mentally ill provide only minimal implications for social policy. The problem of false positives continues, in both domains, to be a serious one, and the values, biases, and social constructions of “experts” will continue to influence their interpretation and presentation of available facts.     

Toward an integrative and collaborative approach to Asian American and Pacific Islander youth violence research, practice, and policy

Research into the prevalence of violence and delinquency among Asian American and Pacific Islander (AAPI) youth has proliferated in the last several years, as a result of federal funding. Consequently, this article reviews the literature on AAPI youth violence and delinquency published from 2001 to 2008. The findings demonstrate the frequency of AAPI youth violence and delinquency, provide a sense of the involvement of these youth in the juvenile justice system, reveal ethnic group differences in violence and delinquency, and explore the effects of immigration and acculturation on these phenomena. This article ends with a discussion on AAPI youth violence and delinquency prevention programs, with suggestions for future directions that incorporate a developmental and life-course approach in research and collaboration among researchers, practitioners, and policymakers.     

A retrospective examination of outpatient commitment in New York

Outpatient commitment (OC) is a growing trend in mental health treatment. The impetus for this movement has been partly due to the public perception that some mentally ill outpatients are prone to violence as result of poor treatment compliance. Numerous studies have shown that poor treatment compliance is associated with increased hospitalization, substance abuse, homelessness, and contact with the criminal justice system. This study examined treatment effectiveness, demographic variables, hospital utilization, and violence among 100 OC participants in New York. Results indicate that OC can be an effective means of increasing treatment compliance and reducing hospitalization and encounters with the criminal justice system.     

The APA and deafness

Until the 1960s, people who were Deaf and mentally ill lacked access to psychological treatment. Few mental hospitals and clinics had interpreters available, and few psychologists and mental health professionals had knowledge of sign language. Major court decisions and federal laws have effected change, culminating with the Americans With Disabilities Act of 1990. This legislation gave people who are Deaf the right to equal access to mental health care as well as a host of other opportunities they had been previously denied. New access laws allowed Deaf students to become educated as psychologists, and a number of hearing psychologists who knew sign language entered the field of deafness. These two groups assumed vital roles within the American Psychological Association in addressing the issue of mental health access for people who are Deaf. ((c) 2006 APA, all rights reserved).     

The short-form Buss-Perry Aggression Questionnaire (BPAQ-SF): a validation study with federal offenders

The 12-item short form of the Buss-Perry Aggression Questionnaire (BPAQ-SF) was originally developed by Bryant and Smith (2001) and modified and confirmed using confirmatory factor analysis with mentally ill offenders by Diamond, Wang, and Buffington-Vollum (2005). In the current study, construct validity of the BPAQ-SF was assessed with a sample of 1,181 male and 435 female general population federal offenders. Confirmatory factor analysis supported the four-factor structure. Tests confirmed factorial invariance across gender for all loadings and covariances. Reliabilities were found to be adequate and comparable to those found in the studies cited above. Concurrent validity was supported by high correlations between the subscales of the BPAQ-SF and several relevant subscales on the Personality Assessment Inventory (PAI). In addition, those offenders with prior history of violence, head injuries, childhood abuse, residential treatment, custody, or foster care as a child had higher scores on the BPAQ subscales.     

Character and behavior in the mentally ill and well mother

The purpose of this study was to examine character and behavior in a group of mentally ill and well mothers. Mentally ill mothers differed from well mothers in mother-child interaction in their positive involvement in the feeding context and in overall optimal mothering during feeding. On measures of intrapsychic conflict and concern, mentally ill mothers demonstrated significantly more conflict in areas of trust, anger, self-esteem, mutuality and nurturance and more concern with issues of self-esteem, and giving and caring than well mothers. For the mentally ill mothers postpartum onset of illness and number of separations from her child were related to some aspects of character and behavior.     

Fairweather and ESID: Contemporary Impact and a Legacy for the Twenty-First Century

This paper illustrates how the articles in this special issue demonstrate the central values, research, and action principles inherent in Fairweather's ESID model. The programs described in these articles address earlier social problems in new forms (e.g., previously, institutionalized mentally ill patients and now, the homeless mentally ill) and new issues (e.g., HIV prevention). Dissemination of innovative programs is abundant, but only recently has research begun in earnest to study the critical processes of dissemination. Moreover, Fairweather has pointed us in important, but yet unrealized directions for how to pursue a theory of social change on the basis of ecological concepts, innovative research methods and data analytic techniques, and salient change agent behaviors and principles.     

Gewalttaten psychisch Kranker

Only a minority of mentally ill persons become conspicuous due to acts of violence. Nevertheless, from time immemorial there has been a certain fear of the alleged unpredictability of the mentally ill, particularly of people who suffer from a psychosis. The creation of psychiatry as an independent medical discipline was designed from the very beginning to separate people deemed to be dangerous from society and to detain them in institutions in order to heal them, to make relevant improvements or to keep them indefinitely. The movement of dehospitalization since the 1970s, which in turn was a consequence of revolutionization of treatment options through modern neuroleptic and antidepressive drugs, led to a distinctive separation between general psychiatry and forensic psychiatry, institutionally (general psychiatric institutions with periods of hospitalization of a few weeks and psychiatric forensic committment lasting many years) as well as increasingly more in scientific discourses; however, a close cooperation is necessary for healthcare treatment, which meets the requirements of patients and also public security. In this respect general psychiatry must still undertake substantial safety reponsibilities, which it can learn from forensic psychiatry, whereas forensic committment must rapidly acquire the therapy experience of general psychiatry.     

A decade of research and services for homeless mentally ill persons. Where do we stand?

Over the past decade, researchers have documented the range of needs and devised new methods for increasing our understanding of the homeless severely mentally ill population. Clinicians have developed an appreciation of the difficulty and complexity of effectively treating this population, and policymakers have become increasingly aware of the barriers to developing services and housing. In this article, the progress-to-date in research, the evolution of new service approaches, and the development of federal, state, and local policies to meet the needs of homeless mentally ill individuals are assessed. The many challenges that remain are also considered.     

Offense Characteristics of Incompetent to Stand Trial Defendants Charged With Violent Offenses

The current study compared offender and offense characteristics of pretrial defendants found incompetent to stand trial (IST) against those described as general offenders by victims in the 2008 Bureau of Justice Statistics (BJS) survey and evaluated factors that differentiated IST defendants who allegedly used weapons from those who did not during the course of a violent offense. IST defendants were older and used “weapons” more frequently than those reported in the BJS survey; however, other characteristics, including use of firearms, did not differ. No demographic, clinical, or legal factors differentiated pretrial defendants who used weapons from those who did not. Overall, pretrial defendants were frequently diagnosed with a comorbid substance use disorder, and were homeless, unemployed, and had an extensive history of psychiatric hospitalizations and prior arrests at the time of their alleged offenses. Such results indicate that models for comprehensive discharge planning may have utility in addressing the unique needs of this subgroup of mentally disordered offenders. The findings also raise questions about the federal and state prohibition of gun rights to all IST defendants. Copyright © 2015 John Wiley & Sons, Ltd.     

Right of active duty military personnel to refuse psychiatric treatment

Under Federal Court precedents, mentally ill patients have a qualified right to refuse treatment. The amount of due process that may be required to override treatment refusals by active duty military patients is discussed. Due process for these individuals need not be judicial, since medical review satisfies federal requirements. Involuntary administration of medication to active duty military personnel is justified in some circumstances. Specific criteria for overriding treatment refusals are suggested. A sample protocol for overriding the treatment refusals of active duty personnel is offered.     

"Stereotypic" delusional offending

Some patients with serious mental illness appear to respond violently to the same delusional content throughout the course of their illness. Anecdotal, empirical, and theoretical evidence is presented establishing the premise of "stereotypic" delusional offending. A method for measuring the similarity of two delusions separated in time also is presented. An empirical focus on stereotypic delusional offending may help identify more accurately persons at risk for violence and those at risk for becoming targets of violence. It also may provide a better understanding of successful treatment of outpatient violence and conceivably could inform the ongoing debate on involuntary outpatient commitment laws. Among the major issues of this debate in the United States are the potential benefits of a forced medication provision. One rationale for such a provision may be found in the treatment response of seriously mentally ill outpatients whose violent behavior appears inescapably tied to their persistent or recurrent delusions.     

TRANSITIONAL EMPLOYMENT FOR THE CHRONICALLY MENTALLY ILL

This article discusses the use of transitional employment in the vocational and psychosocial rehabilitation of the chronically mentally ill. The development and implementation of a transitional employment program at Towne House Creative Living Center, Oakland, California, is described. The value of adapting the work environment and use of support groups in aiding psychosocial and vocational adjustment are discussed. It is concluded that transitional employment is an effective treatment modality that can be utilized by occupational therapists involved in community based treatment of the mentally ill.     

Violence risk: Re-defining variables from the first-person perspective

Over the past 25 years, there have been notable advances in violence risk assessment of mentally ill individuals using actuarial methods to define high versus low risk groups. A focus on readily observable risk factors, however, has led to a relative neglect of how the offender's subjective states may be valuable to consider in research on the ongoing assessment and prevention of violence. We argue for the relevance of considering idiographic features of subjective experience in the development of structured assessment methods. We then identify three heuristic groups of existing constructs related to aggressive and illegal behavior that may capture modifiable, time-varying aspects of mental functioning leading up to involvement in an act of violence. These hypothesized domains are: (i) construal of intent and cause; (ii) normative reference points; and (iii) emotion recognition and regulation. We suggest that risk state for violence can be studied in a parsimonious and direct manner through systematic research on coded speech samples. The coding method for such an assessment procedure would be almost identical to existing structured clinical judgment instruments with the difference that variables be defined from a first-person point of view. Some implications of this approach for the tertiary prevention of violence in high-risk individuals are described.