The question of sanity restoration in jail

Severe mental illness, especially psychotic disorders that are worsening, acute or complicated, normally require intensive psychiatric care and treatment that is most appropriately provided in a mental hospital. For criminal defendants, transfer to a forensic security hospital has traditionally been the means of achieving hospital care for mentally disordered defendants who have been found incompetent to stand trial or not guilty by reason of insanity. In recent years, with the shortage of intermediate and long-term hospital beds in the United States, including forensic security hospital beds, jail-based competency restoration programs are being established, seemingly obviating hospital transfer. Potential advantages of and concerns about jail-based, as opposed to hospital-based, competency restoration programs are discussed in the literature. If defendants with severe mental illness traditionally treated in a forensic security hospital for competency restoration are now treated for competency restoration in jail, it is not inconceivable that insanity acquittees could one day be treated in jail for sanity restoration. With the premise that it is better to consider the potential consequences before this becomes a serious proposal and is implemented, this analysis examine the advantages and concerns that have been put forth for jail-based competence restoration programs as they may or may not apply to jail-based sanity restoration programs. Substantial commonality is recognized, but also some differences, as well as reason for skepticism of the purported virtues of either alternative to care and treatment in forensic security hospitals.     

Predictors of improvement in maximum security forensic hospital patients

In a maximum security forensic hospital population (n = 376), relationships between three groups of patient factors (diagnostic data patient histories, and hospital course) and two indicators of treatment effectiveness (length of hospitalization [LOH] and restoration of competency to stand trial) were analyzed. Schizophrenia, previous hospitalizations, felony charges, drug treatment refusal, involuntary medication, physical restraint, and absence of personality disorders were associated with increased LOH. Nonschizophrenic patients without histories of previous incarceration, and, paradoxically, drug treatment refusers were relatively successful with competency restoration. Implications of these findings and questions for future research are discussed.     

Fitness, attitude toward physical education, and self-concept of elementary school children

Elementary school children scoring in the highest and lowest 26% or 27% of their classes on the Texas Physical Fitness test were compared for attitude toward physical education and self-concept. Data were collected on the Children's Attitude Inventory Toward Physical Education, a Game of Pairs for Preferences Among School Subjects, and the Children's Self-concept Scale. Analysis of variance indicated significant differences on all tests between boys high in fitness, girls high in fitness, boys low in fitness, and girls low in fitness. Subsequent Scheffé tests indicated that highly fit girls had significantly higher attitude and self-concept scores than boys low in fitness. Highly fit boys had higher self-concepts than boys low in fitness. No other group comparisons were significant. Pearson correlations indicated nonsignificant associations between fitness and attitude and self-concept for the four groups.     

Outcome of hospitalization for defendants found incompetent to stand trial

This study assessed the outcome of hospitalization for incompetent criminal defendants admitted to the forensic unit of a state hospital for treatment during a 4-year period. Findings suggested that the overwhelming majority of the defendants were restored to competency. The defendants also showed significant improvement in overall severity of psychopathology during hospitalization. Further, the duration of hospitalization for these defendants was relatively short. Although these results are promising with regard to treatment of incompetent defendants, predicting the outcome of hospitalization for these defendants was problematic. Prediction of competency restoration was precluded because persistent incompetence was so infrequent. Moreover, multiple regression analyses suggested limited predictive ability with regard to defendants' discharge level of functioning or length of hospitalization. These findings are consistent with the view that examiners should exercise caution in making recommendations to the courts concerning treatability of incompetent defendants.     

Influence of coaching efficacy and coaching competency on athlete‐level moral variables in Botswana youth soccer

This study examined coach‐perceived coaching efficacy and athlete‐perceived coaching competency, perceptions of coaches' endorsement of unfair play, and team norm for aggression on athlete‐level moral variables in Botswana youth soccer. Participants were youth soccer players (n = 506) and their coaches (n = 24). Players completed the coaching competency scale, the Judgments About Moral Behavior in Youth Sports Questionnaire, and the Team Norm Questionnaire. Coaches completed the Coaching Efficacy Scale. Multilevel analysis revealed that team norm for aggression, athletes' perceptions of their coaches' endorsement of aggression/cheating, and Game Strategy Coaching Competency were significant predictors of athletes' likelihood to aggress and perceptions of peer cheating. The findings contribute to previous research demonstrating the influence of the coach on athletes' antisocial behaviors.     

Jail‐based competency treatment comes of age: Multi‐site outcomes and challenges to the implementation of an evidence‐based forensic continuum

The jail‐based competency treatment (JBCT) model has become an established forensic practice across the country. From the perspective of implementation science and the three core elements of the Promoting Action on Research Implementation in Health Service (PARiHS) framework, the JBCT model is a remarkable example of how context (an unrelenting and overwhelmingly strong demand for forensic beds) has driven multiple state governments to facilitate implementation of a methodology in the absence of empirical evidence supporting its efficacy. This 7‐year study of outcomes from four JBCT program sites provides this much‐needed evidence by showing that JBCT restored 56% of 1553 male and 336 female patients over an average of 48.7 days. At the same time, the study highlights how variations in JBCT models, methods, and preadmission stabilization time present challenges to planned and effective implementation of evidence‐based practice at the statewide system level. By identifying differential responsiveness to JBCT treatment by diagnosis and other factors, the study suggests preliminary implementation ideas for what types of patients are well served by the JBCT model as part of a continuum of restoration options that includes inpatient, outpatient and diversion. Significant findings showed that JBCT patients were restored at a higher rate and in a shorter time if they were female, < 20 years old (highest restoration rate; those < 60 years old also significantly better rates), free of co‐occurring intellectual and cognitive deficits, and malingering. Of the major diagnoses, schizoaffective disorder required a significantly longer length of JBCT treatment for restoration, and lower restoration rates than schizophrenia and bipolar disorder, although this was moderated by a significant interaction with abuse of amphetamines.     

Patient Characteristics and Outcomes Related to Successful Outpatient Competency Restoration

Criminal defendants have a fundamental right to a fair and speedy trial. However, individuals found incompetent to stand trial are unable to move forward in the adjudication process and are often mired in protracted legal proceedings. If competency restoration is statutorily permissible and can be conducted in the outpatient setting, we propose that it should be considered based on burgeoning empirical data. We present data from an outpatient forensic clinic in which individuals are conditionally released to receive competency restoration in the community. Results indicated that three variables, including being single/never married, having comorbid intellectual disability and mental illness, and having one's conditional release revoked, were negatively related to successful restoration. The final model explained approximately one‐third of the variance in restorability and correctly classified 75% of cases. Results demonstrate that individuals can be safely released to the community and successfully restored to competency in the outpatient setting. Utilizing outpatient competency restoration would not only reduce strain on inpatient facilities, but would also reduce the cost of treatment. Copyright © 2017 John Wiley & Sons, Ltd.     

Can parent‐to‐parent consultation improve the effectiveness of the Maudsley model of family‐based treatment for anorexia nervosa? A randomized control trial

Objective: This paper describes a preliminary randomized control trial that explores the use of parent‐to‐parent consultations as a potential augmentation to the Maudsley model of family‐based treatment for anorexia. Method: Twenty families were randomized into two groups, ten receiving standard treatment and ten receiving an additional parent‐to‐parent consultation early on in treatment. Measures of parental efficacy (Parents versus Anorexia Scale), patient distress (Depression Anxiety and Stress Scale) and percentage ideal body weight were taken each week. The effects of parent‐to‐parent consultations on parental efficacy and weight were analysed by comparing data with random effects models. Results: A significant treatment effect was found, with parent‐to‐parent consultations leading to a small increase in the rate of weight restoration. Conclusion: This practice has the potential to enhance weight restoration when included in the Maudsley model of family‐based treatment for anorexia nervosa. Research that tests more potent forms of intervention may also have merit.     

The Caterpillar Game: A SW-PBIS Aligned Classroom Management System

The Caterpillar Game is a classroom management system that is aligned with School-wide Positive Behavioral Interventions and Supports standards. A single-case, multiple-baseline design was used to evaluate the effects of the Caterpillar Game on disruptive student behavior and teacher praise. Three classrooms were included in the study (preschool, Kindergarten, and second grade). When the Caterpillar Game was implemented, student disruptive behavior decreased and teacher behavior-specific praise increased across all 3 classrooms. Disruptive behavior and teacher praise remained similar to intervention 2–4 weeks later, and teacher satisfaction with the Caterpillar Game was high. This study adds further support for the use of the Caterpillar Game as a classroom management tool.     

The alliance in a friendship coaching intervention for parents of children with ADHD

The alliance between parent and therapist was observed in a group-based parent-training intervention to improve social competency among children with attention-deficit/hyperactivity disorder (ADHD). The intervention, called Parental Friendship Coaching (PFC), was delivered to 32 parents in small groups as part of a randomized clinical trial. PFC was delivered in eight, 90-minute sessions to parents; there was no child treatment component. Observed parent–therapist alliance recorded among 27 of the parents was measured using the Therapy Process Observational Coding System—Alliance scale (TPOCS-A; McLeod, 2005). Early alliance and change in alliance over time predicted improvements in several parenting behaviors and child outcomes, including peer sociometrics in a lab-based playgroup. These preliminary findings lend support to the importance of examining the parent–therapist alliance in parent-training groups for youth social and behavioral problems.     

An Evaluation of Pharmacological Treatment Combined with Stress Inoculation Training in the Management of oral Lichen Planus

The aim of this pilot study was to examine the effects of the inclusion of a cognitive-behavioral intervention to the pharmacological treatment of oral lichen planus (OLP). Using a randomized controlled clinical trial, 16 patients affected by OLP were treated either with a potent corticosteroid in addition with stress inoculation training or with the drug alone. There were significant differences between the groups regarding the severity of the pathology both at the end of the treatment as well as at one-month follow-up. It is concluded that a cognitive-behavioral intervention might be usefully combined with pharmacological treatment for OLP.     

Feasibility and acceptability of an exergame intervention for schizophrenia

ObjectivesTo evaluate the feasibility and acceptability of an exergame intervention as a tool to promote physical activity in outpatients with schizophrenia.DesignFeasibility/Acceptability Study and Quasi-Experimental Trial.MethodSixteen outpatients with schizophrenia received treatment as usual and they all completed an 8-week exergame intervention using Microsoft Kinect^® (20 min sessions, biweekly). Participants completed pre and post treatment assessments regarding functional mobility (Timed Up and Go Test), functional fitness performance (Senior Fitness Test), motor neurological soft signs (Brief Motor Scale), hand grip strength (digital dynamometer), static balance (force plate), speed of processing (Trail Making Test), schizophrenia-related symptoms (Positive and Negative Syndrome Scale) and functioning (Personal and Social Performance Scale). The EG group completed an acceptability questionnaire after the intervention.ResultsAttrition rate was 18.75% and 69.23% of the participants completed the intervention within the proposed schedule. Baseline clinical traits were not related to game performance indicators. Over 90% of the participants rated the intervention as satisfactory and interactive. Most participants (76.9%) agreed that this intervention promotes healthier lifestyles and is an acceptable alternative to perform physical activity. Repeated-measures MANOVA analyses found no significant multivariate effects for combined outcomes.ConclusionThis study established the feasibility and acceptability of an exergame intervention for outpatients with schizophrenia. The intervention proved to be an appealing alternative to physical activity. Future trials should include larger sample sizes, explore patients' adherence to home-based exergames and consider greater intervention dosage (length, session duration, and/or frequency) in order to achieve potential effects.     

The effects of preschool on educationally advantaged children: First phases of a longitudinal study

This study is concerned with the preschool and kindergarten phases of a ten-year longitudinal research project designed to investigate the immediate and long-term effects of preschool on educationally advantaged children. Preschool data dealing with IQ, social competency, and school readiness, as well as physical abilities and self-concept were collected on two waves of subjects. Wave I(N = 129) consisted of 87 experimental and 42 control subjects, and in Wave II(N = 85) there were 54 experimental and 31 control subjects. Follow-up data on school readiness and social competency data were obtained from Wave I subjects in kindergarten. Analysis of data indicated that social competency, was enhanced through preschool participation and although there were no significant group differences in kindergarten test results, substantial social competency gains were observed for both groups. Findings will have greater meaning as the longitudinal study continues.     

Utilizing Family Strengths and Resilience: Integrative Family and Systems Treatment with Children and Adolescents with Severe Emotional and Behavioral Problems

Community mental health agencies are consistently challenged to provide realistic and effective home-based family-centered treatment that meets local needs and can realistically fit within available budget and resource capabilities. Integrated Family and Systems Treatment (I-FAST) is developed based on existing evidence-based approaches for working with at-risk children, adolescents, and families and a strengths perspective. I-FAST identified 3 evidence-based, core treatment components and integrated them into a coherent treatment protocol; this is done in a way that builds on and is integrated with mental health agencies' existing expertise in home-based treatment. This is an intervention development study in which we conducted an initial feasibility trial of I-FAST for treating families with children at risk of out-of-home placement. The outcomes of the study provide initial empirical evidence that supports the effectiveness of I-FAST. Findings indicate that there were significant improvements in child behavior, significant increases in parental competency, and significant increases in the level of cohesion and adaptability in these families. All observed changes were significant from pre- to posttreatment with the families able to maintain these positive changes at 6-month follow-up. A more rigorous and robust research design, however, will be needed to establish definitive evidence of the effectiveness of I-FAST.     

Serial Mediators of Memory Support Strategies Used With Cognitive Therapy for Depression: Improving Outcomes Through Patient Adherence and Treatment Skills

Patient memory for treatment is poor. Memory support strategies can be integrated within evidence-based psychological treatments to improve patient memory for treatment, and thereby enhance patient outcomes. The present study evaluated possible mechanisms of these memory support strategies. Specifically, we tested whether therapist use of memory support strategies indirectly predicts improved patient outcomes via serial improvements in (a) patient adherence throughout treatment and (b) patient utilization and competency of treatment skills. Adults with major depressive disorder (N = 178, mean age = 37.93, 63% female, 17% Hispanic or Latino) were randomized to Cognitive Therapy plus a Memory Support Intervention or Cognitive Therapy-as-usual. Because therapists from both treatment groups used memory support strategies, data from conditions were combined. Blind assessments of depression severity and overall impairment were conducted before treatment, immediately posttreatment (POST), at 6-month follow-up (6FU), and at 12-month follow-up (12FU). Patient adherence to treatment was rated by therapists and averaged across treatment sessions. Patients completed measures of treatment mechanisms—namely, utilization and competency in cognitive therapy skills—at POST, 6FU, and 12FU. Results of serial mediation models indicated that more therapist use of memory support predicted lower depression severity at POST, 6FU, and 12FU indirectly and sequentially through (a) increased patient adherence during treatment and (b) more utilization and competency of Cognitive Therapy skills at POST, 6FU, and 12FU. The same patterns were found for serial mediation models predicting lower overall impairment at POST, 6FU, and 12FU. Together, boosting memory for treatment may represent a promising means to enhance pantreatment mechanisms (i.e., adherence and treatment skills) as well as patient outcomes.     

Psychosocial Functioning in Children and Adolescents with Gastrointestinal Complaints and Disorders

The current study examined the prevalence and presentation of psychosocial symptoms in pediatric patients and their parents presenting for first time appointments at a gastroenterology (GI) clinic compared to healthy controls (HC). One hundred GI patients, aged 8-17 years, and their mothers were compared to 100 age- and gender-matched HC on measures of child and parental behavioral/psychosocial functioning, depression, and anxiety. Results revealed significant correlations between mother- and child-reported internalizing behaviors and psychological symptoms. Significant group differences were observed in internalizing problems, adaptive and social skills, and leadership competency, as well as parental interpersonal sensitivity, depression, phobic anxiety, and number of psychological symptoms. GI patients are at increased risk for psychosocial and social dysfunction compared to healthy peers. Psychosocial factors should be considered when assessing patients in GI clinics. Patients might benefit from treatment plans that involve adjunctive behavioral intervention to assist patients in managing their conditions.     

A controlled evaluation of paraspinal EMG biofeedback in the treatment of chronic low back pain

Sixty-six chronic low back pain sufferers were randomly divided into three groups. Following individual assessments consisting of psychological questionnaires, pain monitoring, and measurement of paraspinal electromyogram (EMG), one group received paraspinal EMG biofeedback and another a placebo treatment. The third group received no intervention. Two further assessments were carried out on all groups immediately after treatment and at a 3-month follow-up. All groups showed significant reduction in pain, anxiety, depression, and paraspinal EMG following treatment and at follow-up, but there were no differences between groups. A regression analysis failed to identify subjects' characteristics that predicted positive outcome in the biofeedback group. However, high scores on the Evaluative scale of the McGill Pain Questionnaire and high hypnotizability were significant predictors of positive outcome for the placebo group. It is concluded that paraspinal EMG biofeedback is not a specific treatment for chronic low back pain in a nonhospitalized population.     

Animal-Assisted Therapy with Farm Animals for Persons with Psychiatric Disorders: Effects on Anxiety and Depression,a Randomized Controlled Trial

This study examined the effects of Animal-Assisted Therapy with farm animals during a 12 weeks' intervention on anxiety and depression among psychiatric patients by using a randomized controlled trial with a follow-up investigation at 6 months. Ninety adult patients were included, with 41 completers in the treatment group and 28 in the control group. Anxiety measured using Spielberger State Anxiety Inventory did not decrease significantly during the intervention for the treatment group but was significantly lower at follow-up compared with baseline (p = 0.002) and with the end of the intervention (p = 0.004). There was no significant change for the control group. Depression measured using Beck Depression Inventory was significantly lower at follow-up compared with baseline for both groups, but there were no significant differences between the groups.     

高校教师胜任特征模型的构建与验证

本研究采取工作分析和行为事件访谈整合的研究范式构建高校教师胜任特征模型,然后通过团体焦点访谈、测验编制、评价第二个校标样本等三种方法,验证模型的专家效度、构想效度与同时结构效度。结果表明：高校教师胜任特征模型包括8项：创新、批判性思维、教学策略、专注、社会服务意识、逻辑分析能力、成就欲、尊重他人;高校教师胜任特征自评问卷可简缩为三个因子,即人员导向、成就导向和创新导向,该问卷具有良好的信效度,可以作为测量高校教师胜任特征水平的工具;将结构化工作分析与行为事件访谈法整合构建胜任特征模型,是可行和有效的建模路径。     

Effects of a 6-week aerobic dance intervention on body image and physical self-perceptions in adolescent girls

Research examining the impact of physical activity on body image dissatisfaction and physical self-perceptions has been both limited and equivocal. The current research investigated the effects of 6-week aerobic dance on these variables with 50 British schoolgirls aged 13–14 years. A cross-over design was used with two equivalent groups taught normal physical education and aerobic dance in a different order. The Body Attitude Questionnaire (BAQ) and Children and Youth Physical Self-Perception Profile (CY-PSPP) were administered as pre, mid and post-test to each participant in each group before the first intervention, at the change over and after 12 weeks. The results of this study revealed that participation in 6 weeks of aerobic dance significantly reduced body image dissatisfaction (Attractiveness, Feeling Fat, Salience and Strength and Fitness) and enhanced physical self-perceptions (Body Attractiveness and Physical Self-Worth), although these improvements were not sustained. The implications and future research directions are discussed.