Treatment readiness in violent offenders: The influence of cognitive factors on engagement in violence programs

Advances in offender rehabilitation theory have led to the development of a clear framework of the factors that need consideration for an offender to be ready for therapy and thus gain maximum benefits. Here, we examine in greater detail the role of cognition in readiness for rehabilitation in violent offenders. We assess how cognitive processes and distortions common in violent offenders may affect and hamper rehabilitation readiness. Methods for remediation of cognitive factors that diminish readiness, including motivational interviewing, are discussed. We conclude that cognitive factors are critical in the assessment of readiness in violent offenders and therapeutic efforts to enhance engagement.     

Social skills training: The moderating influence of culture in the treatment of Latinos with schizophrenia

Providing effective psychiatric rehabilitation to ethnic minority patients with serious persistent mental illness (SPMI) requires an understanding of the role of cultural values and ethnicity-relevant factors on the course and outcome of severe mental disorders. In this paper, the author identifies some of the cultural factors that are relevant for Latinos with SPMI, and describes how these factors were incorporated into existing rehabilitation modalities. The results of a pilot study designed to test the efficacy of culturally-modified social skills training are presented. The results suggest that the cultural modifications improved Latino patients' ability to learn the material and enhanced their use of these skills in their natural environments. Future research will be aimed at identifying and incorporating these salutary cultural forces into the rehabilitation process of the severely mentally ill.     

海洛因成瘾者复吸倾向的研究

目的：探讨海洛因成瘾者复吸倾向的影响因素。方法：采用“复吸倾向问卷”对289名戒毒劳教人员进行测评。结果：发现戒毒意愿、将来环境、身心状态、物质替代和社会支持是影响复吸倾向的五个因素。这个结果提示在海洛因成瘾者的康复治疗中应该采用“药物——心理——社会”模式。     

Predicting individual change in support over time among chronically impaired older adults

Hierarchical linear modeling was used to examine the degree of individual change in friendship and family networks and support over time as a function of sociodemographic characteristics, rehabilitation use, and disability. Participants, 449 older adults, had age-related vision loss, a common, chronic impairment that tends to worsen over time. Three interviews were conducted (baseline and 6- and 18-month follow-ups). All network and support variables showed a decrease over time. Regarding factors predicting individual variation, age (younger) and education (lower) were associated with greater baseline friendship support, rehabilitation was related to maintaining a larger friend network, and disability was positively associated with family network and support. Results supported the importance of examining rates of individual change and factors associated with variability in multiple support components by relationship type.     

Attributions for recovery and adherence to rehabilitation following anterior cruciate ligament reconstruction: A prospective analysis

Abstract

The relationship between causal attributions for recovery and adherence was examined in a sample of 80 individuals (25 females and 55 males) undergoing rehabilitation following anterior cruciate ligament reconstruction. Participants estimated their speed of recovery and then rated their open-ended attributions for recovery on the Revised Causal Dimension Scale (McAuley, Duncan and Russell, 1992). Adherence was assessed in terms of attendance at rehabilitation sessions and practitioner ratings for the remainder of the rehabilitation period. Participants who perceived themselves as recovering rapidly attributed their recovery to more stable and personally controllable factors than participants who perceived themselves as recovering slowly. Causal dimension ratings predicted attendance at rehabilitation sessions, but not practitioner ratings of adherence. The results, which further demonstrate the relevance of causal attributions to health behavior, are compared with previous cross-sectional findings.     

The Use of the Term Virtual Reality in Post-Stroke Rehabilitation: A Scoping Review and Commentary

Virtual reality (VR) offers many opportunities for post-stroke rehabilitation. However, “VR” can refer to several types of computer-based rehabilitation systems. Since these systems may impact the feasibility and the efficacy of VR interventions, consistent terminology is important. In this study, we aimed to optimize the terminology for VR-based post-stroke rehabilitation by assessing whether and how review papers on this topic defined VR and what types of mixed reality systems were discussed. In addition, this review can inspire the use of consistent terminology for other researchers working with VR. We assessed the use of the term VR in review papers on post-stroke rehabilitation extracted from Scopus, Web of Science and PubMed. We also developed a taxonomy distinguishing 16 mixed reality systems based on three factors: immersive versus semi-immersive displays, the way in which real and virtual information is mixed, and the main input device. 64% of the included review papers (N = 121) explicitly defined VR and 33% of them described different subtypes of VR, with immersive and non-immersive VR as the most common distinction. The most frequently discussed input devices were motion-capture cameras and handheld devices, while regular 2D monitors were the most frequently mentioned output devices. Our analysis revealed that reviews on post-stroke VR rehabilitation did not or only broadly defined “VR” and did not focus on a specific system. Since the efficacy and feasibility of rehabilitation may depend on the specific system, we propose a new data-driven taxonomy to distinguish different systems, which is expected to facilitate communication amongst researchers and clinicians working with virtual reality.     

The multifactor offender readiness model

There has been a resurgence of interest in the rehabilitation of offenders. Research has consistently shown that rehabilitation programs for offenders, when they adhere to general principles of program design and delivery, will achieve significant reductions in recidivism. In this paper, we suggest that even greater reductions in recidivism can be achieved when readiness is addressed at the level of the individual offender, the program, and the context. A comprehensive understanding of readiness allows for fuller engagement in treatment, thus increasing probability of good treatment outcomes. We describe person, program, and context factors in a model of offender treatment readiness and discuss implications of the model for both assessment of offenders and for modification of low readiness.     

Alcohol-related expectancies for self and others reported by alcoholic men and women.

A questionnaire used by Rohsenow in 1983 was administered to 87 alcoholic men and women taking part in rehabilitation programs at local Swedish outpatient rehabilitation clinics. The purpose was to explore their alcohol-related expectancies for themselves and for others and to compare these with the results from other similar studies in other cultures. The answers, scored according to Rohsenow's eight factors, indicated that alcoholics expected larger positive and negative effects for others than for themselves. This discrepancy was slightly modified by such variables as sex, age, and drinking habits. Alcoholics in Sweden seem to have alcohol-related expectancies similar to those of social drinkers both in Sweden and in other Western countries.     

The factors that induce or overcome freezing of gait in Parkinson's disease

Freezing of gait (FoG), a transient halt in walking, is a major mobility problem for patients with Parkinson's disease (PD). This study examined the factors that induce FoG, and identified the cues and strategies that help overcome it through a postal survey of 130 PD patients. 72% reported FoG. The factors that commonly induced FoG were turning, fatigue, confined spaces and stressful situations, in addition to emotional factors. FoG was also ameliorated by various attentional and external cueing strategies. The concept of paradoxical kinesis, the potential neural substrates of such external cueing effects, and their importance for rehabilitation in PD are discussed.     

A Multidimensional Approach to Apathy after Traumatic Brain Injury

Apathy is commonly described following traumatic brain injury (TBI) and is associated with serious consequences, notably for patients’ participation in rehabilitation, family life and later social reintegration. There is strong evidence in the literature of the multidimensional nature of apathy (behavioural, cognitive and emotional), but the processes underlying each dimension are still unclear. The purpose of this article is first, to provide a critical review of the current definitions and instruments used to measure apathy in neurological and psychiatric disorders, and second, to review the prevalence, characteristics, neuroanatomical correlates, relationships with other neurobehavioural disorders and mechanisms of apathy in the TBI population. In this context, we propose a new multidimensional framework that takes into account the various mechanisms at play in the facets of apathy, including not only cognitive factors, especially executive, but also affective factors (e.g., negative mood), motivational variables (e.g., anticipatory pleasure) and aspects related to personal identity (e.g., self-esteem). Future investigations that consider these various factors will help improve the understanding of apathy. This theoretical framework opens up relevant prospects for better clinical assessment and rehabilitation of these frequently described motivational disorders in patients with brain injury.     

The transition from drug use and crime to noninvolvement: a case study

There is a paucity of research on the factors related to the process of change from involvement to noninvolvement in drug use and criminal activity. This paper presents a case study of one subject's life history, obtained from depth interviews, which reveals this process. For this subject, rehabilitation was facilitated by specific structural factors which interacted with and altered facilitated by specific structural factors which interacted with and altered personal values.     

The child and adolescent functional assessment scale (CAFAS): a dynamic predictor of juvenile recidivism

This study tested the degree to which the Child and Adolescent Functional Assessment Scale (CAFAS; Hodges & Wong, 1996), a mental health assessment tool, predicted recidivism among juvenile offenders. The CAFAS, which is sensitive to rehabilitation treatment effects, was compared with factors insensitive to rehabilitation (e.g., age, ethnicity, sex, and number of prior offenses). Also addressed was the methodological issue of whether to treat recidivism as a continuous or a dichotomous variable. The CAFAS was found to be significantly related to recidivism. The practical application of the results, as well as the value of emphasizing research on dynamic predictors that enable policy makers to target at-risk juveniles, is discussed.     

Efficacy of Cognitive Rehabilitation Therapies for Mild Cognitive Impairment (MCI) in Older Adults: Working Toward a Theoretical Model and Evidence-Based Interventions

To evaluate the efficacy of cognitive rehabilitation therapies (CRTs) for mild cognitive impairment (MCI). Our review revealed a need for evidence-based treatments for MCI and a lack of a theoretical rehabilitation model to guide the development and evaluation of these interventions. We have thus proposed a theoretical rehabilitation model of MCI that yields key intervention targets–cognitive compromise, functional compromise, neuropsychiatric symptoms, and modifiable risk and protective factors known to be associated with MCI and dementia. Our model additionally defines specific cognitive rehabilitation approaches that may directly or indirectly target key outcomes–restorative cognitive training, compensatory cognitive training, lifestyle interventions, and psychotherapeutic techniques. Fourteen randomized controlled trials met inclusion criteria and were reviewed. Studies markedly varied in terms of intervention approaches and selected outcome measures and were frequently hampered by design limitations. The bulk of the evidence suggested that CRTs can change targeted behaviors in individuals with MCI and that CRTs are associated with improvements in objective cognitive performance, but the pattern of effects on specific cognitive domains was inconsistent across studies. Other important outcomes (i.e., daily functioning, quality of life, neuropsychiatric symptom severity) were infrequently assessed across studies. Few studies evaluated long-term outcomes or the impact of CRTs on conversion rates from MCI to dementia or normal cognition. Overall, results from trials are promising but inconclusive. Additional well-designed and adequately powered trials are warranted and required before CRTs for MCI can be considered evidence-based.     

Development of a social interaction questionnaire for the trainers and mothers of children with disabilities participating in Dousa-hou (Japanese psycho-rehabilitation) camps

A 12-item Social Interaction Questionnaire was developed to measure the social interactions among trainers and mothers of children with disabilities in Dousa-hou camps. Dousa-hou is a Japanese psychological rehabilitation method which is widely used for children with mental retardation, cerebral palsy, and autism in Japan and other Asian countries. The primary focus of the rehabilitation method is to improve bodily movements, posture, and social support to patients and their first-degree relatives as well as promoting social interaction among participants. Two factors of interaction, (1) educational and daily life matters and (2) health and care matters, emerged through factor analysis. Cronbach coefficient alpha of the questionnaire was .91. The back-translated version of the Social Interaction Questionnaire also yielded two factors and Cronbach coefficient alpha of .87. It was found that mothers or first degree relatives (N=138; M = 43.5 yr., SD = 12.3) of the patients reported more social interaction than trainers when interacting with their child's trainer, supervisor, other trainers, and other mothers during six-day Dousa-hou camps.     

Personality Type Differentiation of Employed Versus Unemployed Clients

The 16 Personality Factors (16 PF) Test was used to determine if personality variables were significantly different for employed and unemployed clients. The results of the study indicate that demographic data failed to demonstrate any significant difference but that four factors on the 16 PF were found to be significant. Results should be of great interest to all professionals concerned with evaluation, adjustment, and/or placement of rehabilitation clients.     

Rehabilitation Treatments for Adults with Behavioral and Psychosocial Disorders Following Acquired Brain Injury: A Systematic Review

This review was aimed at systematically investigating the treatment efficacy and clinical effectiveness of neurobehavioral rehabilitation programs for adults with acquired brain injury and making evidence-based recommendations for the adoption of these rehabilitation trainings. Using a variety of search procedures, 63 studies were identified and reviewed using a set of questions about research methods, treatments, results and outcomes for the 1,094 participants. The 63 studies included treatments falling into three general categories: approaches based on applied behavior analysis, interventions based on cognitive-behavior therapy (CBT), and comprehensive-holistic rehabilitation programs (CHRPs). Considerable heterogeneity exists in the reviewed literature among treatment methods and within reported sample subjects. Despite the variety of methodological concerns, results indicate that the greatest overall improvement in psychosocial functioning is achieved by CHRP that can be considered a treatment standard for adults with behavioral and psychosocial disorders following acquired brain injury. Both approaches based on applied behavior analysis and CBT can be said to be evidence-based treatment options. However, findings raise questions about the role of uncontrolled factors in determining treatment effects and suggest the need for rigorous inclusion/exclusion criteria, with greater specification of theoretical basis, design, and contents of treatments for both interdisciplinary-comprehensive approaches and single-case methodologies.     

Vocational Appraisal of Social Security Disability Claimants

Rehabilitation centers offering vocational appraisal services to Social Security disability claimants should be aware that the factors of plant physical examinations, age, race, social class, sex, and religion may be barriers to employment which operate independently of work performance ability. When, after vocational appraisal, a claimant is recommended as employable, the rehabilitation center should back up its recommendation by a job-getting technique training program or direct placement help.     

Aerobic cycle exercising in a rehabilitation program with a wider choice of intensity

When patients in rehabilitation programs use cycle ergometers for aerobic fitness training, the exercise intensity is often restricted to a small range of heart rate. In this study, a wider choice of intensities was left to the patients without giving up the potential to reduce cardiac risks factors. 24 patients in 3-wk. rehabilitation programs could choose the exercise intensity up to a workload limit preset by the physical therapist. 20 of them exercised at an intensity covering the full range between the aerobic and anaerobic lactate threshold and 4 a little above. The opportunity to vary the workload was frequently used by 67%. In 75% of the exercise sessions, the patients' average heart rates exceeded moderate heart-rate targets recommended in rehabilitation and health promotion for people with moderate cardiac risks without a graded exercise test. In 72% of these sessions, the anaerobic lactate threshold at 4 mmol/L was not exceeded. But a tendency of 33% of the patients to exercise at higher blood lactate or blood pressure levels underlined the necessity of limiting the exercise intensity.     

Relationship of Illness Severity with Health and Life Satisfaction in Patients with Cardiovascular Disease: The Mediating Role of Self-efficacy Beliefs and Illness Perceptions

Guidelines for cardiovascular rehabilitation from different countries underline the importance of psychological factors in the achievement of improved clinical conditions and quality of life in patients with cardiovascular disease (CVD). Nevertheless, little research has been performed to identify the specific factors that greatly affect or foster patients’ quality of life. The aim of the current study was to investigate the contribution of illness perceptions (IP) and self-efficacy beliefs (SE) on the impact exerted by illness severity on health and life satisfaction in patients with CVD undergoing a rehabilitation program. The study had a cross-sectional design and involved 116 patients (mean age = 65.6 years; SD = 10.0 years; 79.3 % men). Illness severity was measured in terms of left ventricular ejection fraction (LVEF) at the discharge from the cardiology department, whereas psychological factors were assessed one week later. The results showed no relationships among LVEF and the two indicators of health and life satisfaction; moreover, these two variables are differently influenced by IP and cardiac risk factors SE (χ²(1) = 0.96, p = n.s.). Findings provide important suggestions for the implementation of interventions aimed at bettering patients’ quality of life, underlying the importance of working on IP and SE to improve levels of health and life satisfaction in patients with CVD.     

Heart Rate Recovery After Exercise in Outpatients with Coronary Heart Disease: Role of Depressive Symptoms and Positive Affect

Heart rate recovery after 1 min of exercise cessation (HRR-1) is an important prognostic factor in patients with cardiovascular disease (CVD). We aimed to further elucidate the association between HRR-1 and known psychosocial risk factors in patients referred for comprehensive cardiac rehabilitation. We examined 521 patients with coronary heart disease in the first week of an outpatient cardiac rehabilitation program. Depressive and anxiety symptoms were measured with the Hospital Anxiety and Depression Scale, and positive (PA) and negative affect were rated with the Global Mood Scale. Depressive symptoms showed a significant inverse relationship with HRR-1 (p?<?.05), controlling for sociodemographic and medical covariates, whereas anxiety symptoms did not show a significant association. PA made a significant contribution to HRR-1 as well (p?<?.05). Our findings suggest an independent association between HRR-1 and psychosocial risk factors of CVD.