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.     

Effects of training in rapid decoding on the reading comprehension of adult ESL learners

We report an experimental investigation of the effects on comprehension of increasing the decoding speed of three adult learners of English as a Second Language (ESL). Participants were taught to read lists of 25 difficult words in isolation until they could read the entire list at a mean rate of not more than 1.5 secs per word. They were then asked to read passages containing these words. Decoding speed and accuracy measures, for both the word lists and passages, and passage comprehension measures, were obtained. In a temporally contiguous within-subjects repeated trials reversal design, decoding training on isolated words was shown to be associated with significant increases in decoding speed and accuracy both in isolation and context, and improvements in the participants' comprehension. With all participants rate and accuracy gains in context were maintained in the final reversal phase, though the comprehension score gains did not. These results are discussed in terms of their implications for a decoding sufficiency hypothesis.     

Characteristics and outcomes of insanity acquittees in Oklahoma

The insanity defense is perhaps the most vigorously debated topic at the interface of the legal and mental health systems. This article addresses the need for empirical evidence by providing data on insanity acquittees and their later outcomes in Oklahoma, a jurisdiction not previously studied. Information was obtained on the demographic, legal, psychiatric, hospitalization, and post-hospitalization characteristics of all 61 defendants acquitted not guilty by reason of insanity (NGRI) and treated on the state forensic unit during a 5-year period. Insanity acquittees had few resources, significant psychopathology, and extensive involvement with the legal and mental health systems prior to the NGRI offense. Follow-up of three groups of discharged patients--those released at an initial court review, those who completed the NGRI treatment program, and those who absconded from the forensic unit--revealed that those who escaped from the unit had significantly more arrests and subsequent legal charges than regularly discharged patients.     

Teachers' knowledge of children's exposure to family risk factors: accuracy and usefulness

Teachers' knowledge of children's exposure to family risk factors was examined using the Family Risk Factor Checklist-Teacher. Data collected for 756 children indicated that teachers had accurate knowledge of children's exposure to factors such as adverse life events and family socioeconomic status, which predicted children's mental health problems at 1 year follow-up. For children at high teacher-rated risk, odds ratios ranged from 3.04 to 7.46, after adjusting for prior mental health problems. Teachers had poor knowledge of internal family functioning, such as conflict, parenting practices, or parental drug abuse. The findings suggest that asking teachers to report children's exposure to particular family risk factors is a feasible method for identifying children for selective interventions, but improved family-school communication may further enhance this process.     

The Problematization of Sexuality among Women Living with HIV and a New Feminist Approach for Understanding and Enhancing Women’s Sexual Lives

In the context of HIV, women’s sexual rights and sexual autonomy are important but frequently overlooked and violated. Guided by community voices, feminist theories, and qualitative empirical research, we reviewed two decades of global quantitative research on sexuality among women living with HIV. In the 32 studies we found, conducted in 25 countries and composed mostly of cis-gender heterosexual women, sexuality was narrowly constructed as sexual behaviours involving risk (namely, penetration) and physiological dysfunctions relating to HIV illness, with far less attention given to the fullness of sexual lives in context, including more positive and rewarding experiences such as satisfaction and pleasure. Findings suggest that women experience declines in sexual activity, function, satisfaction, and pleasure following HIV diagnosis, at least for some period. The extent of such declines, however, is varied, with numerous contextual forces shaping women’s sexual well-being. Clinical markers of HIV (e.g., viral load, CD4 cell count) poorly predicted sexual outcomes, interrupting widely held assumptions about sexuality for women with HIV. Instead, the effects of HIV-related stigma intersecting with inequities related to trauma, violence, intimate relations, substance use, poverty, aging, and other social and cultural conditions primarily influenced the ways in which women experienced and enacted their sexuality. However, studies framed through a medical lens tended to pathologize outcomes as individual “problems,” whereas others driven by a public health agenda remained primarily preoccupied with protecting the public from HIV. In light of these findings, we present a new feminist approach for research, policy, and practice toward understanding and enhancing women’s sexual lives—one that affirms sexual diversity; engages deeply with society, politics, and history; and is grounded in women’s sexual rights.     

Couple communication in stepfamilies

Effective communication is assumed to help sustain couple relationships and is a key focus of most relationship education programs. We assessed couple problem-solving communication in 65 stepfamily and 52 first-time-marrying couples, with each group stratified into high risk and low risk for relationship problems based on family-of-origin experiences. Relative to partners in first-time couples, partners in stepfamily couples were less positive, less negative, and more likely to withdraw from discussion. Risk was associated with communication in first-time but not stepfamily couples. Stepfamily couples do not exhibit the negative communication evident in high-risk first-time-marrying couples, and available relationship education programs that focus on reducing negative communication are unlikely to meet the needs of stepfamilies.     

Psychological Distress in Orphan,Vulnerable Children and Non-Vulnerable Children in High Prevalence HIV/AIDS Communities

The degree of psychological distress and access social support is investigated in children (n = 741) living in nine high prevalence HIV/AIDS communities. They comprised (i) vulnerable, maternally-orphaned (n = 319); (ii) vulnerable and not orphaned (n = 276); and (iii) typically developing (n = 146). The following psychometric tests were administered: The Trauma Symptom Checklist for Children (Townsend, 2002); the Reynolds Depression Scale for Children (Reynolds, 1989); and the Social Support Scale (Beale Spencer, Cole, Jones & Phillips Swanson, 1997). Primary caregivers completed the Conners' Parent Rating Scale (Conners, Parker, Sitarenios, & Epstein, 1998) and an Adversity Index (Killian, 2004a) to establish the vulnerability status of each child. The data were analysed to distinguish the groups from each other regarding profiles of distress. The findings suggest that vulnerable children, be they orphaned or not, manifest similar degrees of emotional distress and perceived themselves as unable to access social support. Interventions should address the needs of both orphans and other vulnerable children, without prioritising the needs of orphans over other vulnerable children.     

Increasing Efficiency in Military Learning: Theoretical Considerations and Practical Applications

Given the fundamental importance of higher-order cognitive skills for military personnel, increasing learning efficiency during training is paramount. The current article expands upon the state-based information-loss processing model, a comprehensive framework elucidating the processes involved in acquiring higher-order cognitive skills, to enumerate best practices for military training. Emphasis is placed on identifying empirically supported, state-of-the-art learning efficiency strategies and methodologies to address points of information loss throughout the learning process. Implications and pragmatic recommendations for simulation-based military training are discussed.     

But it still goes on: Therapeutic communities today

The work of therapeutic communities (TCs) have been said to develop from a certain ‘impulse’ or ‘attitude of mind’. The origin and definitional function of these terms are briefly traced and their meaning explored. Subsequently, eight papers submitted to the Journal are reviewed in order to give a survey picture of the theoretical and practical concerns current within European TCs. This brief survey demonstrates that, while rooted in the TC tradition, a number of projects have made interesting developments in both practice and theory. These innovations and the flare which has gone into them can be taken as evidence that the TC impulse is alive and well. What TCs require now are wider and more effective means of transmission to others because at their best TCs are self-regulating systems which can potentially obviate the harm caused by the deregulating systems of traditional health and social care.