Synthesis of studies of co-occurring disorder(s) in criminal justice and a research agenda

The studies reported in this special issue were designed to take advantage of the unique opportunity that the Criminal Justice Drug Abuse Treatment Studies (CJDATS) cooperative provides to the systematic study of several key issues in programming for co-occurring disorder(s) (COD) in the criminal justice system. These papers present findings from CJDATS studies pertaining to co-occurring disorder(s), identify clinical initiatives to strengthen efforts to treat the population with co-occurring disorder(s), and point to a direction for the elaboration of a future research agenda. Four key areas of investigation are presented: Screening and Diagnosis; the Relationship of Co-Occurring Disorder(s) to Violence; Gender Differences; and the Delivery of Services for Co-Occurring Disorder(s). The first section of this article summarizes the studies included in this special issue within the context of the research literature already available. The second section suggests a future research agenda for the study of offender populations with co-occurring disorder(s), and concludes with a broad statement of clinical advancements to date.     

Effects of warned and unwarned demand transitions on vigilance performance and stress

The present study was designed to explore the effects of warned and unwarned demand transitions in vigilance on performance and self-reported stress. Twenty observers (10 women and 10 men) were assigned at random to each of six conditions resulting from the factorial combination of signal salience (high and low salience signals) and switching (no switch, switch with warning, and switch without warning). Performance metrics and self-reported stress state (Task Engagement, Distress, and Worry) were collected. While demand transitions did destabilize subsequent performance, increasing intra-individual variability, overall performance efficiency was uninfluenced by either switching or warning. Demand transitions, whether warned or not, increased self-reported distress. A dynamic model of performance stress may be necessary and research employing vigilance tasks in the future may be useful for developing this performance-stress model.     

Psychological impact of illness intrusiveness in epilepsy - comparison of treatments

Chronic illnesses are associated with multiple stressors that compromise quality of life (QOL). Implicit in many of these is the concept of illness intrusiveness, the disruption of lifestyles and activities attributable to constraints imposed by chronic disease and its treatment. This study tested the illness intrusiveness theoretical framework in epilepsy and compared the impact of pharmacological and surgical treatments on illness intrusiveness and QOL. Cross-sectional data compared three epilepsy groups (N = 145): (a) 40 patients admitted for presurgical evaluation to an Epilepsy Monitoring Unit; (b) 52 patients treated pharmacologically; and (c) 53 post-surgical patients. Illness intrusiveness differed significantly across epilepsy patients with the differences primarily related to seizure control. Illness intrusiveness varied inversely with seizure control (p < .05). Seizure freedom, whether achieved by surgical or pharmacological treatments, was associated with maximal reduction of illness intrusiveness. Increased illness intrusiveness correlated significantly with decreased QOL and increased depressive symptoms. Perceived control over diverse life domains correlated positively with QOL and psychosocial outcomes. Path analysis supported the validity of the illness intrusiveness theoretical framework in epilepsy. Illness intrusiveness is an important determinant of the psychosocial impact of epilepsy and its treatment. Effective pharmacological or surgical treatment may reduce illness intrusiveness in epilepsy. Findings also offer encouragement that QOL in epilepsy, as in other chronic conditions, may be enhanced by multidisciplinary bio-psychosocial efforts. Health care providers should consider multifaceted interventions to reduce illness intrusiveness and, thereby, improve QOL.     

Neuropsychologic functioning in children with autism: further evidence for disordered complex information-processing.

A wide range of abilities was assessed in 56 high-functioning children with autism and 56 age- and IQ-matched controls. Stepwise discriminant analyses produced good group discrimination for sensory-perceptual, motor, complex language, and complex memory domains but lower agreement for the reasoning domain than previously obtained for adults. Group discrimination did not occur for attention, simple language, simple memory, and visuospatial domains. Findings provide additional support for a complex information-processing model for autism, previously based on adult data, demonstrating a pattern across domains of selective impairments on measures with high demands for integration of information and sparing when demands were low. Children as compared to adults with autism exhibited more prominent sensory-perceptual symptoms and less pronounced reasoning deficits reflecting brain maturation.     

An Interview With Frank Miller About the Substance Abuse Subtle Screening Inventory

Frank Miller is a renowned addictions assessment authority who jointly initiated the updated Substance Abuse Subtle Screening Inventory versions and helped establish the inventories in the addictions assessment mainstream. Miller participated in the following interview on February 22, 2005.     

Shared Reality: Experiencing Commonality With Others' Inner States About the World

ABSTRACT— Humans have a fundamental need to experience a shared reality with others. We present a new conceptualization of shared reality based on four conditions. We posit (a) that shared reality involves a (subjectively perceived) commonality of individuals' inner states (not just observable behaviors); (b) that shared reality is about some target referent; (c) that for a shared reality to occur, the commonality of inner states must be appropriately motivated; and (d) that shared reality involves the experience of a successful connection to other people's inner states. In reviewing relevant evidence, we emphasize research on the saying-is-believing effect , which illustrates the creation of shared reality in interpersonal communication. We discuss why shared reality provides a better explanation of the findings from saying-is-believing studies than do other formulations. Finally, we examine relations between our conceptualization of shared reality and related constructs (including empathy, perspective taking, theory of mind, common ground, embodied synchrony, and socially distributed knowledge) and indicate how our approach may promote a comprehensive and differentiated understanding of social-sharing phenomena.     

Violent offenses associated with co‐occurring substance use and mental health problems: Evidence from CJDATS

The present study examines the relationship between substance use, mental health problems, and violence in a sample of offenders released from prison and referred to substance abuse treatment programs. Data from 34 sites (n = 1,349) in a federally funded cooperative, the Criminal Justice Drug Abuse Treatment Studies (CJDATS), were analyzed. Among parolees referred to substance abuse treatment, self‐reports for the six‐month period before the arrest resulting in their incarceration revealed frequent problems with both substance use and mental health. For most offenders with substance use problems, the quantity of alcohol consumed and the frequency of drug use were associated with a greater probability of self‐reported violence. Mental health problems were not indicative of increases in violent behavior, with the exception of antisocial personality problems, which were associated with violence. The paper emphasizes the importance of providing substance abuse treatment in relation to violent behavior among offenders with mental health problems being discharged to the community. Copyright © 2009 John Wiley & Sons, Ltd.     

Community Mental Health Service Providers' Codes of Ethics and the Standards for Educational and Psychological Testing

This study compared the codes of ethics of 13 professional organizations for community mental health service providers that have been represented at the meetings of the Fair Access Coalition for Testing with the Standards for Educational and Psychological Testing (American Educational Research Association [AERA], American Psychological Association [APA], & National Council on Measurement in Education [NCME], 1985) and all those standards cited in the revised Standards (AERA, APA, & NCME, 1999) that the investigators identified as pertaining to clinical assessment, as these standards apply to test users. The results suggest that only 2 of the codes of ethics address many of the Standards. Implications and recommendations for professional organizations are provided.