Operationalizing the Assessment and Management of Violence Risk in the Short-term

Assessing risk of violence in the short term is crucial for managing and preventing violence, especially in institutions such as psychiatric units and prisons. Despite a lack of consensus on the definition of "short term", a number of recent tools and guidelines have been developed to aid short-term clinical decision-making. Whereas the supporting evidence for the new tools is impressive, limitations remain in terms of the focus on prediction, limited consideration of strengths, and poor integration with formulation and risk management. The Short-Term Assessment of Risk and Treatability (START) is a brief clinical guide for the dynamic assessment of risks, strengths and treatability. It focuses on short-term risks and the characteristics of the individual that, if changed, might lead to an increase or decrease in risk. The START has the potential to operationalize the structured professional judgment (SPJ) approach in order to inform the evaluation of multiple risk domains relevant to everyday psychiatric clinical practice. However, explicit guidance on integrating risk assessment, formulation and management is limited in the START and this paper describes the SPJ approach, reviews recent developments in approaches to risk, and considers how the START can be used to inform SPJ approaches and link risk assessment, formulation, and management. Copyright ? 2012 John Wiley & Sons, Ltd.     

Iona College Community Centered Family Health History Project: Lessons Learned from Student Focus Groups

The Community Centered Family Health History project was initiated to create accessible family health history tools produced by and for the community. The project goal was to promote increased community engagement in health education by encouraging conversations among family members that would translate knowledge of family health history into healthy lifestyle choices. As one of seven community partners, Iona College participated in customizing and beta-testing the Does It Run in the Family? toolkit. Twenty-nine college students were engaged to recruit three relatives related by blood to provide feedback on the utility of the toolkit. The toolkit consists of two booklets—“A Guide to Family Health History” and “A Guide to Understanding Genetics and Health”—explaining the importance of knowing and talking about health within the family as well as basics about how conditions are passed down through generations. Twenty-two of the twenty-nine students participated in focus groups to discuss their reactions to participation in the project. Students in the focus group reported that the study participants—students and their family members—found the toolkit to be user friendly and the experience a valuable one that prompted many to take positive steps toward good health.     

Dyadic Coping Among Couples with COPD: A Pilot Study

COPD (chronic obstructive pulmonary disease) is associated with psychological distress for patients as well as their partners. Dyadic coping can be negatively impacted by stressors. This study's objective was to compare the dyadic coping of couples in which one partner suffered from COPD with healthy couples of the same age. A total of 43 complete couples with COPD and 138 healthy couples participated in this pilot study. The surveys were sent by mail. The response rate of the COPD sample was 24.3%. In order to analyze the effect of gender and role (patient vs. partner) on dyadic coping, linear mixed models were calculated. To analyze the effect of gender and group (COPD group vs. normative comparison group) on dyadic coping, two-way analyses of variance were calculated for independent samples. COPD patients and their partners indicated that the patients received more support and were less able to provide support to their partners. This difference was also evident in comparison with the normative comparison group. In addition, couples with COPD perceived higher levels of negative coping and provided a considerably lower assessment of their positive dyadic coping. The dyadic coping of couples with COPD is unbalanced and more negative when compared to that of healthy couples. Interventions aimed at supporting COPD couples should seek to improve couples' dyadic coping in addition to individual coping strategies.     

Caffeine enhances real-world language processing: evidence from a proofreading task

Caffeine has become the most prevalently consumed psychostimulant in the world, but its influences on daily real-world functioning are relatively unknown. The present work investigated the effects of caffeine (0 mg, 100 mg, 200 mg, 400 mg) on a commonplace language task that required readers to identify and correct 4 error types in extended discourse: simple local errors (misspelling 1- to 2-syllable words), complex local errors (misspelling 3- to 5-syllable words), simple global errors (incorrect homophones), and complex global errors (incorrect subject-verb agreement and verb tense). In 2 placebo-controlled, double-blind studies using repeated-measures designs, we found higher detection and repair rates for complex global errors, asymptoting at 200 mg in low consumers (Experiment 1) and peaking at 400 mg in high consumers (Experiment 2). In both cases, covariate analyses demonstrated that arousal state mediated the relationship between caffeine consumption and the detection and repair of complex global errors. Detection and repair rates for the other 3 error types were not affected by caffeine consumption. Taken together, we demonstrate that caffeine has differential effects on error detection and repair as a function of dose and error type, and this relationship is closely tied to caffeine's effects on subjective arousal state. These results support the notion that central nervous system stimulants may enhance global processing of language-based materials and suggest that such effects may originate in caffeine-related right hemisphere brain processes. Implications for understanding the relationships between caffeine consumption and real-world cognitive functioning are discussed.     

Subtyping children and adolescents who are overweight based on eating pathology and psychopathology

Children and adolescents who are overweight can differ on dimensions measuring dietary restraint and psychopathology. Classifying clinical obese children and adolescents based on these psychological characteristics is shown to be useful in making differential prognoses. The present study aimed to research the validity of subtyping children and adolescents with overweight (N?=?138) in a non-clinical sample. Using cluster analysis, results revealed three subtypes: a dietary restraint/internalizing group (DR?+?IN; n?=?41), a pure internalizing group (IN; n?=?20) and a non-symptomatic group (NS; n?=?77). The DR?+?IN group outscored both other groups on measures of eating pathology, whereas the IN group outscored both other groups on measures of negative offect. Interestingly, the three groups did not differ on degree of overweight. The results seem to suggest that different psychological mechanisms can be observed in subgroups of young overweight adolescents. Further research should explore how individual psychological characteristics can be helpful when stipulating weight loss treatment programmes.     

The effect of age on decision making according to the Iowa gambling task

Aging has been associated with several brain changes that often affect the cognitive functioning of adults, but changes in executive functions, particularly in the field of decision making, have not been fully investigated. The Iowa Gambling Task (IGT) is a widely used tool to evaluate decision making, but little is known about the effect of age on its results. This study used the IGT and compared healthy young (n = 40) and elderly (n = 40) adults to evaluate their decision making processes. There were significant differences in the learning curve of the two age groups, but no difference in overall IGT performance. The results for the first IGT block were different from those of the rest of the task, and the group of elderly adults had a better performance in this block. Elderly adults also showed a preference for deck A, the one that resulted in greater losses. Findings confirmed the results of other studies, which reported that the IGT block score is the variable with the greatest sensitivity to age in this instrument.     

Transtheoretical Model Constructs for Physical Activity Behavior are Invariant across Time among Ethnically Diverse Adults in Hawaii

OBJECTIVES: Physical activity (PA) research applying the Transtheoretical Model (TTM) to examine group differences and/or change over time requires preliminary evidence of factorial validity and invariance. The current study examined the factorial validity and longitudinal invariance of TTM constructs recently revised for PA. METHOD: Participants from an ethnically diverse sample in Hawaii (N=700) completed questionnaires capturing each TTM construct. RESULTS: Factorial validity was confirmed for each construct using confirmatory factor analysis with full-information maximum likelihood. Longitudinal invariance was evidenced across a shorter (3-month) and longer (6-month) time period via nested model comparisons. CONCLUSIONS: The questionnaires for each validated TTM construct are provided, and can now be generalized across similar subgroups and time points. Further validation of the provided measures is suggested in additional populations and across extended time points.     

Early pathways to bullying: A prospective longitudinal study examining the influences of theory of mind and social preference on bullying behaviour during the first 3 years of school

Research has focused on the role of theory of mind (ToM) for positive social behaviour, while the association between ToM and negative social behaviours is less well understood. This longitudinal study compares two mediation models examining the role of ToM and peer-rated social preference at ages 5 and 6 for bullying at age 7. Participants were 114 children (58 boys, M_age = 67 months) at entry to primary school (T1). At Time 2 (T2), 106 children and, at Time 3 (T3), 96 children remained. Teacher-rated externalizing problems and children’s language ability were controlled at T1. Poor ToM was found to indirectly predict later bullying via poor social preference, while for boys only, greater earlier ToM directly predicted greater bullying 2 years later. These results suggest that there are different pathways to bullying via ToM and social preference , which has implications for interventions to prevent the development of bullying behaviour.     

What worries first-year students? Psychometric properties of the Student Worry Scale

The transition to university can be stressful for first-year university students. Despite the fact where the feeling of worry is a shared symptom by various mental health issues, there is a lack of studies that investigate into this matter. As worry is a domain-specific construct, there is a need for a valid and reliable measure of worry specifically for university students. Hence, this study aimed to evaluate the psychometric properties of the Student Worry Scale (SWS), particularly in terms of its validity and reliability. For this purpose, the current study recruited a sample of 295 first-year students to evaluate the psychometric properties of SWS. Exploratory factor analysis yielded a five-factor structure of SWS, which explained 55.7% of the total variance. The yielded five factors were general worries, financial-related concerns, significant other’s well-being, academic concerns, and social adequacy concerns. Inter-correlations between the five factors were all significant (r ranged between 0.395 and 0.625). The SWS demonstrated good internal consistency in this study (Cronbach’s alpha ranged between 0.786 and 0.941). Overall, the SWS is psychometrically evidenced to be a reliable and valid content-based worry measure specifically for university students.     

Enactment as Unconscious Communication

ABSTRACT

I explore the way in which unconscious primitive and nonsymbolic experience is communicated to the analyst’s unconscious through enactment. As the analyst receives the projections unconsciously, she is encouraged to enact aspects of the patient’s internal world. The analytic work then is through the understanding of these subtle and ubiquitous enactments. I value the work of understanding enactments as a rich and subtle pathway into the deepest levels of the patient’s unconscious. I explore the nature of this work and illustrate my point with clinical examples.