Training Mental Health Professionals to Assess and Manage Suicidal Behavior: Can Provider Confidence and Practice Behaviors be Altered?

Remarkably little systematic research has studied the effects of clinical suicidology training on changing practitioner attitudes and behaviors. In the current study we investigated whether training in an empirically‐based assessment and treatment approach to suicidal patients administered through a continuing education workshop could meaningfully impact professional practices, clinic policy, clinician confidence, and beliefs posttraining and 6 months later. At the 6 month follow‐up we found that 44% of practitioners reported increased confidence in assessing suicide risk, 54% reported increased confidence in managing suicidal patients, 83% reported changing suicide care practices, and 66% reported changing clinic policy. These results suggest that a brief and carefully developed workshop training experience can potentially change provider perceptions and behaviors with a possible impact on clinical care therein.     

Applicability of two violence risk assessment tools in a psychiatric prison hospital population

The risk of violent behavior is known to be higher for patients who suffer from a severe mental disorder. However, specific prediction tools for clinical work in prison psychiatry are lacking. In this single-center study, two violence risk assessment tools (Forensic Psychiatry and Violence Tool, “FoVOx,” and Mental Illness and Violence Tool, “OxMIV”) were applied to a prison hospital population with a primary psychotic or bipolar disorder and subsequently compared. The required information on all items of both tools was obtained retrospectively for a total of 339 patients by evaluation of available patient files. We obtained the median and inter-quartile range for both FoVOx and OxMIV, and their rank correlation coefficient along with 95% confidence intervals (CIs)—for the full cohort, as well as for cohort subgroups. The two risk assessment tools were strongly positively correlated (Spearman correlation = 0.83; 95% CI = 0.80–0.86). Such a high correlation was independent of nationality, country of origin, type of detention, schizophrenia-spectrum disorder, previous violent crime and alcohol use disorder, where correlations were above 0.8. A lower correlation was seen with patients who were 30 years old or more, married, with affective disorder and with self-harm behavior, and also in patients without aggressive behavior and without drug use disorder. Both risk assessment tools are applicable as an adjunct to clinical decision making in prison psychiatry.     

A simple device for the preparation of exactly aligned dichotic tapes

A system is described involving three tape recorders and a control device whereby dichotic tapes can be prepared with onset alignment accurate to a few milliseconds, or to a measured asynchrony if required. No modifications of any sort are necessary for the three tape recorders. The two channels are separately recorded in the speaker’s own time, the only requirement being that the separate words be spoken with an interword interval of 350 msec or more, to provide sufficient time for starting and stopping the system. A tone burst is placed directly on tape on another channel ahead of each word, the latter being delayed by recording in tandem through two tape recorders. The first recorder is set to the delay (echo, NAB) facility, while the tone is recorded directly on the second. Subsequently, when this is done for each item on the two speech channels, the device, described below. utilizes the tone bursts to align the two input recorders. It then rerecords each pair of words on to the third (output or dichotic) machine, to the desired synchrony/asynchrony, and interitem interval. The system can be left to align the two channels automatically. A maximum repetition rate of two dichotic pairs every 1.3 sec can be achieved with Revox A77 tape recorders.     

Long-Term conditioned fear modification in the dog as measured by changes in urinary 11-hydroxycorticosteroids. Heart rate and behavior

Heart rate (HR), operant key pressing, and urinary 11-hydroxycorticosteroids (11-OH-CS) were recorded while dogs were subjected to various aversive conditioning schedules over a six-month period. The schedules consisted of Sidman avoidance, followed by a Sidman schedule which paired unavoidable shocks (US) with offset of seven discrete conditioned stimuli (CS). Introduction of the Sidman avoidance schedule led to an increase in HR. Changes in the experimental schedule always results in an increase in urinary 11-OH-CS. Neither HR nor urinary 11-OH-CS were correlated with rate of operant key pressing. Differences in the dependent variables reflected the different topological characteristics of the dogs studied. This study demonstrated: (a) a causal independence of physiological and behavioral responses conditioned to the same stimulus complex, and (b) that longterm increases in HR can be maintained if the experimental situation is manipulated to maintain the fear eliciting characteristics of the conditioning situation.