Outcome of patients rehabilitated through a New Zealand forensic psychiatry service: A 7.5 year retrospective study

This paper describes a 7.5 year retrospective study of all patients discharged from inpatient forensic services to forensic community team (FCT) follow-up from the Auckland Regional Forensic Psychiatry Service. Patients' files were studied for clinical, criminal, and risk data, type of service delivered, and final level of function achieved in the community. Rearrest, re-hospitalization, and reimprisonment data were obtained from clinical, court, and prison records.105 patients were included. The most common diagnosis was a psychotic disorder, and index offending behaviour was typically violent. The median period of inpatient stay was 36 months and mean subsequent FCT follow-up 21.7 months (SD 17.8). The majority of patients were from Maori and Pacific Island ethnic groups. At the end of the study, half were in independent living, half were in some form of employment, and 19% were readmitted to a forensic hospital.One patient was rearrested but not reimprisoned whilst under forensic community team care. However, 9 of the 48 who were discharged to general mental health services were rearrested and 5 reimprisoned. Only two offences were as serious as the original index offence.Broad based assertive, mandated, and committed forensic rehabilitation can achieve high quality outcomes. These levels of function may not be sustained under less assertive care.     

The prepared mind: neural activity prior to problem presentation predicts subsequent solution by sudden insight

Insight occurs when problem solutions arise suddenly and seem obviously correct, and is associated with an "Aha!" experience. Prior theorizing concerning preparation that facilitates insight focused on solvers' problem-specific knowledge. We hypothesized that a distinct type of mental preparation, manifested in a distinct brain state, would facilitate insight problem solving independently of problem-specific knowledge. Consistent with this hypothesis, neural activity during a preparatory interval before subjects saw verbal problems predicted which problems they would subsequently solve with, versus without, self-reported insight. Specifically, electroencephalographic topography and frequency (Experiment 1) and functional magnetic resonance imaging signal (Experiment 2) both suggest that mental preparation leading to insight involves heightened activity in medial frontal areas associated with cognitive control and in temporal areas associated with semantic processing. The results for electroencephalographic topography suggest that noninsight preparation, in contrast, involves increased occipital activity consistent with an increase in externally directed visual attention. Thus, general preparatory mechanisms modulate problem-solving strategy.     

New reflections on visual search: Interitem symmetry matters!

A 90 degrees rotation of a display can turn a relatively easy visual search into a more difficult one. A series of experiments examined the possible causes of this effect, including differences in overall item shape and response mapping (Experiment 1), the interpretation of scene lighting (Experiment 2), the axis of internal symmetry of the search items (Experiment 3), and the axes of interitem symmetry between target and distractor items (Experiment 4). Only the elimination of differences in interitem mirror symmetry resulted in equal search efficiency in the upright and rotated displays. This finding is strong support for the view that visual search is guided by an analysis that considers interitem relations.     

Saccadic latency as a function of target duration in a spatial localization task

This study examined a potential confound in the inverse relationship between target duration and saccadic latency reported by Adam, Ketelaars, Kingma, and Hoek in 1993. Eight participants located a briefly flashed target by moving the eyes and the cursor toward its position in a (backward) mask condition and in a no-mask condition. Analysis showed similar saccadic latencies in both conditions, thereby refuting the potentially confounding role of the backward masking procedure. It is tenatively suggested that the longer saccadic latencies noted for shorter target durations may be associated with delayed accumulation of evidence for the detection of the target.     

The Moral Judgment of Juvenile Delinquents: A Meta-Analysis

A meta-analysis of 50 studies was conducted to investigate whether juvenile delinquents use lower levels of moral judgment than their nondelinquent age-mates and, if so, what factors may influence or moderate the developmental delay. The results show a lower stage of moral judgment for juvenile delinquents (d=.76). Effect sizes were large for comparisons involving male offenders, late adolescents, delinquents with low intelligence, and incarcerated delinquents. The largest effect sizes were found for period of incarceration and comparisons involving juvenile delinquents with psychopathic disorder. Production instead of recognition measures, dilemma-free assessment methods, and non-blind scoring procedures yielded relatively large effect sizes, whereas effect sizes were medium for comparisons involving delinquents with average intelligence, non-incarcerated delinquents, female offenders, as well as early and middle adolescents. Psychopathic disorder and institutionalization were identified as unique moderators of the link between moral judgment and juvenile delinquency. It is concluded that developmentally delayed moral judgment is strongly associated with juvenile delinquency, even after controlling for socioeconomic status, gender, age and intelligence.This article stems from a paper presented at the meeting of the Association for Moral Education, July 2006, Fribourg, Switzerland.     

WISC-R subtest but no overall VIQ-PIQ difference in Dutch children with PDD-NOS

VIQ-PIQ differences have been studied in children with autism and Asperger syndrome but have not been studied in a separate group of children with PDD-NO, although, PDD-NOS has a much higher prevalence rate than autism and deficits in communication and social interaction are severe. The Wechsler Intelligence Scale for Children-Revised (WISC-R) was administered to 100 children, aged 6-12 years, with PDD-NOS (n = 76), autism (n = 13), and Asperger syndrome (n = 11). PDD-NOS was diagnosed using explicit research criteria. No overall differences between VIQ and PIQ were found in PDD-NOS and autism. Peaks in the subtest scores on Information, Similarities, Picture Arrangement, and Mazes, and troughs in the subtest scores on Comprehension, Digit Span, and Coding were demonstrated in children with PDD-NOS. Their score on the Freedom from Distractibility factor was lower than the scores on the Verbal Comprehension factor and the Perceptual Organization factor. Children with PDD-NOS seemed to have a similar VIQ-PIQ profile as children with autism, and on the subtest level children with PDD-NOS showed some similarities to children with Asperger syndrome or autism. It was not possible to distinguish PDD-NOS from autism or Asperger syndrome by using IQ scores.     

Neuroprotection and stroke rehabilitation: modulation and enhancement of recovery

Recent advances in research are modifying our view of recovery after nervous system damage. New findings are changing previously held concepts and providing promising avenues for treatment of patients after stroke. This review discusses mechanisms of neuronal injury after brain ischemia and the attempts to study neuroprotection options based on such mechanisms. It also considers measures available at present to improve outcome after stroke and presents new areas of research, particularly stimulation techniques, neurogenesis and trophic factors to enhance recovery. In order to improve outcomes, medications that may be detrimental to recovery should be avoided, while symptomatic therapy of problems such as depression, pain syndromes and spasticity may contribute to better results. Continued surveillance and early treatment of complications associated with acute stroke, along with supportive care remain the mainstay of treatment for stroke patients in the recovery phase. Present research on limiting brain damage and improving recovery and plasticity enhance the prospects for better clinical treatments to improve recovery after stroke.     

Condom use in steady and casual sexual relationships: Planning, preparation and willingness to take risks among adolescents

Condom use within steady and casual sexual relationships was examined among 14-16 year old Dutch adolescents from secondary school (N?=?140). It was hypothesised that among adolescents sex and subsequently condom use with casual sex partners is less likely to be considered in advance, more context-dependent and less habitual; whereas the opposite is true for steady relationships. Therefore, preparatory behaviours (buying and carrying condoms and communicating about condom use) were expected to mediate the intention-behaviour relation in the context of steady relationships, but not in the context of casual sex. Results confirmed that condom use with steady sex partners was explained by preparatory behaviours, habits, and to some extent, behavioural willingness, and that preparatory behaviours mediated the intention-behaviour relationship. Condom use with casual sex partners was predicted by risk willingness and intentions, without any mediation by preparatory behaviours. The results indicate that it is essential to increase awareness among adolescents that unexpected sexual situations may occur and to train them to take preparatory actions.