Violent behavior patterns on psychiatric wards

A study of 379 violent incidents between pairs of psychiatric inpatients during an eight-month period indicates a substantial number of patterned associations between assaulting patients and those struck. In addition, regularities are observed in these incidents between frequency of occurrence and spatiotemporal and other contextual factors. Taken in the aggregate, these relationships support enlargement of most current conceptualizations of the violent act in psychiatric settings, which focus almost exclusively upon physiologic and psychologic state changes within the identified initiator of violent acts.     

Changes in Anxiety Control Beliefs Following a Brief CBT Treatment and Their Association With Anxiety Symptom Reduction

Anxiety control beliefs (i.e., beliefs regarding one’s ability to cope with external, fear-inducing threats and internal reactions to those perceived threats) have been found to negatively predict anxiety symptoms in children and adults and to be modifiable by cognitive-behavioral therapy for anxiety disorders. The current study examines whether changes in anxiety control beliefs were seen following a brief, intensive treatment for specific phobias, and whether those changes were associated with improvements in the targeted phobia and comorbid anxiety disorder symptoms. Participants were 135 children and adolescents (M age = 9.01 years, 49% male) who received one-session treatment (OST) with or without parental involvement for their primary specific phobia. Results indicated that self-reported anxiety control beliefs significantly increased following treatment and that these increases significantly predicted reductions in specific phobia severity and symptoms of comorbid anxiety disorders 6 months and 1 year following treatment. Findings illustrate that involvement in a single 3-hour OST was associated with changes in anxiety control beliefs and demonstrate the potential importance of targeting control beliefs in pediatric anxiety treatment.     

The effects of exposure to political and domestic violence on preschool children and their mothers

The purpose of this study was to examine the effects of exposure to political violence on preschool children and their mothers. We explored whether these dyads are different from dyads with no known history of exposure to violence and from mother–child dyads with known exposure to domestic violence. Specifically, we explored differences in mothers' psychological status (depression and anxiety), dyadic emotional availability (EA), children's social information processing, and children's social behaviour, in a sample of 216 dyads divided into three groups (exposure to political violence, no exposure to violence, and exposure to domestic violence). We found evidence to support our hypotheses that children exposed to domestic violence exhibit the highest levels of social maladjustment with smaller but still significant differences between children exposed to political violence and children in the comparison group. As expected, the lowest EA scores were found in the exposure to domestic violence group, followed by dyads in the exposure to political violence group. Dyads belonging to the comparison group (no exposure) exhibited the highest levels of EA. These findings contribute to our understanding of the meaning of exposure to political violence, as well as sharpen the difference between exposure to political and domestic violence.     

Psychosis,symbol, affectivity 1: etiopathogenesis and treatment through analytical psychology

This is the first of two papers concerning our study into an integrated approach to psychotic disorders, conducted at the University of Palermo’s Psychiatry Unit Polyclinic over approximately 15 years. Here we will explore and reflect upon the acute psychotic condition mainly from a theoretical and conceptual perspective, while in the second paper we will explore the clinical perspective. From the point of view of psychopathology, and in the light of C.G. Jung’s conceptualization of analytical psychology, as well as calling on contributions from other authors from the systemic-relational and post-psychoanalytic field, we will clarify the ideas developed over these last few years by our team. From a more speculative perspective we will advance new interpretive hypotheses in an attempt to thoroughly understand the nature of the psychotic condition, both on a psychodynamic relational and a neuroscientific level. The paper describes how we revised our understanding of psychosis from a brain disease to a process aimed at the rearrangement of psychic functioning, as anticipated by John Weir Perry nearly 40 years ago.     

Fostering Well‐being through Social Support: The Role of Evangelical Communities in the Lives of Dominican Women of Haitian Descent

Women of Haitian descent living in the Dominican Republic experience oppression due to their gender, ethnicity, and economic status. They also exhibit high rates of participation in evangelical Christian communities, a paradoxical finding given the restricted roles women have traditionally played in these settings. The goals of this study were to explore the perceived benefits of participation in evangelical communities and the setting characteristics that lead to these benefits. The research team interviewed 19 current and former church participants aged 18–59. Thematic analysis revealed three perceived benefits of congregational life. Participants viewed their participation as: (a) an opportunity for personal growth and development; (b) protective against negative social influences; and (c) providing social support in the face of life challenges. In addition, dependable, expected, and reciprocal relational support was a key characteristic of evangelical communities. Findings extend the current understanding of how religious communities enhance well‐being for marginalized women through social support networks. Findings also explore the dialectical nature of settings as both empowering and disempowering. Implications for future interventions are discussed.     

Adversary effects and the tactics of violent offenders

We examine the implication of adversary effects for target choice, lethal intent, and the use of weapons and allies in violent incidents. Adversary effects refer to the tendency of offenders to make tactical decisions based on the coercive power of victims and potential victims. Using the victim's gender as a proxy for coercive power, we analyzed violent incidents from the National Incident‐Based Reporting System (2005–2014). The sample included over six million assaults, robberies, and homicides. Consistent with adversary effects, offenders who attack males (vs. females) are more likely to (a) kill victims; (b) use guns, knives, blunt objects, poison, and automobiles; (c) use male (but not female) allies; and (d) use multiple allies. The evidence for target choice is mixed: unarmed female offenders, but not unarmed male offenders, are more likely to target females than males. The evidence shows how a simple theoretical principle can parsimoniously account for basic patterns of violence in society related to gender, weapons, and group violence.     

去人性化知觉:内涵、测量及相关研究

去人性化知觉是人们对人性的否定性认知,它与暴力行为有着密切的联系。本文在介绍去人性化知觉的内涵和测量的基础上,梳理了导致去人性化知觉的情境因素和个体因素,并阐述了去人性化知觉对攻击性和亲社会性的影响。未来研究可以从四个方面开展,包括丰富研究变量、加强干预研究、拓展研究方法、进行本土化和跨文化研究。     

The Lived Experiences of Addiction Counselors After Marijuana Legalization

This qualitative study examines the perceptions of counselors who work with populations with addictions in states where marijuana has been legalized. Findings include themes related to client experiences, counselor experiences, specific interventions, and lack of understanding.     

Brief Cognitive-Behavioral Therapy for Suicidal Inpatients

Suicide risk is elevated in psychiatric patients following discharge from inpatient care. Despite this vulnerability, there has been limited research investigating suicide prevention protocols that take into account the unique system characteristics of this setting (e.g., short lengths of stay, crisis stabilization treatment model, multidisciplinary team coordination). Cognitive-behavioral therapy (CBT) has demonstrated efficacy for improving suicide risk in outpatients, but has not been validated with inpatients. The current study was a treatment development and pilot feasibility open trial that modified brief cognitive-behavioral therapy (BCBT) for an inpatient setting (BCBT-I). Key treatment modifications included administering up to 10 sessions (depending on patient length of stay), daily, and in a standardized order, with core crisis management skills introduced during the first three sessions. In addition, coordination with the inpatient treatment team was included in BCBT-I implementation. Six adult inpatients with a recent suicide attempt enrolled and completed an average of 4.67 BCBT-I sessions (SD = 1.36). The treatment was highly acceptable (Client Satisfaction Questionnaire total score M = 3.49, SD = 0.73). Pre- to posttreatment effect sizes demonstrated improvements in suicidal ideation (d = 0.97), depression (d = 1.33), and suicidal implicit associations (d = 1.28). All but one of the participants (83%) completed follow-up assessments 1-, 2-, and 3-months postdischarge. Over follow-up, two participants reported suicidal ideation (both without intent), and none reported suicide attempts, preparatory acts or behaviors, or nonsuicidal self-injury. This study provided preliminary evidence supporting the feasibility of CBT to treat suicidal inpatients. Future research is needed to validate BCBT-I in a larger, randomized controlled trial to determine whether BCBT-I reduces suicide risk beyond that afforded by inpatient treatment alone.     

Comparing computer‐based training and lecture formats to teach visual analysis of baseline‐treatment graphs

Accurate analysis of data is vital to the validation of interventions. As such, there has been a recent increase in studies evaluating visual analysis training procedures. However, past investigations have not evaluated direct and indirect visual analysis training methods with matched instructional content that was systematically designed. Furthermore, training has rarely included assessment of generalization and maintenance of visual analysis skills. The purpose of the current dissertation study was to compare the effectiveness and efficiency of (a) computer‐based training, (b) lecture formats with and (c) without the opportunity to pause, and (d) a no‐training group to teach visual analysis of AB graphs to university students. To make these formats directly comparable, the instructional content was equated by ensuring information and examples were identical across the three training procedures. Eighty‐three students were randomly assigned to one of the four groups. Results showed that all three training formats produced increases in accurate responding compared to the no‐training group. Visual analysis skills generalized to novel graphs and maintained approximately 2 weeks following all trainings. These results suggest that structured approaches that are carefully designed to train visual analysis are effective and lead to gains that generalize and maintain in the absence of training.