Dual diagnosis in an Australian forensic psychiatric hospital: prevalence and implications for services

Despite a growing awareness of the unique needs of psychiatric patients with co-occurring substance abuse and dependence disorders (i.e. dual diagnosis), there is a dearth of research investigating the prevalence of dual diagnosis in forensic psychiatric populations. Similarly, little work has been done to determine the implications of dual diagnosis for forensic psychiatric patients. Patients at the Thomas Embling Hospital in Victoria, Australia, were assessed to determine the prevalence of substance abuse disorders and mental illnesses within this population. Results reveal that the majority of patients (approximately 74%) have a lifetime substance abuse or dependence disorder. Information was collected concerning patients' criminal histories and the Level of Service Inventory, Revised, was completed for each patient who participated. Results suggest that patients with both major mental illnesses and substance abuse disorders have more extensive criminal histories and demonstrate a higher level of risks and needs when compared with patients with major mental illness alone. The implications for the development and delivery of effective forensic mental health services that address both co-occurring disorders are also discussed.     

Enhanced Cognitive Behavior Therapy: A Single Treatment for All Eating Disorders

Eating disorders are serious mental illnesses affecting a significant proportion of women and a smaller number of men. Approximately half of those with an eating disorder (ED) will not meet the criteria for anorexia or bulimia nervosa, and will be diagnosed with an eating disorder not otherwise specified (EDNOS). Until recently, there were no recommended treatments for EDNOS. This article provides an overview of enhanced cognitive behavior therapy, a validated treatment for all forms of EDs.     

Foundations of infants' social group evaluations

Previous research has suggested that infants exhibit a preference for familiar over unfamiliar social groups (e.g., preferring individuals from their own language group over individuals from a foreign language group). However, because past studies often employ forced‐choice procedures, it is not clear whether infants' intergroup preferences are driven by positivity toward members of familiar groups, negativity toward members of unfamiliar groups, or both. Across six experiments, we implemented a habituation procedure to independently measure infants' positive and negative evaluations of speakers of familiar and unfamiliar languages. We report that by 1 year of age, infants positively evaluate individuals who speak a familiar language, but do not negatively evaluate individuals who speak an unfamiliar language (Experiments 1 and 2). Several experiments rule out lower‐level explanations (Experiments 3–6). Together these data suggest that children's early social group preferences may be shaped by positive evaluations of familiar group(s), rather than negative evaluations of unfamiliar groups.     

High-performance work systems and occupational safety

Two studies were conducted investigating the relationship between high-performance work systems (HPWS) and occupational safety. In Study 1, data were obtained from company human resource and safety directors across 138 organizations. LISREL VIII results showed that an HPWS was positively related to occupational safety at the organizational level. Study 2 used data from 189 front-line employees in 2 organizations. Trust in management and perceived safety climate were found to mediate the relationship between an HPWS and safety performance measured in terms of personal-safety orientation (i.e., safety knowledge, safety motivation, safety compliance, and safety initiative) and safety incidents (i.e., injuries requiring first aid and near misses). These 2 studies provide confirmation of the important role organizational factors play in ensuring worker safety.     

Unexpected downshifts in reward magnitude induce variation in human behavior

We investigated how changes in outcome magnitude affect behavioral variation in human volunteers. Our participants entered strings of characters using a computer keyboard, receiving feedback (gaining a number of points) for any string at least ten characters long. During a “surprise” phase in which the number of points awarded was changed, participants only increased their behavioral variability when the reward value was downshifted to a lower amount, and only when such a shift was novel. Upshifts in reward did not have a systematic effect on variability.     

Increased wait-list time predicts dropout from outpatient enhanced cognitive behaviour therapy (CBT-E) for eating disorders

Between 30 and 70% of patients with eating disorders drop out from outpatient treatment. However, research has been unable to identify factors that consistently predict dropout from eating disorder treatment. Most studies have exclusively investigated the role that individual patient characteristics play in dropout and have ignored more process-based factors such as expectations about treatment, the therapeutic alliance, or time spent on a treatment waiting list. This study aimed to investigate the roles of both individual patient characteristics and process-based factors in dropout from outpatient treatment for eating disorders. The study involved data collected from consecutive eating disorder referrals to the only public specialist eating disorder service for youth and adults in Perth, Western Australia. The standard treatment provided at this service is Enhanced Cognitive Behaviour Therapy on an individual basis. The study involved 189 patients referred to the service between 2005 and 2010. Forty five percent of this sample dropped out of treatment. Results showed that, in this sample, two individual factors, lowest reported weight and the tendency to avoid affect, and one process-based factor, time spent on the wait list for treatment, were significant predictors of dropout. These findings are valuable because a process-based factor, such as wait-list time, may be easier to address and modify than a patient's weight history or the trait of mood intolerance. Increased resources for eating disorder services may reduce waiting list times which would help to reduce dropout and maximize treatment outcomes.     

Critical hermeneutics and higher education: a perspective on texts,meaning and institutional culture

This paper is a discussion of critical hermeneutics as a research methodology employed in a conceptual analytic study of the concept ‘institutional culture’ within the context of higher education. The research was undertaken to develop an understanding of the concept and to explore its construction in university policy documents. The aim of this paper is to motivate the choice of critical hermeneutics as a research methodology for the mentioned study. I explore both aspects of critical hermeneutics, namely hermeneutics and critical theory. The interpretive nature of hermeneutics enabled me to expose the hidden meanings of institutional culture, while its context-specific nature was beneficial for pointing out the nature of institutional culture in the university setting. Critical theory, on the other hand, was appropriate because it is a theory that is self-conscious about historicity and the role of the social environment. In combination, the merits of these two aspects of critical hermeneutics facilitated the understanding of the university setting as a social reality. Employing critical hermeneutics as a research methodology furthermore assisted in analysing the construction of institutional culture within university policy documents, taking into account the important role of history in interpretation. In essence, critical hermeneutics facilitated my understanding of the difficult-to-explain concept ‘institutional culture’ in the higher education setting.     

Research Agenda to Facilitate Community Participation In HIV Vaccine Research: A Participatory Approach

This article reports on a participatory process to generating a research agenda to guide research on community participation in HIV vaccine research. Community members representing stakeholder parties involved in the HIV vaccine research enterprise were invited to participate in the process. Fourty-five participants participated in the process and we used interactive techniques to stimulate discussion and interaction between community members at different levels of the HIV vaccine research enterprise. Through the process we generated a locally grounded research agenda to guide research on community participation in HIV vaccine research that originates out of the experiences, challenges and concerns of community members.     

Sensory responsiveness and the effects of equal subjective rewards on tactile learning and memory of honeybees

In tactile learning, sucrose is the unconditioned stimulus and reward, which is usually applied to the antenna to elicit proboscis extension and which the bee can drink when it is subsequently applied to the extended proboscis. The conditioned stimulus is a tactile object that the bee can scan with its antennae. In this paper we describe the quantitative relationships between gustatory antennal stimulation, gustatory proboscis stimulation, and tactile learning and memory. Bees are 10-fold more responsive to sucrose solutions when they are applied to the antenna compared to proboscis stimulation. During tactile conditioning, the sucrose solution applied to the proboscis determines the level of acquisition, whereas antennal input is of minor importance. Bees differing in their gustatory responsiveness measured at the antenna differ strongly in their tactile acquisition and memory. We demonstrate how these differences in tactile acquisition and memory can be greatly reduced by calculating equal subjective rewards, based on individual gustatory responsiveness.     

Men's experience of considering counselling: ‘Entering the unknown’

Agency statistics in the UK and North America reveal that fewer men than women attend counselling, at a ratio of about 1:2. This study investigated men's experience of considering counselling, with the aim of gaining further understanding of factors that might contribute to the existing gender discrepancy in utilisation of counselling. Following responses by 47 men to written questionnaires, 10 men who had considered and ultimately attended counselling were interviewed, and a grounded theory method of analysis was used to generate and analyse the participants' experiences. Three interconnected categories emerged: societal perceptions of counselling and gender roles; change of experience over time; and knowledge — ‘knowing’ and ‘not knowing’ the protocols of counselling. The implications of these findings are discussed. It is recommended that prospective male clients should be provided with information about the counselling process, and that there needs to be increased awareness by counsellors and referring agents of male gender issues.