Assessing risk for violence among male and female civil psychiatric patients: the HCR-20, PCL:SV, and VSC

This study evaluated the predictive validity of violence risk assessments conducted using the HCR-20, the Psychopathy Checklist: Screening Version (PCL:SV), and by the Violence Screening Checklist (VSC) in a sample of 268 involuntarily hospitalized male and female psychiatric patients. Information pertaining to violence and crime was coded from medical charts and correctional records. The HCR-20/PCL:SV evidenced modest non-significant associations in postdictive assessments of inpatient violence among men. Moderate to strong significant associations were found between the HCR-20/PCL:SV and inpatient violence among women. Pseudo-prospective assessments using the HCR-20 and PCL:SV resulted in moderate to large relationships with violence and crime in men and women following community discharge. It is concluded that the VSC is a promising tool for assessing acute inpatient violence risk with men. Findings offer preliminary validation of the predictive validity of the HCR-20 and PCL:SV with female civil psychiatric patients.     

From ABLE to TAPAS: A New Generation of Personality Tests to Support Military Selection and Classification Decisions

This article discusses 3 modern forced-choice personality tests developed for the U.S Armed Services to provide resistance to faking and other forms of response distortion: the Assessment of Individual Motivation, the Navy Computerized Adaptive Personality Scales, and the Tailored Adaptive Personality Assessment System. These tests represent the transition from Likert to forced-choice formats and from static to computerized adaptive item selection to meet the challenges of large-scale, high-stakes testing environments. For each test, we briefly describe the personality constructs that are assessed, the response format and scoring methods, and selected ongoing research and development efforts. We also highlight the potential of these tests for personnel selection, classification, and diagnostic screening purposes.     

Short-Term Assessment of Risk and Treatability (START): The case for a new structured professional judgment scheme

The Short-Term Assessment of Risk and Treatability (START) is a new structured professional judgment scheme intended to inform multiple risk domains relevant to everyday psychiatric clinical practice (e.g. risk to others, suicide, self-harm, self-neglect, substance abuse, unauthorized leave, and victimization). The article describes the processes involved in establishing an interdisciplinary approach to risk assessment and management. The authors present a review of the rationale for START, including the value of dynamic variables, the importance of strengths, and the extent to which clinicians must be attentive to multiple risk domains, reflecting theoretical and scientific evidence of the overlap among risks. Using the development, validation, and implementation of START as an example, the authors describe the processes by which other researchers, clinicians, and administrators could adapt existing assessment schemes or create new ones to bridge some remaining gaps in the risk assessment and management continuum.     

Probing the public's honesty: A field experiment using the “lost letter” technique∗

The present study probed the honesty of the general public through an experimentl approach. A variaty of experimental procedures have been used in previous research. This study used the “lost letter” technique, whereby ordinary citizens are offered an opportunity to keep envelopes that are planted on their cars and that are apparently lost. They are stamped and addressed (actually they are addressed to the investigators).

One quarter of the “lost” letters were kept by the subjects. On the whole, the value of the contents (some contained a coin made to appear valuable) did not seem to affect the return rate. Also, little difference was found in the behavior of the male and female subjects. Age, however, did appear important as younger subjects were significantly more likely to keep the letters. Since the value of the contents was not important, a failure to return could simply indicate less altruism on their part. Also, an interaction was found between the variables of age and sex, as young females had the lowest return rate and older females the highest return rate, with males of both age categories falling in between these extremes. This finding suggests that future research comparing the criminality or deviance of tie sexes consider the variations in the behavior of each sex across different age categories.     

Mental fatigue influence on effort-related cardiovascular response: difficulty effects and extension across cognitive performance domains

Two experiments investigated cardiovascular effects of mental fatigue as a function of (1) the difficulty of the cognitive challenge with which participants were confronted, and (2) the relevance of that challenge to the activity that instigated the fatigue. In the first, participants performed an easy (fatigue low) or difficult (fatigue high) counting task and then were presented an arithmetic challenge (task B relevance high) or a scanning challenge (task B relevance low) with instructions that they would avoid a noise if they attained a modest performance standard. Analysis of blood pressure responses assessed during the work periods revealed fatigue main effects, reflecting stronger responses for High Fatigue participants, regardless of the character of the second task. In the second, the procedure was the same except that it included a high performance standard and provided the chance to win a prize. Analysis of the pressure data revealed fatigue x work period interactions, reflecting relatively stronger responses among High Fatigue participants in work period 1, but relatively weaker responses among these participants in work period 2. Results confirm previous findings and support an analysis of fatigue influence on effort and associated cardiovascular responses. They also argue against the idea that mental fatigue influence may be confined to relevant cognitive performance realms.

Externalizing and personalizing biases in persecutory delusions: the relationship with poor insight and theory-of-mind

The presence of externalizing bias (EB) for negative events together with personalizing bias (PB) (a bias to blame others rather than circumstances) may jointly constitute a vulnerability to develop persecutory delusions (PDs). Whereas EB purportedly serves to defend a vulnerable self-concept by avoiding negative self-attributions and might therefore exacerbate poor insight, PB may reflect cognitive deficits, including theory-of-mind impairment. We investigated these proposals in 34 schizophrenic patients with a history of PDs and 21 healthy controls. Patients with moderate- to severe-PDs and patients without a current PD showed excessive EB which was, surprisingly, absent in patients with mild persecutory delusions (mild-PDs). That EB might wax and wane with fluctuating delusional intensity was interpreted in accord with a new dynamic model of attribution self-representation cycles. As predicted, EB exacerbated poor insight. However, counter to predictions, theory-of-mind impairment did not increase PB, which was marked in all participants, whether clinical or non-clinical; instead, theory-of-mind impairment was also correlated with poor insight. Our findings indicate multiple pathways to poor insight, one of which is a theory-of-mind difficulty, impairing the capacity to simulate other perspectives for the purpose of critically evaluating one's own beliefs and circumstances.     

Close encounters of the third order kind

This article describes an exercise developed for assessing trainee family therapists' practice at the end of a placement year in a manner consistent with the third‐order positioning the trainees were endeavouring to adopt in their practice. Evaluation by the trainees confirmed that the exercise had provided them with a significant opportunity to co‐construct with the supervisors their practice learning and future learning goals.     

A psychometric evaluation of the Harvey Imposter Phenomenon Scale

In this article, we present psychometric properties on the 14-item Harvey Imposter Phenomenon (IP) Scale (Harvey, 1981) among a sample of U.S. adolescents (N = 136). Item analyses, internal consistency reliability, and principal components analysis (PCA) were computed to assess the reliability and factor structure of the IP scores. Although the internal consistency reliability (e.g., Cronbach's alpha) was reasonably acceptable (alpha =.70), the item analyses and subsequent PCA suggest concern for the content homogeneity and factor structure of composite scores obtained from the 14-item measure. The results of this study suggest that the indiscriminate use of the Harvey IP Scale is cautioned relative to the insufficient psychometric properties.     

The Use of Risk and Need Factors in Forensic Mental Health Decision-Making and the Role of Gender and Index Offense Severity

Canadian legislation makes Review Boards (RBs) responsible for rendering dispositions for individuals found Not Criminally Responsible on account of Mental Disorder (NCRMD) after considering public safety, the mental condition of the accused, and his/her potential for community reintegration. We reviewed 6,743 RB hearings for 1,794 individuals found NCRMD in the three largest Canadian provinces to investigate whether items from two empirically supported risk assessment measures, the Historical Clinical Risk Management-20 and the Violence Risk Appraisal Guide, were considered. Less than half the items were included in expert reports or in RBs' reasons for dispositions, and consideration of these items differed according to gender and index offense severity of the accused. These items included evidence-based risk factors and/or legally specified criteria: mental health, treatment, and criminal history. These results illustrate the gap between research on risk factors and the integration of this evidence into practice. In particular, we recommend the implementation of structured measures to reduce the potential for clinicians to be unduly influenced by gender and offense severity. Copyright © 2015 John Wiley & Sons, Ltd.