Psychiatric and Mental Health Commons^™

At-Risk Ems Employees- A Model Of Assessment And Intervention.Pdf, Ron J. Hammond, Kate Miller

Ron J. Hammond

Changing Patterns Of Acute Psychiatric Hospitalization Under A Public Managed Care Program, Christopher G. Hudson

Christopher Hudson

This study evaluates changes in patterns of acute psychiatric hospitalization under Massachusetts' Medicaid-funded Mental Health and Substance Abuse (MMHSA) carve-out program. The data consists of the Case Mix Database, for FY 1996 and FY 1997, compiled by the state's Division of Health Care Finance and Policy, on all acute hospital episodes in the state. Key comparisons involve hospital utilization during the nine months preceding the 1996 implementation of the current expanded carve-out program and the subsequent 15 months of its implementation. Secondary comparisons are made between patients funded by the state's two major Medicaid programs, its behavioral carve-out and its …

Psychiatric Impact Of Tuberous Sclerosis Complex And Utilization Of Mental Health Treatment, Kate Mowrey, Hope Northrup Md

Kate Mowrey

Models For Predicting Incident Delirium In Hospitalized Older Adults: A Systematic Review, Sundeep Kalimisetty, Wajih Askar, Brenda Fay, Ariba Khan

Ariba Khan, MD, MPH

Background: Delirium is common in hospitalized older adults, and 40% of cases may be preventable. Hospital Elder Life Program is an evidence-based program to reduce incidence of delirium. It has been successfully implemented in one hospital and will be implemented in four other hospitals. Identification of patients at highest risk of developing delirium using the electronic health record (EHR) may be an effective targeted strategy to reduce the incidence of delirium.

Purpose: To systematically review and summarize the medical literature regarding risk prediction models for delirium in older inpatients.

Methods: A medical librarian customized and conducted the search strategy for …

Models For Predicting Incident Delirium In Hospitalized Older Adults: A Systematic Review, Sundeep Kalimisetty, Wajih Askar, Brenda Fay, Ariba Khan

Brenda Fay

Background: Delirium is common in hospitalized older adults, and 40% of cases may be preventable. Hospital Elder Life Program is an evidence-based program to reduce incidence of delirium. It has been successfully implemented in one hospital and will be implemented in four other hospitals. Identification of patients at highest risk of developing delirium using the electronic health record (EHR) may be an effective targeted strategy to reduce the incidence of delirium.

Purpose: To systematically review and summarize the medical literature regarding risk prediction models for delirium in older inpatients.

Methods: A medical librarian customized and conducted the search strategy for …

Review: Sylvia Martin, 'Ink In Her Veins: The Troubled Life Of Aileen Palmer', (Crawley: Uwa Publishing, 2016)., Rowan Cahill

Rowan Cahill

Review: Sylvia Martin, 'Ink In Her Veins: The Troubled Life Of Aileen Palmer', (Crawley: Uwa Publishing, 2016)., Rowan Cahill

Rowan Cahill

A Transformational Melancholy: One Law Professor's Journey Through Depression, Marjorie A. Silver

Marjorie A. Silver

In the fall 2007 issue of the Journal of Legal Education, Professor James Jones shared his deeply personal, remarkable, ongoing, story of living, struggling and succeeding as a law professor with bipolar disorder (James T.R. Jones, Walking the Tightrope of Bipolar Disorder: The Secret Life of a Law Professor, 57 J. LEGAL ED. 349 (2007). His essay ended with an invitation to other members of the legal academy to contact him or Professor Elyn Saks, author of an extraordinary memoir about her life with schizophrenia, (ELYN R. SAKS, THE CENTER CANNOT HOLD (2007)) if interested in forming a confidential support …

Double The Outcomes: Employing Sensory Based Approaches To Improve The Quality Of Care And Reduce The Use Of Restraints On Inpatient Behavioral Health Units, Mary Ellen O'Connell Rn, Bsn, Msn, Mba, Jennifer P. Maloney Ms, Otr/L, Stephanie Lenhart Mba, Cphq

Mary Ellen O'Connell

No abstract provided.

Angina Characteristics As Predictors Of Trajectories Of Quality Of Life Following Acute Coronary Syndrome In The Transitions, Risks And Actions In Coronary Events-Center For Outcomes Research And Education Cohort (Trace-Core), Lisa Nobel, Jennifer Tjia, Jane S. Saczynski, Molly E. Waring, Milena D. Anatchkova, Arlene Ash, Catarina I. Kiefe, Jeroan Allison

Jennifer Tjia

BACKGROUND: To describe longitudinal trajectories of health-related quality of life (HRQoL) after hospitalization with an acute coronary syndrome (ACS), their associations with baseline angina characteristics, and associations with anxiety, depression, and cognitive impairment.

METHODS: TRACE-CORE participants (N=1,613) completed the SF-36 during hospitalization for ACS and 1, 3, & 6 months post-discharge. Latent growth curves identified trajectories of physical and mental components of HRQOL (MCS and PCS) and sequential multiple logistic regression estimated associations between trajectories and angina characteristics.

RESULTS: Participants (N=1613) had mean age 63.3 (SD 11.4) years, 33.0% female, and 78.2% non-Hispanic white. We identified 2 MCS trajectories: AVERAGE …

Addressing The Ethical, Legal, And Social Issues Raised By Voting By Persons With Dementia, Jason H. Karlawish, Richard J. Bonnie, Paul S. Appelbaum, Constantine Lyketsos, Bryan James, David Knopman, Christopher Patusky, Rosalie A. Kane, Pamela S. Karlan

Bryan G Kane MD

This article addresses an emerging policy problem in the United States participation in the electoral process by citizens with dementia. At present, health care professionals, family caregivers, and long-term care staff lack adequate guidance to decide whether individuals with dementia should be precluded from or assisted in casting a ballot. Voting by persons with dementia raises a series of important questions about the autonomy of individuals with dementia, the integrity of the electoral process, and the prevention of fraud. Three subsidiary issues warrant special attention: development of a method to assess capacity to vote; identification of appropriate kinds of assistance …

A Pilot Study Of Deaf Trauma Survivors’ Experiences: Early Traumas Unique To Being Deaf In A Hearing World, Melissa L. Anderson, Kelly S. Wolf Craig, Wyatte C. Hall, Douglas M. Ziedonis

Melissa L. Anderson

Conducting semi-structured American Sign Language interviews with 17 Deaf trauma survivors, this pilot study explored Deaf individuals’ trauma experiences and whether these experiences generally align with trauma in the hearing population. Most commonly reported traumas were physical assault, sudden unexpected deaths, and “other” very stressful events. Although some “other” events overlap with traumas in the general population, many are unique to Deaf people (e.g., corporal punishment at oral/aural school if caught using sign language, utter lack of communication with hearing parents). These findings suggest that Deaf individuals may experience developmental traumas distinct to being raised in a hearing world. Such …

Understanding The Employment Barriers And Support Needs Of People Living With Psychosis, Margaret Hampson, Richard Hicks, Bruce Watt

Bruce Watt

This study investigated the employment barriers and support needs of people living with psychosis. A purposive community sample of 137 volunteers drawn from six key stakeholder groups were invited to participate in focus groups and semi-structured individual interviews to elicit their perceptions on the employment barriers and support needs of people living with psychosis. The stakeholder groups included in this study were people with lived experience of schizophrenia or bipolar disorder, carers, health professionals, employers, employment service providers, and community members. Data obtained from 14 focus groups and 31 semi-structured individual interviews were transcribed, imported into NVivo 10, and coded …

Gender-Specific Research On Mental Illness In The Emergency Department: Current Knowledge And Future Directions., Megan L Ranney, Natalie Locci, Erica J Adams, Marian Betz, David B. Burmeister Do, Facep, Ted Corbin, Preeti Dalawari, Jeanne L. Jacoby Md, Judith Linden, Jonathan Purtle, Carol North, Debra E Houry

David Burmeister, DO, FACEP, CPE

Mental illness is a growing, and largely unaddressed, problem for the population and for emergency department (ED) patients in particular. Extensive literature outlines sex and gender differences in mental illness' epidemiology and risk and protective factors. Few studies, however, examined sex and gender differences in screening, diagnosis, and management of mental illness in the ED setting. Our consensus group used the nominal group technique to outline major gaps in knowledge and research priorities for these areas, including the influence of violence and other risk factors on the course of mental illness for ED patients. Our consensus group urges the pursuit …

Attitudes Towards Anorexia Nervosa: Volitional Stigma Differences In A Sample Of Pre-Clinical Medicine And Psychology Students, Amy Bannatyne, Peta Stapleton

Peta B. Stapleton

Background:

Anorexia nervosa (AN) is a highly stigmatised condition, with treatment often involving multidisciplinary care. As such, understanding and comparing the attitudes of emerging mental health and medical professionals towards AN, within the content of sex-based differences, is pertinent to facilitate the development of targeted stigma interventions.

Aims:

Examine the volitional stigmatisation of AN in emerging medical and mental health professionals.

Method:

Participants (N = 126) were medical (n = 41) and psychology students (n = 85) who completed a range of attitudinal outcome measures (e.g. Causal Attributions Scale, Eating Disorder Stigma Scale, Opinions Scale, Characteristics Scale and Affective Reaction …

Student Reflections Of Psychiatric/Mental Health: Using Journals And Creative Expressions

Melinda Hermanns

Patient-Centered Communication And Prognosis Discussions With Cancer Patients, Cleveland G. Shields, Casey J. Coker, Shruti S. Poulsen, Jennifer M. Doyle, Kevin Fiscella, Ronald M. Epstein, Jennifer J. Griggs

Shruti Poulsen

To examine physician communication associated with prognosis discussion with cancer patients.

Symptom Patterns Of Posttraumatic Stress Disorder Among Deaf Trauma Survivors, Melissa Anderson, Amanda Sortwell, Kelly Wolf Craig, Douglas Ziedonis

Melissa L. Anderson

Details about Deaf people’s pattern of posttraumatic stress disorder (PTSD) symptoms remain relatively unknown due to inaccessible methods used in most epidemiological research. We conducted semi-structured American Sign Language interviews with 16 trauma-exposed Deaf individuals to explore their PTSD symptom patterns. Half met criteria for current PTSD, a rate higher than the general population. Underlying this disparity may be heightened rates of dissociation and psychogenic amnesia reported by many Deaf trauma survivors. Future research with large samples of Deaf survivors is needed to clarify this hypothesis, and to inform interventions that more accurately target Deaf people’s pattern of trauma symptoms.

Sex Offending And Serious Mental Illness: Directions For Policy And Research, Andrew Harris, William Fisher, Bonita Veysey, Laura Ragusa, Arthur Lurigio

Arthur J. Lurigio

Over the past decade, two rapidly evolving areas of criminal justice practice have garnered increasing attention from policy makers, practitioners, and researchers: the management and treatment of justice involved individuals with serious and persistent mental illness, and the challenges of managing the perceived societal risk presented by sex offenders. Yet, whereas each of these issues has independently attracted significant attention, the nexus between them has remained largely unexamined. Matters of concern include the manner in which individuals with serious mental illness may be disproportionately affected by the expanding range of restrictions placed on those with sexual offense histories, the demands …

Adhd, Major Depressive Disorder, And Simple Phobias Are Prevalent Psychiatric Conditions In Youth With Velocardiofacial Syndrome, Kevin Antshel, Wanda Fremont, Nancy Roizen, Robert Shprintzen, Anne Marie Higgins, Amit Dhamoon, Wendy Kates

Robert J. Shprintzen

Objective: To examine prevalence rates of psychopathology in children with velocardiofacial syndrome (VCFS).

Method: One hundred fifty-four children ages 6 to 15 participated in our between-group design with three samples, 84 children with VCFS (37 girls, 47 boys), 32 sibling controls (18 girls, 14 boys), and 38 community controls (12 girls, 26 boys). The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version and several other parent report measures were used to assess for psychopathology.

Results: Compared to both control samples, children with VCFS had higher prevalence rates of major depressive disorder, attention-deficit/hyperactivity disorder, simple phobias, and …

The Macarthur Adjudicative Competence Study: The Development And Validation Of A Research Instrument, Steven Hoge, Richard Bonnie, Norman Poythress, John Monahan

Norman Poythress

Assessment of competence to stand trial is a common evaluation that can have substantial consequences for defendants and the criminal justice system. Despite a voluminous literature, much remains unknown. An obstacle to progress in understanding what is better termed ldquoadjudicative competencerdquo is the absence of structured, standardized research measures for assessment of defendants. This article presents the legal framework, assessment strategy, instrument description, psychometric properties, and construct validation of the MacArthur Structured Assessment of the Competencies of Criminal Defendants (MacSAC-CD). The measures meet or exceed accepted indices of internal consistency, and interscorer agreement. Observed patterns of correlations among measures support …

Correspondence Between Self-Report And Interview-Based Assessments Of Antisocial Personality Disorder, Laura Guy, Norman Poythress, Kevin Douglas, Jennifer Skeem

Norman Poythress

Antisocial personality disorder (ASPD) is associated with suicide, violence, and risk-taking behavior and can slow response to first-line treatment for Axis I disorders. ASPD may be assessed infrequently because few efficient diagnostic tools are available. This study evaluated 2 promising self-report measures for assessing ASPD—the ASPD scale of the Personality Diagnostic Questionnaire-4 (PDQ-4; S. E. Hyler, 1994) and the Personality Assessment Inventory (PAI; L. Morey, 1991, 2007)—as well as the ASPD module of the Structured Clinical Interview for DSM–IV Axis II (SCID-II; M. B. First, R. L. Spitzer, M. Gibbon, J. B. W. Williams, & L. S. Benjamin, 1997). The …

Mentally Ill And Non-Mentally Ill Defendants' Abilities To Understand Information Relevant To Adjudication: A Preliminary Study, Steven Hoge, Norman Poythress, Richard Bonnie, Marlene Eisenberg

Norman Poythress

The legal construct of competence to stand trial, or “adjudicative competence,” is based on the premise that some mentally disordered defendants have impaired abilities when compared with most defendants and that adjudication should be barred if these competence-related abilities are significantly impaired. Where the line is drawn between sufficient and insufficient abilities has important consequences: as a result of being adjudicated incompetent, defendants may be detained and treated involuntarily and their trials will be delayed. However, no studies have systematically compared the capacities of relevant groups of defendants. In this studv. 84 criminal defendants—42 of whom were hospitalized as incompetent …

Externalizing Disorders Of Childhood And Adolescence, P.J. Frick, Eva Kimonis

Eva Kimonis

No abstract provided.

The Broward Mental Health Court: Process, Outcomes, And Service Utilization, Roger Boothroyd, Norman Poythress, Annette Christy, John Petrila

Norman Poythress

Mental health courts are one of a variety of special jurisdiction courts that have been created in a number of countries, including the United States (Petrila, 2003). While there is no prototypical mental health court (Steadman, Davidson, & Brown, 2001; Watson, Luchins, & Hanrahan, 2001), most of those in existence today share several common characteristics. These include (a) the creation of a special docket (usually, but not always, nonviolent misdemeanants with mental illness) that is (b) handled by a particular judge, with (c) a primary goal of diverting defendants from the criminal justice system and into treatment (Goldkamp & Irons-Guynn, …

Psychopathic Features In A Juvenile Diversion Population: Reliability And Predictive Validity Of Two Self-Report Measures, Diana Falkenbach, Norman Poythress, Kathleen Heide

Norman Poythress

The reliability and predictive validity of two experimental self-report versions of two measures of psychopathic features in youth, the Antisocial Process Screening Device (APSD: Frick & Hare, 2001) and a modified version of the Child Psychopathy Scale (CPS: Lynam, 1997) were examined in a sample of 69 arrested youth (M age¼14.4 years) referred to a juvenile diversion program. Parents or legal guardians completed parent-rating versions of the same measures. Reliability indicators for the APSD total measure were satisfactory although internal consistency indices (coefficient alpha) for the Callous/Unemotional and Impulsive/Conduct Problems scales were slightly lower than desirable. Reliability indicators for the …

Evaluation Of The Hare-Pscan In A Non-Clinical Population, Cristal Elwood, Norman Poythress, Kevin Douglas

Norman Poythress

Using 100 university undergraduates as participants, this study examined the structural reliability and construct validity of Hare and Hervé's P-SCAN (Hare & Hervé, 1999) a 90-item measure that purports to serve as an “… early warning system” or “rough screening device” (p. 1) for identifying individuals with substantial psychopathic features. Internal consistency indices (e.g. Cronbach's α, mean inter-item correlations) for the three P-SCAN subscales (Interpersonal, Affective, Lifestyle) suggested excellent reliability. Statistically significant, though modest correlations (range 0.21–0.33) were obtained in 5 of 6 comparisons with the self-report Primary psychopathy and Secondary psychopathy scales developed by Levenson, Kiehl, and Fitzpatrick (1995) …

Psychometric Properties Of Carver And White’S (1994) Bis/Bas Scales In A Large Sample Of Offenders, Norman Poythress, Jennifer Skeem, John Weir, Scott Lilienfeld

Norman Poythress

Contemporary motivational theories of psychopathy (Lykken, 1995) employ constructs from Gray’s Reinforcement Sensitivity Theory (RST; Gray, 1982), behavioral inhibition system (BIS) and behavioral activation system (BAS) functioning, to explain etiologic differences in psychopathy subtypes. Carver and White’s (1994) BIS/BAS scales are the most widely used measures of these constructs, yet there is a dearth of research on how these measures perform with offenders. Using a sample of 1515 offenders, we found evidence that five, rather than the usual four factors, underpin the BIS/BAS scales. Importantly, BIS items that tap into anxiety and fear sensitivity, respectively, split to form separate factors, …

The Relationship Between Psychopathic Personality Features And Malingering Symptoms Of Major Mental Illness, Norman Poythress, John Edens, M. Watkins

Norman Poythress

This study examined the relationship between psychopathy and malingering in a subsample of male prison inmates (n D 55) participating in a larger study of the clinical utility of various assessment measures in correctional settings. Participants’ capacity to feign major mental illness successfully was evaluated using standard cutoff scores for the detection of malingering on a variety of instruments, including the Structured Inventory of Malingered Symptomatology (SIMS; G. P. Smith & G. O. Burger, 1997), the Structured Interview of Reported Symptoms (SIRS; R. Rogers, R. M. Bagby, & S. E. Dickens, 1992), and the Personality Assessment Inventory (PAI; L. Morey, …

The Self-Report Psychopathy Scale And Passive Avoidance Learning: A Validation Study Of Race And Gender Effects , M. Epstein, Norman Poythress, K. Brandon

Norman Poythress

SRPS; psychopathy; gender; race; validity; passive avoidance errors; trait anxiety; intelligence