Psychiatric and Mental Health Commons^™

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 …

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.

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

Stability Of Psychiatric Patients' Perceptions Of Their Admission Experience, Michele Cascardi, Norman Poythress, Lee Ritterband

Norman Poythress

The primary aim of this study was to evaluate the stability (i.e., consistency of patients’ responses over time) of newly developed scales to measure the admission experience of psychiatric hospitalization. Eighty-four psychiatric patients involuntarily committed to a crisis stabilization unit participated. All participants were admitted under an emergency petition or ex parte order for a psychiatric evaluation. Patients were interviewed soon after admission (M 5 3.33 days, SD 5 1.86 days). The test–retest interval was 24–48 hours with most (83.3%) re-evaluated at 24 hours. Overall, the measures showed acceptable levels of stability (r ’s range from .62 to .72). Factors …

Correlates Of Perceived Coercion During Psychiatric Hospital Admission, Michelle Cascardi, Norman Poythress

Norman Poythress

The objectives of this study were to replicate the study of C. W. Lidz et al (see record 1996-15479-001); examine the differences in perceptions about hospital admission for voluntary and involuntary patients (16 yr olds and older), all of whom had been involuntarily detained initially for psychiatric evaluation; and examine the impact of community members vs hospital staff, locus of control, and psychiatric symptom severity on patients' perceptions of coercion. Results substantiate earlier findings of Lidz et al in that legal status (involuntary), procedural justice, and negative pressures are significantly related to perceived coercion. Although all patients in this study …

Controversies In Evaluating Competency To Stand Trial, Norman Poythress, P. Zapf

Norman Poythress

No abstract provided.

Further Validation Of The Psychopathic Personality Inventory Among Offenders: Personality And Behavioral Correlates, John Edens, Norman Poythress, M. Watkins

Norman Poythress

The Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996) is a relatively new self-report measure that has shown considerable promise as an index of psychopathic traits in both nonoffender and offender samples. The present study examined the construct validity and predictive utility of the PPI by examining its association with theoretically relevant scales of the Personality Assessment Inventory (PAI; Morey, 1991) among 60 male prison inmates, and its ability to predict institutional misbehavior in an expanded sample (n = 89). As expected, correlations with the PAI scales were highest for the Antisocial Features (ANT) and Aggression (AGG) scales (rs = …

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

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, and L. S. Benjamin, 1997). The …

A Client-Based Description Of Reflecting Team-Work In Family Therapy , David Brown

David C. Brown

Though the practice of reflecting team-work has a strong theoretical base there has been little research examining its actual use. What has been written is primarily based on the therapist's and/or supervisor's experience, rather than the client's. This dissertation describes clients' perceptions of two different strategies of reflecting team-work that emerged from interviews conducted and analyzed using a moderately structured ethnographic interview methodology. The primary results suggested that reflecting team-work was helpful in providing clients with different perspectives; that in-room teams should be used sparingly during early therapy; that teams should reflect at least twice in-session; and that a three-person …

Reliability Of Risk Assessment Measures Used In Sexually Violent Predator Proceedings, Cailey Miller, Randy Otto, Eva Kimonis, Adam Wasserman

Eva Kimonis

The field interrater reliability of three assessment tools frequently used by mental health professionals when evaluating sex offenders’ risk for reoffending—the Psychopathy Checklist–Revised (PCL-R), the Minnesota Sex Offender Screening Tool–Revised (MnSOST-R) and the Static-99—was examined within the context of sexually violent predator program proceedings. Rater agreement was highest for the Static-99 (intraclass correlation coefficient [ICC1] .78) and lowest for the PCL-R (ICC1 .60; MnSOST-R ICC1 .74), although all instruments demonstrated lower field reliability than that reported in their test manuals. Findings raise concerns about the reliability of risk assessment tools that are used to inform judgments of risk in high-stake …

Construct Validity Of The Youth Psychopathic Features Inventory (Ypi) And The Antisocial Process Screening Device (Apsd) With Justice Involved Adolescents, Norman Poythress, Richard Dembo, Jennifer Wareham, Paul Greenbaum

Norman Poythress

Two measures of psychopathic features in youths, the self-report version of the Antisocial Process Screening Device (APSD) and the Youth Psychopathic traits Inventory (YPI) were administered to 165 youths in a juvenile diversion program. For both measures, internal consistency was poor for the scales that assess the affective domain of psychopathic features; otherwise, internal consistency was excellent for the YPI and generally superior to that of the APSD. However, the published three-factor models for both measures did not replicate when examined using confirmatory factor analysis. Both measures obtained the expected correlations with measures of a variety of criminal justice (e.g., …

The Macarthur Adjudicative Competence Study: A Comparison Of Criteria For Assessing The Competence Of Criminal Defendants, Richard Bonnie, Steven Hoge, John Monahan, Norman Poythress

Norman Poythress

A set of measures assessing competence-related abilities was administered to three groups of criminal defendants: a group committed for restoration of competence, a group identified by jail personnel as mentally ill but not incompetent, and a group without identified mental disorder. Data from this study were used to test key assumptions bearing on the legal criteria for adjudicative competence. The. data show that among defendants able to understand the nature and purpose of the criminal proceedings, a significant proportion have an impaired ability to appreciate their situations as criminal defendants or to communicate relevant information to counsel; among defendants able …

Evaluating The Efficiency And Community Safety Goals Of The Broward County Mental Health Court, Annette Christy, Norman Poythress, Roger Boothroyd, John Petrila

Norman Poythress

Mental health courts have developed as one response to persons with mental illness who are involved with the criminal justice system. This study investigated the efficiency and safety goals of one such court in Broward County, FL. Mental health court (MHC) clients spent significantly fewer days in jail for the index arrest associated with study enrollment than a comparison group. MHC clients had similar survival time to re-arrest up to one year after study enrollment. MHC clients did not significantly differ from the comparison group in selfreported aggressive acts over an 8 month follow-up period, while they did self-report significantly …

Types Of Aggression, Responsiveness To Provocation, And Callous-Unemotional Traits In Detained Adolescents, Luna Muñoz, Paul Frick, Eva Kimonis, Katherine Aucoin

Eva Kimonis

The present study investigated differences in the behavioral and psychophysiological responses to provocation and in the level of callous-unemotional traits in boys exhibiting different patterns of aggression. Eighty-five boys (ages 13–18) in a juvenile detention center played a competitive computer task against a hypothetical peer who provided low and high levels of provocation. Youth high on both self-reported reactive and proactive aggression showed different behavioral responses to provocation than youth high on only reactive aggression. Specifically, the combined group showed high levels of aggressive responses without any provocation, whereas the group high on reactive aggression showed an increase in aggressive …

Procedural Preferences, Perceptions Of Fairness, And Compliance With Outcomes: A Study Of Alternatives To The Standard Adversary Trial Procedure, Norman Poythress

Norman Poythress

Mental health professionals (N=198) read a vignette describing malpractice case and were asked to imagine themselves in the role of defendant. Using a between-subjects design, each subject was offered two possible trial procedures for resolving the case, the standard adversary procedure (ADVERS) and one of five possible hybrid procedures. Using scales that juxtaposed these two procedures, subjects provided judgments on 12 procedural justice dimensions. A series of regression analyses examined the most important determinants of PREFERENCE judgments, FAIRNESS ratings, and ratings of imagined COMPLIANCE with trial outcomes. PREFERENCE raings were significantly influenced by perceived FAIRNESS of the procedures and by …

Legal, Ethical, And Methodological Considerations In The Internet-Based Study Of Child Pornography Offenders, James Ray, Eva Kimonis, Christine Donoghue

Eva Kimonis

With its ever-growing penetration of remote regions of the world, the Internet provides great opportunity for conducting research. Beyond clear advantages such as increased cost-effectiveness and efficiency in collecting large samples, Internet-based research has proven particularly useful in reaching hidden or marginalized populations who engage in illegal or deviant behaviors. However, this new medium for research raises important and complex legal, ethical, and methodological/technological issues that researchers must address, particularly when studying undetected criminal behaviors. The current paper chronicles various issues that were encountered in the implementation of an active Internet-based pilot research study of child pornography (CP) users. Moreover, …

The Relationship Between Psychopathic Features, Violence And Treatment Outcome: The Comparison Of Three Youth Measures Of Psychopathic Features, Sarah Spain, Kevin Douglas, Norman Poythress, Monica Epstein

Norman Poythress

Few studies have compared self-report and clinician-administered measures of youth psychopathic features in juvenile-justice settings in terms of antisocial behavior and treatment indices. In a sample of 85 adjudicated delinquents, the predictive validities of the Antisocial Process Screening Device (APSD), the modified Childhood Psychopathy Scale (mCPS), and the Hare Psychopathy Checklist: Youth Version (PCL:YV) were tested. Three indices of institutional antisocial behavior (physical aggression; verbal aggression; administrative infractions) and two indices of treatment progress (time to treatment level promotion; whether treatment levels were dropped) were used as external correlates. The self-report measures (mCPS more so than APSD) were more consistently …

Procedural Justice In The Context Of Civil Commitment: An Analogue Study, Michelle Cascardi, Norman Poythress, Alicia Hall

Norman Poythress

Procedural justice theory posits that the process by which disputes are resolved in¯uences perceptions of fairness and satisfaction with outcomes, even if the outcomes are unfavorable. Within the context of civil commitment, Tyler (1992) has suggested that enhancing respondents' perceptions of procedural justice (i.e., participation, dignity, and trust) during commitment proceedings might facilitate accommodation to an adverse judicial determination (i.e., commitment) and subsequently enhance therapeutic outcomes. The study reported here used videotapes of mock commitment hearings to examine whether patients committed for involuntary treatment are sensitive to procedural justice manipulations. Results suggest that patients are sensitive to procedural justice manipulations …