The Sex Offender Risk Appraisal Guide (SORAG)

In North America, the use of actuarial instruments is considered to be state of the art in the assessment of offender recidivism risk. One of these instruments is the "Sex Offender Risk Appraisal Guide" (SORAG), which was developed specifically for the use in sex offender risk assessment. The present review investigates the current state of knowledge regarding the instrument's validity specifically for its use in German-speaking countries. Overall the results speak for the instrument's good discriminatory power. However, this is not true to the same degree for all types of sex offender populations. The discriminatory power is especially good in the subpopulation of child molesters. Part of the present review is a German translation of the instrument authorised by the developers of the SORAG.     

Gender Differences in at Risk Versus Offender Adolescents: A Dimensional Approach of Antisocial Behavior

The current study investigated gender differences in the main components of antisocial behavior in an at-risk versus an offender group of adolescents. One-hundred and forty-three adolescents divided into two different risk groups [at risk (n = 54) and offenders (n = 89)] were compared according to gender (111 boys and 32 girls). Externalizing symptoms were assessed with the Delinquent and Aggressive subscales of the Youth Self-report Questionnaire, internalizing problems with the Beck Anxiety Inventory and the Beck Depressive Inventory and personality traits with the Barratt-Impulsiveness Scale as well as the Youth Psychopathic Traits Inventory. Results revealed a consistent interaction pattern, with girls presenting higher levels of externalizing symptoms, more motor impulsivity and a more arrogant and deceitful interpersonal style than boys in the at-risk group. In contrast, in the offenders’ group, psychopathic traits were more present in boys than in girls. Regarding internalizing problems, girls showed more depression than boys, independently of the risk group. Among offending youths, girls present equally severe externalizing problems, and problematic personality traits as boys. At-risk girls have the highest rates of difficulties across the tested domains and should therefore be specifically targeted for prevention and intervention.     

FORUM The Quantified Process Approach: An Emerging Methodology to Neuropsychological Assessment

An important development in the field of neuropsychological assessment is the quantification of the process by which individuals solve common neuropsychological tasks. The present article outlines the history leading to this development, the Quantified Process Approach, and suggests that this line of applied research bridges the gap between the clinical and statistical approaches to neuropsychological assessment. It is argued that the enterprise of quantifying the process approach proceeds via three major methodologies: (1) the “Satellite” Testing Paradigm: an approach by which new tasks are developed to complement existing tests so as to clarify a given test performance; (2) the Composition Paradigm: an approach by which data on a given test that have been largely overlooked are compiled and subsequently analyzed, resulting in new indices that are believed to reflect underlying constructs accounting for test performance; and (3) the Decomposition Paradigm: an approach which investigates the relationship between test items of a given measure according to underlying facets, resulting in the development of new subscores. The article illustrates each of the above paradigms, offers a critique of this new field according to prevailing professional standards for psychological measures, and provides suggestions for future research.     

Predicting Juvenile Offender Recidivism: Risk-Need Assessment and Juvenile Justice Officers

This study compared the validity of structured versus unstructured risk predictions. Fourteen Juvenile Justice Officers (JJOs) provided 121 risk-need inventory assessments for offending youth under community supervision. Using a rating scale (0-10), another group of 20 JJOs provided estimates of reoffending for a different sample of 107 young offenders. Follow-up data from a few months to approximately 2 years were accessed to identify new convictions. Predictive validity analyses yielded marginally higher, but non-significant, differences in favour of the inventory (area under ROC curve = .75 versus .70). Detection indices improved slightly when reoffending status was determined for a subset of male offenders at 15 months post-assessment. It was noteworthy that when risk scores were converted to categorical ranges (low, medium, high), the distribution was significantly different for the inventory compared with the officers. This was due to more high-risk ratings by JJOs compared with more low-risk rating from the inventory and highlights one advantage of the latter approach.     

Issues Surrounding the Risk Assessment of Sexual Offenders with an Intellectual Disability

The assessment and treatment of sex offenders with an intellectual disability has received increasing attention over the last 15 to 20 years but there has been little research conducted on the evaluation of assessment and treatment approaches to this client group. The general area of sex offender risk assessment has been subject to a considerable degree of research over the years but none of this research has clearly differentiated the intellectually disabled in population samples. Nevertheless, in at least two prominent risk assessments, intellectual disability is defined as a static risk factor. Serious methodological problems exist in the research that has focused upon the offender with an intellectual disability, with inconsistent criteria being set to define intellectual disability. This precludes any attempt to define base rates of recidivism for this population. Protective factors for this population in Victoria are discussed, particularly the informed monitoring ability of staff working with this client group. Future research needs to differentiate this population from other samples and care must be taken to include only those individuals who have been formally diagnosed as having an intellectual disability.     

Sexual Barrier Weight: A New Approach

Abstract

An eating disorder may have part of its roots in sexual abuse and/or trauma. We have studied 42 women with eating disorders, two-thirds of who gave histories of sexual trauma. By graphic analysis, age vs. weight, we have shown that fluctuations in body weight have followed sexually significant life events. This is especially significant in victims of rape and termination of a sexual relationship. We suggest that sexually traumatized persons may resist a specific body weight due to fear of sexual attractiveness or impulses relating to specific sexual trauma that occurred at that weight. Further study is necessary to confirm these hypotheses.     

The Facts About Sexual (Dys)function in Schizophrenia: An Overview of Clinically Relevant Findings

A limited number of studies have evaluated sexual functioning in patients with schizophrenia. Most patients show an interest in sex that differs little from the general population. By contrast, psychiatric symptoms, institutionalization, and psychotropic medication contribute to frequently occurring impairments in sexual functioning. Women with schizophrenia have a better social outcome, longer lasting (sexual) relationships, and more offspring than men with schizophrenia. Still, in both sexes social and interpersonal impairments limit the development of stable sexual relationships. Although patients consider sexual problems to be highly relevant, patients and clinicians not easily discuss these spontaneously, leading to an underestimation of their prevalence and contributing to decreased adherence to treatment. Studies using structured interviews or questionnaires result in many more patients reporting sexual dysfunctions. Although sexual functioning can be impaired by different factors, the use of antipsychotic medication seems to be an important factor. A comparison of different antipsychotics showed high frequencies of sexual dysfunction for risperidone and classical antipsychotics, and lower frequencies for clozapine, olanzapine, quetiapine, and aripiprazole. Postsynaptic dopamine antagonism, prolactin elevation, and α₁-receptor blockade may be the most relevant factors in the pathogenesis of antipsychotic-induced sexual dysfunction. Psychosocial strategies to treat antipsychotic-induced sexual dysfunction include psychoeducation and relationship counseling. Pharmacological strategies include lowering the dose or switching to a prolactin sparing antipsychotic. Also, the addition of a dopamine agonist, aripiprazole, or a phosphodiesterase-5 inhibitor has shown some promising results, but evidence is currently scarce.Key words: antipsychotic, sexual dysfunction, schizophrenia, dopamine, prolactin, negative symptoms     

An Examination of the Performance of the interRAI Risk of Harm to Others Clinical Assessment Protocol (RHO CAP) in Inpatient Mental Health Settings

Psychiatric Quarterly - We study violence risk prediction at St. Joseph’s Healthcare Hamilton. Data from January 2016 to December 2017 have been anonymized and collected, for a total of 870...     

Methodological Challenges in Research on Sexual Risk Behavior: III. Response to Commentary

Background: We recently provided two detailed reviews of sexual risk behavior research (1,2) in which we identified methodological challenges, reviewed new developments, and made recommendations to guide future research. In this issue, Catania et al. provide a commentary on our two reviews.Purpose: Clarifications.Method: We carefully reviewed the commentary provided by Catania et al. and respond to their critique.Results: Catania et al. emphasized three major points in their commentary: (a) When assessing sexual risk behavior, categorical assessments of unprotected intercourse may be preferable to count data; (b) quantification of sexual risk via counts of unprotected intercourse does not reflect the complexity of the sexual transmission of HIV; and (c) analysis of variance and analysis of covariance options in analyzing the effects of randomized HIV risk-reduction trials were overemphasized in our review. We address each of these points in turn and clarify the three points that were misunderstood.Conclusions: We remain convinced that count data of sexual risk behavior are the more useful, versatile, and valid indicators of sexual risk reduction in the evaluation of sexual risk behavior interventions. We urge interested readers to review our original articles, which provide a more detailed account of the challenges and opportunities of sexual behavior research.     

Leading Change: An Approach to Developing Collaborative Leadership

This article explores the development of a new leadership program for mental health services. This program has been designed around the belief that learning is most effective when it is based on real tasks in a real place. The program has also taken a team leadership approach as opposed to focusing primarily on individuals. The twin aims of the program are to find ways of achieving application of learning and sustainability of learning and application beyond the life of the program. Evaluation and review as part of learning are, therefore, also explored, as providing both evidence of impact and also as means to improving the design and delivery of the learning program.     

An international study to assess reliability of the Migraine Disability Assessment (MIDAS) score.

BACKGROUND: The Migraine Disability Assessment (MIDAS) instrument is a five-item questionnaire developed to measure headache-related disability and improve doctor-patient communication about the functional consequences of migraine. OBJECTIVES: To examine the test-retest reliability and internal consistency of the five items and of the overall MIDAS score in population-based samples of migraine sufferers in two countries and to compare consistency across countries. METHODS: Using a clinically validated telephone interview, population-based samples of migraine-headache sufferers were identified in the United States (Baltimore, MD) and the United Kingdom (Merton and Sutton, Surrey). Eligible individuals completed the MIDAS questionnaire on two occasions an average of 3 weeks apart. The MIDAS score is derived from five questions about missed time from work and household work (one question each about missed days and days with at least 50% reduced productivity) and missed days of nonwork activities. RESULTS: A total of 97 migraine-headache sufferers from the United States and 100 from the United Kingdom completed the MIDAS questionnaire twice. Mean and median item values and overall MIDAS scores were similar between the United States and the United Kingdom. Test-retest Spearman correlations of individual items ranged from 0.46 to 0.78. No significant differences in item-specific correlations were observed between the United States and United Kingdom. The test-retest Pearson correlation of the MIDAS score (i.e., sum of lost days and reduced-effectiveness days in each domain) was 0.80 in the United States and 0.83 in the United Kingdom. The Cronbach alpha, a measure of internal consistency, was 0.76 in the United States and 0.73 in the United Kingdom. CONCLUSIONS: This is the first international population-based study to assess the reliability of a disability-related illness severity score for migraine. The reliability and internal consistency of the Migraine Disability Assessment score are similar to that of a previous questionnaire (Headache Impact Questionnaire). However, the Migraine Disability Assessment score requires fewer questions, is easier to score, and provides intuitively meaningful information on lost days of activity in three domains.     

Solution Focused Therapy: An Alternative Approach to Addictions Nursing

topic : The application of solution-focused therapy as an alternative approach to addictions nursing.
purpose : To acquaint nurses with solution-focused therapy as a treatment modality that uses specific techniques to focus on clients'strengths and resources, rather than on pathology.
source : Traditional method of addictions treatment as a way of confronting a client's denial are contrasted with solution-focused therapy approaches, which provides a positive framework that uses clients'competencies to create necessary solutions.
conclusions : Solution-focused therapy represents a caring and humanistic approach to the practice of addictions nursing.