Greaves, Caroline L.

Treatment adherence in early psychosis individuals is considered problematic. Some studies have tried to understand reasons for medication non-adherence in this population, though few have also considered engagement in services. We conducted a cross-sectional study with 118 early psychosis individuals, assessing multiple constructs (symptoms, insight, personality traits, alliance, childhood trauma, substance abuse, social functioning and sociodemographics) suggested in the literature as potentially linked to medication adherence or engagement in services. Forward Wald logistic regression suggested that more positive symptoms, having witnessed violence as a child and high agreeableness as a personality trait predicted poor medication adherence. Forward linear regression revealed that physical abuse as a child, lack of knowledge regarding consumer rights, difficulties in building an alliance, low neuroticism and high agreeableness predicted poor service engagement. Profiles of non-adherers or low service engagement were strongly linked to childhood trauma, and high agreeableness, as well as more severe symptoms and poor alliance. Males with histories of legal problems were also more prevalent in both groups. No significant differences were found for insight or substance abuse. Overall, individuals with early psychosis who adhered less to treatment in general could have issues with trusting authority and place more importance on peer acceptance. Results are presented in light of the existing literature and clinical implications are discussed.

Though studies have surveyed police officers’ perceptions of people with mental illnesses (PMI), few have examined perceptions held by PMI regarding the police, and none have compared them with those held by the general population. This study sought to (a) examine perceptions of police held by PMI, (b) compare them to perceptions held by the general population, and (c) explore whether differences between PMI and general population perceptions are attributable to contact with the police in the past year. We drew data from a survey of 244 PMI and the 2009 Canadian General Social Survey (GSS) (Brennan, 2011). Both surveys administered the same items querying perceptions of and contact with the police in the prior 12 months. GSS participants were individually matched to PMI participants on sociodemographic characteristics (n = 225 per group). Overall, participants held fairly positive perceptions of the police, but perceptions held by GSS participants were more positive than those held by PMI participants. PMI participants were more likely than GSS participants to have contact with the police in the prior 12 months. In multivariate models, perceptions differed between PMI and GSS participants for police performance in being approachable and treating people fairly, and overall confidence in police; police contact was not associated with perceptions nor did it moderate effects of participant group. Consistent with the procedural justice framework, fair and equitable treatment appears to be of primary relevance to PMI perceptions of the police. Further efforts are needed to improve PMI perceptions of the police in these areas. (APA PsycInfo Database Record (c) 2016 APA, all rights reserved).

In predicting treatment compliance in individuals with severe mental illness, research has focused on variables such as substance abuse, personality, history of child abuse, and symptomatology, although these relationships have not been investigated in great detail in individuals at the onset of mental illness. To better understand these correlates of treatment compliance, two samples were examined: a sample of 117 individuals presenting with a first episode of psychosis and a more chronic forensic sample of 65 participants recruited from a psychiatric hospital. These samples were investigated for service engagement in terms of violence history, substance abuse, symptom severity, psychopathic traits and history of childhood abuse. Linear regressions performed for the first episode sample revealed that childhood physical abuse was the strongest predictor of poor service engagement, followed by problems with alcohol, a history of physical violence, any history of violence and higher psychopathic traits. Linear regression revealed for the forensic group that a lower level of service engagement was most strongly predicted by a history of childhood abuse and a higher score on the Brief Psychiatric Rating Scale (BPRS). Results are presented in light of the existing literature and clinical implications are discussed.

Special Issue: Violent and Antisocial Behavior in Women<p>Research on resiliency and recovery in forensic psychiatric patients is still limited. Information pertaining to factors associated with successful community reintegration would contribute to a more comprehensive assessment of functioning and informed treatment planning that fits within a recovery approach of service provision. Using a retrospective design involving file reviews and a 3-year follow-up period, the authors investigated the rate of successful/unsuccessful community reintegration (defined by the presence or absence of an absolute discharge/readmission to hospital) in female forensic psychiatric patients (N = 48). The study evaluated the extent to which the risk and protective factors captured in the Short-Term Assessment of Risk and Treatability (START) predicted a range of positive and negative outcomes in the study sample. Results showed that 47.9% of the women qualified as having successfully reintegrated into the community, with the remaining 52.1% qualifying as still being in recovery. Successful individuals possessed significantly more protective factors and significantly fewer risk factors than individuals still in recovery. Furthermore, both the vulnerability and the strength scale of the START demonstrated good predictive validity, however we did not find evidence of incremental validity of the strength scale. Copyright © 2011 John Wiley & Sons, Ltd.

Treatment adherence in early psychosis individuals is considered problematic. Some studies have tried to understand reasons for medication non-adherence in this population, though few have also considered engagement in services. We conducted a cross-sectional study with 118 early psychosis individuals, assessing multiple constructs (symptoms, insight, personality traits, alliance, childhood trauma, substance abuse, social functioning and sociodemographics) suggested in the literature as potentially linked to medication adherence or engagement in services. Forward Wald logistic regression suggested that more positive symptoms, having witnessed violence as a child and high agreeableness as a personality trait predicted poor medication adherence. Forward linear regression revealed that physical abuse as a child, lack of knowledge regarding consumer rights, difficulties in building an alliance, low neuroticism and high agreeableness predicted poor service engagement. Profiles of non-adherers or low service engagement were strongly linked to childhood trauma, and high agreeableness, as well as more severe symptoms and poor alliance. Males with histories of legal problems were also more prevalent in both groups. No significant differences were found for insight or substance abuse. Overall, individuals with early psychosis who adhered less to treatment in general could have issues with trusting authority and place more importance on peer acceptance. Results are presented in light of the existing literature and clinical implications are discussed.

[Background] Previous investigations suggest that women judged to be not criminally responsible on account of mental disorder (NCR-MD) differ markedly from their male counterparts in important ways, underscoring the necessity of subsequent study. [Objective] The goal of the present study was to inform our understanding of the presenting profile of female forensic psychiatric patients and contrast their risk of inpatient aggression with their male counterparts. [Method] The population of patients assessed and/or treated at a secure Canadian forensic psychiatric hospital were available for study. In total, 527 patients had complete data and were part of intensive retrospective file reviews; inpatient aggression was evaluated using the Overt Aggression Scale. [Results] Women were no less likely than men to have a violent index offence and to perpetrate inpatient aggression. Examining the range of aggressive behaviours and severity levels did little to increase the relevance of gender to inpatient risk. [Discussion] Female forensic patients represent a highly selected subgroup of women with exceptional clinical and behavioural challenges and associated treatment needs.

Female perpetrators of intimate partner violence (IPV) are now beginning to receive some scholarly attention both in Canada and the United States, particularly with zero tolerance policies and the increasing number of female arrestees. This article reviews research on the relative prevalence of IPV (comparing males and females) and the context and motivation for perpetration and female perpetrators' general psychopathology (e.g., their attachment issues, trauma experiences, and personality organization). We not only examine intergroup comparisons between women and men, but also highlight some of the intragroup heterogeneity within female perpetrators of the IPV population. The aim of this review is also to describe some of current treatment approaches and provide recommendations for the future.

Studies in the area of psychosis and violence to date suggest that those who suffer from psychosis are at higher risk for perpetration of such aggressive behaviours. In fact, it has been suggested that variables such as substance use and personality may mediate this relationship. Other variables, such as childhood physical abuse, might also be implicated in the etiology. In the current study, a sample of one hundred and eighteen participants with a primary diagnosis of psychosis were interviewed and prevalence rates for aggressive experiences were as follows: history of trouble with the law (45%), history of emotional abuse (9.6%), physical abuse (38.8%), and sexual abuse (60.2%). With regard to perpetration, 69.6% reported verbal or physical aggression (69.6%), and further, 61% reported problems with substances. Logistic regression procedures were used with a number of the variables under study and relationships were evidenced between psychopathy scores, history of abuse, and regular drug use. History of child abuse was related to violence history, with those who were victims of child abuse being more likely to be violent in later life. In addition higher scores on the psychopathy measure were linked with violence history. This study was a first step towards identifying persons suffering from a mental illness who may be at risk for violence by identifying who, among first episode clients, may be more likely to perpetrate violent behaviours. Targeted interventions and strategies may be further refined so that individuals receiving mental health services may be better served.