Behavioral Activation Group Therapy in Public Mental Health Settings: A Pilot Investigation.

Depression is among the most common psychiatric disorders seen in mental health practices. Although effective treatments for the condition exist, managed care pressures providers to utilize empirically supported, cost-effective treatments. Behavioral activation (BA) treatment for depression has emerged in recent years as a promising, cost-effective intervention for major depressive disorder. If its effectiveness could be established. BA delivered through a group format would offer additional cost effectiveness over its individual therapy counterpart. This investigation examined the effects of behavioral activation group therapy (BAGT) for depression in public mental health settings. The results suggest that BAGT can be a valuable addition to the practicing psychologist's set of interventions to use with depressed clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Violence Risk Assessment: Getting Specific About Being Dynamic.

Substantial strides have been made in the field of violence risk assessment. Numerous robust risk factors have been identified and incorporated into structured violence risk assessment instruments. The concepts of violence prevention, management, and treatment have been infused into contemporary thinking on risk assessment. This conceptual development underscores the necessity of identifying, measuring, and monitoring changeable (dynamic) risk factors--the most promising targets for risk reduction efforts. However, empirical investigation of dynamic risk is virtually absent from the literature. In this article, the authors (a) differentiate risk status (interindividual risk level based largely on static risk factors) from risk state (intraindividual risk level determined largely by current status on dynamic risk factors), (b) analyze the relevance of contemporary risk assessment measures for capturing dynamic risk, and (c) distill potentially important dynamic risk factors from the literature in order to facilitate future research. Suggestions for theory development and research design are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and community violence among civil psychiatric patients: Results from the MacArthur Violence Risk Assessment Study.

Although psychopathy is recognized as a relatively strong risk factor for violence among inmates and mentally disordered offenders, few studies have examined the extent to which its predictive power generalizes to civil psychiatric samples. Using data on 1,136 patients from the MacArthur Violence Risk Assessment project, this study examined whether the 2 scales that underlie the Psychopathy Checklist: Screening Version (PCL:SV) measure a unique personality construct that predicts violence among civil patients. The results indicate that the PCL:SV is a relatively strong predictor of violence. The PCL:SV's predictive power is substantially reduced, but remains significant, after controlling for a host of covariates that reflect antisocial behavior and personality disorders other than psychopathy. However, the predictive power of the PCL:SV is not based on its assessment of the core traits of psychopathy, as traditionally construed. Implications for the 2-factor model that underlies the PCL measures and for risk assessment practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role and relevance of the Psychopathy Checklist-Revised in court: A case law survey of U.S. courts (1991-2004).

The Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991, 2003) is the most empirically validated instrument for measuring psychopathy in correctional and forensic psychiatric populations. The PCL-R's predictive utility with criminal justice populations has led to its frequent use by clinicians conducting forensic assessments in criminal and sexually violent predator (SVP) cases. Despite its apparent wide acceptance in U.S. courts, little is known about how often the PCL-R is being introduced, the types of cases in which it is being used, and whether claims made in court regarding psychopathy are empirically defensible and/or relevant to the question at hand. This project documents some uses of the PCL-R in U.S. courts from 1991 through 2004 by year, jurisdiction, type of evaluation, and party. The results suggest that the PCL-R is being used by expert witnesses with increasing regularity across U.S. jurisdictions, primarily to assess risk of future violence. A review of 3 recent cases is also provided that illustrates concerns about the validity of the PCL-R for certain types of legal questions that may arise in criminal and SVP trials. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Unresolved controversies concerning psychopathy: Implications for clinical and forensic decision making.

At some point in their careers, clinicians who work or consult in forensic and correctional settings will almost certainly encounter individuals who exhibit psychopathic personality features. Because of the widespread use of this disorder to inform legal and clinical decision making, psychologists should be exceedingly familiar with the relevant research literature on this topic before venturing into these settings. This article reviews the empirical bases of several clinically relevant claims and assertions regarding psychopathy and concludes that many areas of research are decidedly more equivocal in their findings than is commonly perceived. Although there is much to be gained by assessing psychopathy in various contexts, clinicians need to be cautious about drawing overzealous and empirically questionable conclusions about an important disorder that also has great potential for abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Operationalizing the International Classification of Functioning, Disability and Health in Clinical Settings.

Functional status may be a better indicator of health care needs and outcomes than diagnosis. Appropriate use of the International Classification of Functioning, Disability and Health (ICF) in health service settings can provide a standardized way for clinicians to communicate complex clinical assessments to other professionals, administrators, and payers. The American Psychological Association is working with the World Health Organization to develop a Procedural Manual and Guide for a Standardized Application of the ICF for use by multidisciplinary health professionals. The Procedural Manual includes operational definitions of concepts, examples of each code, and assessment information relevant to each qualifier. The purpose of the Procedural Manual is to provide health professionals with the guidance necessary for reliable, valid, and clinically useful classification. This article discusses a range of issues and problems in the application of individual ICF codes in the context of health care and offers some potential solutions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

程潮矿区周边土壤重金属污染风险评价和健康风险评估

采用单因子指数法、内梅罗指数法、潜在生态风险指数法和地累积指数法对程潮铁矿尾矿库及周边农田土壤重金属（镉、砷、铅、铬、铜、镍和锌）的生态风险及人体健康风险进行综合评价。单因子风险评价结果显示,尾矿库土壤As和Cu的污染问题突出,超标率分别为33.3%和41.7%,其它重金属在少数点位超标;农田土壤仅重金属Cd超标。内梅罗综合污染指数结果表明,16.7%的尾矿位点处于中度污染水平,25%的尾矿位点处于重度污染水平;农田土壤整体上较清洁。尾矿土壤中41.7%的Cu处于中等潜在生态风险水平,41.7%的土壤Cu属于中度~强污染地质累积风险,少数位点由于Cd和As含量较高,达到较高等级的潜在生态风险和地质累积风险。农田土壤重金属污染物主要为Cd,局部地区达到中等潜在生态风险和地质累积风险。人体健康风险评价结果表明,As和Cr的非致癌风险和致癌风险均较为突出,整体而言,尾矿区有33.3%的位点存在致癌风险,所有土壤的非致癌风险等级低,对人体健康的风险较低。由于少数位点重金属污染问题突出,仍需加强该尾矿及其周边农田土壤重金属的污染防治和风险管控。     

Psychopathy, IQ, and Violence in European American and African American County Jail Inmates.

The accuracy of the prediction of criminal violence may be improved by combining psychopathy with other variables that have been found to predict violence. Research has suggested that assessing intelligence (i.e., IQ) as well as psychopathy improves the accuracy of violence prediction. In the present study, the authors tested this hypothesis by using a contemporary measure of psychopathy, the Psychopathy Checklist-Revised (R. D. Hare, 2003), in a sample of 326 European American and 348 African American male offenders. The postdictive power of psychopathy was evident for both ethnic groups and robust across most changes in the operationalization of violence and the analysis conducted, whereas the postdictive power of IQ was not. No Psychopathy x IQ interactions were identified. Implications of these results for violence prediction are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Voluntary, but Knowing and Intelligent: Comprehension in Mental Health Courts.

The number of mental health courts (MHCs) is steadily increasing. Although the courts are voluntary, it is unknown whether decisions to enter MHCs are made knowingly and intelligently. However, the ability to make these decisions is important given that MHCs are informal (and thus may lack built-in safeguards against constitutional violations) and given their rate of growth. Relevant research on other types of legal competencies suggests there may a substantial number of MHC participants who do not fully comprehend court processes and requirements. Furthermore, the level of comprehension at entry may predict future success or failure in the court. Thus, for both legal and practical reasons, the issue of MHC comprehension among its participants is critical. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peer Influence on Risk Taking, Risk Preference, and Risky Decision Making in Adolescence and Adulthood: An Experimental Study.

In this study, 306 individuals in 3 age groups--adolescents (13-16), youths (18-22), and adults (24 and older)--completed 2 questionnaire measures assessing risk preference and risky decision making, and 1 behavioral task measuring risk taking. Participants in each age group were randomly assigned to complete the measures either alone or with 2 same-aged peers. Analyses indicated that (a) risk taking and risky decision making decreased with age; (b) participants took more risks, focused more on the benefits than the costs of risky behavior, and made riskier decisions when in peer groups than alone; and (c) peer effects on risk taking and risky decision making were stronger among adolescents and youths than adults. These findings support the idea that adolescents are more inclined toward risky behavior and risky decision making than are adults and that peer influence plays an important role in explaining risky behavior during adolescence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What Do Clinicians Expect? Comparing Envisioned and Reported Violence for Male and Female Patients.

Mental health professionals' (MHPs') accuracy in assessing the risk of violence in female patients is particularly limited. Based on assessments made by 205 MHPs of 605 patients in an emergency room, this study explored potential causes of MHPs' poorer accuracy in assessing women's potential for violence. The dimensions that underlie MHPs' envisioned violence in patients were identified and were compared with those that characterized patients' reported violence during a 6-month follow-up period. There were three key findings from their study. First, violence envisioned by MHPs differed depending on their professional role and varied in its congruence with patients' reported violence. Second, patients' violence was organized by dimensions of domesticity and substance relatedness; women's violent incidents were more domestic than were men's. Third, when MHPs envisioned violence that was highly conditional on psychiatric deterioration and medication noncompliance, violence often did not occur. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating Capacity of Older Adults in Rehabilitation Settings: Conceptual Models and Clinical Challenges.

Psychologists who work in rehabilitation settings are likely to receive increasing numbers of referrals to evaluate the decision-making capacity of older patients. To aid in these assessments, psychologists may refer to state guardianship and transactional law and related psychological models and may utilize a 5-step process of assessment involving referral clarification, assessment planning, assessment, synthesis of data and communication of findings, and follow-up. The authors discuss several types of cases that may be particularly challenging to assess involving individuals with subtle but measurable decisional impairments who may also be displaying long-held yet atypical approaches to decision making influenced by experience, culture, race/ethnicity, values, or personality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The predictive validity of the Structured Assessment of Violence Risk in Youth in secondary educational settings.

Current developments in violence risk assessment warrant consideration for use within educational settings. Using a structured professional judgment (SPJ) model, the present study investigated the predictive validity of the Structured Assessment of Violence in Youth (SAVRY) within educational settings. The predictive accuracy of the SAVRY scales was assessed using a retrospective file review to gather data on 87 adolescents ranging in age from 12 to 18 years. Receiver-operating characteristic analyses were used to gauge the predictive accuracy. With an area under the curve of .72 (p = .001), the accuracy of the SAVRY total score in correctly identifying violent youth exceeds the accuracy of identifications based on chance predictions in this sample. Logistic regression analyses assessed the relative contribution of the SAVRY subscales, whereas the omnibus equation using all subscale scores correctly classified 82% of those adolescents who were nonviolent and 45% of those adolescents who were violent. These results build on previous research and provide support for the use of the SAVRY in educational settings for identification as well as directing intervention efforts. Practical implications and areas for future research are also discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Psychologists in Schools of Public Health: Current Status, Future Prospects, and Implications for Other Health Settings.

The deans and departmental chairs of the 22 schools of public health were asked in 1981 to list all psychologists holding full-time faculty appointments and the names of courses with a substantial behavioral/psychological content. Responses were received from 98% of the departments. The psychologists were then sent a survey concerning their backgrounds, job responsibilities, and satisfaction/dissatisfaction with their positions. There was an 80% response rate. Psychologists accounted for 5.7% of the approximately 1,300 full-time faculty in schools of public health. Psychologists represented a larger percentage of the faculty in departments of behavioral science than in departments of epidemiology, biostatistics, environmental health, and so forth. Public health psychologists were active researchers and publishers, with average totals of 2.5 articles and 26.9 citations for a three-year period. The primary advantages of employment in a school of public health had to do with an appreciation of the public health perspective, an interdisciplinary orientation, and research opportunities. The primary dissatisfactions cited were financial insecurity, isolation from psychology, and lack of appreciation among public health colleagues of the contribution of psychology to public health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Assessing and managing violence risk in juveniles.

Reviews the book, Assessing and managing violence risk in juveniles by Randy Borum and David Verhaagen (see record 2006-12484-000). This book is a compilation of research findings designed to accomplish the goal of equipping the reader to "conduct risk assessments that are thorough, fair, helpful, and developmentally and empirically sound." New school psychologists will find an excellent framework for learning how to approach the daunting task of assessing risk of violence in children and adolescents. Experienced practitioners will find new research results integrated throughout the book to improve the precision of their risk assessments as well. This book is written for mental health professionals in schools, therapy settings, and juvenile justice systems. Although these three contexts are presented as very different from each other (differences in treatment plans are noted), the basic principles of assessment are applicable to all. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social Motives and Strategic Misrepresentation in Social Decision Making.

In 4 experiments, the authors studied the influence of social motives on deception and strategic misrepresentation. In a newly developed information provision game, individuals faced a decision maker whose decision would affect both own and other's outcomes. By withholding information or by giving (in)accurate information about payoffs, participants could try to influence other's decision making. Less accurate and more inaccurate information was given when the decision maker was competitive rather than cooperative (Experiment 1), especially when participants had a prosocial rather than selfish value orientation (Experiments 3 and 4). Accurate information was withheld because of fear of exploitation and greed, and inaccurate information was given because of greed (Experiment 2). Finally, participants engaged in strategic misrepresentation that may trick competitive others into damaging their own and increasing the participant's outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Structured Assessment of Violence Risk in Youth as a predictor of recidivism in a United Kingdom cohort of adolescent offenders with conduct disorder.

This prospective study examined the predictive validity of the Structured Assessment of Violence Risk in Youth (SAVRY) and the Psychopathy Checklist: Youth Version (PCL: YV) in 99 male adolescents who were assessed in custody and followed up 12 months post release. Outcome data on recidivism were based on official Home Office records. The base rates for violent and general recidivism, respectively, were 38.4% and 70.7%. The predictive validity of the SAVRY Risk Total and the SAVRY Risk Rating was moderate for both violent and general recidivism, but both showed incremental validity in predicting outcomes compared with the PCL: YV. Data are discussed in relation to the limited published international literature. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Building Trust and Managing Risk: A Look At A Felony Mental Health Court.

Although many mental health courts are restricted to misdemeanors, the Brooklyn Mental Health Court primarily handles felonies. This article describes a felony mental health court and explores the decision to focus on felonies, including the planning team's experiences with problem-solving courts and the effort to balance a fair court process with effective, but lengthy, treatment mandates. The author describes several ways by which the court and its partners manage potential public safety risks posed by felony offenders: thorough evaluations of offenders, individualized treatment plans, shared decision making, candid communications between the court and its partners, and close judicial monitoring. The author also describes the ongoing program evaluation of the court and suggests areas for future research for felony mental health courts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using a Five-Factor Lens to Explore the Relation Between Personality Traits and Violence in Psychiatric Patients.

Recent work suggests that predictors of violence are similar for individuals with and without mental illness. Although psychopathy is among the most potent of such predictors, the nature of its relation to violence is unclear. On the basis of a sample of 769 civil psychiatric patients, the authors explore the possibility that measures of psychopathy provide a glimpse of higher order personality traits that predispose individuals toward violence. Results indicate that general traits captured by a measure of the 5-factor model, particularly antagonism, were relatively strongly associated with violence and shared most of their violence-relevant variance with a leading measure of psychopathy. Because interpersonal and affective features of psychopathy are less important than basic traits of antagonism in postdicting violence, it may be appropriate to broaden focus in risk assessment to patients' basic personality traits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical decision making in the prediction of falls.

Objective: Examine rehabilitation professionals' capacity to identify risk factors for patient falls. Design: Survey study. Setting: Three academic medical center rehabilitation departments. Participants: Fifty-six rehabilitation specialists representing disciplines typically involved in patient care, including physiatry and occupational, physical, recreation, and speech therapy. Measures: A 2-part, self-report questionnaire with spontaneous and cued rank-order listing of factors related to fall risk. Results: Clinicians did not consider advanced age and history of falling when spontaneously delineating risks for falls. The importance of fall history, but not of advanced age, was recognized through cueing. Conclusions: Clinicians appear aware of strong predictors of fall risk but require cueing to consistently use them. Cueing increased hypothetical predictive accuracy, although clinicians still downplayed some of the most salient predictive factors. Staff education regarding validated fall risk factors and potential errors in clinical decision making can improve patient care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)