Integrative Perspectives on Behavioral Emergencies and Crises

2015 ◽  
Author(s):  
Phillip M. Kleespies
Keyword(s):  
Decision Making ◽  
At Risk ◽  
Suicidal Behavior ◽  
Crisis Intervention ◽  
Increased Risk ◽  
Interpersonal Victimization ◽  
Behavioral Emergencies ◽  
Victims Of Violence ◽  
Patient At Risk ◽  
Imminent Risk

In this chapter, the author discusses two ways in which the area of behavioral emergencies can be viewed as integrative. First, evidence is presented demonstrating how the three major behavioral emergencies (i.e., risks of interpersonal victimization, suicide, and violence) overlap and are interrelated in certain respects. For example, data indicate that those who have been victims of violence have an increased risk of becoming perpetrators of violence and/or victims of suicidal behavior. Second, the author distinguishes between the concepts of crisis and emergency, and then discusses how crises often precede the development of behavioral emergencies, and how crisis intervention techniques can be used to avert a developing emergency. The chapter concludes with a discussion of the decision making involved in determining whether a patient at risk can be treated as an outpatient in crisis or needs to be hospitalized because of imminent risk of suicide or violence.

Introduction

2016 ◽  
Author(s):  
Phillip Kleespies
Keyword(s):  
At Risk ◽  
Children And Adolescents ◽  
Crisis Intervention ◽  
Suicide Risk ◽  
The Elderly ◽  
Integrative Approach ◽  
Emergency Intervention ◽  
Interpersonal Victimization ◽  
Behavioral Emergencies ◽  
Psychological Risks

This book is about behavioral emergencies and the association between interpersonal victimization and subsequent suicidality and/or risk for violence toward others. Section I focuses on the differences between behavioral crises and behavioral emergencies and presents an integrative approach to crisis intervention and emergency intervention. Section II discusses the evaluation of suicide risk, risk of violence, and risk of interpersonal victimization in children and adolescents. Sections III and IV explore behavioral emergencies with adults and the elderly, while Section V deals with certain conditions or behaviors that may either need to be differentiated from a behavioral emergency, or understood as relevant to possibly heightening risk. Section VI describes treatments for patients with recurrent or ongoing risks, and Section VII is devoted to legal, ethical, and psychological risks faced by clinicians who work with patients who might be at risk to themselves or others.

Counseling for Adolescents and Children At-Risk in Italy

2005 ◽  
Vol 27 (3) ◽  
pp. 249-265 ◽  
Author(s):  
Salvatore Soresi ◽  
Laura Nota ◽  
Lea Ferrari
Keyword(s):  
Decision Making ◽  
At Risk ◽  
Juvenile Delinquency ◽  
Drug Addiction ◽  
Suicidal Behavior ◽  
Counseling Program ◽  
Children At Risk ◽  
Prevention Project ◽  
Social Difficulties ◽  
Italian Children

The aim of the present article is to describe the difficulties experienced by some Italian children and adolescents.We distinguish, however, between overt forms of maladjustment, such as juvenile delinquency, drug addiction, depression, and suicidal behavior, and less severe forms of maladjustment, which are generally associated with poor decision-making skills, social difficulties, and unproductive coping strategies. This presentation is then followed by a description of the current counseling situation in Italy.Also presented is a specific counseling program for at-risk young adolescents and children, conducted with a small group of individuals as part of a broader prevention project aimed at preventing bullying.

scholarly journals Decision-making for the infant sleep environment among families with children considered to be at risk of sudden unexpected death in infancy: a systematic review and qualitative metasynthesis

2021 ◽  
Vol 5 (1) ◽  
pp. e000983
Author(s):  
Anna Pease ◽  
Joanna J Garstang ◽  
Catherine Ellis ◽  
Debbie Watson ◽  
Jenny Ingram ◽  
...  
Keyword(s):  
Decision Making ◽  
At Risk ◽  
Sudden Unexpected Death ◽  
Infant Sleep ◽  
Unexpected Death ◽  
Parental Decision ◽  
Parental Decision Making ◽  
Increased Risk ◽  
Sleep Environment ◽  
Families With Children

BackgroundAdvice to families to sleep infants on their backs, avoid smoke exposure, reduce excess bedcovering and avoid specific risks associated with cosleeping has greatly reduced sudden unexpected death in infancy (SUDI) rates worldwide. The fall in rates has not been equal across all groups, and this advice has been less effective for more socially deprived families. Understanding decision-making processes of families with infants at risk would support the development of more effective interventions.AimTo synthesise the qualitative evidence on parental decision-making for the infant sleep environment among families with children considered to be at increased risk of SUDI.MethodsThis study was one of three related reviews of the literature for the Child Safeguarding Practice Review Panel’s National Review in England into SUDI in families where the children are considered at risk of harm. A systematic search of eight online databases was carried out in December 2019. Metasynthesis was conducted, with themes extracted from each paper, starting with the earliest publication first.ResultsThe wider review returned 3367 papers, with 16 papers (across 13 studies) specifically referring to parental decision-making. Six overall themes were identified from the synthesis: (1) knowledge as different from action; (2) external advice must be credible; (3) comfort, convenience and disruption to the routine; (4) plausibility and mechanisms of protection; (5) meanings of safety and risk mitigation using alternative strategies; and (6) parents’ own expertise, experience and instincts.ConclusionInterventions that are intended to improve the uptake of safer sleep advice in families with infants at risk of sleep-related SUDI need to be based on credible advice with mechanisms of protection that are understandable, consistent with other sources, widened to all carers of the infant and fit within the complex practice of caring for infants.

Mediastinal Mass Biopsy

2013 ◽  
Author(s):  
Jon Tomasson ◽  
Mohamed A Mahmoud ◽  
James P Spaeth
Keyword(s):  
Decision Making ◽  
At Risk ◽  
Mediastinal Mass ◽  
Clinical Symptoms ◽  
Preoperative Evaluation ◽  
Mediastinal Masses ◽  
Asymptomatic Patients ◽  
Increased Risk

It has been long recognized that patients with anterior mediastinal masses (AMMs) have a significantly increased risk of adverse perioperative events. Even asymptomatic patients or those with mild clinical symptoms are at risk for cardiopulmonary collapse and even death with induction of anesthesia, thus highlighting the need for careful preoperative evaluation and decision making.

Are Patient Admission Handoffs from the ED to MICU PARfect?

2018 ◽  
Vol 7 (1) ◽  
pp. 195-202
Author(s):  
Imade Ihianle ◽  
Shirley Burton ◽  
Joanna Abraham
Keyword(s):  
At Risk ◽  
Exploratory Study ◽  
Patient Admission ◽  
Clinical Deterioration ◽  
Physiological Measures ◽  
Increased Risk ◽  
Critical Patients ◽  
Patient At Risk

Studies have highlighted the importance of using objective physiological measures in quickly identifying critical patients who are at an increased risk of clinical deterioration and decompensation. In this exploratory study, we investigate the use of physiological measures within a modified Patient at Risk (PAR) framework for identifying potential ICU admissions during ED-MICU handoffs.

Incarcerated Adolescents' Distress and Suicidality in Relation to Parental Bonding Styles

Crisis ◽  
1999 ◽  
Vol 20 (4) ◽  
pp. 164-170 ◽  
Author(s):  
Elizabeth L McGarvey ◽  
Ludmila A Kryzhanovskaya ◽  
Cheryl Koopman ◽  
Dennis Waite ◽  
Randolph J Canterbury
Keyword(s):  
At Risk ◽  
Attachment Theory ◽  
Suicidal Behavior ◽  
Parental Bonding ◽  
Psychosocial Problems ◽  
Self Esteem ◽  
Suicidal Thoughts ◽  
Parental Bonding Instrument ◽  
Significant Relationships ◽  
Incarcerated Adolescents

This study examines the relationships between the bonding style of an incarcerated adolescent with parents and his/her current feelings of self-esteem, hopelessness, and suicidal thoughts and attempts. It also investigates differences between bonding to mother and bonding to father. Some 296 incarcerated adolescents were interviewed using the Parental Bonding Instrument. Significant relationships were found between youths' self-esteem, hopelessness, and suicidal behavior and their bonding style. Youths whose parent(s) had a parental bonding style of affectionless control reported the greatest distress, and youths whose parent(s) had an optimal bonding style reported the least distress. Differences were found between bonding styles with the mother and with the father. Attachment theory may be useful in targeting incarcerated youths who have affectionless control bonding with parent(s) for special interventions since these youths are most at risk for psychosocial problems.

A Silenced Population

Crisis ◽  
2017 ◽  
Vol 38 (6) ◽  
pp. 433-442 ◽  
Author(s):  
Kim Gryglewicz ◽  
Melanie Bozzay ◽  
Brittany Arthur-Jordon ◽  
Gabriela D. Romero ◽  
Melissa Witmeier ◽  
...  
Keyword(s):  
At Risk ◽  
Depressive Symptomatology ◽  
The United States ◽  
Future Research ◽  
At Risk Youth ◽  
Peer Relationship ◽  
Student Records ◽  
Cross Sectional ◽  
Increased Risk ◽  
Method Student

Abstract. Background: Given challenges that exceed the normal developmental requirements of adolescence, deaf and hard-of-hearing (DHH) youth are believed to be at elevated risk for engaging in suicide-related behavior (SRB). Unfortunately, little is known about the mechanisms that put these youth potentially at risk. Aims: To determine whether peer relationship difficulties are related to increased risk of SRB in DHH youth. Method: Student records (n = 74) were retrieved from an accredited educational center for deaf and blind students in the United States. Results: Peer relationship difficulties were found to be significantly associated with engagement in SRB but not when accounting for depressive symptomatology. Limitations: The restricted sample limits generalizability. Conclusions regarding risk causation cannot be made due to the cross-sectional nature of the study. Conclusion: These results suggest the need for future research that examines the mechanisms of the relationship between peer relationship difficulties, depression, and suicide risk in DHH youth and potential preventive interventions to ameliorate the risks for these at-risk youth.

Dental Implant Placement in Patients with a History of Medications Related to Osteonecrosis of the Jaws: A Systematic Review

2020 ◽  
Author(s):  
Judd Sher ◽  
Kate Kirkham-Ali ◽  
Denny Luo ◽  
Catherine Miller ◽  
Dileep Sharma
Keyword(s):  
Systematic Review ◽  
At Risk ◽  
Drug Therapy ◽  
Dental Implant ◽  
Case Series ◽  
Cochrane Central Register ◽  
Bisphosphonate Treatment ◽  
Implant Placement ◽  
Increased Risk ◽  
History Of

The present systematic review evaluates the safety of placing dental implants in patients with a history of antiresorptive or antiangiogenic drug therapy. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. PubMed, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and OpenGrey databases were used to search for clinical studies (English only) to July 16, 2019. Study quality was assessed regarding randomization, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases using a modified Newcastle-Ottawa scale and the Joanna Briggs Institute critical appraisal checklist for case series. A broad search strategy resulted in the identification of 7542 studies. There were 28 studies reporting on bisphosphonates (5 cohort, 6 case control, and 17 case series) and one study reporting on denosumab (case series) that met the inclusion criteria and were included in the qualitative synthesis. The quality assessment revealed an overall moderate quality of evidence among the studies. Results demonstrated that patients with a history of bisphosphonate treatment for osteoporosis are not at increased risk of implant failure in terms of osseointegration. However, all patients with a history of bisphosphonate treatment, whether taken orally for osteoporosis or intravenously for malignancy, appear to be at risk of ‘implant surgery-triggered’ MRONJ. In contrast, the risk of MRONJ in patients treated with denosumab for osteoporosis was found to be negligible. In conclusion, general and specialist dentists should exercise caution when planning dental implant therapy in patients with a history of bisphosphonate and denosumab drug therapy. Importantly, all patients with a history of bisphosphonates are at risk of MRONJ, necessitating this to be included in the informed consent obtained prior to implant placement. The James Cook University College of Medicine and Dentistry Honours program and the Australian Dental Research Foundation Colin Cormie Grant were the primary sources of funding for this systematic review.

scholarly journals Deficits in explicit emotion regulation in bipolar disorder: a systematic review

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Marcel Kurtz ◽  
Pia Mohring ◽  
Katharina Förster ◽  
Michael Bauer ◽  
Philipp Kanske
Keyword(s):  
At Risk ◽  
Bipolar Disorder ◽  
Emotion Regulation ◽  
Mood State ◽  
Bipolar Disorders ◽  
Protective Measure ◽  
Behavioral Measures ◽  
Increased Risk ◽  
Regulation Strategies ◽  
Depressive Episodes

Abstract Background This study aimed to compile and synthesize studies investigating explicit emotion regulation in patients with bipolar disorder and individuals at risk of developing bipolar disorder. The importance of explicit emotion regulation arises from its potential role as a marker for bipolar disorders in individuals at risk and its potent role in therapy for bipolar disorder patients. Methods To obtain an exhaustive compilation of studies dealing specifically with explicit emotion regulation in bipolar disorder, we conducted a systematic literature search in four databases. In the 15 studies we included in our review, the emotion-regulation strategies maintenance, distraction, and reappraisal (self-focused and situation-focused) were investigated partly on a purely behavioral level and partly in conjunction with neural measures. The samples used in the identified studies included individuals at increased risk of bipolar disorder, patients with current affective episodes, and patients with euthymic mood state. Results In summary, the reviewed studies' results indicate impairments in explicit emotion regulation in individuals at risk for bipolar disorder, patients with manic and depressive episodes, and euthymic patients. These deficits manifest in subjective behavioral measures as well as in neural aberrations. Further, our review reveals a discrepancy between behavioral and neural findings regarding explicit emotion regulation in individuals at risk for bipolar disorders and euthymic patients. While these groups often do not differ significantly in behavioral measures from healthy and low-risk individuals, neural differences are mainly found in frontostriatal networks. Conclusion We conclude that these neural aberrations are a potentially sensitive measure of the probability of occurrence and recurrence of symptoms of bipolar disorders and that strengthening this frontostriatal route is a potentially protective measure for individuals at risk and patients who have bipolar disorders.

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