Clinical Appraisals of Individual Differences in Treatment Responsivity Among Patients With Psychopathy: A Consensual Qualitative Research Study

2020 ◽  
pp. 009385482097059
Author(s):  
Evelyn Klein Haneveld ◽  
Wineke Smid ◽  
Kelsey Timmer ◽  
Jan H. Kamphuis
Keyword(s):  
Qualitative Research ◽  
Psychiatric Treatment ◽  
Negative Impact ◽  
Treatment Success ◽  
Patient Characteristics ◽  
Consensual Qualitative Research ◽  
Treatment Team ◽  
Psychopathy Checklist Revised ◽  
Forensic Psychiatric ◽  
Treatment Responsivity

This study addressed which factors expert clinicians consider crucial in successful completion versus dropout in the mandatory forensic psychiatric treatment of psychopathic patients in the Netherlands. Eleven clinicians were interviewed about patient characteristics, treatment (provider) characteristics, and other factors they deemed associated with failure (transfer to another facility) or completion. The interviews were coded using the guidelines of Consensual Qualitative Research (CQR). Overall, extremely high scores on Psychopathy Checklist–Revised (PCL-R) Facets 1 (Deceitful Interpersonal Style) and 2 (Defective Affective Experience) were thought to impede treatment retention, particularly by its negative impact on motivation and therapeutic relationship. Older patients, those with a prosocial network, and/or patients with comorbid borderline traits appeared to fare better. Treatment success was deemed more likely when treatment goals and expectations are stipulated in a concrete fashion, when an extended and gradual resocialization trajectory is offered, and the treatment team is expert, cohesive, and stable.

Physical Violence During Mandatory Psychiatric Treatment: Prevalence and Patient Characteristics

2020 ◽  
Vol 47 (7) ◽  
pp. 771-789
Author(s):  
Nienke Verstegen ◽  
Vivienne de Vogel ◽  
Anneloes Huitema ◽  
Robert Didden ◽  
Henk Nijman
Keyword(s):  
Personality Disorder ◽  
Legal Status ◽  
Psychiatric Treatment ◽  
Physical Violence ◽  
Binary Logistic Regression ◽  
Patient Characteristics ◽  
Treatment Prevalence ◽  
Psychopathy Checklist Revised ◽  
Self Harm ◽  
Forensic Psychiatric

This study explores variables that predict physical violence in 614 (forensic) psychiatric inpatients. All violent incidents that occurred in a Dutch forensic psychiatric hospital between 2014 and 2019 ( N = 3,713) were coded with the Modified Overt Aggression Scale+ based on daily hospital reports and patients’ medical records. Binary logistic regression analyses examined which patient variables could differentiate between patients with and without physical violence during treatment and between patients with single and multiple incidents of physical violence. Variables included in the analyses were gender, legal status, borderline personality disorder, antisocial personality disorder, schizophrenia spectrum disorder, psychopathy (Psychopathy Checklist–Revised [PCL-R] score), self-harm during treatment, impulsivity, intellectual disability, and length of stay. A clear association was found between self-harm and inpatient physical violence on all outcome measures and in all analyses. Adequate monitoring of self-harm is advised as a strategy to early identify patients with a high risk to threaten ward safety.

PCL-R Psychopathy Predicts Disruptive Behavior Among Male Offenders in a Dutch Forensic Psychiatric Hospital

2004 ◽  
Vol 19 (1) ◽  
pp. 13-29 ◽  
Author(s):  
MartIn Hildebrand ◽  
Corine De Ruiter ◽  
Henk Nijman
Keyword(s):  
Disruptive Behavior ◽  
Psychiatric Treatment ◽  
Physical Violence ◽  
Verbal Abuse ◽  
Language Version ◽  
Psychopathy Checklist ◽  
Forensic Hospital ◽  
Psychopathy Checklist Revised ◽  
Forensic Psychiatric ◽  
Verbal Threat

In this study, the relationship between psychopathy, according to the Dutch language version of Hare’s Psychopathy Checklist-Revised (PCL-R), and various types of disruptive behavior during inpatient forensic psychiatric treatment is investigated. Ninety-two male participants were administered the PCL-R following admission to an inpatient forensic hospital. From daily hospital information bulletins, incidents of verbal abuse, verbal threat, physical violence, and violation of hospital rules were derived. Also, the number of seclusion episodes was recorded. As expected, significant correlations were found between PCL-R scores and verbal abuse, verbal threat, violation of rules, total number of incidents, and frequency of seclusion. Psychopaths (PCL-R 30) were significantly more often involved in incidents than nonpsychopaths. Multiple regression analyses revealed that the PCL-R Factor 2 score in particular contributed uniquely to the prediction of the total number of incidents. The findings are discussed in terms of their clinical implications.

Wie erlebten Ausbildungskandidaten das allianzfokussierte Training im Rahmen der Psychotherapieausbildung? – Eine qualitative Studie

2020 ◽  
Author(s):  
Laurence Reuter ◽  
Lena Walther ◽  
Antje Gumz
Keyword(s):  
Qualitative Research ◽  
Consensual Qualitative Research ◽  
Qualitative Studie

ZusammenfassungEin kompetenter therapeutischer Umgang mit Spannungen und Krisen in der Therapiebeziehung ist mit dem Therapieerfolg assoziiert. Diesen Umgang zu erlernen und zu trainieren ist daher ein wesentliches Ziel der Therapieausbildung. Eine Methode, die speziell hierfür entwickelt wurde, ist das allianzfokussierte Training (AFT). Sieben Psychotherapeuten in Ausbildung wurden in halbstrukturierten Interviews vor und nach ihrer Teilnahme zu ihren Erwartungen an das AFT und ihren Erfahrungen mit dem AFT befragt. Die transkribierten Interviews wurden mit der Consensual Qualitative Research (CQR) – Methode ausgewertet. In der Prä-Erhebung zeigten sich ambivalente Haltungen v. a. im Hinblick auf die im AFT ausgeübte selbstoffenbarende Haltung. In der Post-Erhebung wurden v. a. persönliche Entwicklungen und Lernzuwachs bzgl. des Umgangs mit Spannungen und Krisen beschrieben. Videoaufnahmen der Therapiesitzungen, Rollenspiele und Übungen zum Kommunizieren auf der Meta-Ebene wurden als sehr praxisrelevant und hilfreich erlebt. Die Ergebnisse sprechen dafür, dass das AFT großes Potenzial zur Verbesserung der Psychotherapieausbildung hat.

scholarly journals The Profile of People with Parkinson’s Disease Included in Community Boxing Exercise Programs

2021 ◽  
Vol 5 (1) ◽  
pp. 5
Author(s):  
Josefa Domingos ◽  
Tamine Capato ◽  
Catarina Godinho
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Negative Impact ◽  
Patient Characteristics ◽  
Inclusion Criteria ◽  
Exercise Programs

Exercise is widely recommended for people with Parkinson (PD). Boxing is a popular mode of training. However, including individuals with less favorable profiles may have a negative impact on participation. We performed a systematic review to study the patient characteristics that were included in boxing exercise programs research and reflect on the possible inclusion criteria that professionals can use for boxing exercise programs. Indications for the best profiles were limited due to the small number of studies. Boxing programs should include people with the diagnosis of PD in earlier stages, independently ambulatory, and without current severe musculoskeletal or cardiovascular conditions.

scholarly journals The status of integrated care on the chronic abuse of alcohol response - A cross-sectional study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Moreira de Sousa ◽  
L Lopes ◽  
P Costa ◽  
G Martins-Coelho ◽  
R Capucho
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Abuse ◽  
Negative Impact ◽  
Cross Sectional Study ◽  
Treatment Team ◽  
Health Administration ◽  
Sectional Study ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Index Value

Abstract Background In 2017, the risk-weighted prevalence of alcohol consumption was the health indicator with a more negative impact on the Institute for Health Metrics and Evaluation Sustainable Development Goals Health Index Value in Portugal. According to data from 2012-14, the Alto Tâmega and Barroso (ATB) had the highest value of Years of potential life lost (YPLL) in North Portugal - 4570,1/10.000 people. Liver chronic disease was the specific cause of death that contributed to the value of YPLL - 465,4/10.000 people. Methods A cross-sectional study was conducted with data from the Northern Health Administration and the General Directorate for Intervention on Addictive Behaviours and Dependencies. We compared the number of patients with chronic alcohol consumption (CAC) in 2018, the leading causes of death between 2012-14, the main morbidity causes according to data from primary healthcare (PHC) physicians in 2018 and the number of patients in specialized treatment team (STT) for alcohol abuse treatment in 2018 in ATB. Results In 2018, 2643 patients of ATB had a diagnosis of CAC; only 178 were followed by an STT. Although CAC had a massive influence on YPLL, this was only the 11º cause of morbidity in ATB according to the data from PHC. The number of women with CAC was stable between 2012 (n = 284) and 2018 (n = 291). In the same period, there was an increase of 52,86% of CAC on men (n = 1523 to n = 2348). Even though 18,4% of YPLL due to chronic liver disease happen in women, only 11,2%of the patients with CAC in the PHC are women. Conclusions There is a need for the improvement of CAC diagnosis in PHC, and the improvement of referral of patients to STT and hospital care. Besides, to reach the SDG3, there is the need to work intensely on SDG 17 (partnership for the goals). The Public Health Unit of ATB is organizing Operation PROMETEU to improve communication, institutional collaboration, and monitoring of the existing health activities that are tackling CAC. Key messages The need to integrate data from different healthcare sources for a better analysis on health problems. The urgent need to tackle the alcohol abuse problem in ATB.

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