The Clinical Utility of the NAB Judgment Subtest Among Individuals Diagnosed With Schizophrenia Spectrum Disorder Within a Forensic Inpatient Setting

Assessment ◽  
2021 ◽  
pp. 107319112110276
Author(s):  
Scott Roye ◽  
C. Adam Coffey ◽  
Stephen R. Nitch ◽  
David M. Glassmire ◽  
Dominique I. Kinney

Executive functioning (EF) has been identified as a significant predictor in determining competence to stand trial. Individuals deemed incompetent to stand trial are provided a limited time frame before conservatorship is considered, thus, treatment providers practicing within inpatient facilities have a responsibility to efficiently identify factors that may lead to prolonged hospitalizations, in order to avoid delays in a defendant’s legal proceedings. Although previous studies have demonstrated the utility of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Total Index Score in predicting length of stay (LOS), the Neuropsychological Assessment Battery (NAB) Judgment subtest provides a measure of executive function, which is a domain not captured by the RBANS. The current study examined the relationship between both the RBANS and NAB Judgment performance as predictors of LOS among 63 individuals diagnosed with schizophrenia spectrum disorders undergoing competency restoration treatment. Additionally, sensitivity analyses were used to determine cutoff scores for individuals requiring additional competency services. Results indicated that the NAB Judgment subtest was more predictive of LOS than the RBANS Total Index Score. Additionally, a raw score of ≤9 on NAB Judgment was indicative of increased LOS. These results highlight the utility of the NAB Judgment subtest within a forensic inpatient setting.

Psych ◽  
2021 ◽  
Vol 3 (4) ◽  
pp. 780-791
Author(s):  
Aikaterini Garbi ◽  
Ioannis Tiniakos ◽  
Zacharenia Mikelatou ◽  
Ioannis Drakatos

In recent years serious mental health issues, such as schizophrenia spectrum disorders and bipolar disorder, have been treated in the community by community-based mental health services. In the present study our goal was to estimate the modification in the number of hospitalizations and duration of admissions in either psychotic patients or patients with bipolar disorder, treated by a Mobile Mental Health Unit in the islands of Kefalonia, Zakynthos and Ithaca (MMHU-KZI). Data were collected from a total of 108 patients with schizophrenia spectrum disorders and bipolar disorder. For each patient comparison was made for the same time interval prior and after engagement to treatment with the MMHU-KZI and not for the total hospitalizations that patients had in their history. There was a statistically significant reduction (45.9%) in hospitalizations after treatment engagement with the MMHU-KZI, as the Wilcoxon signed ranks test indicated. Furthermore, a major decrease (54.5%) of hospitalization days was noted after treatment engagement with the unit. This pattern of mental health provision may be beneficial for the reduction of the number and duration of psychiatric hospitalizations. Despite the beneficial contribution of community-based mental health units, hospital based treatment should always be available, since severe relapses are better treated in inpatient setting.


2019 ◽  
Vol 35 (4) ◽  
pp. 512-520
Author(s):  
Caterina Novara ◽  
Paolo Cavedini ◽  
Stella Dorz ◽  
Susanna Pardini ◽  
Claudio Sica

Abstract. The Structured Interview for Hoarding Disorder (SIHD) is a semi-structured interview designed to assist clinicians in diagnosing a hoarding disorder (HD). This study aimed to validate the Italian version of the SIHD. For this purpose, its inter-rater reliability has been analyzed as well as its ability to differentiate HD from other disorders often comorbid. The sample was composed of 74 inpatients who had been diagnosed within their clinical environment: 9 with HD, 11 with obsessive-compulsive disorder (OCD) and HD, 22 with OCD, 19 with major depressive disorder (MDD), and 13 with schizophrenia spectrum disorders (SSD). The results obtained indicated “substantial” or “perfect” inter-rater reliability for all the core HD criteria, HD diagnosis, and specifiers. The SIHD differentiated between subjects suffering from and not suffering from a HD. Finally, the results indicated “good” convergent validity and high scores were shown in terms of both sensitivity and specificity for HD diagnosis. Altogether, the SIHD represents a useful instrument for evaluating the presence of HD and is a helpful tool for the clinician during the diagnostic process.


2000 ◽  
Author(s):  
B. Cornblatt ◽  
M. Obuchowski ◽  
S. Roberts ◽  
S. Pollack ◽  
L. Erienmeyer-Kimling

2020 ◽  
Author(s):  
Sean Carruthers ◽  
Gemma Brunetti ◽  
Susan Rossell

Schizophrenia spectrum disorders are chronic and debilitating mental illnesses characterised by both cognitive impairments and sleep deficits. In this systematic review protocol, we outline an approach to examine the available literature investigating the relationship between sleep and cognition in individuals with schizophrenia spectrum disorder.


2020 ◽  
Author(s):  
Jessica Mow ◽  
Arti Gandhi ◽  
Daniel Fulford

Decreased social functioning and high levels of loneliness and social isolation are common in schizophrenia spectrum disorders (SSD), contributing to reduced quality of life. One key contributor to social impairment is low social motivation, which may stem from aberrant neural processing of socially rewarding or punishing stimuli. To summarize research on the neurobiology of social motivation in SSD, we performed a systematic literature review of neuroimaging studies involving the presentation of social stimuli intended to elicit feelings of reward and/or punishment. Across 11 studies meeting criteria, people with SSD demonstrated weaker modulation of brain activity in regions within a proposed social interaction network, including prefrontal, cingulate, and striatal regions, as well as the amygdala and insula. Firm conclusions regarding neural differences in SSD in these regions, as well as connections within networks, are limited due to conceptual and methodological inconsistencies across the available studies. We conclude by making recommendations for the study of social reward and punishment processing in SSD in future research.


2018 ◽  
Author(s):  
Armando Rotondi ◽  
Jonathan Grady ◽  
Barbara H. Hanusa ◽  
Michael R. Spring ◽  
Kaleab Z. Abebe ◽  
...  

BACKGROUND E-health applications are an avenue to improve service responsiveness, convenience, and appeal, and tailor treatments to improve relevance, engagement, and use. It is critical to user engagement that the designs of e-health applications are intuitive to navigate. Limited research exists on designs that work for those with a severe mental illness, many of whom infrequently seek treatment, and tend to discontinuation medications and psychosocial treatments. OBJECTIVE The purpose of this study was to evaluate the influence of 12 design elements (e.g., website depth, reading level, use of navigational lists) on the usability of e-health application websites for those with, and without, mental health disorders (including severe mental illness). METHODS A 212-4 fractional factorial experimental design was used to specify the designs of 256 e-health websites, which systematically varied the 12 design elements. The final destination contents of all websites were identical, only the navigational pages varied. Three subgroups of participants comprising 226 individuals, were used to test these websites (those with schizophrenia-spectrum disorders, other mental illnesses, and no mental illness). Unique to this study was that the 12 design elements were manipulated systematically to allow assessment of combinations of design elements rather than only one element at a time. RESULTS The best and worst designs were identified for each of the three subgroups, and the sample overall. The depth of a website’s navigation, that is, the number of screens/pages users needed to navigate to find desired content, had the strongest influence on usability (ability to find information). The worst performing design for those with schizophrenia-spectrum disorders had an 8.6% success rate (ability to find information), the best had a 53.2% success rate. The navigational design made a 45% difference in usability. For the subgroup with other mental illnesses the design made a 52% difference, and for those with no mental illness a 50% difference in success rate. The websites with the highest usability all had several key similarities, as did the websites with the poorest usability. A unique finding is that the influences on usability of some design elements are variable. For these design elements, whether they had a positive or negative effect, and the size of its effect, could be influenced by the rest of the design environment, that is, the other elements in the design. This was not the case for navigational depth, a shallower hierarchy is better than a deeper hierarchy. CONCLUSIONS It is possible to identify evidence-based strategies for designing e-health applications that result in a high level of usability. Even for those with schizophrenia, or other severe mental illnesses, there are designs that are highly effective. The best designs have key similarities, but can also vary in some respects. Key words: schizophrenia, severe mental illness, e-health, design, website, usability, website design, website usability, fractional factorial design.


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