The Relationship Between and Correlates of Problematic Sexual Behavior and Major Mental Illness

While research has consistently found that general distress and psychopathology are not predictive of sexual recidivism, examination of specific syndromes and their relationship to offending has revealed a potentially more complicated relationship. One proposed mechanism for the mixed findings with respect to major mental illness and sexual offending may be the confound of neurological injury. As identified in Mann et al. (2010) work on psychologically meaningful risk factors, mental illness represents an area in need of more study given the indirect influence it may exert on risk. To this end, the current paper summarizes the study of the relationship between neurological injury, psychosis and problematic sexual behavior among two Canadian samples of forensic and civil psychiatric patients. In the first study we observed higher than expected rates of sexually-themed psychotic symptoms (45%) and problematic sexual behavior (PSB; 40%) among a combined group of forensic and civil psychiatric patients (n = 109). Indeed 70 percent of those individuals who engaged in PSB endorsed sexually-themed psychotic symptoms. While comorbidity is common amongst this group, brain injury appeared to represent a specific liability. Compared to those who did not engage in PSB, those who did were almost 4x (OR = 3.83) more likely to have a documented history of brain injury (e.g., traumatic and acquired brain injury, including fetal alcohol syndrome). In the second study we sought to replicate this finding in a larger forensic sample of 1,240. However, the recorded rates of brain injury were significantly less, such that no relationship to PSB was observed. Based on the mixed findings to date, including our own data, questions remain about the nature of a potential shared vulnerability for psychosis and PSB previously postulated. Among psychiatrically complex individuals who engage in PSB, understanding etiology and links to risk are helpful, but perhaps more importantly is attention to the mechanisms through which symptoms confer risk (e.g., problem solving, sexual disinhibition, social/intimacy deficits) and how best to treat and manage them.

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Exploring the Relationship Between Major Mental Illness and Sex Offending Behavior in a High-Risk Population

Criminal Justice and Behavior ◽

10.1177/0093854819887204 ◽

2019 ◽

Vol 47 (3) ◽

pp. 290-309

Author(s):

Sharon M. Kelley ◽

David Thornton ◽

Ryan Mattek ◽

Letitia Johnson ◽

Gina Ambroziak

Keyword(s):

Mental Illness ◽

High Risk ◽

Psychiatric Symptoms ◽

Sexual Offending ◽

Psychotic Symptoms ◽

High Risk Population ◽

Sex Offenses ◽

Offending Behavior ◽

Criminogenic Needs ◽

The Relationship

Empirically supported risk factors are predictive of sexual re-offense regardless of whether individuals suffer from a major mental illness. A small subgroup of individuals with major mental illness may be more likely to demonstrate acute psychotic symptoms at the time of their sexual offending behavior (Smith & Taylor, 1999). This study reviewed archival data from a high-risk sample to identify 55 individuals with major mental illness who had committed a total of 176 sex offenses. The relationship between acute psychiatric symptoms and criminogenic needs was explored. Most sex offenses were not temporally related to acute psychiatric symptoms. The apparent effect of mental health symptoms on criminogenic factors over the individual’s life was rated. Where acute symptoms were associated with worsened criminogenic factors, this most often involved Grievance Thinking, Poor Emotional Control, and Poor Problem-Solving. Typologies emerged based on the pattern of criminogenic needs along with demographic and offense characteristics. Assessment and treatment implications are discussed.

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Quality of parenting and vulnerability to depression: results from a family study

Psychological Medicine ◽

10.1017/s0033291797006016 ◽

1998 ◽

Vol 28 (1) ◽

pp. 185-191 ◽

Cited By ~ 64

Author(s):

C. DUGGAN ◽

P. SHAM ◽

C. MINNE ◽

A. LEE ◽

R. MURRAY

Keyword(s):

Mental Illness ◽

Family Study ◽

Past History ◽

Familial Risk ◽

Self Report ◽

History Of ◽

Quality Of Parenting ◽

Independent Effects ◽

The Relationship ◽

History Of Depression

Background. We examined a group of subjects at familial risk of depression and explored the relationship between the perceptions of parents and a history of depression. We also investigated: (a) whether any difference in perceived parenting found between those with and without a past history of depression was an artefact of the depression; and (b) whether the relationship between parenting and depression was explained by neuroticism.Method. We took a sample of first-degree relatives selected from a family study in depression and subdivided them by their history of mental illness on the SADS-L, into those: (a) without a history of mental illness (N=43); and (b) those who had fully recovered from an episode of RDC major depression (N=34). We compared the perceptions of parenting, as measured by the Parental Bonding Instrument (PBI), in these two groups having adjusted for the effect of neuroticism and subsyndromal depressive symptoms. We also had informants report on parenting of their siblings, the latter being subdivided into those with and without a past history of depression.Results. Relatives with a past history of depression showed lower care scores for both mother and father combined compared with the never ill relatives. The presence of a history of depression was associated with a non-significant reduction in the self-report care scores compared to the siblings report. Vulnerable personality (as measured by high neuroticism) and low perceived care were both found to exert independent effects in discriminating between the scores of relatives with and without a history of depression and there was no interaction between them.Conclusion. This study confirmed that low perceived parental care was associated with a past history of depression, that it was not entirely an artefact of having been depressed, and suggested that this association was partially independent of neuroticism.

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Associations between adverse childhood experiences and acquired brain injury, including traumatic brain injuries, among adults: 2014 BRFSS North Carolina

Injury Prevention ◽

10.1136/injuryprev-2018-042927 ◽

2018 ◽

Vol 25 (6) ◽

pp. 514-520 ◽

Cited By ~ 4

Author(s):

Angie S Guinn ◽

Katie A Ports ◽

Derek C Ford ◽

Matt Breiding ◽

Melissa T Merrick

Keyword(s):

Mental Illness ◽

North Carolina ◽

Sexual Abuse ◽

Brain Injury ◽

Adverse Childhood Experiences ◽

Acquired Brain Injury ◽

Childhood Experiences ◽

Adverse Childhood ◽

Race Ethnicity ◽

The Relationship

Adverse childhood experiences (ACEs) can negatively affect lifelong health and opportunity. Acquired brain injury (ABI), which includes traumatic brain injury (TBI) as well as other causes of brain injury, is a health condition that affects millions annually. The present study uses data from the 2014 North Carolina Behavioral Risk Factor Surveillance System to examine the relationship between ACEs and ABI. The study sample included 3454 participants who completed questions on both ABI and ACEs. Multivariable logistic regression models were used to determine the relationship between ACEs and ABI as well as ACEs and TBI. Sexual abuse, emotional abuse, physical abuse, household mental illness and household substance abuse were significantly associated with ABI after adjusting for age, race/ethnicity, gender and employment. Compared with those reporting no ACEs, individuals reporting three ACEs had 2.55 times the odds of having experienced an ABI; individuals reporting four or more ACEs had 3.51 times the odds of having experienced an ABI. Examining TBI separately, those who experienced sexual abuse, physical abuse, household mental illness and had incarcerated household members in childhood had greater odds of reported TBI, after adjusting for age, race/ethnicity, gender and income. Respondents reporting three ACEs (AOR=4.16, 95% CI (1.47 to 11.76)) and four or more ACEs (AOR=3.39, 95% CI (1.45 to 7.90)) had significantly greater odds of reporting TBI than respondents with zero ACEs. Prevention of early adversity may reduce the incidence of ABI; however, additional research is required to elucidate the potential pathways from ACEs to ABI, and vice versa.

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Moral Treatment: Philippe Pinel

International Journal of Indian Psychology ◽

10.25215/0302.152 ◽

2016 ◽

Vol 3 (2) ◽

Author(s):

Mrs. Sushma. C ◽

Dr. Meghamala. S. Tavaragi

Keyword(s):

Mental Illness ◽

Mental Disorders ◽

Social Stress ◽

Psychiatric Care ◽

Psychiatric Patients ◽

Demonic Possession ◽

Moral Treatment ◽

Modern Psychiatry ◽

History Of ◽

First Time

Philippe Pinel a pioneer, a french psychiatrist, a physician, known as father of modern psychiatry, revolutions psychiatric care of patients with mental illness by introducing concept of moral treatment. Pinel rejected the then prevailing popular notion that mental illness was caused by demonic possession and stated that mental disorders could be caused by a variety of factors including psychological or social stress, congenital conditions, or physiological injury, psychological damage, or heredity. Philippe Pinel for the first time in history of psychiatric patients treated them humanly by unchaining patients known as madmen. This historic event was done for first time in Bicêtre Hospital in 1798 a Parisian insane asylum. In this article a brief history of life and work of pioneer Philippe Pinel is mentioned.

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Normative Sexual Behavior in Children

PEDIATRICS ◽

10.1542/peds.88.3.456 ◽

1991 ◽

Vol 88 (3) ◽

pp. 456-464 ◽

Cited By ~ 4

Author(s):

William N. Friedrich ◽

Patricia Grambsch ◽

Daniel Broughton ◽

James Kuiper ◽

Robert L. Beilke

Keyword(s):

Sexual Behavior ◽

Sexual Behaviors ◽

Large Scale ◽

Older Children ◽

Community Based ◽

History Of ◽

Family Variables ◽

Relationship Of ◽

The Relationship ◽

Internalizing And Externalizing

A large-scale, community-based survey was done to assess the frequency of a wide variety of sexual behaviors in normal preadolescent children and to measure the relationship of these behaviors to age, gender, and socioeconomic and family variables. A sample of 880 2-through 12-year-old children screened to exclude those with a history of sexual abuse were rated by their mothers using several questionnaire measures. The frequency of different behaviors varied widely, with more aggressive sexual behaviors and behaviors imitative of adults being rare. Older children (both boys and girls) were less sexual than younger children. Sexuality was found to be related to the level of general behavior problems, as measured by the Achenbach Internalizing and Externalizing T scores and to a measure of family nudity. It was not related to socioeconomic variables.

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Assumption of drugs with self-injurer purpose: a retrospective study about 111 patients hospitalized in Policlinico of Modena

Italian Journal of Medicine ◽

10.4081/itjm.2009.93 ◽

2013 ◽

pp. 93-98

Author(s):

Lucio Brugioni ◽

Paola Magnani ◽

Eleonora Berti ◽

Cristina Gozzi ◽

Francesca De Niederhausern ◽

...

Keyword(s):

Mental Illness ◽

Retrospective Study ◽

Psychiatric Patients ◽

Suicidal Attempt ◽

Pharmacologic Therapy ◽

Psychiatric Ward ◽

Family Doctors ◽

Suicidal Attempts ◽

History Of

AIM OF THE STUDY The aim of this work was to evaluate the epidemiology of suicidal attempts by ingestion of drugs in our area. MATERIALS AND METHODS This is a retrospective study considering all patients admitted to the hospital between January 2004 and December 2006 for suicidal attempts using drugs. RESULTS A total of 111 patients were seen in our Department in the evaluated period. The large majority of patients were women (75%). Suicidal attempt was more common in individuals aged 31 to 40 years. The more common drugs used were: BDZ (28%), anti-depressive (21%), anti-psychotics (10%) and anti-epileptics (8%). A gastric washout was performed in 65.8% of all patients admitted to the hospital. The most used antidote was flumazenil. Alterations of laboratory exams were seen only in a small percentage of the cases. In the majority of cases, suicide was at the first attempt. 71% of patients were followed by psychiatrist and were taking daily psychiatric pharmacologic therapy; 5% had a history of previous admission to the hospital in a psychiatric ward; only 24% had no a history of a prior mental illness. 43% of patients were admitted to a psychiatric ward after intensive treatment in our department. Self-discharging was not usual (10%), and only few patients were restrained against their will (3%). CONCLUSIONS Our study has identified some risk factors for a suicidal attempt. Family doctors should have a stronger control of their patients with mental illness especially during the first period of treatment. In future it should be very helpful to create an informatic network connecting all departments involved in the care of these patients. Moreover, it is crucial to increase the role of family doctors in the care of psychiatric patients after their hospitalization.

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Cigarette smoking and psychotic symptoms in bipolar affective disorder

The British Journal of Psychiatry ◽

10.1192/bjp.179.1.35 ◽

2001 ◽

Vol 179 (1) ◽

pp. 35-38 ◽

Cited By ~ 50

Author(s):

Aiden Corvin ◽

Ed O'Mahony ◽

Myra O'Regan ◽

Claire Comerford ◽

Robert O'Connell ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Affective Disorder ◽

Bipolar Affective Disorder ◽

Psychotic Symptoms ◽

Heavy Smoking ◽

Ordinal Logistic Regression Analysis ◽

History Of ◽

Categorical Diagnosis ◽

The Relationship

BackgroundAn association exists between smoking and schizophrenia, independent of other factors and related to psychotic symptomatology.AimsTo determine whether smoking is associated with psychosis in bipolar affective disorder.MethodSmoking data were collected from 92 unrelated patients with bipolar affective disorder. An ordinal logistic regression analysis tested the relationship between smoking severity and psychotic symptomatology, allowing for potential confounders.ResultsA significant relationship was detected between smoking/heavy smoking and history of psychosis (68.7%, n=44). Smoking was less prevalent in patients who were less symptomatic (56.5%, n=13) than in patients with a more severe psychosis (75.7%, n=31). Prevalence and severity of smoking predicted severity of psychotic symptoms (P=0.001), a relationship independent of other variables (P=0.0272).ConclusionA link between smoking and psychosis exists in bipolar affective disorder and may be independent of categorical diagnosis.

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COVID-19-associated brief psychotic disorder

BMJ Case Reports ◽

10.1136/bcr-2020-236940 ◽

2020 ◽

Vol 13 (8) ◽

pp. e236940 ◽

Cited By ~ 7

Author(s):

Colin M Smith ◽

Jonathan R Komisar ◽

Ahmad Mourad ◽

Brian R Kincaid

Keyword(s):

Mental Illness ◽

Family History ◽

Psychotic Disorder ◽

Neuropsychiatric Symptoms ◽

Healthy Woman ◽

Psychotic Symptoms ◽

First Case ◽

Brief Psychotic Disorder ◽

History Of ◽

New Onset

A 36-year-old previously healthy woman with no personal or family history of mental illness presented with new-onset psychosis after a diagnosis of symptomatic COVID-19. Her psychotic symptoms initially improved with antipsychotics and benzodiazepines and further improved with resolution of COVID-19 symptoms. This is the first case of COVID-19-associated psychosis in a patient with no personal or family history of a severe mood or psychotic disorder presenting with symptomatic COVID-19, highlighting the need for vigilant monitoring of neuropsychiatric symptoms in these individuals.

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The Frequency and Factors Related to Aggressive Behavior in Psychiatric Patients Controlled by a Variety of Restraint Methods

Iranian Journal of Psychiatry and Behavioral Sciences ◽

10.5812/ijpbs.98881 ◽

2022 ◽

Vol In Press (In Press) ◽

Author(s):

Ali Kheradmand ◽

Anita Hosseini ◽

Abdollah Farhadinasab

Keyword(s):

Aggressive Behavior ◽

Psychiatric Patients ◽

Nonparametric Test ◽

Demographic Variables ◽

P Value ◽

Medical Illness ◽

Factors Affecting ◽

History Of ◽

Overt Aggression Scale ◽

The Relationship

Background: Aggressive behavior of patients in psychiatric wards is one of the main challenges faced by healthcare workers. Despite the abundance of research on the frequency of aggressive behavior, not enough attention has been paid to its severity. Furthermore, limited studies have evaluated the restraint methods used to manage aggressive behaviors. Objectives: The current descriptive study aimed to compare the relationship between demographic characteristics, diagnosis of psychiatric illness, medical illness, and hospitalization characteristics with features of aggressive behavior in patients experiencing different types of restraint during hospitalization. Methods: We evaluated subjects admitted to the adult psychiatric wards of Imam Hossein and Taleghani hospitals in Tehran, Iran, in 2018. The patients were controlled by various restraint methods during hospitalization. All the patients were evaluated for the severity of aggression, which was determined utilizing the Persian version of the Modified Overt Aggression Scale (MOAS). All the data along with demographic and clinical characteristics obtained from medical records were analyzed using the Mann-Whitney and Kruskal-Wallis nonparametric test (P-value = 0.05) and Spearman correlation coefficient to describe the factors affecting the aggressive behavior of patients. Results: In this study, the prevalence of aggressive behavior was 11.7%. Among the demographic variables, gender (P-value = 0.003), education level (P-value = 0.05), and the history of aggressive behavior (P-value = 0.001) were significantly associated with the MOAS. Furthermore, as the hospitalization duration increased, the frequency of aggressive behavior decreased, and its severity intensified. Moreover, there was a significant relationship between aggression severity with admission type (P-value = 0.00), concurrent medical illness (P-value = 0.026), and substance abuse (P-value = 0.025). Conclusions: According to the obtained results, the factors affecting the aggression and early identification of patients with the potential of aggressive behavior is an effective management strategy for controlling these patients.

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Basic symptoms in offspring of parents with mood and psychotic disorders

BJPsych Open ◽

10.1192/bjo.2019.40 ◽

2019 ◽

Vol 5 (4) ◽

Cited By ~ 2

Author(s):

Alyson Zwicker ◽

Lynn E. MacKenzie ◽

Vladislav Drobinin ◽

Emily Howes Vallis ◽

Victoria C. Patterson ◽

...

Keyword(s):

Mental Illness ◽

Mood Disorders ◽

Psychotic Disorders ◽

Familial Risk ◽

Linear Regression Models ◽

Basic Symptoms ◽

Symptom Scores ◽

History Of ◽

Psychotic Features ◽

The Relationship

Background Basic symptoms, defined as subjectively perceived disturbances in thought, perception and other essential mental processes, have been established as a predictor of psychotic disorders. However, the relationship between basic symptoms and family history of a transdiagnostic range of severe mental illness, including major depressive disorder, bipolar disorder and schizophrenia, has not been examined. Aims We sought to test whether non-severe mood disorders and severe mood and psychotic disorders in parents is associated with increased basic symptoms in their biological offspring. Method We measured basic symptoms using the Schizophrenia Proneness Instrument – Child and Youth Version in 332 youth aged 8–26 years, including 93 offspring of control parents, 92 offspring of a parent with non-severe mood disorders, and 147 offspring of a parent with severe mood and psychotic disorders. We tested the relationships between parent mental illness and offspring basic symptoms in mixed-effects linear regression models. Results Offspring of a parent with severe mood and psychotic disorders (B = 0.69, 95% CI 0.22–1.16, P = 0.004) or illness with psychotic features (B = 0.68, 95% CI 0.09–1.27, P = 0.023) had significantly higher basic symptom scores than control offspring. Offspring of a parent with non-severe mood disorders reported intermediate levels of basic symptoms, that did not significantly differ from control offspring. Conclusions Basic symptoms during childhood are a marker of familial risk of psychopathology that is related to severity and is not specific to psychotic illness. Declaration of interest None.

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