Ethics, money, and the problem of coercion in managed behavioral health care.
Explore the source record for details and available documents.
Capitation Fee↗
SEARCH · Search PubMed
Results for “Dangerous Behavior”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Aberrant driving behaviour: errors and violations.
The present study was a replication of the research of Reason et al. (1990). Its aim was to confirm the distinction between driving errors and violations in a Western Australian driving population. Sixty-one male drivers and 74 female drivers completed a questionnaire containing items on driver demographics, driving penalties incurred, driving convictions and accident history and driver behavioral aberrations drawn from the Driver Behaviour Questionnaire (DBQ). In agreement with Reason et al. factor analysis revealed three factors; in the present study these were general errors, dangerous errors, and dangerous violations. Young drivers committed more dangerous errors and dangerous violations than older drivers. Females reported more dangerous errors than males. Males reported more dangerous violations than females. Drivers who reported a high level of road exposure and those who reported having been convicted for speeding reported more dangerous violations. Differences in the results of the two studies can largely by accounted for by differences in the representation of age and gender in the two populations studied.
Accidents, Traffic↗
Adolescent substance use: brief interventions by emergency care providers.
Use of tobacco, alcohol and other drugs plays a major role in adolescent morbidity and mortality. When under the influence of alcohol or other drugs, adolescents are at increased risk for injuries, unprotected sex, or interpersonal violence. Alcohol and other drugs are major factors in adolescent deaths, contributing to motor vehicle crashes, homicides, and suicides. Adolescents tend to have shorter substance use histories therefore they often experience emergency/acute care health treatment resulting from substance use related trauma and/or overdose. Substance use screening of adolescents who present to an Emergency Department (ED) is vitally important. The CRAFFT is a valid and reliable screening tool that was developed for use with adolescents. If an adolescent screens positive, then the next step is to determine their stage of use and readiness for change in preparation for doing a brief intervention. Helping patients to recognize the potential relation between their substance use and health related consequences, may motivate them to decrease their use for harm reduction. Motivational interviewing is an effective, evidence-based approach to helping people change their high risk behavior.
Adolescent↗
The resurgent tuberculosis epidemic in the era of AIDS: reflections on public health, law, and society.
Explore the source record for details and available documents.
Behavior↗
Criminals' explanations of their criminal behavior, Part II: A possible role for psychopathy.
The author reviewed the literature concerning the effect of criminals' current psychopathology on their explanations about their crimes. He then studied 100 incarcerated men, examining the associations between their explanations and various historically documented aspects of psychopathy. Previously and independently documented patterns of pathological lying, lack of remorse or guilt, callousness or lack of empathy, and failure to accept responsibility for their own behavior were significantly associated with the offenders not admitting responsibility for their crimes. Further, independently described histories of pathological lying were associated with criminals' blaming their convictions on a faculty criminal-justice system, while histories of failure to accept responsibility for their behavior were associated with blaming someone else for their index crimes.
Adult↗
[Control of stress and violent behavior in Puerto Rico: progress toward the national objectives of health for all in 1990 (VIII)].
Explore the source record for details and available documents.
Dangerous Behavior↗
[Effect of previous experience in reacting to a danger signal on "open field" behavior in the rat].
Modification of rats behaviour in an "hopen field" test was investigated, induced by an acoustic stimulus, previously subjected to conditioning in a shuttle chamber in experiments with possibility and impossibility of avoidance from electrical shock. It has been established that presentation of a stimulus having the meaning of a danger signal, in a new situation, significantly suppresses investigating behaviour of rats, whereas the stimulus which had not been subjected to conditioning exerts no marked effect on behaviour. The greatest suppression was observed in rats with "learned helplessness". This fact suggests that the degree of suppression of the behaviour in an open field in response to a danger signal, depends on the animal's previous experience in reacting to this signal.
Animals↗
The relationship of suicidality and psychiatric diagnosis in hospitalized pre-adolescent children.
Two structured interview measures of suicidal behavior were administered to 43 child psychiatric inpatients between the ages of 7 and 11 and their parents. DSM-III-R diagnoses were assigned to the children, with twenty-six Axis I and Axis II diagnostic categories represented. Generally, the interview measures of suicidal behavior were found to be unrelated to psychiatric diagnosis. The results suggest that to better understand pre-adolescent suicidal behaviors, it may be more useful to examine associations between these behaviors and the biopsychosocial dimensions that underlie the diagnostic categories.
Child↗
Behavioral monitoring of DUI offenders with the Alcohol Ignition Interlock Recorder.
AIMS: To evaluate patterns of blood alcohol concentration (BAC) and driving logged on the ignition interlock recorder and to assess whether this event record is a useful outcome measure for a behavioral intervention. DESIGN: Descriptive analyses of recorder data and multivariate analysis of the predictors of high BACs associated with a motivational intervention for driving-under-the-influence (DUI) offenders using an interlock. SETTING: Two interlock service centers in Alberta, Canada. PARTICIPANTS: 1309 first-time and multiple DUI offenders who agreed to participate during interlock installation. INTERVENTION: A human-services (supportive guidance) intervention based on motivational interviewing and pragmatic counseling was delivered to interlock users in Calgary, but not to interlock users in Edmonton, Canada. MEASUREMENTS: This report summarizes the patterns and predictors of BAC warnings (0.02-0.039%) (20-39 mg/dl) and failures (> or = 0.04) (> or = 40 mg/dl) from more than 3 million in-vehicle breath tests. Data come from three sources: driver records, questionnaires and the interlock. FINDINGS: From the beginning to the end of the interlock use period, there was a significant linear decline in the proportion of positive BAC driving to total driving. After controlling for prior offenses, demographics and reported drinking levels, offenders in the intervention site (Calgary) were less likely to have recorded fail BACs than were offenders in the control site (Edmonton). The temporal patterns of BAC fails with the interlock mimic the high-risk periods for DUI arrests and alcohol-involved fatal crashes. CONCLUSIONS: The interlock successfully blocks drinking and driving during high-risk periods. Preliminary recorder data suggest the services intervention may be affecting DUI behavior.
Alberta↗
Warning third parties at risk of AIDS: APA's policy is a barrier to treatment.
The American Psychiatric Association has adopted a policy stating that psychiatrists may warn third parties who are placed at risk by the behavior of a patient infected with human immunodeficiency virus (HIV). The author argues that although the policy appears reasonable and has well-established precedent, the public will ultimately be better served if HIV-infected patients are assured absolute confidentiality. He contends that the Tarasoff decision is not directly applicable to most HIV-infected patients, that education alone will not be sufficient to deter some infected patients from placing others at risk, that additional psychiatric interventions will be necessary to reduce the high-risk behaviors of those individuals, and that APA's policy will prevent many from seeking treatment.
Acquired Immunodeficiency Syndrome↗
Hand Test indices of violent and destructive behavior for institutionalized mental retardates.
The Hand Test (Wagner, 1962) and the maladaptive behavior scale of the AAMD Adaptive Behavior Scale (ABS) were administered to 78 institutionalized retardates (46 males and 32 females) in order to investigate the relationship between violent and destructive behavior and two purported indicants of violent and destructive acting-out behavior on the Hand Test, the acting-out-score (AOS and movement-content response (ACT-MOV). Significant correlations between the two Hand Test indices and the number of types of violent and destructive behavior evinced during a three-month period were obtained.
Acting Out↗
[Relationship between violent behavior and quality of communication in couples with an alcoholic member].
Explore the source record for details and available documents.
Alcoholism↗
HIV risk factors among injecting drug users in five US cities.
OBJECTIVES: To examine factors associated with HIV infection in injecting drug users (IDU), the independent and interactive effects of potential risk factors, and geographic differences in risk factors. METHODS: IDU entering methadone treatment in New York City, Asbury Park and Trenton in New Jersey, Baltimore and Chicago between February 1987 and December 1991 were interviewed using a standard questionnaire and tested for HIV antibodies (n = 4584). Associations of HIV serostatus with race/ethnicity, other demographic characteristics, and injecting and sexual risk behaviors were assessed by logistic regression analyses. RESULTS: African Americans were at increased risk for HIV in four of the five cities, and Puerto Ricans in two cities. Injection in shooting galleries and 'speedball' injection emerged as behavioral variables highly associated with HIV, although interaction of these variables indicates that each variable contributes to HIV risk only in the absence of the other behavior. CONCLUSIONS: Geographic differences in HIV risk factors and the interaction of 'speedball' and shooting gallery use suggest that multiple HIV risk models are needed that reflect seroprevalence rates, variation in risk behaviors, and the social context of risk behaviors. Increased risk among racial/ethnic minorities independent of risk behaviors, suggests the need to examine further potential social and environmental factors, such as the social networks in which injecting and sexual behaviors occur, HIV seroprevalence within these networks, and the locales in which risk behaviors occur.
Adult↗
Women and arson: a demographic study.
This study describes women accused of setting fires in the City of New York who were evaluated between 1980 and 1983 at the Forensic Psychiatry Clinic for the New York Criminal and Supreme Courts. Consideration is given to their age, ethnicity, history of prior mental illness, abuse of controlled substances, economic status, family background, education, and employment. Their methodology, planning, and targeting for their firesetting behavior, as well as reported motivations for engaging in arson, are also considered.
Adolescent↗
The life attitudes schedule: a scale to assess adolescent life-enhancing and life-threatening behaviors.
The purpose of this study was to develop a questionnaire to measure suicidal and other risk-taking behaviors, the Life Attitudes Schedule (LAS), and to test a theoretical model that postulates a single domain of behaviors to which all life-threatening and life-enhancing behaviors belong. The LAS was developed and piloted on 1539 high school students and young adults. The schedule measures four different content categories: death related, health related, injury related, and self-related. Each content category includes an equal number of items designed to assess actions, thoughts, and feelings. Consistent with the theoretical model, the LAS includes positive (life-enhancing) and negative (life-threatening) behaviors. In this paper we present psychometric information for the LAS. The results are interpreted as providing support for a broad, bipolar conceptualization of suicidal and other risk-taking behavior that encompasses life-threatening and life-enhancing behaviors.
Adolescent↗
Violence, civil commitment, and hospitalization.
The frequency of violent behavior and civil commitment leading to hospitalization of psychiatric patients was examined comparing the years 1973 and 1983. For each year, 150 patients were randomly selected among admissions to a locked acute psychiatric unit in a university setting. Medical charts were reviewed for descriptions of violent behavior, demographic information, and legal status. While the rate of preadmission violence did not change significantly between 1973 and 1983, there was a threefold increase in the proportion of patients admitted involuntarily as a danger to others. Possible explanations of the inconsistent application of civil commitment statutes are discussed.
Adolescent↗
Warning third parties at risk of AIDS: APA's policy is a reasonable approach.
The author argues that the American Psychiatric Association's AIDS policy on confidentiality and disclosure provides reasonable guidelines for psychiatrists struggling to balance their obligation to maintain the confidentiality of individual patients infected with human immunodeficiency virus (HIV) with their obligation to protect the community's health. The policy states that notification of third parties who may be exposed to infection through the behavior of an HIV-positive patient is ethically permissible if the psychiatrist has exhausted efforts to work with the patient to terminate behavior that places others at risk and if the patient understands the limits of confidentiality. The author points out that judicious notification is within the medical tradition that includes disclosure of a patient's dangerousness in situations involving infectious diseases such as tuberculosis and is supported by the duty-to-warn precedent set by the Tarasoff decision.
Acquired Immunodeficiency Syndrome↗
Characteristics of psychiatric inpatients who stalk, threaten, or harass hospital staff after discharge.
OBJECTIVE: The purpose of this study was to identify demographic and clinical characteristics of psychiatric inpatients who stalk, threaten, or harass hospital staff after discharge. METHOD: The authors retrospectively summarized the demographic and clinical characteristics of 17 inpatients who engaged in this type of behavior and a comparison group of 326 inpatients. RESULTS: The patients who stalked, threatened, or harassed staff after discharge were significantly more likely than the comparison patients to have a diagnosis of personality disorder and/or paranoid disorder, erotomanic subtype, and to have a history of physically assaultive or fear-inducing behavior. The data suggest that they were more likely to be male and never married and to have histories of multiple hospitalizations, suicidal or self-injurious behavior, and substance abuse or dependence. CONCLUSIONS: The findings reveal several risk factors that may be useful in identifying a subgroup of patients who pose a risk of directing aggressive behavior toward hospital staff after discharge.
Adult↗