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The first seventy admissions to an adolescent unit in Edinburgh: general characteristics and treatment outcome.

1. The clinical functioning of the Young People's Unit, Edinburgh is described. This involves a relatively permissive, democratic "milieu". Psychotherapeutic efforts are devoted to the resolution of family psychopathology and the achievement of maturational progress for the adolescent. 2. Data on the first seventy admittions to the Unit were examined. Two-thirds of the patients were diagnosed "developmental crisis"; the majority of these also had a personality disorder. 3. Assessments of family functioning showed high levels of disturbance and psychiatric morbidity among the parents. The adolescents had mutually good, positive relationships with their opposite-sexed parents, but markedly negative ones with the same-sexed parents. This was not in accordance with the usual findings in "normal" families. Delinquent and impulsive patients showed uniformly negative family attitudes. 4. A simple estimation of treatment outcome at discharge gave results comparable to those of other units, with 70 per cent of patients rated as improved. Neurotic and psychotic patients had a relatively better outcome. Tension-discharge personality disorder and a history of very disruptive or antisocial behaviour were associated with poor outcome. 5. The poor response of very disturbed, impulsive adolescents to this type of therapeutic regime is discussed. These individuals do not appear to have sufficient personality resources and organization to benefit from this type of treatment. Emerging from this is a suggestion for an increased provision of specialized units offering containment and intensive care to the very disturbed adolescent.

Adolescent↗

Exploring core relationships between insight and communication and social skills in mentally disordered offenders.

This paper reports collective data analysis for the Behavioural Status Index insight and communication and social skills subscales. This is an instrument designed specifically for health care practitioners to measure behavioural and social functioning among mental health clients, in particular those in forensic care. Data were collected, using a repeated measures method by primary nurses, from a sample of 503 patients in two high security mental health hospitals in the UK. Results are reported for interscalar item correlations and factor analysis. Data trends are indicative of clinically interesting relationships. A six-factor structure emerged suggesting groupings of intra- and interscalar behaviours. The first of these contained all the Behavioural Status Index insight items. Significant differences were found on a number of factors between independent groups. Generally, results indicate that patients on lower dependency wards scored more normatively on the factors, adding to instrument validity. Men were found to score more normatively than women. According to Mental Health Act 1983 classifications, psychopathically disordered patients scored more normatively than mentally ill patients, who in turn scored more normatively than patients with learning disability. Clinical practice implications and ongoing European studies examining the use of the instrument in clinical practice and its association to treatment planning are discussed.

Attitude to Health↗

The relationship of comorbid problem behaviors to social skills in persons with profound mental retardation.

Research into behavior problems among individuals with mental retardation has been well developed. However, few studies have addressed the effect of multiple problem behaviors on social skills. In the present study, the authors examined the relationship between two problem behaviors, stereotypy and self-injury, and social skills among individuals with profound mental retardation. A total of 120 participants were divided into four groups based on the presence of stereotypic and self-injurious behavior. Persons with comorbid stereotypy and self-injury evinced more negative nonverbal social skills than did those with self-injury alone or no problem behaviors. In the past, researchers examined behavior problems as isolated phenomena. However, a recent shift in the conceptualization of problem behaviors has exposed the lack of research regarding the nature of social and adaptive skills in the face of multiple topographies of problem behaviors using broader conceptualizations.

Adult↗

A factor analytic study of the 60-item general health questionnaire in Australian community and general practice settings.

A factor analytic study of responses to a 60-item General Health Questionnaire of people in general practice and in the community in Perth, Western Australia, was performed. Five identified factors, accounting for 46% of the variance, were very similar to factors identified in an English general practice study but differed from two published Australian studies. The statistic of a relative GHQ profile was generated to compare these factors in various sets of data. There was no significant difference between the relative GHQ profile in the community and general practice data or between demographic factors such as sex, social class and country of birth. The major positive finding was of an excess of overtly psychological factors in 'cases' compared with an excess of more physical factors in 'non-cases'.

Anxiety Disorders↗

[Murder as fun].

Aggressive behaviors are often accompanied by excitement. Violence is often triggered to as a means of helping a felon reach an emotional thrill. This is also true in the case of homicides. Hedonistic motivation of a murderer derives from a need to feel an emotional 'high' from killing a human being. In such instances, a murderer's pattern of behavior reflects elements of fun and entertainment.

Aggression↗

Children's symptoms and items of behaviour. An epidemiological study of sociocultural aetiology.

The aim of this article is to present the results from a point-prevalence study of symptoms and items of behaviour among children and adolescents in the western part of Norway. Empirical manifestations of personality traits and psychopathology in the ordinary population are factor-analysed. The prevalences in different types of local communities are calculated, and the variations are discussed using the concept of socialization, especially development and internalization of values, norms and behaviour in cultures with different rates of change.

Adolescent↗