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PubMed2005

Examining anxiety as a predictor of homicidality: a pilot study.

Homicidality rates have been shown to be more prominent among persons diagnosed with mental disorders as compared to the general population. However, the role that anxiety plays in homicidal ideation and intent is poorly understood. This study investigated predictors of homicidal intent, thought, or plan in an adult population of psychiatric inpatients diagnosed with anxiety disorders. Results suggest that the factors most strongly associated with homicidality include male gender, substance abuse, mania, and current legal problems. Multiple regression analyses showed that only male gender predicted homicidality when other variables were taken into account.

Adult↗
PubMed2006

The identification of sexual and violent motivations in men who assault women: implication for treatment.

A qualitative analysis of interview data with 41 rapists determined that five implicit theories (ITs) underlie rapists' offense supportive beliefs/feelings/motives: (a) dangerous world (DW)-where men have feelings of generalized anger and/or resentment toward others; (b) women are dangerous-where men hold a set of attitudes that are hostile toward women; (c) women as sexual objects (WSO)-where women are seen as primarily sexual objects; (d) male sex drive is uncontrollable-where sexual urges are seen all consuming; (e) entitlement-where men feel that they can do exactly what they want. Consideration of whether DW or WSO ITs were present or absent indicated that three main groups could be identified: Group 1: violently motivated-presence of DW and/or absence of WSO; Group 2: sexually motivated-presence of WSO and/or absence of DW; Group 3: sadistically motivated-presence of DW and WSO. These results are discussed in terms of treatment needs of rapists.

Adult↗
PubMedDate not supplied

Psychiatric commitment of the elderly.

Involuntary hospitalization of the elderly has been the focus of controversy. In many jurisdictions, commitment criteria are stringently and narrowly defined, require a showing of "dangerousness," and are difficult to apply toward securing proper treatment for the elderly. In other areas, broader criteria apply, but some authors argue that such criteria are inappropriately used with the elderly and leave them vulnerable to the abuse of unnecessary institutionalization. The authors examined 274 consecutive admissions aged 55 years and over, comparing voluntary and involuntary patients. Patients admitted involuntarily were significantly more likely to have organic mental disorders, be violent before admission, and be disoriented, withdrawn, and apathetic. Voluntary patients were significantly more likely to have major mood disorders. Patients who lived with others were more likely to be committed than those living alone. The authors discuss these findings with attention to the appropriateness of broader commitment standards and the more stringent dangerousness criteria as they apply to the geriatric population.

Aged↗
PubMed2000

Coming to terms with perceived danger. A researcher's narrative.

Little attention has been given to the topic of perceived or imagined dangers in fieldwork, even though such dangers may significantly affect both collection and interpretation of data in qualitative research. Furthermore, methodological arguments persist in regard to interpreting qualitative research that gives voice simultaneously to the research participant and the researcher. In this article reflexivity and narrative methods were used to examine the concept of perceived danger(s) in a field setting using naturalistic inquiry. First, reflexivity and narrative methods were used to retrospectively construct a personal narrative that describes the impact of the field experience on the researcher. Then, narrative analysis was used to interpret this personal narrative and to further examine why the researcher "perceived" certain dangers, and how she came to know that these risks and dangers were presumed but unwarranted. This narrative is an example of how qualitative researchers can give voice to their field experiences.

Anecdotes as Topic↗
PubMedDate not supplied

Injection drug use-related HIV healthcare--problems and management in Edinburgh.

The relatively high numbers of patients with IDU-related HIV in Scotland has resulted in considerable management difficulties not previously experienced by other medical units. Chronic physical ill health in drug users is becoming commoner with the advent of HIV and other centres are now experiencing the type of problems that the Regional Infectious Disease Unit (RIDU) in Edinburgh has faced over the last 10 years. Very little has been published concerning the difficulties of managing patients who use drugs and have a physical illness in medical units in the UK. This paper presents examples of common problems together with the RIDU's experience of management in the hope that it will help others to deliver effective and efficient physical and mental health care to patients with drug problems.

Dangerous Behavior↗
PubMed2006

The impact of differential patterns of physical violence and stalking on mental health and help-seeking among women with protective orders.

This study examined the severity of partner violence on women's mental health and help-seeking as well as perceptions of safety and protective-order effectiveness. Three groups based on partner violence victimization in the past year were compared: (a) women who reported experiencing moderate physical violence but no history of severe violence or stalking (n = 102), (b) women who experienced severe violence but no history of stalking (n = 142), and (c) women who experienced severe violence and stalking (n = 145). Results suggest that stalking has a unique impact on victims' mental health and perceived safety, and that protections afforded by protective orders may not be adequate for women experiencing stalking.

Adult↗
PubMed2005

Family violence among adults with severe mental illness: a neglected area of research.

Violence against family caregivers by their adult relatives with severe mental illness is a taboo area of public discourse and scientific research because of fears of further stigmatizing this population. Yet, these families experience violence at a rate estimated to be between 10% and 40%, which is considerably higher than the general population. This article reviews the limited research on violence of adults with severe mental illness against their family caregivers and proposes a conceptual framework that can further stimulate study in an area that has been neglected too long by both mental health and family violence investigators. Research on this topic is essential in developing effective policy and practice interventions.

Caregivers↗
PubMed2007

Preventing female-perpetrated sexual abuse.

Sexual abuse and sexual assault are serious public health concerns. Although almost all of the research shows that the majority of sexual perpetrators are males, there is growing evidence that female-perpetrated sexual abuse is not rare and that the consequences of female-perpetrated sexual abuse can be just as traumatic as male-perpetrated sexual abuse. Despite this, there has been very little research published that has focused on female sex offending. Furthermore, although there have been some efforts in the past decade to stop sexual offenses by targeting potential perpetrators, few efforts have specifically focused on preventing females from becoming sex offenders. In an attempt to fill this gap, this article describes common characteristics of female sex offenders; and, based on these characteristics, suggestions are given of possible ways to intervene in the lives of at-risk females before they offend.

Dangerous Behavior↗
PubMed1977

Assessing dangerousness in criminals.

This article formulates a definition of the term dangerousness, indicates why the commission of dangerous offences cannot be reliably predicted, and then reviews the several factors which have been or might be used by those who have to make decisions about dangerousness in criminals. Its suggests that these factors are useful insofar as they help to illuminate the individual's capacity to feel sympathy and to learn by experience. Since the accuracy of prediction varies inversely with time, the maintenance of personal relationships and good communication seems the inescapable requirement in the management of potentially dangerous criminals.

Age Factors↗
PubMed1980

Transfer of special hospital patients to the NHS.

In 1976, 163 patients were approved by the Department of Health and Social Security for transfer from the Special Hospitals to the open wards of the National Health Service. By autumn 1978, a quarter were still waiting for admission. Patients meeting most difficulty were the severely handicapped non-offenders, who were usually refused unseen on the ground that local subnormality hospitals were full. The role of the DHSS and of the Regional and Area Authorities was in general restricted to bewailing problems they could not help to solve. Some two years after their transfer, enquiries were made in the NHS about the 105 transferred patients. Removal back to the Special Hospital had been requested for seven, and another three had been removed by the police and prosecuted.

Adult↗
PubMed1983

Bipolar illness: correlates of dangerous inpatient behaviour.

Forty male patients with bipolar affective illness were examined for factors correlating with dangerous inpatient behaviour. It was found that 63 per cent of the variance for inpatient assaults could be accounted for by a combination of a history of severe childhood discipline, a manic state, the degree of psychosis and a record of violence prior to admission. Such information may be of use in the clinical prediction of violent acts by bipolar patients, as well as suggesting ways of preventing them.

Adult↗
PubMed1984

The reliability of dangerousness assessments. A decision making exercise.

One hundred and ninety three raters drawn from six countries and representing different professional groups considered 16 case histories. Raters were asked to indicate what degree of 'dangerousness' they attributed to each individual and what they considered to be the optimal management. The level of agreement between raters concerning the assessment of dangerousness was generally low, the level of 60 per cent being reached for only 4 cases out of 16. Psychiatrists did not reach a higher level of agreement on the ratings of dangerousness than non-psychiatrists. Psychiatrists had a tendency to rate individuals as more dangerous than did non-psychiatrists. The results of this exercise do not support the use of 'dangerousness' as a scientifically or operationally valid concept.

Dangerous Behavior↗
PubMed1985

A study of 250 patients referred to a department of psychiatry for the deaf.

250 patients referred to a department of psychiatry for the deaf were selected by random sampling and studied. The results underline the need for specialised services for deaf patients of all types, not only those who communicate solely by manual methods. Patients are referred to this department suffering from mental illness and communication disorders, as well as from problems related to their deafness. Some of the difficulties of managing a supra-regional service are discussed.

Adjustment Disorders↗
PubMed1985

A survey of the Regional Secure Unit programme.

Progress in building and opening permanent and interim secure units between October 1982 and March 1984 was surveyed. Reasons for the delays in implementing the secure unit policy recommended in the 1975 Butler Report are described, and comparisons made between the different Regional Secure Unit (RSU) designs, staffing policies, and Regional Forensic Service models. The development of this Health Service innovation has now reached the stage when the limiting factor to further progress is not building but finding suitable staff and paying their salaries. The secure unit programme will highlight another group of underprivileged patients who will require further Health Service innovation.

Dangerous Behavior↗