[Show abstract][Hide abstract] ABSTRACT: This research identified the presence and severity of salient risk factors for violence and assessed the predictive validity of the Structured Assessment of Violent Risk in Youth (SAVRY) for an Australian young male offender cohort held in detention. As the bulk of previous research has focused on European and North American Caucasian youth, comparisons were made between participants from Australian ethnic subgroups: English-Speaking Background (ESB), Culturally and Linguistically Diverse (CALD), and Indigenous and Torres Strait Islanders (IND). The study found the instrument to moderately predict general and violent recidivism across the larger cohort and the SAVRY Risk Rating was able to differentiate between times to reoffense. However, the predictive validity differed significantly across ethnic subgroups with moderate to strong predictive accuracy for the ESB group, poor predictive accuracy for the CALD group, and only particular SAVRY scores attained significant accuracy for the IND group. Findings on subgroup risk factors were considered in light of contemporary understandings of the unique experiences and trajectories of minority youth. Future investigation is necessary to differentiate and characterize the risk factors and offending patterns of the ethnicities within the CALD classification. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
Psychology Public Policy and Law 01/2013; 20(1):31-45. DOI:10.1037/a0033972 · 1.93 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The defence of insanity has been in existence for centuries, but it underwent a significant reformulation in English law in the first half of the 19th century. Since that time it has remained largely unchanged. Since its inception, expert evidence in these cases has primarily been the domain of medicine. In spite of this, more recently psychology has been gaining acceptance in this field of mental health and law. Victorian legislation allows for the assessment of mental impairment to be undertaken by psychologists but some courts have been trepidatious in allowing it. The aim of this article is to outline the role that psychologists can and do play in the evaluation of those who plead that they are not criminally responsible on account of mental disorder.
Psychiatry Psychology and Law 02/2011; Psychology and Law(Vol. 18):79-94. DOI:10.1080/13218719.2010.482952 · 0.35 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Interpersonal style, a key component of personality and personality disorder, has emerged as an important characteristic that is relevant to aggressive behavior by patients in psychiatric hospitals. However, studies examining the relationship between interpersonal style and aggression have thus far only been conducted with patients with personality disorder and/or mild and stable symptoms of mental illness. This study explored the relative importance of patients' interpersonal style, psychiatric symptoms, and perceptions of staff coercion on aggression and self-harm during acute psychiatric hospitalization. One hundred and fifty-two patients (M = 38.32 years, SD = 12.06; 56.8% males and 43.2% females) admitted for short-term assessment and treatment to the acute units of a civil and a forensic psychiatric hospital were administered the Brief Psychiatric Rating Scale, Impact Message Inventory, and MacArthur Admission Experience Survey. Participants' files were reviewed and nursing staff were interviewed at the end of each patient's hospital stay to determine whether participants had self-harmed or acted aggressively towards others. Initial univariate analyses showed that thought disorder and dominant and hostile-dominant interpersonal styles predicted aggression. Using multiple regression and controlling for gender and age, only a hostile-dominant interpersonal style predicted aggression (β = .258, p < .05). No factors were significantly related to self-harm. These results suggest that measures of interpersonal style are sensitive to those aspects of interpersonal functioning that are critical to patient's responses to the demands of psychiatric in-patient treatment. Procedures to assess risk and engage and manage potentially aggressive patients, including limit-setting styles and de-escalation strategies, should take into account the interpersonal style of patients and the interpersonal behavior of staff.
[Show abstract][Hide abstract] ABSTRACT: Routine needs assessments have become mandated requirements for public mental health services. However, the appropriateness of these generic health needs assessments to specialist populations remains questionable. This study sought to assess individual needs assessed using a widely used clinician rated assessment (Health of the Nation Outcome Scales-Secure; HoNOS-Secure), a subjective needs assessment that considers both staff and patient perspectives (Camberwell Assessment of Need-Forensic version; CANFOR), and a measure of risk for general criminal recidivism (Level of Service Inventory: Screening Version; LSI:SV) in a secure forensic mental health service. Results revealed significant positive correlations between staff ratings on HoNOS-Secure, CANFOR total needs, and CANFOR met needs scores, but no significant association between CANFOR ratings or HoNOS-Secure ratings and LSI:SV scores. Although patients and staff reported the same number of needs overall according to CANFOR (7.2 vs. 7.5, P > 0.05), patients reported that more of these needs were unmet (3.1 vs. 2.3, P < 0.05). Differences between staff and patient ratings of need suggest that needs assessments should include patient perspectives to facilitate more collaborative and comprehensive care planning. Divergent perspectives between patients and staff may impair patient engagement in treatment and therefore negatively impact on outcome. Service planning issues and opportunities for future research are discussed.
International journal of mental health nursing 08/2010; 19(4):223-30. DOI:10.1111/j.1447-0349.2010.00665.x · 2.01 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Despite seclusion being described as one of the most ethically- and legally-controversial management options available, it remains a widely-used clinical strategy for managing disruptive, aggressive, and violent behaviour. This study sought to determine how frequently seclusion was used, the common characteristics of those secluded and not secluded, and the degree to which the Level of Service Inventory - Revised: Screening Version (LSI-R: SV) could predict seclusion. The study was retrospective, covering the first 2 years of operation of a statewide forensic psychiatry hospital in Victoria, Australia. Data were collected from individual case files, electronic databases, and paper copies of records pertaining to violent incidents and episodes of seclusion. Eighty five (44%) of the 193 patients admitted during this period were secluded. Those secluded were significantly younger and had a more established psychiatric history. LSI-R: SV scores were significantly and positively associated with being secluded. A statistical model containing three LSI-R: SV items, along with age on admission and psychiatric history, achieved an area under the curve of 0.74. Seclusion is used on a regular basis in response to a range of different forms of aggressive behaviour of different severity. The LSI-R: SV demonstrated moderate-to-good accuracy in predicting seclusion and warrants further research using detailed prospective methodologies.
International journal of mental health nursing 03/2009; 18(1):2-9. DOI:10.1111/j.1447-0349.2008.00567.x · 2.01 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Effective treatment of aggressive behaviour and accurate release decision making are necessary components of adequate clinical practice in forensic psychiatric units. Unfortunately, methods to identify treatment targets and ameliorate aggressive behaviour have developed at a slower pace than risk assessment technologies. Recent progress on the identification of offence paralleling or functionally equivalent behaviour offers a framework for individually tailored treatment and idiographic release decision making, although empirical scrutiny of this approach is inadequate. This paper describes an examination of the relationship between aggressive behaviour prior to admission with aggression during inpatient psychiatric treatment, and reconviction for violent offending following discharge. Results showed a relationship between pre- and post-admission aggression but no relationship between aggression during inpatient psychiatric treatment with either pre-admission aggressive behaviour or violent recidivism. These findings indicate the importance of state psychological variables, specifically those states affected by symptoms of psychiatric illness, as well as environmental activators and inhibitors of violence that operate within the hospital. These require inclusion in an adequate functional analysis of aggressive behaviour for forensic psychiatric patients.
Psychology Crime and Law 10/2007; 13(5):431-441. DOI:10.1080/10683160601060861 · 0.69 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The assessment of risk for aggression has become a central concern of many mental health services. Some structured schemes for guiding risk assessment, developed primarily to assess risk in psychiatric patients discharged from hospital and offenders being considered for release from prison, have recently been trialled in the inpatient setting. Against the background of some prior research demonstrating the potential benefits of structured assessment schemes, and some concerns about the practicality of these schemes for assessing risk in inpatients, the current research was initiated to assess the effectiveness of the Level of Service Inventory-Revised: Screening Version (LSI-R: SV) in the prediction of aggression within a forensic psychiatric hospital. Results showed that only a weak association between the LSI-R: SV total score and inpatient aggression existed. This is probably because the LSI-R: SV addresses more static variables and does not assess the clinical characteristics and recent hostility that is associated with aggression in psychiatric patients. The predictive validity of the LSI-R: SV in this context is therefore limited. There might be more effective schemes, some of which were designed specifically for the purpose of assessing inpatient aggression that should be used in preference to the LSI-R: SV.
International Journal of Forensic Mental Health 10/2005; 4(2):201-206. DOI:10.1080/14999013.2005.10471224 · 1.05 Impact Factor