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Empirical knowledge regarding risk factors for intimate partner violence (IPV) from multiple partners (MP) is scarce and sought by clinicians and many women themselves for the prevention of future intimate partner violence relationships (IPVRs). Quantitative data were obtained through a structured interview with a stratified sample of help-seeking women (N = 154) with no (n = 48, 0IPVR), one (n = 55, 1IPVR), or multiple (n = 51, 2IPVR) IPVRs. This study investigated the association between (a) childhood family violence, (b) other childhood adversities, (c) victimization and perpetration of IPV in the last (index) relationship, and (d) controlling sociodemographic and contextual variables, and the following dependent variables: (a) women with 1IPVR and 2IPVR compared with 0IPVR and (b) women with 1IPVR compared with 2IPVR. Multivariate logistic regression analyses indicated that, compared with nonvictimized women, IPV victimized women were nearly three times more likely to report childhood sexual abuse. They also reported a higher frequency of peer victimization and a higher likelihood of having an immigrant partner. In addition, the length of the index relationship was shorter for IPV victimized women. Compared with women with 1IPVR, women with IPV by MP were more likely to report childhood emotional abuse and less education, and they were less likely to be immigrants. The two groups of IPV victimized women were indistinguishable regarding characteristics of victimization and perpetration of IPV. This study indicated that there were other risk factors for IPV by MP than for IPV in general and highlighted the importance of addressing parenting and emotional care in IPV families. [ABSTRACT FROM AUTHOR]

This cross-sectional study compared attachment characteristics among women victimized by intimate partner violence (IPV) in no, one, and multiple relationships (N = 154). Results indicated that compared with the nonvictimized, victimized women had increased likelihood of higher attachment avoidance. Compared with women victimized in one relationship, women victimized in multiple relationships had higher likelihood of higher attachment anxiety scores. Adjusting for childhood adversities, childhood sexual abuse was an independent risk factor for IPV. Childhood emotional abuse mediated the association between attachment anxiety and IPV victimization in multiple relationships in particular. Attachment theory appeared useful for better understanding women's vulnerability for multiple violent relationships. [ABSTRACT FROM AUTHOR]

Aims: To synthesize evidence of the psychometric properties of the Five‐item World Health Organization Well‐being Index in mental health settings and critically appraise the methodologies of the included studies. Design: Protocol for a systematic psychometric review. Methods: The review protocol has been registered in the International Prospective Register for Systematic Reviews. The bibliographic databases MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Library, and Web of Science will be searched for relevant studies. The psychometric properties of each study will be evaluated according to the Consensus‐based Standards for the Selection of Health Measurements Instruments. Discussion: The results of our psychometric review will synthesize the psychometric properties of the Five‐item World Health Organization Well‐being Index in mental health settings and identify possible gaps in the literature regarding methodological quality and its reliability, validity, and responsiveness to change. Impact: The evaluation of patient well‐being is important, and the Five‐item World Health Organization Well‐being Index is an increasingly used patient‐reported outcome measure. It is simple to collect, free to use, and consists of five questions using positive health statements. Although the number of studies assessing the validity, reliability, and responsiveness of the questionnaire is increasing worldwide, there is a need to summarize the existing evidence of the psychometric properties of this questionnaire. The proposed study's findings will contribute to future research recommendations and help midwives and nurses in different settings pick an effective, appropriate questionnaire to evaluate patient well‐being. [ABSTRACT FROM AUTHOR]

aims were to find predictors of violence and to test the feasibility of a matched pair design for this purpose. Methods: Patients from the Safe pilot project (n=18) and a group of controls (n=18) were matched on 10 variables, such as diagnosis, seriousness of violence, setting after discharge, and risk management plans. All the Safe pilot patients had been through repeated measurement of dynamic risk factors of violence the year before discharge to develop efficient risk management plans for use after discharge. We wanted to test whether violent recidivism during follow-up would be lower and less serious in the Safe pilot group. Results: We found no significant between-group difference concerning number of patients with violent recidivism. However, the Safe pilot patients had significantly lower rates of violence and fewer severe violent episodes. In the control group, there was a significant association between a high number of risk management plans and high rates of violence. There was a statistical trend for the opposite association in the Safe pilot group. Conclusion: We discuss this in terms of a possible gap between the development and implementation of plans. [ABSTRACT FROM AUTHOR]

Aims and objectives: To gain insight into mental health staff’s perception of writing progress notes in an acute and subacute psychiatric ward context. Background: The nursing process structures nursing documentation. Progress notes are intended to be an evaluation of a patient’s nursing diagnoses, interventions and outcomes. Within this template, a patient’s status and the care provided are to be recorded. The therapeutic nurse–patient relationship is recognised as a key component of psychiatric care today. At the same time, the biomedical model remains strong. Research literature exploring nursing staff’s experiences with writing progress notes in psychiatric contexts, and especially the space given to staff–patient relations, is sparse. Design: Qualitative design. Methods: Focus group interviews with mental health staff working in one acute and one subacute psychiatric ward were conducted. Systematic text condensation, a method for transverse thematic analysis, was used. Results: Two main categories emerged from the analysis: the position of the professional as an expert and distant observer in the progress notes, and the weak position of professional–patient interactions in progress notes. Conclusions: The participants did not perceive that the current recording model, which is based on the nursing process, supported a focus on patients’ resources or reporting professional–patient interactions. This model appeared to put ward staff in an expert position in relation to patients, which made it challenging to involve patients in the recording process. Essential aspects of nursing care related to recovery and person-centred care were not prioritised for documentation. Relevance to clinical practice: This study contributes to the critical examination of the documentation praxis, as well as to the critical examination of the documentation tool as to what is considered important to document. [ABSTRACT FROM AUTHOR]

Violent victimization in persons with severe mental illness has long-term adverse consequences. Little is known about the long-term prevalence of victimization in first episode psychosis, or about factors affecting victimization throughout the course of illness. To assess the prevalence of violent victimization during a 10-year follow-up period in a group of first episode psychosis (FEP) patients, and to identify early predictors and risk factors for victimization. A prospective design was used with comprehensive assessments of violent victimization, treatment variables and functioning at baseline and during 10-year follow-up. A clinical epidemiological sample of FEP patients (n = 298) was studied. FEP patients in our study were at a 3.5 times greater risk of victimization as compared to the normal population. During the 10-year follow-up period, 23% of subjects fell victim to one or more violent assaults. Victimized patients were younger and reported less occupational activity. At 10-year follow-up, victimization was associated with more concomitant drug use, alcohol misuse and violent behavior, but not with a worse clinical or functional outcome. Treatment programs should focus on risk factors for victimization and develop behavioral alternatives to mitigate risk in FEP patients. [ABSTRACT FROM AUTHOR]

Several studies indicate an association between low levels of serum cholesterol and aggressive behaviour, but prospective studies are scarce. In this naturalistic prospective inpatient and post-discharge study from an acute psychiatric ward, we investigated total cholesterol (TC) and high-density lipoprotein (HDL) as risk markers of violence. From March 21, 2012, to March 20, 2013, 158 men and 204 women were included. TC and HDL were measured at admission. Violence was recorded during hospital stay and for the first 3 months post-discharge. Univariate and multivariate binary logistic regression were used to estimate associations between low TC and low HDL and violence. Results showed that HDL level was significantly inversely associated with violence during hospital stay for all patients. For men, but not for women, HDL level was significantly inversely associated with violence the first 3 months post-discharge. Results indicate that low HDL is a risk marker for inpatient and post-discharge violence in acute psychiatry and also suggest gender differences in HDL as a risk marker for violence. [ABSTRACT FROM AUTHOR]

In this one-year prospective, naturalistic study in an acute psychiatric facility, we explored gender differences between 230 men and 284 women regarding the predictive validity of the Violence risk screening-10 (V-RISK-10). Hospital staff recorded violent incidents during hospital stays (range 1–176 days; median: 5.5 days) resulting in 50 men (22%) and 30 women (11%) being recorded for violence. The predictive validity was significant for both genders, with ROC-AUCs of .79 for males and .80 for females. Scoring at cut-off or beyond indicated a two-fold increased risk of becoming violent for men and a three-fold risk for women. A lower score indicated a five-fold decrease in risk for both genders. Estimates of explained variance for the prediction model were higher for men. Findings indicate gender differences for risk factors of violence and highlight the need of further research on this issue. [ABSTRACT FROM PUBLISHER]

• We analyzed the role of dynamic protective factors in risk of violence: hope, insight, and resilience. • These protective factors were combined with a history of criminality in the risk assessment. • Main effects and interaction models indicated that hopelessness and criminal convictions increased violence. • Interaction models showed that higher resilience lowered the risk of violence even with criminal convictions. • High resilience and high levels of patient acknowledged emotional distress from hopelessness led to lower violence. Assessing violence risk amongst forensic patients is a vital legal and clinical task. The field of violence risk assessment has developed considerably over the past two decades but remains primarily risk focused. Despite this, growing attention to and work on protective factors or strengths has occurred. In this prospective naturalistic study with repeated observer-rated measures of 27 forensic patients, we tested the role of three potentially important but understudied dynamic protective factors: hope, insight, and resilience, along with a history of criminality, in terms of their impact on violence. Main effects models indicated that higher hopelessness and past criminal convictions were predictive of violence acts; higher resilience was associated with lower violence. In interaction models, hopelessness remained predictive. Importantly, there were significant interactions between resilience and past criminal convictions, with higher levels of resilience leading to lower violence, most amongst those with criminal convictions, and between resilience and hopelessness related emotional distress, in that higher resilience at high levels of patient acknowledged emotional distress due to hopelessness led to lower violence. Findings indicate the importance of focusing on strengths or protective factors in the assessment of risk and treatment planning for forensic patients. Despite the small sample, the repeated measures design was feasible and informative. [ABSTRACT FROM AUTHOR]

This prospective observational study included 345 (70%) of 489 patients discharged from an emergency psychiatric hospital during one year. Episodes of offending and victimization were recorded during first year after discharge. Forty-eight persons (14%) committed violent offenses only, 27 persons (8%) were violence victims only, and 42 persons (12%) were both offenders and victims. Significant differences in demographic and clinical variables were found between the three groups. The results pointed to two distinct groups of victims: one group with a robust offender–victim overlap and another group without offender–victim overlap. The latter group was difficult to distinguish from other discharged patients. [ABSTRACT FROM AUTHOR]

This research reports on an investigation of if and how help-seeking women perceived that they had coped in intimate partner violence situations. Within a cross-sectional design, a representative sample of 157 help-seeking women in Norway was interviewed. Multivariate logistic regression analysis was conducted. Results indicated that exposure to psychological, physical, and sexual intimate partner violence, respectively, did elicit different coping strategies in one and the same woman. There were also significant differences between women who perceived they had effective coping strategies and those who did not. This research suggests that a multivariate design within an interactional perspective could inform and enhance our understanding of coping strategies in intimate partner violence situations as complex, heterogeneous, and dynamic phenomena. [ABSTRACT FROM AUTHOR]

Abstract: Background: First episode psychosis (FEP) patients have an increased risk for violence and criminal activity prior to initial treatment. However, little is known about the prevalence of criminality and acts of violence many years after implementation of treatment for a first episode psychosis. Aim: To assess the prevalence of criminal and violent behaviors during a 10-year follow-up period after the debut of a first psychosis episode, and to identify early predictors and concomitant risk factors of violent behavior. Method: A prospective design was used with comprehensive assessments of criminal behavior, drug abuse, clinical, social and treatment variables at baseline, five, and 10-year follow-up. Additionally, threatening and violent behavior was assessed at 10-year follow-up. A clinical epidemiological sample of first-episode psychosis patients (n=178) was studied. Results: During the 10-year follow-up period, 20% of subjects had been apprehended or incarcerated. At 10-year follow-up, 15% of subjects had exposed others to threats or violence during the year before assessment. Illegal drug use at baseline and five-year follow-up, and a longer duration of psychotic symptoms were found to be predictive of violent behavior during the year preceding the 10-year follow-up. Conclusion: After treatment initiation, the overall prevalence of violence in psychotic patients drops gradually to rates close to those of the general population. However, persistent illicit drug abuse is a serious risk factor for violent behavior, even long after the start of treatment. Achieving remission early and reducing substance abuse may contribute to a lower long-term risk for violent behavior in FEP patients. [Copyright &y& Elsevier]

Abstract: This retrospective study from three catchment-area-based acute psychiatric wards showed that of all the pharmacologically and mechanically restrained patients (n=373) 34 (9.1%) had been frequently restrained (6 or more times). These patients accounted for 39.2% of all restraint episodes during the two-year study period. Adjusted binary logistic regression analyses showed that the odds for being frequently restrained were 91% lower among patients above 50 years compared to those aged 18–29 years; a threefold increase (OR=3.1) for those admitted 3 times or more compared to patients with only one stay; and, finally, a threefold increase (OR=3.1) if the length of stay was 16 days or more compared to those admitted for 0–4 days. Among frequently restrained patients, males (n=15) had significantly longer stays than women (n=19), and 8 of the females had a diagnosis of personality disorder, compared to none among males. Our study showed that being frequently restrained was associated with long inpatient stay, many admissions and young age. Teasing out patient characteristics associated with the risk of being frequently restraint may contribute to reduce use of restraint by developing alternative interventions for these patients. [Copyright &y& Elsevier]

Individual differences in impulsive traits have been associated with a number of deviant behaviors, and impulsivity has been assumed to play a critical role in the manifestation of violent and other criminal behavior. Despite frequent citations of a positive association between impulsivity and violence in persons with psychosis, conflicting findings in the research literature elicited this systematic review. The main aims were to examine the empirical evidence of the association and to determine whether the research design and measurement used were sufficient for testing a possible causal relationship. Two types of empirical evidence were searched for in keeping with the traditional trait-state dichotomy: documentation of the direct impact of impulsivity on carrying out the violent act (state), and documentation of elevated levels of impulsivity in a person and increased occurrence of violent acts (trait). Searches that were conducted in six databases resulted in one study that supported the association and three that did not. Only 2 out of 22 estimates obtained from bivariate analysis indicated evidence of an impulsivity–violence link. No single study had a design that yielded data on a direct impact of impulsivity on carrying out the violent act (i.e., the state aspect of the association). [Copyright &y& Elsevier]

Abstract: Restraint use has been reported to be common in acute psychiatry, but empirical research is scarce concerning why and how restraints are used. This study analysed data from patients' first episodes of restraint in three acute psychiatric wards during a 2-year study period. Logistic regression analyses were used to identify predictors for type and duration of restraint. The distribution of restraint categories for the 371 restrained patients was as follows: mechanical restraint, 47.2%; mechanical and pharmacological restraint together, 35.3%; and pharmacological restraint, 17.5%. The most commonly reported reason for restraint was assault (occurred or imminent). It increased the likelihood of resulting in concomitant pharmacological restraint. Female patients had shorter duration of mechanical restraint than men. Age above 49 and female gender increased the likelihood of pharmacological versus mechanical restraint, whereas being restrained due to assault weakened this association. Episodes with mechanical restraint and coinciding pharmacological restraint lasted longer than mechanical restraint used separately, and were less common among patients with a personality disorder. Diagnoses, age and reason for restraint independently increased the likelihood for being subjected to specific types of restraint. Female gender predicted type of restraint and duration of episodes. [Copyright &y& Elsevier]

The rapid development of empirical studies in the field of interprofessional collaboration (IPC) calls for a wide array of scientific approaches ranging from recruitment and motivation to measurement and design questions. Regardless of whether researchers choose qualitative or quantitative approaches, they must substantiate their findings. We argue that more attention should be given to reliability and validity issues to improve our understanding of IPC as a phenomenon and practice. A mixed methods approach is presented as a relevant design format for the study of IPC. This paper aims to argue that a combination of methodologies may be a feasible way to enhance our understanding of IPC, with a special focus on reliability and validity issues; illustrate the application of different methodologies in an IPC research project; and emphasize the distinction between validity and validation to mitigate possible obstacles in integrating qualitative and quantitative research in the study of IPC. [ABSTRACT FROM AUTHOR]

Objective: The development of the health and social care system has made it increasingly specialized, decentralized and professionalized. Accordingly, demands of efficient approaches to collaboration and integration of services for children, adolescents and their family networks have emerged. The aim of this article is to present and analyze findings from a review of the literature on parents as collaboration partners with professionals. Method: A literature review was conducted in two databases. A multifaceted model was developed to depict and analyze collaboration complexity. Results: Preliminary application of the multifaceted collaboration model suggests that first- and second-order therapy positions have different impact on collaborative relationships. Conclusion: It is suggested that professionals may want to acknowledge the different impact of first- and second-order positions in interprofessional collaboration involving parents. This may be accomplished by staging a routine requirement for discussion of meta-positions as an introductory theme in the opening stages and as a recurrent theme throughout the collaboration process. [ABSTRACT FROM AUTHOR]

This article reports a study of the impact of marital status on interactional aspects of intimate partner violence (IPV) among help-seeking women. Are there differences among marital status groups concerning (a) other sociodemographic variables, (b) IPV categories, (c) interactional IPV variables, and (d) perception and interpretation of IPV? A representative sample of 157 women recruited from family counseling, the police, and shelters were interviewed. There was no significant sociodemographic difference among the marital status groups. There were no significant differences pertaining to IPV categories, neither for IPV severity, injury, duration, frequency, mortal danger, and regularity, nor for physical, psychological, or sexual IPV. However, multivariate logistic regression showed that post-separation women were significantly more likely to have (a) had longer duration since the last psychological and sexual IPV episode, (2) reported the physical IPV to be more predictable, and (3) used more active coping strategies against physical IPV. However, our research was not able to determine if perception and interpretation predict actual leaving behavior, or vice versa, or how the victim's subjective perception and interpretation of the IPV changes over time. [ABSTRACT FROM AUTHOR]

Research on the fate of patients after discharge from maximum security psychiatric care is scarce. Nonetheless, results indicate that readmission and reconviction rates are unacceptably high. Our research aimed to address three main issues: (1) to report findings from an eight-year follow-up of 125 patients discharged from a maximum security forensic unit (MSU) and to compare the results with studies from other countries; (2) to explore the feasibility and usefulness of face-to-face interviews (N= 38) as compared to using the traditional register-based follow-up method; and (3) to explore differences in psychosocial functioning from discharge to follow-up as a correlate of outcome. Findings replicated results from other research concerning rates of readmission, reconviction, and the strong association between substance abuse and the likelihood of being readmitted to the MSU. Despite methodological limitations, the face-to-face interview appeared to enhance access to significant clinical and psychosocial information. When compared with official records, patients' self-report was reliable for violent crime, not reliable concerning petty crime, and significantly more accurate for crimes pertaining to illegal drugs. Being readmitted to the MSU predicted decreased GAF-score values (OR =-12.89), and living with family predicted increased GAF-score values (OR = 19.20) in the multivariate linear regression analysis. [ABSTRACT FROM AUTHOR]

This article reports a study of the possible impact of immigration on interactional aspects of intimate partner violence (IPV) among help-seeking women. Are there differences concerning (a) IPV categories, (b) IPV severity, frequency, duration, regularity, and predictability, (c) guilt and shame, (d) partners’ ethnicity, and (e) children being exposed to interparental IPV, adjusted for sociodemographic variables? A representative sample of IPV help-seeking women (N = 157) recruited from family counseling, police, and shelters in Norway were interviewed. Multivariate analyses showed that immigrant women had lower income, were less likely to use alcohol and had increased likelihood of having an immigrant partner. No differences were found concerning IPV severity, frequency, guilt, shame, or victimization pertaining to different IPV categories. Immigrant women were better at predicting physical IPV but had an increased risk of physical injury related to sexual IPV. Children’s risk of being exposed to interparental IPV increased if parents were immigrants. Psychosocial consequences of being an immigrant such as having a lower sociodemographic rank rather than IPV aspects constituted the main difference between ethnic Norwegian and immigrant help-seeking women. [ABSTRACT FROM PUBLISHER]

Abstract: Recently patients'' responsibility for and ownership of their own treatment have been emphasised. A literature search on patients'''' structured self-reported assessment of future risk of violent, suicidal or self mutilating behaviour failed to disclose any published empirical research. The present prospective naturalistic study comprised all involuntary and voluntary acutely admitted patients (n =489) to a psychiatric hospital during one year. Patients'' self-reported risks of violence and self-harm at admission and at discharge were compared with episodes recorded during hospital stay and 3months post-discharge. Patients'' predictions were significant concerning violent, suicidal and self-injurious behaviour, with AUC values of 0.73 (95%CI=0.61–0.85), 0.92 (95%CI=0.88–0.96) and 0.82 (95%CI=0.67–0.98) for hospital stay, and 0.67 (95%CI=0.58–0.76), 0.63 (95%CI=0.55–0.72) and 0.66 (95%CI=0.57–0.76) after 3months, respectively. Moderate or higher risk predictions remained significant in multivariate analysis, and risk of violence even after gender stratification. Self-harm predictions were significant for women. Moderate or higher risk scores remained significant predictors of violence one year post-discharge. Controlling for readmissions the results remained the same. Low sensitivity limits the clinical value, but relatively high positive predictive values might be clinically important. Still future research is recommended to explore if self prediction is a valid adjuvant method to established risk assessment procedures. [Copyright &y& Elsevier]

The authors report on the impact of motherhood and pregnancy on interactional aspects of intimate partner violence (IPV) among help-seeking women. Is having children a protective or a risk factor for IPV severity, injury, duration, frequency, and mortal danger, controlling for sociodemographics? Regarding interactional aspects of IPV, do survivors who experience IPV during pregnancy differ from those who do not? Is IPV during pregnancy characterized by different severity, injury, frequency, and mortal danger? A representative sample of women was interviewed. Motherhood increased the risk for longer duration of physical, psychological, and sexual IPV, even controlling for duration of partnership. Combinations of main categories of IPV during pregnancy were different from when not pregnant. Duration of physical and psychological IPV was the only variable increasing the likelihood of experiencing IPV during pregnancy. All physical IPV variables were significantly lower during pregnancy. For psychological IPV, all variables but frequency were lower. Only mortal danger was significantly lower in the sexual IPV main category. [ABSTRACT FROM AUTHOR]

Abstract: The main purpose of this article is to delineate findings from a review of the literature on the empirical basis for the existence of a relationship between Asperger''s syndrome (AS) and violence risk. A second aim is to examine whether certain characteristics of the disorder may have a higher violence-triggering potential. Results of this review show that there are very few empirical studies that confirm a stable link between AS and violence. Only 11 studies involving 22 patients and 29 violent incidents met the criteria for inclusion in the review after the search of the literature. However, a qualitative analysis of the studies yielded some indications of possible patterns of dynamics of violence that may prove to be typical of persons with AS. A tentative comparison of AS and psychopathy indicated that there may be qualitative differences in the characteristics of violent behavior between the disorders. Suggestions for further research are presented. [Copyright &y& Elsevier]

This article reports a study of the possible impact of sociodemographic and interactional aspects of intimate partner violence (IPV) on help-seeking behavior. Do different sociodemographic groups of IPV survivors use different professional supports and treatments? Do different professional support and treatment agencies come predominantly in contact with women who have been subjected to different characteristics of IPV? Do different interactional IPV variables predict whether IPV victims contact the police, a family doctor, or a psychologist or psychiatrist? A representative sample of 157 women recruited from family counseling, the police, and shelters in Norway was interviewed. Three of seven sociodemographic variables showed statistically significant differences among the recruitment groups. No significant differences in characteristics of IPV were found among the recruitment groups. However, there were significant differences between the main categories (physical, psychological, and sexual) of IPV and interactional IPV factors concerning help-seeking. Our findings indicate that the help-seeking of IPV survivors is differentiated and interaction-specific and that they respond adequately to the different interactional consequences of IPV. [ABSTRACT FROM AUTHOR]

Abstract: This paper presents data from a systematic review and meta-analysis of published quality of life (QOL) studies on the subjective general well-being (GWB) of persons with major mental disorder (MMD) who live in the community. Four research questions were addressed: (1) What is the subjective QOL in persons with MMD who live in the community? (2) Are any specific subjective subdomains of QOL superior predictors of subjective GWB? (3) Is there an association between measures of psychopathology and subjective GWB? (4) Is there an association between sociodemographic variables and subjective GWB? We initially considered 134 potentially relevant articles, but only 42 studies reporting on 49 study units (N =6774 persons with MMD) met criteria of acceptable quality or relevance to be included in the meta-analysis. First, we found that measures of subjective GWB were relatively high. Second, certain subdomains such as Leisure and Social relations were strong predictors of subjective GWB, while the links between both Personal safety and Work, and GWB were weak. Third, we found that the empirical basis for using subjective QOL as an outcome variable in clinical research is scant. In particular, the relationship between changes in measures of psychopathology and subjective QOL appears to be obscure. Finally, the present study failed to confirm any stable relationship between sociodemographic factors and subjective GWB in persons with MMD who live in the community. Consequences of the findings for clinical practice and research are discussed. Limitations inherent in the meta-analytic approach in general, and the lack of homogeneity in the reviewed studies, need to be considered when interpreting the results of this meta-analysis. [Copyright &y& Elsevier]

This article reports a study of women victimized by intimate partner violence (IPV). We describe three interactional aspects of IPV: (1) responses and conduct before, during, and after IPV episodes, (2) impact of alcohol and drug intoxication, and (3) Predictors of risk for IPV victimization in more than one partnership. A representative sample of 157 help-seeking women, recruited from family counseling offices, the police and shelters, were interviewed about physical, psychological and sexual IPV. The nature and characteristics of the IPV interactions were complex and heterogeneous. There were significant interactional differences between the IPV categories concerning the women’s responses and conduct before, during and after the IPV. The impact of alcohol and drug intoxication was relatively small on the occurrence of IPV. About 75% reported that neither the perpetrator nor the female victim had consumed alcohol or drugs before the index IPV exposure. Only 23% of the women had experienced IPV by previous partners. Women who had been subjected to sexual abuse in their family of origin were at almost 25 times increased risk of IPV victimization in more than one partnership. Childhood exposure to physical IPV between parents increased the risk of IPV victimization in more than one partnership significantly more than if the woman had been subject to childhood physical victimization. [ABSTRACT FROM AUTHOR]

The Acute Project is a research project conducted on acute psychiatric admission wards in Norway. The objective is to develop and validate a structured, easy-to-use screening checklist for assessment of risk for violence in patients both during their stay in the ward and after discharge. The Preliminary Scheme 33 is a 33-item screening checklist with content domain inspired by the Historical-Clinical-Risk Management Scheme (HCR-20), the Brøset Violence Checklist, and eight risk factors extracted from the literature on risk assessment. The Preliminary Scheme 33 was designed and tested in two steps by a research group which includes the authors. The common aim of both steps was to develop this into a time economical, reliable, and valid checklist, in the first step in 2006 the predictive validity of the individual items was tested. The present work presents results from the second step, a study conducted to assess the interrater reliability of the 33 items. Eight clinicians working in an acute psychiatric unit volunteered to be raters and were trained to score the 33 items on a three-point scale in relation to 15 clinical vignettes, which contained information from 15 acute psychiatric patients' files. Analysis showed high interrater reliability for the total score with an intraclass correlation coefficient (ICC) of .86 (95% CI: 0.74-0.94). However, a substantial proportion of the items had medium to low ICCs. Consequences of this finding for further development of these items into a brief screen are discussed. [ABSTRACT FROM AUTHOR]

The Acute Project is a research project conducted on acute psychiatric admission wards in Norway. The objective is to develop and validate a structured, easy-to-use screening checklist for assessment of risk for violence in patients both during their stay in the ward and after discharge. The Preliminary Scheme 33 is a 33-item screening checklist with content domain inspired by the Historical-Clinical-Risk Management Scheme (HCR–20), the Brøset Violence Checklist, and eight risk factors extracted from the literature on risk assessment. The Preliminary Scheme 33 was designed and tested in two steps by a research group which includes the authors. The common aim of both steps was to develop this into a time economical, reliable, and valid checklist. In the first step in 2006 the predictive validity of the individual items was tested. The present work presents results from the second step, a study conducted to assess the interrater reliability of the 33 items. Eight clinicians working in an acute psychiatric unit volunteered to be raters and were trained to score the 33 items on a three-point scale in relation to 15 clinical vignettes, which contained information from 15 acute psychiatric patients' files. Analysis showed high interrater reliability for the total score with an intraclass correlation coefficient (ICC) of.86 (95% CI: 0.74-0.94). However, a substantial proportion of the items had medium to low ICCs. Consequences of this finding for further development of these items into a brief screen are discussed. [ABSTRACT FROM AUTHOR]

The article focuses on the validity and utility of risk assessment tools for violence in acute care settings. It mentions that risk assessment instruments concluded that the V-RISK-10 and the Broset Violence Checklist (BVC) provided the best assessment for violence risk in the acute care mental health setting; and also mentions the VRISK- 10 has shown significant predictive accuracy in general psychiatric acute wards.

Abstract: Lack of insight has established itself both as an important element of models of risk of violence and as a clinical item in structured approaches to measuring risk of violence. The main purpose of this paper is to delineate findings from a review of the literature concerning the empirical basis for the existence of a relationship between insight and violence risk. A second aim is to examine whether certain dimensions of insight may have a higher violence-triggering potential, and, if so, to learn more about valid and reliable approaches for measuring these dimensions. Results of this review show that there are very few empirical studies that demonstrate a possible association between insight and violence risk. Five out of a total of nine investigations found a positive relationship between poor insight and violent behavior. Nonetheless, the strength and specific nature of the relationship remain unclear due to considerable methodological and conceptual shortcomings in the reviewed studies. Seven recommendations for future research are presented to address these shortcomings. [Copyright &y& Elsevier]

This paper presents a stress-vulnerability approach to the understanding and treatment of intimate partners' violence. The potential benefit of integrating detailed analyses of warning signs of violence in treatment interventions is examined. A brief search in the literature yielded few articles on the clinical relevance of warning signs in relation to partners' violence. However, the preliminary nature of the present literature search precludes firm conclusions concerning current clinical research and practise. The possibility that both perpetrator and victim might profit from therapy focusing on ability to identify and intervene in relation to early danger signals of violence is discussed. [ABSTRACT FROM AUTHOR]

The main scope of this paper is to delineate some findings from a review of the literature concerning the possible impact of delusions on violence toward others by psychiatric patients. According to this review, studies on a possible association between delusions and increased risk of violence are scarce, but steadily growing, and have shown some interesting results. However, since delusions are also common in nonviolent psychiatric patients, there is emerging evidence that our attention should be directed to specific hallmarks of delusions that indicate an increased risk of violence. Among the main findings of the present review are: the number of empirical studies were surprisingly low; about 80% of the studies were conducted during the last 8 years; and less than one third of the studies used a prospective design. Further findings were that persecutory delusions appear to increase risk of violence in some patients; co-occurence of persecutory delusions and emotional distress may increase risk of violence; and there is limited but tentative support to the existence of an association between symptoms of perceived threat and internal control override (TCO) and violence. [Copyright &y& Elsevier]

According to the clinical impressions of a number of authors and mental health professionals, an increased risk of violence is associated with the presence of hallucinations and — in particular — command hallucinations. In contrast to this, some empirical studies have reported that there is no evidence of such a relationship. The present review examines the role of hallucinations in violence toward others. Possible empirical evidence for a violence-escalating interaction between delusions and hallucinations is also analyzed. Among the main findings were: There appears to be no evidence that auditory command hallucinations are dangerous per se. However, there is some evidence that voices ordering acts of violence toward others may increase compliance and thereby be conducive to violent behavior. Finally, the evidence for or against the existence of a possible violence-escalating interaction between delusions and hallucinations is inconclusive. The findings are discussed particularly in relation to problems of measurement and other research design factors. Discrepancies between some of the findings of the present review and current clinical lore are also briefly considered. [Copyright &y& Elsevier]

A sample of 39 patients who had committed serious violent acts toward others were assessed with the revised Symptom Checklist (SCL-90-R). The SCL-90-R is a self-report symptom inventory for the measurement of psychopathology in psychiatric and medical patients. In addition to the patients' self-report, an observer-rated SCL-90-R was obtained. This was accomplished by letting one pair of nurses complete SCL-90-R ratings for each patient. The first aim of the study was to compare the SCL-90-R self-report scores of the patient sample with the psychiatric inpatient norms [Derogatis LR (1992): Clinical Psychometric Research Inc]. Another purpose of this study was to explore possible trends of discordance between the observer ratings and the self-reports of the study group. Always considering the limitations of the small sample, it was nevertheless also of interest to look for possible sex differences and differences between violent subgroups and between diagnostic groups in the self-reported scores as well as in the observer ratings. The most striking findings of the present study were that the self-reported scores were lower than the inpatient norms for SCL-90-R and that the patients' self-reported levels of distress were significantly lower than those found in the observer ratings. Underreporting of psychopathology as a marker of violence risk is discussed in light of these findings. In this study, women reported higher distress levels than men in the Interpersonal Sensitivity symptom dimension. There were no significant differences concerning SCL-90-R ratings between patients who had committed homicide, attempted homicide, or physically assaulted another person in a serious but not life-threatening way. Aggr. Behav. 28:446–457, 2002. © 2002 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

This paper reports on the inter-rater reliability of the Report Form for Aggressive Episodes (REFA). This rating scale is designed to measure displayed aggressive behavior and its situational determinant(s) according to a list of 30 potential precipitants of aggression. Findings from this study, where 48 raters assessed 10 clinical vignettes each by means of the REFA, show high levels of inter-rater agreement and reliability. Results also indicate that REFA items are homogenous in terms of how raters respond to them. [ABSTRACT FROM AUTHOR]

Background: This study aimed to explore the internal consistency and factor validity of the 13-item self-report questionnaire Parent-Patient Activation Measure (P-PAM) in a sample of parents of children with Attention-deficit/hyperactivity disorder. Methods: In a cross-sectional study, 239 parents were recruited from four outpatient clinics of the Child and Adolescent Mental Health Services and completed the P-PAM along with demographic variables. The factor structure of the P-PAM was examined through exploratory factor analysis, and internal consistency was estimated with the use of both Cronbach's alpha and McDonald's omega. A confirmatory factor analysis was used to estimate and test individual parameters. Results: The fit indices suggest an acceptable two-factor model of P-PAM and show high internal consistency and reliability for both factors, indicating that the scale measures two concepts. Conclusions: Our findings provide evidence for an acceptable factor structure and a high reliability of P-PAM as a measure of parent activation, suggesting that the theoretical factors reflect the construct of parent activation as intuitively compiled into an inner cognitive factor and an outer behavioral factor, which are related. [ABSTRACT FROM AUTHOR]

Intimate partner homicide (IPH) is an extreme outcome of intimate partner violence (IPV). It is a societal challenge that needs to be investigated over time to see whether changes occur concerning the incidence of IPH, IPH characteristics, socioeconomic factors, and contact with service providers. This study includes the total Norwegian cohort of IPHs between 1990 and 2019 with a final conviction (N = 224). Poisson regression was applied to model the incidence rate of homicide and IPH between 1990 and 2020 as well as the incidence rates of immigrant perpetrators and victims. Multivariate logistic regression analyses were used to test the association between characteristics and period 1990–2012 compared to after 2012 as dependent variable. The results show that though homicide incidence rates in Norway declined steadily and significantly after 1990, IPH rates did not begin to decline until 2015. The following IPH characteristics showed reduced incidence after 2012: IPH-suicide, perpetrators with a criminal record, and IPHs perpetrated subsequent to preventive interventions towards the perpetrator. Sentence length in IPH cases had increased. Changes were not observed for any of the other IPH characteristics investigated. IPH is often the culmination of long-term violence and can be prevented, even if risk assessment is challenging due to the low base rates. [ABSTRACT FROM AUTHOR]

• Our prospective design for the psychotic symptom-violence link is rare in forensic psychiatry • The use of repeated measures design we used to investigate this link is also scarce • Our study is one out of very few intensive prospective studies before and after discharge • We found clinical and statistical association between psychotic symptoms and violence • Results showed interaction effects between psychotic symptoms and criminal conviction The research evidence is very strong for high recidivism rates of violence after discharge from forensic facilities. Big data research has found that a substantial proportion of the forensic population with relapse into violence has a psychosis diagnosis and a criminal record. However, more research on the association between psychotic symptoms and violence may inform and enhance risk assessment, prevention, and treatment. We conducted a prospective naturalistic study with a repeated measures design in a sample of 22 psychotic patients during follow-up after discharge from forensic mental health facilities. We had three aims: to test the predictive validity of three psychotic symptom scales for violence, to analyze main and interaction effects between psychotic symptoms and previous criminal conviction, and to explore the feasibility and potential benefit of the repeated measures design for prospective follow-up research. Interpreted within the limitation of the small sample size, the results were promising for all scales, particularly for adjusted effects without interaction. Two scales remained significant when their interaction with criminal conviction was adjusted. This indicates that risk judgment of psychotic patients with criminal conviction can be improved by adding measurement of fluctuations in psychotic symptoms. The repeated measures design was instrumental in this research. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to gain insight into mental health staff's perception of writing progress notes in an acute and subacute psychiatric ward context in Norway. Progress notes are the staff's daily reports in the electronic patient journal. The staff represents professionals with different educational backgrounds, for instance registered nurses and social workers. The therapeutic professional-patient relationship is recognized as a key component of psychiatric care, implying models of person-centered care and recovery. At the same time, the problem and deficit-oriented medical model remains strong. Progress notes are written within this context of competing models and within a hierarchical system of professions. Research literature exploring staff's experiences with writing progress notes in psychiatric contexts, and especially the space given to staff-patient relations, is sparse. To keep and further develop efficient cooperation in inter-professional work in mental health settings oral and written reports are of paramount importance. The main aims of this presentation are to report 1 staff experiences of the role of progress notes in focusing on staff-user interactions, and 2 staff perceptions of the impact of different treatment models on the progress notes. Methods: Staff who were familiar in writing progress notes and worked in one acute and one subacute psychiatric ward were invited to participate in two focus groups. A moderator and a co-moderator facilitated the interviews. Data analysis followed Systematic text condensation, which is a systematic method for transverse thematic analysis within a qualitative design. Results: The analysis revealed two themes: The position of the professional as an expert and distant observer in the progress notes, and The weak position of professional-patient interactions in progress notes. Reporting neutral observations of the patient for diagnostic purposes was considered most important. Though the participants told stories about challenging staff-patient situations where they drew on advanced communication skills to attune to the patient, they did not prioritize to document these interactions. In addition, the participants found it difficult to report patient resources in the reporting system. Discussions: The discussion of the results addresses the issue of progress notes in relation to different perspectives of recovery and person-centered care, and traditional medical models, respectively. The role of progress notes in inter-professional care and coordination is also discussed. Conclusions: The participants did not perceive that the current recording model supported a focus on patients' resources or reporting professional-patient interactions. This model appeared to put staff in an expert position in relation to patients, which made it challenging to involve patients in the recording process. Lessons learned: Essential aspects of care related to recovery and person-centered perspectives were not prioritized for documentation. Limitations: The focus groups covered two different contexts of psychiatric inpatient wards. The small sample may limit the findings' generalizability. Suggestions for future research: Our findings reflect staff's point of view. Studies designed to explore patients' perceptions of the use and content of progress notes are called for. [ABSTRACT FROM AUTHOR]

Several studies have found an association between salivary cortisol levels and dropping out of inpatient substance addiction treatment programs. The results are mixed due to variations in the study design and the lack of standardized routines for cortisol assessment. The aim of this study was to investigate whether there was (1) an association between salivary cortisol levels and dropping out from inpatient substance addiction treatments; (2) higher predictive validity for dropout in one of the cortisol indexes: Area Under the Curve with respect to ground (AUCG) or Daily Cortisol Slope (DCS); (3) an interaction effect with time for each cortisol index; and (4) different dropout rates for sex and patients in short-term versus long-term treatment programs. This was a prospective, repeated-measures observational study. Patients (n = 173) were recruited from 2 inpatient facilities in the central region of Norway between 2018 and 2021. Salivary cortisol was measured 4 times during the treatment period, with 8 samples collected over 2 consecutive days at each time point. Cortisol levels were calculated using the cortisol indices AUCG and DCS. Dropout was used as the outcome measure at each time point. Associations were calculated using a logistic linear regression. The results suggest a main effect of AUCG, whereby higher levels reduce dropout risk (OR = 0.92, P =.047). An interaction with time in treatment also revealed a higher dropout risk (OR = 1.09, P =.044) during week 4 of the treatment, depending on the AUCG. These results support using AUCG as the recommended index when assessing cortisol, and that the relationship between cortisol levels and length of treatment should be further investigated. [ABSTRACT FROM AUTHOR]

Several studies have found an association between salivary cortisol levels and dropping out of inpatient substance addiction treatment programs. The results are mixed due to variations in the study design and the lack of standardized routines for cortisol assessment. The aim of this study was to investigate whether there was (1) an association between salivary cortisol levels and dropping out from inpatient substance addiction treatments; (2) higher predictive validity for dropout in one of the cortisol indexes: Area Under the Curve with respect to ground (AUCG) or Daily Cortisol Slope (DCS); (3) an interaction effect with time for each cortisol index; and (4) different dropout rates for sex and patients in short-term versus long-term treatment programs. This was a prospective, repeated-measures observational study. Patients (n = 173) were recruited from 2 inpatient facilities in the central region of Norway between 2018 and 2021. Salivary cortisol was measured 4 times during the treatment period, with 8 samples collected over 2 consecutive days at each time point. Cortisol levels were calculated using the cortisol indices AUCG and DCS. Dropout was used as the outcome measure at each time point. Associations were calculated using a logistic linear regression. The results suggest a main effect of AUCG, whereby higher levels reduce dropout risk (OR = 0.92, P = .047). An interaction with time in treatment also revealed a higher dropout risk (OR = 1.09, P = .044) during week 4 of the treatment, depending on the AUCG. These results support using AUCg as the recommended index when assessing cortisol, and that the relationship between cortisol levels and length of treatment should be further investigated. [ABSTRACT FROM AUTHOR]

Several studies have found co-occurrence between substance abuse and mental health problems, as well as an association between treatment retention and psychological distress. The aim of this study was to investigate the association of possible protective factors with psychological distress. The present study tested physical activity, self-esteem and sense of coherence, and psychological distress level among inpatients in substance use treatment. The study design was cross-sectional and multicenter. Patients (N = 167) were recruited in 2018 from 10 Norwegian inpatient facilities. They self-reported on 3 validated measurement instruments: Rosenberg Self-Esteem Scale, Antonovsky's Sense of Coherence Scale, and frequency of physical activity. The Hopkins Symptom Checklist-10 was used as an outcome variable of psychological distress. The associations were investigated with multiple linear and logistic regression methods. The results suggested that high self-esteem and sense of coherence were protective factors against high levels of psychological distress: self-esteem (β = −.39, P <.001) and sense of coherence (β = −.352, P <.001). The results offer support for a salutogenic approach in substance use disorder (SUD) treatment by enhancing individuals' protective factors to reduce psychological distress. [ABSTRACT FROM AUTHOR]

Background: Therapeutic staff-patient interaction is fundamental in psychiatric care. It is recognized as a key to healing in and of itself, or a premise to enhance psychiatric treatment adherence. Still, little is known about how these interactions are recorded in nursing documentation. The purpose of the study was to assess the quality and quantity of staff-patient interactions as recorded in progress notes in nursing documentation. Methods: The study has an observational registry study design. A random sample of 3858 excerpts was selected from progress notes in 90 patient journals on an acute psychiatric unit and an open inpatient district psychiatric centre (DPC) in Norway. The Scale for the Evaluation of Staff-Patient Interactions in progress notes (SESPI) was used to assess the progress note excerpts. It is developed to assess the quality and quantity in excerpt descriptions of staff-patient interactions in terms of empathic attunement. Descriptive statistics were calculated for the total sample and for each ward separately. Ordinal and multinomial logistic regression were used to estimate control for shift type, staff education level, and type of hospital ward. Results: Only 7.6% of the total number of excerpts (N = 3858) described staff-patient interactions sufficiently to analyze them in terms of attunement. Compared to the DPC, the acute ward reported more staff-patient interactions. The evening excerpts reported more successful types of attunement than those from the night shifts. Education level did not contribute significantly to our models. Conclusion: These findings present a unique insight into the quality and quantity of mental health nursing documentation regarding staff-patient interactions. Therapeutic interactions where staff tried to attune to the patients were rarely described. However, this is the first study measuring nursing documentation with the SESPI, and more studies are required to validate the scale and our findings. One potential clinical implication of this research is the development of a scale that personnel in psychiatric wards can have for evaluation of the quality of their reporting practice with emphasis on staff-patient interactions. By regular use this may help keeping up emphasis on emphatic attunement in milieu treatment contexts. [ABSTRACT FROM AUTHOR]

As one of the efforts to prevent intimate partner violence (IPV) and intimate partner homicide, countries have adopted legislation requiring professionals to report cases of IPV, or suspected IPV injuries, to the police or the criminal justice system. The term for this is mandatory reporting. In spite of its good intention, mandatory reporting of IPV is a controversial issue. The objective of this review was to systematically search for, appraise the quality of, and synthetize the evidence from quantitative and qualitative studies on mandatory reporting of IPV. A systematic review of the scientific literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A comprehensive search was conducted through Ovid MEDLINE, PsycINFO, Scopus, Criminal Justice Abstracts, and SveMed+. Articles were included if they (a) were peer-reviewed empirical studies rather than theories or discussions, (b) described mandatory reporting of IPV, and (c) were written in English or Scandinavian languages. No time limit was applied. Twenty-five research studies met the criteria for review. Victims were generally supportive of a law requiring professionals to report IPV, although subsamples' attitudes opposing mandatory reporting were presented as main findings in a substantial number of studies. Group differences between abused or nonabused women and knowledge about mandatory reporting of IPV among professionals was mixed and inconclusive. Few professionals had actually reported IPV under mandatory reporting. Empirical research appears to be scarce, with moderate to high degree of bias and with only limited recent development. [ABSTRACT FROM AUTHOR]

Homicide-suicide incidents make up a relatively small proportion of homicides overall, but occur more frequently in certain subtypes of homicide, such as men who kill their female partners. This study investigates aspects of intimate partner homicide-suicide (IPHS) by comparing it with intimate partner homicide (IPH). All IPHs in Norway from 1990 to 2012 (N = 177) were included. Quantitative data were extracted from court documents. Qualitative data were collected by interviews with bereaved. Multivariate logistic regression analyses and systematic text condensation were conducted. Nearly one fourth of IPHs were identified as IPHS. Perpetrators of IPHS were less likely to have a previous criminal record, even having a history of disregard and violations of the law. Perpetrators of IPHS were mainly native-born citizens and were more educated than IPH perpetrators. The motive of IPHS was more often jealousy than a dispute, but the motive was most often recorded as "other" or "unknown." IPHS was perceived as intentional, and the bereaved did not unambiguously support the interpretation that the IPHS had been triggered by stressful situations. The bereaved pointed to the loss of hope or loss of a future combined with an inability to cope with severe disappointments as an important risk factor. Within the framework of an interactional perspective, our findings indicate that IPHS shares more characteristics with IPH than it does with other categories of homicide and other violent deaths in general. [ABSTRACT FROM AUTHOR]

Several studies have found co-occurrence between substance abuse and mental health problems, as well as an association between treatment retention and psychological distress. The aim of this study was to investigate the association of possible protective factors with psychological distress. The present study tested physical activity, self-esteem and sense of coherence, and psychological distress level among inpatients in substance use treatment. The study design was cross-sectional and multicenter. Patients (N = 167) were recruited in 2018 from 10 Norwegian inpatient facilities. They self-reported on 3 validated measurement instruments: Rosenberg Self-Esteem Scale, Antonovsky's Sense of Coherence Scale, and frequency of physical activity. The Hopkins Symptom Checklist-10 was used as an outcome variable of psychological distress. The associations were investigated with multiple linear and logistic regression methods. The results suggested that high self-esteem and sense of coherence were protective factors against high levels of psychological distress: self-esteem (β = −.39, P <.001) and sense of coherence (β = −.352, P <.001). The results offer support for a salutogenic approach in substance use disorder (SUD) treatment by enhancing individuals' protective factors to reduce psychological distress. [ABSTRACT FROM AUTHOR]

Objectives: To determine the effectiveness of culturally tailored education on attendance at breast and cervical cancer screening among ethnic minority women.Data Sources: Systematic database searches in Ovid MEDLINE, ProQuest, PubMed, PsycINFO, and Cochrane CENTRAL.Study Design: Randomized controlled trials (RCTs) of culturally tailored educational interventions to ethnic minority women in Western countries were investigated for a meta-analysis. RCTs that assessed attendance at mammography or the Papanicolaou test (Pap test) were eligible for inclusion.Data Collection Methods: Study characteristics and results were extracted separately. Independent raters assessed risk of bias by using Cochrane Collaboration's tool.Principal Findings: Seven RCTs (n = 4246) were included in the meta-analysis of mammography attendance, and four RCTs (n = 1750) were included in the meta-analysis of Pap test attendance. The effect of culturally tailored educational interventions on attendance at mammography was an increase of 18 percent (RR = 1.18, 95% CI, 1.09-1.28, P < .001), with low heterogeneity (I2  = 30.0, P = .237), and a 54 percent increase at the Pap test (RR = 1.54, 95% CI, 1.14-2.09, P = .005), with substantial heterogeneity (I2  = 75.9%, P = .001).Conclusions: Interpreted within the limitations set by the low number of studies and substantial heterogeneity for the Pap test, findings from the current meta-analyses indicate that culturally tailored educational interventions may increase attendance of ethnic minority women at breast and cervical cancer screenings. There is a need for more studies, in particular RCTs conducted outside the United States, to determine if such findings are similar in other countries. [ABSTRACT FROM AUTHOR]

Background Facilities providing health- and social services for youth are commonly faced with the need for assessment and management of violent behavior. These providers often experience shortage of resources, compromising the feasibility of conducting comprehensive violence risk assessments. The Violence Risk Assessment Checklist for Youth aged 12–18 (V-RISK-Y) is a 12-item violence risk screening instrument developed to rapidly identify youth at high risk for violent behavior in situations requiring expedient evaluation of violence risk. The V-RISK-Y instrument was piloted in acute psychiatric units for youth, yielding positive results of predictive validity. The aim of the present study was to assess the interrater reliability of V-RISK-Y in child and adolescent psychiatric units and acute child protective services institutions. Methods A case vignette study design was utilized to assess interrater reliability of V-RISK-Y. Staff at youth facilities (N = 163) in Norway and Sweden scored V-RISK-Y for three vignettes, and interrater reliability was assessed with the intraclass correlation coefficient (ICC). Results Results indicate good interrater reliability for the sum score and Low-Moderate-High risk level appraisal across staff from the different facilities and professions. For single items, interrater reliability ranged from poor to excellent. Conclusions This study is an important step in establishing the psychometric properties of V-RISK-Y. Findings support the structured professional judgment tradition the instrument is based on, with high agreement on the overall risk assessment. This study had a case vignette design, and the next step is to assess the reliability and validity of V-RISK-Y in naturalistic settings. [ABSTRACT FROM AUTHOR]

Objectives: Compulsory mental health care includes compulsory hospitalisation and outpatient commitment with medication treatment without consent. Uncertain evidence of the effects of compulsory care contributes to large geographical variations and a controversy on its use. Some argue that compulsion can rarely be justified and should be reduced to an absolute minimum, while others claim compulsion can more frequently be justified. The limited evidence base has contributed to variations in care that raise issues about the quality/appropriateness of care as well as ethical concerns. To address the question whether compulsory mental health care results in superior, worse or equivalent outcomes for patients, this project will utilise registry‐based longitudinal data to examine the effect of compulsory inpatient and outpatient care on multiple outcomes, including suicide and overall mortality; emergency care/injuries; crime and victimisation; and participation in the labour force and welfare dependency. Methods: By using the natural variation in health providers' preference for compulsory care as a source of quasi‐randomisation we will estimate causal effects of compulsory care on short‐ and long‐term trajectories. Conclusions: This project will provide valuable insights for service providers and policy makers in facilitating high quality clinical care pathways for a high risk population group. [ABSTRACT FROM AUTHOR]

Intimate partner homicides (IPH) are fatal violent attacks perpetrated by intimate partners. Research has indicated that substance use can co-occur in IPH. This study investigates the role of substance influence at the time of the crime and the prevalence of substance use in these cases. All IPHs in Norway from 1990–2012 (N = 177) were included. Quantitative data were extracted from court documents. Information concerning risk factors was drawn from three validated risk assessment instruments. Multivariate logistic regression analyses were conducted. For IPH committed by a substance-influenced perpetrator, there was an increased risk of the victim being substance influenced as well (OR = 11.697, CI = 4.259 – 31.631). Similarly, there was an association between perpetrators' type of influence at the time of the crime and perpetrators' substance misuse in general. Blood alcohol or other toxins were present in half of the perpetrators and 41% of the victims. Our results point to an association between IPH and substance use which needs to be established. Hence, this will have clinical and policy implications. [ABSTRACT FROM AUTHOR]