Search

Author(s): F. A. J. Fluttert [sup.1] [sup.2] [sup.3] [sup.4] , Stål Bjørkly [sup.1] [sup.2] , Karl Yngvar Dale [sup.1] Author Affiliations: (1) grid.411834.b, 0000 0004 0434 9525, Molde University College, [...], By means of a nurse-driven risk management strategy, a community mental health nursing team was assisted in their struggles to cope in the care of a very aggressive and disturbed patient. The aim of this study was to discuss how a wrong diagnosis lead to relational consequences in care and how applying the Early Recognition Method (ERM) contributed to a relational change. Self psychology concepts were used to analyze and understand the underlying psychological process in the interaction between the nurses and patient. This case narrative illustrates qualitative research strategies through the lens of the theoretical framework of symbolic interactionism. Nurses gained a better understanding of the complexity of the patient and the nature and effects of their interactions with her. The patient's diagnosis was adjusted, resulting in perspectives that allowed for meaningful interactions and stabilization of aggressive behaviors. The most prominent result was the nurses becoming more confident and competent in their management of the care process. Nurses in community mental health care benefit from structured risk management strategies in unraveling the complexity of severe aggression. Self psychology is a meaningful lens by which to better understand the underlying psychological process in the interaction between nurses and a complex patient.

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]

Author(s): Elisabeth Christie Ørke [sup.1] , Solveig Karin Bø Vatnar [sup.1] [sup.2] , Stål Bjørkly [sup.1] [sup.3] Author Affiliations: (Aff1) 0000 0004 0389 8485, grid.55325.34, Centre for Research and Education [...], Are victims of intimate partner violence (IPV) by multiple partners (MP) different from victims of IPV by one partner? Are there different victim-related risk factors for IPV by MP? This systematic literature review identified seven empirical studies that related to these issues. The review findings indicated that (1) empirical research on IPV by MP appears to be scarce, with only limited recent development; (2) there were significant differences between women who had been subjected to IPV in a single relationship and women with IPV by MP; (3) IPV by MP was significantly associated with childhood domestic trauma, drug abuse, IPV characteristics, and attachment style; (4) regarding PTSD and personality disorders, the results were mixed and inconclusive; and (5) depression did not appear as a salient risk factor for IPV by MP. Interpretations must be made cautiously because of the wide diversity in measurement approaches. It is important that service personnel and researchers attend with increased awareness to women with IPV by MP.

The reason for this study was the void of validated risk assessment screening tools for violence in adolescence psychiatry. Our aims were to test the predictive validity and feasibility of a pilot version of the Violence Risk Screening for Youth (V-RISK-Y). The V-RISK-Y was based on a violence risk screen for adults, the V-RISK-10, and adapted to adolescents, resulting in 12 risk items that are scored for (a) presence and (b) relevance for future violence. In this naturalistic, prospective observational study, the V-RISK-Y was scored at admission and compared with recorded episodes of violent acts and threats during hospital stay. The target population was all 92 patients admitted to the emergency department of adolescent psychiatry at Oslo University Hospital for 1 year, of which 67 patients were scored with the V-RISK-Y at admission and constituted the study sample. The predictive validity of the V-RISK-Y for violent behavior showed an AUC of 0.762 (p = 0.006). Staff approved the screener and found it to be equally or better usable than the V-RISK-10, which was previously used in the department. Still, a high proportion of raters failed to follow the scoring instructions of relevance scores, reducing feasibility. The results must be interpreted within the limits of a pilot study and low power. We conclude that results suggest changes of certain parts of the V-RISK-Y and provide a basis for testing a revised edition of the screener in a more comprehensive study, preferably with a multicenter design. [ABSTRACT FROM AUTHOR]

Background: Forensic evaluations of legal insanity include the experts' assessment of symptoms present at the mental state examination (MSE) and the mental state at the time of offense (MSO). Delusions and hallucinations are most important. We explored how often symptoms were recorded in written forensic reports. Design: This exploratory, cross-sectional study included 500 reports of legal insanity written in 2009–2018 from cases of violent crimes in Norway. The first author read all reports and coded symptoms recorded from the experts' assessments of the offenders. Two co-authors repeated this procedure for 50 randomly selected reports. Interrater reliability was calculated with Gwet's AC1. Generalized Linear Mixed Models with Wald tests for fixed effects and Risk Ratios as effect sizes were used for the statistical analyses. Results: Legal insanity was the main conclusion in 23.6% of the reports; 71.2% of these were diagnosed with schizophrenia while 22.9% had other psychotic disorders. Experts recorded few symptoms from MSO, but more from MSE, although MSO is important for insanity. We found a significant association between delusions and hallucinations recorded present in the MSO and legal insanity for defendants with other psychotic disorders, but no association for defendants with schizophrenia. The differences in symptom recordings between diagnoses were significant. Conclusion: Few symptoms were recorded from the MSO. We found no association between presence of delusions or hallucinations and legal insanity for defendants with schizophrenia. This may indicate that a schizophrenia diagnosis is more important to the forensic conclusion than the symptoms recorded in the MSO. [ABSTRACT FROM AUTHOR]

Purpose: To adapt the Scale for the Evaluation of Staff Patient Interactions in Progress Notes to Spanish and to test the psychometric properties. Design and methods: The study was conducted in two phases: (1) Adaptation of the instrument to Spanish following the Standards for Educational and Psychological Testing. (2) Psychometric study in a sample of mental health nurses. Findings: The Cronbach's alpha values were 0.97 for the total scale and 0.83 to 0.81 for each dimension. The inter-rater reliability values were between 0.94 and 0.97. Practice implications: The scale is a reliable tool for assessing nurses' clinical notes in relation to the quality of nurse-patient interactions. [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]

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]

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]

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]

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]

Purpose: We aimed to use the self-efficacy model to examine the participants' experience, attitudes, and viewpoints regarding the association between work, health and lifestyle factors that influence work participation after completing a new one-year multidisciplinary vocational rehabilitation (VR) programme with a lifestyle intervention for people on or at risk of sick leave due to obesity or obesity-related problems. Materials and Methods: This case study was based on focus group (FG) interviews with 11 previous participants. The interviews were conducted 2 to 4 years after they completed the program, between August and September 2019. The analysis followed Braun and Clarke's six-phase reflexive thematic analysis (RTA) approach. Results: The main theme "Work participation enhances quality of life" was prominent and related to mastery experience. Four sub-themes directly and indirectly affect work participation. The first sub-theme is "My attitude to life", influenced by mastery experiences. Next, "Body size matters", related to physiological and affective states. "Good physical capacity profit in everyday life" is associated to physiological and affective states, and the last "Support from the surroundings" influenced by vicarious experience and Verbal Persuasion. Conclusion: This study's main finding highlights how participants value work participation as a meaningful activity that positively influences their work self-efficacy. Future VR programs should pay attention to interventions focusing on the workplace, cognitive approaches to develop skills for coping strategies, lifestyle change purposing BMI reduction, physical activity, and support from the surroundings. Clinical Trials: Technical information about the study on Clinical Trials NCT03286374. [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]