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To improve patient care/outcome, an evaluation was conducted of nursing procedures and protocols for pro re nata (PRN) medications.A 14-day chart review was conducted for 27 patients with mood and thought disorders (MTD) and for 24 patients with organic disorders (OD) at a geriatric psychiatric hospital, and a questionnaire was completed by 20 nurses.377 PRNs were administered to patients in the MTD and OD units (240 and 137, respectively). The majority of PRNs were administered during the evening shifts on the MTD unit and during the day shifts on the OD unit. Chart notes indicated the behavior requiring PRN administration was not always specifically described and therapeutic interventions were not often attempted before PRN administration. Inconsistency between chart notes and medication record books was noted in the majority of cases. It was often not known whether the PRN was initiated by the staff, patient, or family. PRNs were reported to be not effective in the majority of cases.Documentation was suboptimal and effectiveness was poor.It would be worthwhile to train all staff in a patient-centered or ecopsychosocial (i.e., non-pharmacological) model of care, which would provide staff alternatives to PRNs. In that context, it would be important to implement standards of practice into geriatric psychiatry inpatient settings for PRN administration and documentation.

The purpose of the study was to evaluate relapse prevention skill acquisition within the context of a comprehensive treatment program involving group psychotherapy, relapse prevention programming, and other essential psychoeducational components. The Sex Offender Situational Competency Test (SOSCT) was administered pretreatment and posttreatment to 139 convicted adult sex offenders in intensive inpatient treatment for 5.7 to 22.9 months. The SOSCT measures the ability to recognize high-risk situations and the effectiveness of the coping skills generated. Participants were presented with differing scenarios depending on their sex-offender subtype (75 heterosexual child molesters, 23 homosexual child molesters, and 36 rapists of women). Posttreatment scores on the SOSCT improved significantly (p .357) nor the interaction between treatment time and group (p > .097) obtained statistical significance. It is very unlikely that the SOSCT improvements obtain...

Executive functions in 100 incarcerated adolescent female offenders were examined using the Cognitive Assessment System (CAS). As hypothesized, mean scores for the sample were significantly lower than norms on measures of Planning and Successive Processing. Contrary to our hypothesis, the Attention mean did not differ significantly from the normative data. The Simultaneous mean was also significantly lower than norms although no hypothesis had been made and only a small effect size was noted. These findings suggest that incarcerated delinquent females can be differentiated from non-delinquent females on the basis of specific neuropsychological deficits in much the same way that male delinquents can be differentiated from non-delinquent males.

This report is primarily concerned with reporting on the normative results obtained on a large sample of serious adult offenders. An expanded Halstead-Reitan Neuropsychological Test Battery was administered to 584 adult offenders (OF), 132 normal controls (NC), and 494 acute psychiatric patients (PP). Subjects were between 18 and 44 years of age. Descriptive statistics for all neuropsychological measures are reported. Impairment analyses indicate substantial neuropsychological impairment in the OF and PP groups, especially on measures of executive function and verbal capacities. The neuropsychology of the prefrontal cortex and of Attentional Deficit Hyperactivity Disorder and Conduct Disorder is reviewed. This review, in the context of the present findings, supports a working hypothesis that the executive deficits and behavioral disinhibition of offenders represent heterotypic continuities of brain dysfunction among some children with disruptive behavior disorders. Implications for research, the ...

Inpatient assault of forensic and psychiatric staff is a complex and multifaceted issue. Hence, the consequences reported in the literature regarding prosecuting assaultive inpatients are quite variable. In this article, issues pertaining to the prosecution of violent inpatients are reviewed. Illustrative cases, challenges of prosecution, potential policies, therapeutic jurisprudence, pocket probation, and mental health courts are discussed.

Following 11–98 weeks of inpatient residential treatment, 69 male adolescent sex offenders completed the 60-item, 12-factor Yalom Card Sort. The rank orders were compared to adult sex offenders and a psychiatric adult outpatient group. Relative to adult psychiatric outpatients, the adolescent sex offenders had rated Instillation of Hope three ranks higher; Family Reenactment, four ranks higher; and Interpersonal Learning (input), eight ranks lower. In comparison to adult sex offenders, both Instillation of Hope and Universality were rated three ranks higher, and Interpersonal Learning (input) was rated four ranks lower. Rankings were correlated with age and treatment length. As age increased, the ranking of Family Reenactment decreased and as treatment length increased so did the importance of Group Cohesiveness. Implications for adolescent sex offender treatment are discussed.

The durability of the psychosocial benefits of Life Skills programming on outpatient adults with mental health/forensic issues was examined. Participants were 52 adults (28 males, 24 females) who completed 16 weeks of Life Skills at a psychiatric outpatient clinic and were re-assessed between six months and six years following treatment. Psychosocial adjustment was assessed using the three scales of the Holden Psychological Screening Inventory (HPSI). Two groups of participants were compared, based on time since completion of treatment. There were no significant differences between time-based groups on the HPSI, but there was a significant gender effect for psychiatric symptoms, with females scoring higher on this scale than males (p = .028). When current HPSI scores were compared to HPSI scores that were assessed upon completion of Life Skills in a recent pre-post study on the same clientele (Reddon, Hoglin, & Woodman, 2008), analyses produced no statistically significant differences between fol...

A total of 206 (105 men, 101 women) adult psychiatric patients participated in life skills programming 5 half days per week for 16 weeks. Psychosocial adjustment was assessed pre- and post-treatment with the three primary scales of the Holden Psychological Screening Inventory (HPSI). A multivariate pre- versus post-treatment analysis resulted in a nonsignificant effect for the covariate age (p= .136) but significant effects for time (p

Executive functions in 111 adolescent male offenders were examined using the Cognitive Assessment System (CAS). As hypothesized, mean scores for the sample were significantly lower than norms on CAS measures of Planning, Attention, and Successive Processing, and deficits remained for individuals with a childhood-onset when the sample was divided by age-of-onset for antisocial behaviors. Contrary to our hypothesis, mean scores for individuals with adolescent-onset antisocial behaviors were significantly below norms for Planning and Successive Processing. The study provides a direct rather than putative assessment of executive functions and identifies specific executive function deficits regardless of age-of-onset of antisocial behaviors. Implications for practice and limitations of the study are reviewed.

Thirteen probation officers were interviewed to obtain their opinions about the nature of remorse. Six hundred sixty-eight features were identified and reduced to 50 key concepts. A 50-item construct rating form was then administered to 79 probation officers to obtain their opinions about remorse. A refined 42-item Remorse Construct Rating Form (RCRF) was administered in the final study along with the Jackson Personality Inventory-Revised (JPI-R) to 363 college students. The 42 items of the RCRF loaded on 2 factors representing Internal and External aspects of remorse. Gender was independent of the ratings given to the internal factor but females tended to rate the external factor less strongly than males. In terms of personality correlates, empathy was positively related to the internal factor but negatively related to the external factor. A number of other personality dispositions were congruently related to the 2 remorse dimensions. Both remorse factors are discussed with respect to assessment...

A sample of 84 male young offenders, admitted for inpatient treatment in a psychiatric hospital, was used to examine the relationship between leisure motivation, leisure satisfaction, and perceived freedom in leisure using the Leisure Motivation Scale (LMS), the Leisure Satisfaction Scale (LSS), and the Perceived Freedom in Leisure Scale-Short Form Version A (PFS), respectively. All 3 inventories were completed as part of the pre-treatment assessment on the third week following admission. Age was not significantly correlated with any of the measures. All but 2 of the correlations between the 4 LMS scales and the 6 LSS scales were statistically significant and all 24 correlations were positive. Significant negative correlations were obtained between the PFS total score and all LMS and LSS scales. Three factors emerged from a principal components analysis, and the varimax rotated factors were labeled freedom-to engage, freedom-from constraints, and freedom-physical. Implications for therapeutic int...

Forty-seven psychiatric inpatients in a Canadian psychiatric hospital participated in an evaluation of the stability and validity of the Holden Psychological Screening Inventory (HPSI). Stability coefficients over a 1-month period were .85, .79, and .66 for the HPSI Psychiatric, Social, and Depression Symptomatology scales, respectively, and coefficient alpha reliabilities for these scales ranged between .76 and .89 across both time periods. Staff rating composite scales corresponding to the self-report HPSI scales had stability coefficients of .74, .85, and .82, respectively. As well, they had inter-rater reliabilities that ranged between .65 and .84 across both time periods. The 3 staff rating composites at time 1 correlated equivalently with the corresponding 3 primary HPSI scales at times 1 and 2 (p > .05). Similarly, the 3 staff rating composites at time 2 correlated equivalently with the corresponding 3 primary HPSI scales at times 1 and 2 (p > .05). Over a 1-month period, HPSI scale scores...

Lehman's Brief Quality of Life Interview (QOLI) was administered to psychiatric rehabilitation program clients 6 times at 6-month intervals. Participants were individuals with predominantly psychotic-type diagnoses. Results showed no change over time and few gender differences. No change over time indicates no improvement but also no deterioration in this chronic population. Correlations between test times indicated that the subjective scales were relatively stable in comparison to the objective scales. Results indicate that the QOLI has poor sensitivity, and therefore limited utility, for assessing change in psychiatric rehabilitation of individuals with severe and persistent mental disorders. However, the QOLI does have an important use: It provides a good indication of the clients' perspectives on the quality of their lives and services received.

The effectiveness of an anger management program in a mixed security (minimum and medium security) institution was evaluated using a sample of 33 female inmates (19 treatment and 14 control). A significant within-participant effect revealed statistically significant decreases in anger and aggression variables as measured by the Novaco Anger Scale and the Aggression Questionnaire, respectively. As well, significant reductions in the number of institutional charges at post-test were obtained for the treatment group but not the control group. Inmate surveys also indicated moderate levels of program impact and satisfaction. Although the present findings support the effectiveness of the current program, the magnitude of the results is conservative in comparison to those currently reported in the literature. Implications and recommendations for future anger treatment research are discussed.

The records of 1,185 female and 5,114 male forensic psychiatry outpatients, within the age range of 15-44 years, were used to evaluate absenteeism from treatment in relation to age and gender. Age was divided into the 3 age groups 15-24, 25-34, and 35-44. Females had a significantly higher absentee rate than males in all age groups (p < .05). This gender difference is likely due to varying social roles as well as differential perceptions of treatment relevance. For both males and females, missed appointments declined significantly with age (p < .05). This age effect likely results from the decline in risk-taking and impulsivity with age. Because the efficacy of any treatment lies in a client's continued participation, it is important to address program attendance barriers and commitment to treatment issues. Commitment to treatment can be increased by active follow-up on non-attendance and by providing a positive therapy experience.

One hundred and six adolescent offenders completed the High Risk Situations Questionnaire for Young Offenders (HRSQ-YO), an instrument designed to assess the self-reported importance of various antecedents to a past, highly salient offense. Principal components analysis of responses to the 66 HRSQ-YO items resulted in three factors which were rotated to a varimax criterion and labelled Delinquency, Negative Affectivity, and Aggression. Consistent with previous findings, Delinquency factor scores were significantly higher for property offenses than for violent offenses, whereas Aggression factor scores were significantly higher for violent offenses than for property offenses. Negative Affectivity scores also tended to be higher for violent offenses than for property offenses. Implications of the results for the rehabilitation of adolescent offenders are discussed.

The Personality Research Form-E (PRF-E; 20 need structure scales), the Holden Psychological Screening Inventory (HPSI; 3 psychosocial adjustment scales), and the Leisure Motivation Scale (LMS; 4 leisure motivation scales) were administered to 60 young offenders and 50 high school students. Significant between sample differences in means resulted for the HPSI Psychiatric, Social, and Depression Symptomatology scales; the PRF-E Affiliation, Aggression, Autonomy, and Harm Avoidance content scales; and the LMS Social scale. Statistically significant correlations resulted between the LMS and 19 of the 20 PRF-E content scales as well as the HPSI Depression and Social Symptomatology scales. It is concluded that young offenders, as compared to high school students, are significantly less well adjusted and have different leisure motivations and personality needs. It is likely that need structure impacts directly on psychosocial adjustment as well as indirectly through leisure motivation.

Forty-four psychogeriatric patients, participating in a daily walking program, were rated pre-and post-treatment using scales which measured walking status, coordination of legs, posture, and gait pattern. Statistically significant (p< .05) improvements with substantial effect sizes (approximately .5) were obtained in all areas except gait pattern. Secondary benefits of increased mobility included improved self-efficacy, made it easier for the nursing staff to provide care, and improved discharge placement options. This evaluation lends credence to the incorporation of a daily walking program as an integral component of psychogeriatric patient care.

The effect of low intensity laser therapy (LILT) biosti-mulation on wound healing in a largely psychogeriatric population was assessed over a period of 6 years (1991-1996). In total, 84 psychiatric...

Standard meta-analysis (Hunter & Schmidt, 1990a) assumes unidirectional (i.e., all positive or all negative) predictor-criterion relations. We challenge this assumption in the context of personality-job performance linkages based on several lines of evi- dence supporting the coexistence of true positive and true negative correlations in- volving the same trait. Subjecting such bidirectional relations to standard meta-analysis will underestimate effect sizes to an unknown degree owing to cancel- lation of positive and negative values. A modification of standard procedures is pro- posed that accounts for the possibility of bidirectionality. It employs successive itera- tion of an initial estimate of the absolute correlation, accounting for sample sizes and the sampling distribution of the correlation.

In a 5 year cohort of successive discharges from the Phoenix Program, an eclectic sex offender treatment program at Alberta Hospital, Edmonton, there were 120 successful completers and 100 noncompleters. Sexual and nonsexual offense recidivism with an average follow-up time of 38.8 months was used to evaluate treatment efficacy. The recidivism rates differed significantly between groups and were 3.3% and 10.0% for sexual offenses, and 12.5% and 27.0% for nonsexual offenses, respectively, for completers and noncompleters. The results suggest that comprehensive treatment of sexual offenders can substantially reduce sexual as well as nonsexual offense recidivism rates.

Sixty-nine nonclinical couples completed the Waring Intimacy Questionnaire and Profile of Mood States in order to assess the empirical generality of the theory of family psychopathology. Of 48 possible correlations for husbands and wives, between the eight intimacy content scales and six mood scales, only three for husbands were in the nonhypothesized direction but were not significant. For husbands all mood scales and only six intimacy scales, and for wives all mood scales and only seven intimacy scales were responsible for these relationships. The first canonical correlation between moods and intimacy was .66 for husbands and .69 for wives, each equivalent to the canonical partial correlations with desirability controlled for. Intimacy accounted for 17 percent of the variance in moods for husbands and 28 percent for wives, but moods accounted for a substantially smaller amount of intimacy variance in both groups. The results were interpreted as providing empirical support for the theory of fami...

Three personality tests, the Basic Personality Inventory (BPI), the Jackson Personality Inventory (JPI), and the Personality Research Form-E (PRF-E) were evaluated for readability using a number of indices. Sentence length, word length, sentence type, and four readability formulas indicated that the readability of the BPI, JPI, and PRF-E would not impede the administration or interpretation of these tests in broad segments of the population.