Search

The Brief Psychiatric Rating Scale (BPRS) was originally conceived to assess psychopathology in several psychiatric disorders, making it an appropriate candidate to be used as a transdiagnostic instrument. We analyzed the utility and validity of the BPRS in a diagnostically heterogeneous sample of 600 psychiatric inpatients. As a comparator, we chose the mini-ICF-APP, a scale used to measure functioning and impairment across the diagnostic spectrum. Both scales had good internal consistency. The BPRS and the mini-ICF-APP showed a moderate correlation, with good levels of agreement. We were able to identify general symptoms present across the diagnostic spectrum, influencing severity and a cluster of symptoms specific for each diagnosis. Our results show the utility and validity of the BPRS as a transdiagnostic assessment tool that could easily be introduced in routine clinical work.

Protecting the human rights is particularly important within the forensic context because patients in forensic psychiatry are not admitted voluntarily and so the treatment itself is of a coercive nature. Coercive measures (i.e., actions against the will of the patient such as forced medication, seclusion or restraint) form an additional incision of personal rights. Although the use of coercion within forensic psychiatric institutions remains controversial, little empirical research has been conducted on the use of coercive measures within forensic settings. The study presented here can contribute to close this research gap by informing about rates of coercive measures within the present institution. National and international organizations on the prevention of torture or inhuman or degrading treatment have emphasized the need to keep the incidents of coercive measures to a minimum. Criticisms by such organizations on high rates of seclusion, restraint, and compulsory medication have led to organizational changes within the present institution which is Switzerland’s largest forensic clinic with an average of 124 patients per year. After a first visit of such a committee, e.g., the detailed documentation of coercive measures became obligatory and part of special reports. Changes in the use of coercive measures are presented here. Data on coercive measures was analyzed for years 2010 to 2018. With respect to the most invasive coercive measurement, restraint, a minimum of four patients in 2017 and a maximum of 14 patients in 2010 have been subject to this form of coercive measurement. A minimum of sixteen patients in 2012 and a maximum of 40 patients in 2010 were secluded. Though total number and duration show a trend towards a reduction in severity of coercive measures on average, a few patients are not responsive to deescalating interventions. Preventive mechanisms, documentation standards, and efforts to ensure humane and adequate treatment are discussed under ethical considerations of coercive measures within court mandated treatment.

We tested developmental trends in eyewitness identification in biased and unbiased lineups. Our main interest was adolescent's lineup performance compared with children and adults. 7-10-year-olds, 11-13-year-olds, 14-16-year-olds, and adults (N = 431) watched a wallet-theft-video and subsequently identified the thief, victim, and witness from simultaneous target-present and target-absent six-person photo lineups. The thief-absent lineup included a bystander previously seen in thief proximity. Research on unconscious transference suggested a selection bias toward the bystander in adults and 11-13-year-olds, but not in younger children. Confirming our hypothesis, adolescents were more prone to bystander bias than all other age groups. This may be due to adolescents making more inferential errors than children, as predicted by fuzzy-trace theory and associative-activation theory, combined with lower inhibition control in adolescents compared with adults. We also replicated a clothing bias for all age groups and age-related performance differences in our unbiased lineups. Consistent with previous findings, participants were generally overconfident in their decisions, even though confidence was a better predictor of accuracy in older compared with younger participants. With this study, we show that adolescents have an increased tendency to misidentify an innocent bystander. Continued efforts are needed to disentangle how adolescents in comparison to other age groups perform in forensically relevant situations.