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This study compared the efficacy of a novel group-based aggressive script rehearsal treatment program with an emotion regulation program. Participants were 48 incarcerated adult males (28 in the script rehearsal program and 20 in the emotion regulation program). Outcomes, including the frequency of aggressive script rehearsal, aggressive behavior, and emotion regulation difficulties, were measured pre-and post-treatment and at 46 days (on average) after treatment completion, and 104 days (on average) following treatment completion. Linear Mixed Model analyses revealed no significant difference in the frequency of script rehearsal overtime for either program. There was a significant reduction in aggressive behavior associated with the script rehearsal program and a reduction in emotion regulation difficulties for both programs. Future iterations of this aggressive script rehearsal treatment program may benefit from greater intensity and incorporation of strategies that address the many cognitive, affective, and situational factors that trigger and maintain aggressive scripts. [ABSTRACT FROM AUTHOR]

This study describes and examines the impact of a novel Reflective Practice program tailored to the multidisciplinary clinical workforce at an inpatient forensic mental health setting. Surveys assessing wellbeing, self-efficacy and reflective practice capacity were administered to all clinical staff prior to commencement of the Reflective Practice program, as well as six months post-implementation. Interviews were also conducted with key clinical stakeholders to obtain detailed feedback regarding the impact of the program across the organization following six-eight months of implementation. Staff who participated in post-implementation surveys reported significantly higher confidence in their work when compared to staff at baseline, while clinical stakeholders observed improvements in the cohesion of the multidisciplinary team. In spite of the limitations of the pragmatic study design and small sample size, results suggest the novel Reflective Practice program offers an acceptable model for adoption in an inpatient forensic mental health setting, with potential to improve the wellbeing, learning and morale of a forensic mental health workforce. The findings also highlight the need to support practice development and wellbeing in early career clinicians, where low confidence and high stress are predominant. [ABSTRACT FROM AUTHOR]

Fitness to stand trial (equivalent to competency to stand trial) requires that defendants have a basic understanding of the purpose of the trial and the trial procedures. Little is known, however, about what constitutes a basic factual understanding of the matters. This study developed a legal knowledge survey in which participants were asked to define legal concepts and respond to legal scenarios. They then rated the importance of each component of the fitness to stand trial test to achieving a fair trial. Participants (N = 393; females 69.7%) aged between 18 and 66-years (M = 31.26-years, SD = 11.48-years) from each Australian state and territory completed the online survey. Legal knowledge was high (86.5% correct) and there was no difference between participants on any clinical (e.g., current or past mental illness, neurological conditions), criminological (e.g., criminal history), or demographic variable (e.g., gender, employment, education), except age (curvilinear R2 =.12). Participants under 30-years old used significantly more Americanisms on difficult items compared with participants over 30-years old. On average, participants rated almost every component of the legal test as "extremely important" to a fair trial. The legal knowledge survey had good psychometric properties (Cronbach's α =.86, interrater reliability ĸ >.80 on most variables, single solution factor analysis). Overall, the results support the presumption underpinning the Australian test for fitness, which is that people possess a basic factual understanding of a trial and trial procedures. Further research should focus on testing knowledge in special populations (e.g., mental illness, dementia, intellectual disability). [ABSTRACT FROM AUTHOR]

Aims: This exploratory study is the first to examine previously identified variables of increased vulnerability to victimization, the prevalence of aggression in a cohort of patients with first‐episode psychosis and the potential impact of impairments in facial affect recognition (FAR) on victimization. Methods: Sixty‐nine male participants completed assessments of IQ, substance use, psychopathy, childhood trauma, aggressive behaviour and psychopathology. Participants were asked about violent victimization in the past year and charges for violent offences. FAR was assessed using the Animated Full Facial Comprehension Test. Results: The victimized group (n = 25) had significantly higher psychopathy traits (P =.042) and lower recognition of sadness (P <.01) compared to the non‐victimized group (n = 44). Participants who reported charges for violent offences (n = 15) had significantly higher scores on measures of physical abuse in childhood (P <.01), substance use (P <.05 for cannabis, P <.001 for cocaine and amphetamine use), psychopathy traits (P <.01), psychopathology (P =.031) and lifetime aggressive behaviour (P <.01). The logistic regression models using FAR sadness and Psychopathic Personality Inventory‐Revised (PPI‐R) total score as predictors for victimization (χ2 [2] = 13.81, P =.001; Nagelkerke R2 =.30) and using physical abuse in childhood, PPI‐R total score, and psychopathology as predictors for violent offences (χ2 [3] = 14.89, P =.002; Nagelkerke R2 =.36) were significant. Conclusions: These findings highlight the value of considering victimization in psychotic illness from a social information processing perspective in addition to known clinical and lifestyle factors. Based on these results, future studies could explore the use of affect recognition training early in the course of the illness as a possible intervention to reduce victimization. [ABSTRACT FROM AUTHOR]

Adolescent females who have engaged in severe and/or chronic offending are an understudied population internationally. The literature on female offending pathways has indeed advanced, and there is a better understanding of how female offending behaviours manifest and how correctional agencies should be responding. However, much of the existing research has focused on the risk factors and retrospective biographical narratives of adult female offenders. The present study focused on thematically exploring the self-reported life experiences and offending pathways of 36 detained adolescent females. Findings identified multiple themes including disconnection from education, early care-giver disruption/family separation, personal and family mental health problems, poly-substance abuse, anti-social peers, victimisation and anger problems. The study identifies that early family disruption is an important factor that may contribute to later offending behaviour and other negative life events. Prevention efforts should begin with the family when it comes to high-risk young females. [ABSTRACT FROM AUTHOR]

This study examines whether Australian psychiatrists would support requests in a psychiatric advance directive (PAD) and the reasons underlying their decisions in response to a hypothetical vignette. An online survey was completed by 143 psychiatrists. Fewer than 3 out of 10 psychiatrists supported the patient to create a PAD which requested cessation of pharmacotherapy (27%) or remaining out of hospital and not being subject to an involuntary treatment order (24%) should their depression condition deteriorate. A thematic analysis showed that patient autonomy was the strongest theme among those who supported the patient to create a PAD, whereas the clinical profile of and risk to the patient and the professional or ethical imperative of the psychiatrist were strongest among those who were unsure about supporting the patient or who did not support the patient. These findings provide a challenge about how to fulfil obligations under the United Nations Convention on the Rights of Persons with Disabilities (2006). [ABSTRACT FROM PUBLISHER]

Despite the growing population of women in Australian prisons, limited research has explored whether commonly used risk assessments – predominantly developed and tested on men – are valid for women. We investigated the discriminative and predictive validity of the Level of Service Inventory–Revised: Screening Version (LSI-R:SV), Level of Service/Risk, Need, Responsivity (LS/RNR), and the Historical, Clinical, Risk Management 20–Version 3 (HCR-20v3) for Victorian women imprisoned for serious violence (N = 79). The LS/RNR was related to any, violent, and non-violent recidivism, and both the LSI-R:SV and the H-Scale of the HCR-20v3 were related to violent recidivism, with the H-Scale demonstrating strong predictive validity for violence. Four LS/RNR needs domains demonstrated discriminative and predictive validity for any and/or violent recidivism (criminal history, family/marital, alcohol/drug problem, antisocial pattern). Findings are locally significant, showing that the LS/RNR and HCR-20v3 H-Scale are useful for the prediction and discrimination of recidivism for Australian women incarcerated for serious violence. [ABSTRACT FROM AUTHOR]

A letter to the editor and a response by R. S. Fullam, S. McKie and M. C. Dolan on a study regarding the association between neural responses during the act of deception and psychopathic traits are presented.