Social adjustment, including alcohol use, directly affects the success of college students. Due to an increased reliance on computer-delivered alcohol interventions (CDIs) a need has emerged to ...further investigate alcohol use and web-based interventions.
In-depth focus group interviews were conducted with 51 undergraduate students to elicit information from students on the shared experience of participating in a CDI.
Participants identified the influence of gender, culture, parents, and family on alcohol use behavior. A difference in personal factors, previous exposure, and experiences can affect the attitudes, behaviors, and outcomes of a CDI.
Multiple approaches geared towards a wide variety of students from different backgrounds and environments are needed to be truly successful in preventing alcohol misuse.
Background and aim
Reducing alcohol misuse by male prisoners is an important global issue. Control of drinking behaviour could be a useful target for intervention in this population, and locus of ...control could be a causal factor in this. We aimed to assess the effect of a clinical psychologist‐facilitated group intervention on male prisoners’ locus of control of drinking behaviour.
Design
A two‐arm, single‐site, open, randomized controlled trial.
Setting
A category B local training prison in South Wales, housing about 770 mainly sentenced men.
Participants
Prisoners serving less than 2 years who met inclusion criteria for pre‐imprisonment alcohol misuse, alone or with drug misuse. A total of 119 were allocated to the intervention arm and 119 to the control arm; 104 and 87, respectively, completed the post‐randomization baseline interview and 68 and 60 completed a second interview approximately 4 weeks later, respectively, after intervention or treatment as usual (TAU) alone.
Intervention
Nine clinical psychologist‐facilitated groups in the prison over 3 weeks. Range of participants per session was one to seven, with three to five most usual.
Measures
The primary outcome was locus of control of behaviour (LCB); secondary outcomes included mental state generally (comprehensive psychiatric rating scale/CPRS) and specifically (Beck Depression Inventory/BDI). An integral process evaluation was conducted.
Findings
LCB scores decreased during the study, but without significant intervention effect −1.7, 95% confidence interval (CI) = –5.1 to 1.6, P = 0.329. Change among completers in the control group was from a mean score of 37.4 standard deviation (SD) = 10.0 to 33.7SD = 11.7 and in the intervention group from 37.4 (SD = 11.6) to 31.9 (SD = 11.8). Secondary outcomes, including change in mental state, did not differ between arms, but 686 (64%) sessions were lost, most because of ‘prison issues’.
Conclusions
A clinical psychologist‐facilitated group intervention did not have a statistically significant effect on sense of control of drinking behaviour among men with pre‐imprisonment alcohol misuse serving less than 2 years in a South Wales prison. The study proved coterminous, however, with 40% prison staff cuts which seem likely to have contributed to the high loss of group sessions and possibly overwhelmed any treatment effect. Intervention completion failures, previously cited as harmful, had no effect here, so the trial should be repeated when the prison climate improves.
Abstract A small but significant relationship between schizophrenia and violence is well established, but not yet fully explained. Research has highlighted anger as an important factor in ...precipitating actual violence in general and psychiatric populations. However, anger has not been extensively studied as a risk factor for violence in people with schizophrenia and related psychoses. We evaluated published evidence on the relationship between anger and violence in patients with schizophrenia and related psychoses by means of a systematic review of the literature. A search of main online databases from inception till January 2012 was performed and supplemented with correspondence with authors and data available online. 11 studies which measured angry affect in patients with schizophrenia who had been violent were included in the review. 5 studies with a total of 510 individuals had anger data that were suitable to be pooled in a meta-analysis in form of standardised mean difference values comparing the anger scores of the non-violent groups with violent groups. All the studies included showed significantly higher scores for anger in the violent group compared with the non-violent group with the pooled result expressed as standardised mean difference of 0.74 95% CI (0.53, 0.94) and the Z value for overall effect = 7.01. The studies not included in the meta-analysis which looked at 610 individuals, were analysed descriptively and all of them reported higher scores for anger for individuals with schizophrenia who acted violently. There is a consistency of significant association between angry affect and violent behaviour in the context of psychotic illness across various study designs, settings and populations. Theoretical support already exists for this relationship and this review lends further support to explore this relationship further.
Background
Safe alternatives to custody for offenders with mental disorder are vital, not least as self‐harm, and violence rates are rising among them in prisons. In England and Wales, the Criminal ...Justice Act 2003 allows a mental health treatment requirement (MHTR) to supplement a community or suspended prison sentence, but this combination is poorly understood and rarely sought.
Aim
To explore offenders' perspectives on the MHTR.
Methods
We interviewed all 25 consenting offenders under an MHTR in two probation areas. Verbatim transcripts of their audio‐taped narratives were analysed using grounded theory methods.
Results
Their core concern was “instability,” characterised by many health and social difficulties and resolved by achieving stability, which included not reoffending as well as becoming healthy, substance free, and “having a life.” Most considered that the MHTR helped their motivation and service provision, but some cited poor supervisor accessibility, supervisor role confusion, and sense of stigma under the order as stressful and threatening good outcomes.
Conclusions
This first account of offenders' perspectives on the MHTR suggests a model in which, under it, offenders see themselves making progress as courts require. They understand the risk of return to court and imprisonment if in breach. This model of understanding how MHTRs work could provide for professional guidance and evaluation of their effectiveness.
Up to half of the approximately 10,000 people resident in a UK secure hospital are parents. There are well-established child safeguarding policies, but no model for social work support of parenting. ...Our study aimed to investigate social workers' experience of secure hospital patients as parents and develop a testable model of good practice. Each social worker in one medium security hospital unit was invited to an individual semi-structured interview about his/her perspectives on patients parenting from the unit. Six social workers participated; all had experience there of patients with and without children. A core concern of 'artificiality' best encompassed the emergent themes covering the nature of the setting, poor mental health with sometimes delusional family life, difficult family dynamics, weakened parenting skills and patient-parent wish for communication inhibited by a sense of stigma. Resolution towards 'naturalness', with improved mental health, communication skills, family dynamics, and reducing confinement was partially achieved during the inpatient stay, much of the change actively facilitated by clinical interventions. While child safeguarding during a parent's secure hospital stay is vital, longer-term psychosocial repair of relationships seems feasible. An actively restorative model envisaged by these social workers offers a testable progression towards responsible parenting.
Abstract Purpose Almost everything known about risk factors for homelessness is based on cross-sectional studies of non-random samples. Furthermore, most studies have focused on a small number of ...risk factors and have not evaluated their relative importance. Our aim was to examine which factors, in a population-based sample of adolescents, independently predict homelessness in young adults. Methods Participants (n = 10,433) in the US National Longitudinal Study of Adolescent Health (Add Health) were initially selected through systematic random sampling of US high schools. Interviews were conducted at home in 1994–1995 when the participants were 11–18 years of age and again in 2001 when participants were 18–28 years of age. We examined the relationships between a range of risk factors reported in adolescence (mood-related problems, substance involvement, delinquency, personality, quality of family relations, neighborhood quality, school adjustment, religious affiliation, perpetration of violence, and experiences of victimization) and experiences of homelessness reported in young adulthood, using regression analysis. Results Each risk factor predicted homelessness. However, only family relationship quality (odds ratio OR = .79, 95% confidence interval CI = .69–.90), school adjustment problems (OR = 1.57, 95% CI = 1.35–1.82), and experiences of victimization (OR = 1.27, 95% CI = 1.11–1.45) were found to independently predict homelessness. Conclusions Among a range of well-established risk factors, a troubled family background, school adjustment problems and experiences of victimization were found to be the strongest predictors of homelessness in a general population of young people. Our findings suggest possibilities for the early identification of young persons at risk for homelessness through schools, agencies offering family-based support, and clinical services.
To disentangle the alcohol-related needs of short stay, revolving door, male prisoners, and offer a theoretically driven but practical approach for allocation of scarce service resources.
A ...prospective longitudinal interview, questionnaire and records study of pre-trial men newly imprisoned in Wales and SW England.
Two hundred and forty-one pre-trial men completed an interview and questionnaires within a week of a new reception into prison; 170 completed follow-up 3 weeks later. Questions about problems with alcohol or illicit drugs revealed that problem drinkers were less likely than problem drug users to recognize their difficulty or seek or get help for this during their first month of imprisonment. Co-morbidity was common, but a third of the men had alcohol problems alone. Use of the Alcohol Use Disorders Identification Test (AUDIT) questionnaire identified 80% (195/241) men likely to require some intervention, twice the number identified by direct questions relying on prisoners' judgment about problem use. Furthermore it allowed categorization according to likely risk (dependency), need (problem recognition) and responsivity (wish for help).
Alcohol misuse is recognized, worldwide, as fuelling crime and more common among prisoners than the general population. In England and Wales, it is a particular factor in brief but recurrent periods of imprisonment. There have been calls to pay more attention to its use in this context, albeit without any increase in resources. Adding two questions to standard screening enables application of the risk-need-responsivity model to problem drinkers and may identify those most likely to benefit from treatment.
Abstract Background A small but significant association between schizophrenia and violence is open to a number of explanations. Impaired empathy has been associated with schizophrenia, and with ...violence in the general population. Our aim was to conduct a systematic review of any research into relationships between schizophrenia, empathy and violence. Methods The electronic databases Medline, Psychinfo, Embase, Cochrane and DARE were searched using combinations of terms for schizophrenia, empathy and violence, as were selected journals and reference lists of relevant articles. Selection of studies and data extraction was done by each of us, blind to the other. Results Six studies were identified, but sample selection, research procedures and empathy, illness and violence measures differed sufficiently between them that only descriptive analysis was possible. Apart from one single case study, sample sizes were between 24 (12 violent) and 116 (35 violent). A component of emotional empathy (emotion recognition) was measured in three of the studies, all of which showed some specific dysfunctional recognition related to violence. Cognitive empathy was measured in three studies, two linking impairments to violence and one not. Emotional responsiveness was measured in one study and no association with violence was found. Conclusion Although evidence is inconclusive on empathy impairment as a mediator of violence by people with chronic psychosis, it's likely relevance is most apparent in the better controlled studies. Larger scale studies are indicated with rigorous control for comorbidities.
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