Methodological limitations in the measurement and statistical modeling of violence among adults with mental illness.

Objectives: Methodological limitations of extant research hinder the development of effective violence risk screening, assessment, and management strategies for adults with mental illness. This study quantifies the effects of three common limitations: (a) insensitive measurement of violence that results in violence classification with high levels of information bias, (b) use of cross-sectional data, and (c) use of data lacking spatiotemporal contiguity.

Methods: We utilize secondary data (N = 3,000 participants; N = 10,017 observations) and parametric and nonparametric bootstrap simulation methodologies.

Performance and clinical utility of a short violence risk screening tool in U.S. adults with mental illness.

Risk assessment instruments are typically long, costly, and resource-intensive. Thus, a short, easily administered preliminary screening tool can increase the efficiency of the subsequent violence risk assessment process. A preliminary tool can identify those at low risk of violence so that they can be screened out of the process of further violence risk assessment.

Jail-to-community treatment continuum for adults with co-occurring substance use and mental disorders: study protocol for a pilot randomized controlled trial.

Background: Adults with co-occurring mental and substance use disorders (CODs) are overrepresented in jails. In-custody barriers to treatment, including a lack of evidence-based treatment options and the often short periods of incarceration, and limited communication between jails and community-based treatment agencies that can hinder immediate enrollment into community care once released have contributed to a cycle of limited treatment engagement, unaddressed criminogenic risks, and (re)arrest among this vulnerable and high-risk population. This paper describes a study that will develop research and communication protocols and adapt two evidence-based treatments, dual-diagnosis motivational interviewing (DDMI) and integrated group therapy (IGT), for delivery to adults with CODs across a jail-to-community treatment continuum.

Reliability and Validity of START and LSI-R Assessments in Mental Health Jail Diversion Clients.

Risk assessment instruments are increasingly used in mental health jail diversion programs. This study examined the reliability and validity of Short-Term Assessment of Risk and Treatability (START) and Level of Service Inventory-Revised (LSI-R) assessments overall and by client race. Research assistants completed START and LSI-R assessments for 95 diversion clients.

Effects of sample size and distributional assumptions on competing models of the factor structure of the PANSS and BPRS.

Factor analytic work on the Positive and Negative Syndrome Scale (PANSS) and Brief Psychiatric Rating Scale (BPRS) has yielded varied and conflicting results. The current study explored potential causes of these discrepancies. Prior research has been limited by small sample sizes and an incorrect assumption that the items are normally distributed when in practice responses are highly skewed ordinal variables.

A longitudinal analysis of the overlap between violence and victimization among adults with mental illnesses.

Prior research suggests considerable overlap of violence perpetration and victimization among adults with mental illnesses. However, there has been no examination of how the likelihood of being a victim and/or perpetrator of violence may change over time, nor consideration of clinically-relevant factors affecting these transitions. In a pooled sample of adults with mental illnesses (N=3,473) we employed latent transition analysis to: (a) determine prevalence of four violence and victimization classifications (i.

The latent structure of psychiatric symptoms across mental disorders as measured with the PANSS and BPRS-18.

Raw data were used from five studies of adults with mental illnesses (N=4,480) in an attempt to identify a psychiatric symptoms factor structure, as measured by the Positive and Negative Syndrome Scale or the Brief Psychiatric Rating Scale, that was generalizable across participant characteristics. First, the fit of four extant models was tested via confirmatory factor analysis (CFA), then exploratory factor analyses (EFA) were conducted with a 50% random sample, followed by a CFA with the remaining 50% to confirm the EFA factor structure. Measurement invariance of the factor structure was also examined across diagnosis, sex, race, age, and hospitalization status.

Performance of recidivism risk assessment instruments in U.S. correctional settings.

With the population of adults under correctional supervision in the United States at an all-time high, psychologists and other professionals working in U.S. correctional agencies face mounting pressures to identify offenders at greater risk of recidivism and to guide treatment and supervision recommendations.

Proximal Risk Factors for Short-Term Community Violence Among Adults With Mental Illnesses.

Objective: This study examined the role of static indicators and proximal, clinically relevant indicators in the prediction of short-term community violence in a large, heterogeneous sample of adults with mental illnesses.

Methods: Data were pooled from five studies of adults with mental illnesses (N=4,484). Follow-up data were available for 2,579 participants.

Latent class analysis of discordance between results of drug use assessments in the CATIE data.

Objective: The primary aim is to examine concordant/discordant results of drug use assessments in adults with schizophrenia.

Methods: Latent class analysis and multinomial logistic regression were used to examine concordance/discordance between drug use measures and identify characteristics differentiating participants across classes.

Results: Four classes - non-users, users, probable users, and RIA discordant - fit best.

A typology of community violence perpetration and victimization among adults with mental illnesses.

The primary objective of this article was to evaluate the overlap between community violence perpetration and victimization in a large, heterogeneous sample of adults with mental illnesses (N = 4,474). We also explored participant characteristics differentiating four categories of perpetration and victimization: non-victim/non-perpetrators, victims only, perpetrators only, and victim-perpetrators. Results indicated that adults with mental illnesses were unlikely to report violent outcomes but, when they did, were more likely to report perpetration and victimization, rather than perpetration alone.

Community violence perpetration and victimization among adults with mental illnesses.

Objectives: In a large heterogeneous sample of adults with mental illnesses, we examined the 6-month prevalence and nature of community violence perpetration and victimization, as well as associations between these outcomes.

Methods: Baseline data were pooled from 5 studies of adults with mental illnesses from across the United States (n = 4480); the studies took place from 1992 to 2007. The MacArthur Community Violence Screening Instrument was administered to all participants.

Drug and alcohol trajectories among adults with schizophrenia: data from the CATIE study.

Objective: The primary aim is to describe drug and alcohol trajectories in adults with schizophrenia.

Method: Growth mixture models were used to examine disordered and non-disordered use and abstinence in the Clinical Antipsychotic Trials of Intervention Effectiveness study.

Results: Five classes - always abstinent; fluctuating use, abuse, and occasional abstinence; occasional (ab)use; stopped (ab)use; abusing - fit best.