The validity and clinical utility of structured diagnoses of antisocial personality disorder with forensic patients.

Current DSM-based instruments for personality disorders (PDs) limit the investigation of the course and outcome of treatment of these disorders. This study examined the validity of the Shedler-Westen Assessment Procedure-200 (SWAP-200) and the Structured Clinical Interview for DSM-IV Axis II PD (SCID-II) in a sample of forensic PD patients. Results based on 66 participants indicated that the SWAP-200 Q-factors reduced the frequency of diagnostic comorbidity of PD categories by half compared with the SCID-II.

The Index Offence Representation Scales; a predictive clinical tool in the management of dangerous, violent patients with personality disorder?

Background: Forensic mental health professionals attach considerable importance to their patient's description of his or her index offence. Despite this, there is no systematic approach to examining and formulating the patient's offence narrative.

Aim: To use the index offence narratives and capacity to mentalize of violent offender-patients with personality disorder to develop a tool to predict their progress and to evaluate that tool.

Factors that predict infant disorganization in mothers classified as U in pregnancy.

The unresolved (U) state of mind in parents has been validated by its association with infant attachment disorganization (D), yet all studies show a transmission gap, and a proportion of individuals classified as U have infants who are not D. This paper reports on 31 mothers who showed the characteristic lapses in thinking and reasoning of the unresolved/disorganized state of mind in relation to stillbirth (U(sb)), when assessed with the Adult Attachment Interview (AAI) in the pregnancy after stillbirth. Seventeen (55%) of their infants were D at 1 year old.

Using the SWAP-200 in a personality-disordered forensic population: is it valid, reliable and useful?

Background: Treatment and risk management of forensic patients relies heavily on diagnosing psychopathology, yet the reliability of clinical diagnoses of personality disorder has been found to be only fair to low. Structured instruments for the global assessment of personality disorder are infrequently used in clinical assessments possibly due to their limited validity and clinical utility.

Aims/methods: The Shedler-Westen Assessment Procedure-200 (SWAP-200) was developed in an effort to address these limitations.

Doctor-patient relationships in chronic illness: insights from forensic psychiatry.

Collaborative management of chronic illness is undermined by neglect of emotional and psychological factors in both the patient and doctor

Factors associated with the unresolved classification of the Adult Attachment Interview in women who have suffered stillbirth.

The "unresolved" state of mind with respect to loss or trauma as assessed in the Adult Attachment Interview is common in clinical and forensic groups, as well as in mothers whose infants are classified as disorganized in their attachment relationship to them. However, questions remain about what the unresolved state represents and what factors predict the unresolved state. This case controlled study reports on 64 women who had suffered stillbirth and who were pregnant with their next child.

The adult attachment interview: rating and classification problems posed by non-normative samples.

Non-normative samples can pose major procedural and coding challenges to interviewers and raters of the Adult Attachment Interview (AAI). With reference to interview transcripts drawn from a population of personality disordered offenders detained in a high-security hospital, specific difficulties are identified and discussed. These difficulties have their roots in three separate but overlapping areas: extreme attachment-related experience; interviewees' psychological or psychiatric state; and factors relating to the context in which the interview is conducted.

Disorganised attachment behaviour among infants born subsequent to stillbirth.

There is limited evidence that siblings of stillborn infants are more vulnerable to psychological problems. This case-controlled study examines the relationship between previous stillbirth and the next child's pattern of attachment and explores factors in the mother which may be associated with and which may explain the pattern of infant attachment. We examined 53 infants next-born after a stillbirth, and 53 control infants of primigravid mothers.

The psychological consequences and quality of life in adults with growth hormone deficiency.

It is now recognized that adults with pituitary disease and growth hormone (GH) deficiency have impaired physical and psychological functioning, including decreased quality of life. Research on quality of life continues to develop with reference to this patient group. In particular, disease-specific measures of quality of life have been developed, and data on long-term follow-up are now becoming available.

The effects of two doses of replacement growth hormone on the biochemical, body composition and psychological profiles of growth hormone-deficient adults.

This study examined the effects of growth hormone (GH) replacement on the insulin-like growth factor-I (IGF-I), body composition and psychological profiles of GH-deficient adults. We assessed whether two doses of GH produced different effects on these variables and whether patients who, at the end of the study chose to remain on long-term GH replacement responded differently to those who chose to abandon therapy. Forty-two adults (aged 42.

Growth hormone deficiency and quality of life.

Quality of life research in adults with growth hormone deficiency (GHD) is a developing field. It has been recognised that adults with childhood onset GHD suffer social and psychological disadvantages. The effects of GHD of adult onset have only been shown relatively recently.

Psychological well-being before and after growth hormone treatment in adults with growth hormone deficiency.

The effect of recombinant-DNA human growth hormone treatment on psychological well-being and quality of life was studied in adults with GH deficiency (GHD). 24 adults who satisfied strict criteria for GHD took part in a double-blind, placebo-controlled, 6-month trial. Quality of life assessments were performed at entry, 1 and 6 months by means of self-rating questionnaires.

The dexamethasone suppression test and negative symptoms of schizophrenia.

The dexamethasone suppression test (DST) was administered to 28 subjects who met DSM-III criteria for chronic schizophrenia and shared similar environments. Samples were assayed for both plasma cortisol and dexamethasone levels. After controlling for other factors, the mean postdexamethasone cortisol level (MPDC) was correlated with the patients' score on the Scale for the Assessment of Negative Symptoms (SANS).

Quality of life assessment before and after growth hormone treatment in adults with growth hormone deficiency.

The effect of recombinant human growth hormone (rhGH) treatment on the quality of life was studied in adults with growth hormone deficiency (GHD). Twenty-four adults who satisfied strict criteria for GHD took part in a double-blind, placebo-controlled, 6-month trial. 'Quality of life' assessment was performed at entry into the trial and after 1 month and 6 months, by means of self-rating questionnaires.