Striatal brain volume linked to severity of substance use in high-risk incarcerated youth.

Substance use disorders among juveniles are a major public health concern and are often intertwined with other psychosocial risk factors including antisocial behavior. Identifying etiological risks and mechanisms promoting substance use disorders remains a high priority for informing more focused interventions in high-risk populations. The present study examined brain gray matter structure in relation to substance use severity among = 152 high-risk, incarcerated boys (aged 14-20).

Childhood Trauma Predicts Sadistic Traits and Violent Behavior in Incarcerated Youth.

Childhood trauma exposure is prevalent among incarcerated youth and associated with antisocial traits and behavior. It has been proposed as a risk factor for the development of sadistic traits, which has been shown to predict future violence in youth. Using regression analyses, we examined the association between self-report and expert-rated measures of childhood trauma, sadistic traits (i.

Ethics Oversight in Psychiatry: Data from a Model of Organizational Monitoring.

Hallmarks of professions include self-regulation. The American Psychiatric Association fulfills this responsibility by delegating the handling of ethics complaints against members to each of 72 District Branches (DBs). The authors sought to explore the number and typology of ethics complaints received by member DBs, the handling of complaints, the relationship between the DB and state licensing authorities, the challenges and resources needed for conducting complaints, and the overall attitude of DBs regarding ethics review.

Practical Research Ethics in Psychiatric Clinical Trials: A Guide for Investigators.

The conduct of clinical psychiatric research is critical to advance the science and efficacy of treatment while also safeguarding the interests of participants. This article emerges from the authors' experience, providing practical guidance to colleagues seeking input on how to design and implement clinical research protocols in accordance with key ethical considerations. Thus, the intent of this article is to provide (1) an overview of common ethical considerations when conducting psychiatric clinical research along with (2) practical advice for preparing Institutional Review Board applications and associated materials in the ethical conduct of psychiatric clinical research.

Dimensions of impulsivity related to psychopathic traits and homicidal behavior among incarcerated male youth offenders.

Despite impulsivity being included as scoring criteria within several measures of youth psychopathic traits, the relationship between psychopathic traits and dimensions of impulsivity among high-risk youth is not well-understood. Here we assessed psychopathic traits via total, factor, and facet scores from the Psychopathy Checklist: Youth Version (PCL:YV) and impulsivity through total, three-factor, and six-factor model scores from the Barratt Impulsiveness Scale (BIS-11) in incarcerated male youth offenders. Correlational analyses indicated PCL:YV total, Factor 2, Facet 3, and Facet 4 scores were significantly positively correlated with BIS-11 total scores.

and the Constitutionality of the Approach to Insanity.

In 1995, the Kansas legislature adopted what is referred to as the " approach" and abolished the affirmative insanity defense. This approach allows a defendant to be acquitted who lacks the requisite mental state for the crime, without consideration of the defendant's understanding of wrongfulness. In , the U.

Adverse Childhood Experiences Among Sexual Offenders: Associations With Sexual Recidivism Risk and Psychopathology.

Adverse childhood experiences (ACEs) are increasingly recognized as a public health crisis. Cumulative effects of these experiences lead to a wide range of deleterious physical and psychological outcomes. Prior research has identified higher prevalence rates of ACEs and increased criminal behavior in samples of individuals who have committed sexual offenses.

A Quality Improvement Curriculum for Psychiatry Residents.

Introduction: Quality improvement (QI) is an increasingly important aspect of health care and residency education. There is relatively little research describing QI curricula for residents in psychiatry. Although QI curricula have been published in , the current resource represents the first such curriculum specific to psychiatry residents.

'Medical Clearance' of Patients With Acute Mental Health Needs in the Emergency Department: A Literature Review and Practice Recommendations.

Introduction: Emergency departments have seen increasing numbers of patients presenting with acute mental illness. Currently, there is not a standard for assessing the medical stability of these patients prior to transfer to inpatient psychiatric services, which causes unnecessary delays in patient care.

Objective: Provide a literature review and multidisciplinary expert consensus recommendations to simplify and expedite the medical evaluation of patients requiring admission to inpatient psychiatric facilities.

The Validity of the Personality Assessment Inventory-Adolescent in Assessing Callous-Unemotional Traits in At-Risk Adolescents.

This study examines the validity of the Personality Assessment Inventory-Adolescent (PAI-A; Morey) in assessing callous-unemotional (CU) traits within two independent samples of at-risk adolescents from a residential intervention program. The study tests the extent to which CU traits are represented within PAI-A scales with respect to empirically- or theoretically-related indicators, such as antisociality, aggression, low warmth, low social connectedness, and subdued internalizing psychopathology. The PAI-A substantive scales statistically accounted for an average of 55.

The Measurement of Positive Valence Forms of Empathy and Their Relation to Anhedonia and Other Depressive Symptomatology.

Construct validity of a brief self-report measure of "positive-valence empathy" (the tendency to exude positive emotion as a means to stimulate positive affect in others, and/or to vicariously share in another's positive emotion; Light et al., 2009) was attained utilizing a sample of 282 healthy adults. Positive-valence empathy may have unique predictive ability for differentiating depression versus depression with anhedonia.

Development of an expert-rater assessment of trauma history in a high-risk youth forensic sample.

Objective: Exposure to childhood trauma is particularly prevalent among incarcerated juveniles. Although there is a growing understanding of the detrimental impact trauma exposure can have on child and adolescent development, childhood maltreatment can be very difficult to accurately measure. Integration of self-report trauma histories as well as supplemental file reports of trauma exposure may provide the most accurate estimate of experienced trauma among youth in correctional settings.

A Curriculum for Residents to Develop Successful Quality Improvement Projects.

Background: Quality improvement (QI) education in residency training has become critical for numerous reasons, but little has been written about factors that lead to successful improvement projects within residency training.

Methods: A quality improvement curriculum for third-year psychiatry residents was developed. The percentage of resident projects that have been successfully implemented was calculated.

Functional connectivity during affective mentalizing in criminal offenders with psychotic disorders: Associations with clinical symptoms.

Psychotic disorders are associated with neurobehavioral impairments in mental state attribution (mentalizing). These impairments are most severe in psychotic patients with elevated symptom levels, particularly negative and cognitive symptoms. There have been few studies of functional connectivity related to mentalizing in psychotic disorders and associations with symptoms.

Abnormal brain structure in youth who commit homicide.

Background: Violence that leads to homicide results in an extreme financial and emotional burden on society. Juveniles who commit homicide are often tried in adult court and typically spend the majority of their lives in prison. Despite the enormous costs associated with homicidal behavior, there have been no serious neuroscientific studies examining youth who commit homicide.

Evaluation of the timeliness of psychiatric consultations.

Background: Emergency department (ED) delays have multiple causes and create frustration for patients and staff alike.

Methods: New adult psychiatric ED consultations were studied. Elapsed time between workflow stages was tested as a predictor of total time from triage to disposition.

A description of 200 consecutive admissions to an adolescent male treatment unit.

Objectives: The objective of this study is to characterize patients admitted to a mental health Adolescent Male Treatment Unit (AMTU) over an 18-month interval.

Methods: The study is a cross-sectional retrospective chart review. Data concerning medication management was abstracted along with age, psychiatric diagnoses, degree of impairment, length-of-stay (LOS), and episodes of locked seclusion/restraint.

Understanding psychopathy through an evaluation of interpersonal behavior: testing the factor structure of the interpersonal measure of psychopathy in a large sample of jail detainees.

Interpersonal characteristics are core features of the psychopathy construct which have a unique pattern of correlations with a variety of external correlates. To improve the assessment of interpersonal traits, the current study evaluated the internal structure of the Interpersonal Measure of Psychopathy (IM-P) through exploratory and confirmatory factor analyses (CFA) in a large sample of jail inmates. A 17-item, 3-factor (Dominance, Grandiosity, and Boundary Violations) structure evidenced good fit in European American inmates.

An investigation of the ECST-R in male pretrial patients: evaluating the effects of feigning on competency evaluations.

Forensic clinicians have the option of employing well-validated structured interviews when conducting competency to stand trial (CST) evaluations to ensure adequate coverage of the three prongs delineated in Dusky v. United States. This study evaluates the effects of feigning on the Evaluation of Competency to Stand Trial-Revised (ECST-R) in a sample of 100 male defendants undergoing CST evaluations.

Predicting short-term institutional aggression in forensic patients: a multi-trait method for understanding subtypes of aggression.

Accurately predicting inpatient aggression is an important endeavor. The current study investigated inpatient aggression over a six-month time period in a sample of 152 male forensic patients. We assessed constructs of psychopathy, anger, and active symptoms of mental illness and tested their ability to predict reactive and instrumental aggression.

Detection strategies for malingering with the Miller Forensic Assessment of Symptoms Test: a confirmatory factor analysis of its underlying dimensions.

Two of the most widely used measures for the assessment of malingering in forensic populations are the Miller Forensic Assessment of Symptoms Test (M-FAST) and the Structured Interview of Reported Symptoms (SIRS). The underlying dimensions of the SIRS have been well established in the literature, but the structure of the M-FAST remains relatively untested. Understanding of its dimensions is critical for construct validity and guiding its proper use.

Psychopathy and behavioral correlates of victim injury in serious juvenile offenders.

The study examines delinquent behavior and psychopathy and assesses their relationship to victim injury in a population of 168 incarcerated juvenile delinquent males with lengthy histories of criminal and violent behavior. A series of multiple regressions found that 17% of the variance associated with level of victim injury was accounted for by a model that included the three-factor model of the Psychopathy Checklist: Youth Version [Forth, Kosson, and Hare, 2003], criminal versatility, and age of onset of criminal offending. Notably, anger and DSM-IV symptoms of conduct disorder were not related to level of victim injury.