Journal of Aggression Maltreatment and Trauma, 9(1/2), 2004, pp.97-108.
Publisher:
Taylor and Francis
The terrorist attacks in the US on September 11, 2001 stimulated an unprecedented rapid response by the social and health research communities into the aftermath. This article summarizes the findings of the major studies that assessed various types of “psychological distress,” and identifies some of the important gaps that remain in our understanding of the nature and etiology of human distress following purposeful, unpredictable mass violence.
The terrorist attacks in the US on September 11, 2001 stimulated an unprecedented rapid response by the social and health research communities into the aftermath. This article summarizes the findings of the major studies that assessed various types of “psychological distress,” and identifies some of the important gaps that remain in our understanding of the nature and etiology of human distress following purposeful, unpredictable mass violence.
Journal of Forensic Psychiatry and Psychology (The), 19(1), March 2008, pp.64-85.
Publisher:
Taylor and Francis
... The authors report on the literature on PTSD, its diagnosis, assessment, and treatment. The difficulties encountered when assessing PTSD - the subjective nature of the symptoms, the risk of malingering, and the possibility of secondary gain - have been highlighted. Assessment and treatment in forensic settings is further complicated by the possibility of perpetrator PTSD. This article reviews the prevalence
There has been an increased interest in the relationship between posttraumatic stress disorder (PTSD) and violence, and in the factors that mediate their linkage. PTSD is a common, often under diagnosed, condition with high levels of psychiatric comorbidity. It often has poor outcomes, with many cases becoming chronic, leading to substantial costs both to the individual and society as a whole. The authors report on the literature on PTSD, its diagnosis, assessment, and treatment. The difficulties encountered when assessing PTSD - the subjective nature of the symptoms, the risk of malingering, and the possibility of secondary gain - have been highlighted. Assessment and treatment in forensic settings is further complicated by the possibility of perpetrator PTSD. This article reviews the prevalence of PTSD with particular reference to offender and forensic populations. The association between PTSD and violence, its relevance across the spectrum of criminal responsibility, and relevant case law are explored.
Subject terms:
offenders, post traumatic stress disorder, violence, assessment, diagnosis, forensic psychiatry;
Psychiatric Bulletin, 30(7), July 2006, pp.254-256.
Publisher:
Royal College of Psychiatrists
... asked to give a preferred diagnosis. Rates of diagnosis of bipolar disorder, schizoaffective disorder and schizophrenia were compared within vignette pairs. For each pair of vignettes, the rate of diagnosis of schizophrenia was higher (33 v. 21.5%, P=0.008 and 44.4 v. 32.1%, P=0.011), and the rate of diagnosis of bipolar disorder was lower (44.2 v. 62.6%, P<0.0005 and 34.9 v. 49.3%, P=0.004), among those who received the vignette containing a history of violence. A history of violence may lead to an increased likelihood of receiving a diagnosis of schizophrenia as opposed to bipolar affective disorder. This bias in diagnostic decision-making may affect the treatment received by a patient and may perpetuate and exacerbate the stigma associated with a diagnosis of schizophrenia.
The aim of the study was to investigate whether psychiatrists consider that patients with schizophrenia present a greater risk of violence than patients with other forms of mental illness. Two pairs of clinical vignettes were devised. In each pair, one contained a history of violence and one did not. One vignette was mailed to each of 2000 consultant psychiatrists in the UK. Respondents were asked to give a preferred diagnosis. Rates of diagnosis of bipolar disorder, schizoaffective disorder and schizophrenia were compared within vignette pairs. For each pair of vignettes, the rate of diagnosis of schizophrenia was higher (33 v. 21.5%, P=0.008 and 44.4 v. 32.1%, P=0.011), and the rate of diagnosis of bipolar disorder was lower (44.2 v. 62.6%, P<0.0005 and 34.9 v. 49.3%, P=0.004), among those who received the vignette containing a history of violence. A history of violence may lead to an increased likelihood of receiving a diagnosis of schizophrenia as opposed to bipolar affective disorder. This bias in diagnostic decision-making may affect the treatment received by a patient and may perpetuate and exacerbate the stigma associated with a diagnosis of schizophrenia.
Psychiatric Bulletin, 30(4), April 2006, pp.142-145.
Publisher:
Royal College of Psychiatrists
Ten people with a diagnosis of schizophrenia were interviewed. The interviews were analysed qualitatively with the aim of examining the concept of patient satisfaction in the context of a recent in-patient admission. The analysis identified two themes that influenced the expression of patient satisfaction: external factors and internal factors. The theme of external factors contained four categories: fear of violence, communication with staff, lack of autonomy and ward routines. The theme of internal factors comprised participants’ conceptions and expectations. This small study suggests the complexity of the concept of patient satisfaction should be respected in assessing experiences of people with a diagnosis of schizophrenia.
Ten people with a diagnosis of schizophrenia were interviewed. The interviews were analysed qualitatively with the aim of examining the concept of patient satisfaction in the context of a recent in-patient admission. The analysis identified two themes that influenced the expression of patient satisfaction: external factors and internal factors. The theme of external factors contained four categories: fear of violence, communication with staff, lack of autonomy and ward routines. The theme of internal factors comprised participants’ conceptions and expectations. This small study suggests the complexity of the concept of patient satisfaction should be respected in assessing experiences of people with a diagnosis of schizophrenia.
Journal of Interpersonal Violence, 19(10), October 2004, pp.1087-1101.
Publisher:
Sage
The study of post-traumatic stress disorder (PTSD) in maltreated youth has received increased attention, though extensive comparisons to maltreated youth without PTSD and administrations of anxiety-based structured diagnostic interviews remain needed. We examined maltreated youth with or without PTSD using structured diagnostic interviews and standardized child self-report measures. We hypothesized that maltreated youth with PTSD, compared to their peers without PTSD, would experience significantly greater duration of abuse, diagnostic comorbidity, PTSD symptomatology, dysfunctional family environment, and avoidant coping styles. Results indicated that the group with PTSD did indeed experience significantly greater duration of abuse, diagnostic comorbidity, and PTSD symptomatology, though less so dysfunctional family environment or avoidant coping styles. The presence of a mood or anxiety disorder was highly predictive of PTSD in this sample. Results are discussed within the context of evolving etiological and maintenance models of PTSD in maltreated youth.
The study of post-traumatic stress disorder (PTSD) in maltreated youth has received increased attention, though extensive comparisons to maltreated youth without PTSD and administrations of anxiety-based structured diagnostic interviews remain needed. We examined maltreated youth with or without PTSD using structured diagnostic interviews and standardized child self-report measures. We hypothesized that maltreated youth with PTSD, compared to their peers without PTSD, would experience significantly greater duration of abuse, diagnostic comorbidity, PTSD symptomatology, dysfunctional family environment, and avoidant coping styles. Results indicated that the group with PTSD did indeed experience significantly greater duration of abuse, diagnostic comorbidity, and PTSD symptomatology, though less so dysfunctional family environment or avoidant coping styles. The presence of a mood or anxiety disorder was highly predictive of PTSD in this sample. Results are discussed within the context of evolving etiological and maintenance models of PTSD in maltreated youth.
Subject terms:
post traumatic stress disorder, violence, anxiety, child abuse, diagnosis, comorbidity;
Discusses the difficulties of proving shaken baby syndrome, as there are yet no definite answers on how much force is required to cause a subdural haemorrahage. Looks at the implications for those providing expert medical opinions and those involved in protecting babies and young children.
Discusses the difficulties of proving shaken baby syndrome, as there are yet no definite answers on how much force is required to cause a subdural haemorrahage. Looks at the implications for those providing expert medical opinions and those involved in protecting babies and young children.
British Journal of Forensic Practice, 2(2), June 2000, pp.9-11.
Publisher:
Emerald
So-called 'serial killing' is frequently a topic of both professional and media concern and comment. As such, the term can be misused and may serve to obfuscate rather than illuminate. This short contribution proposes a socio-legal classification of all forms of unlawful killing into which serial killing might best be fitted.
So-called 'serial killing' is frequently a topic of both professional and media concern and comment. As such, the term can be misused and may serve to obfuscate rather than illuminate. This short contribution proposes a socio-legal classification of all forms of unlawful killing into which serial killing might best be fitted.
Journal of Child Psychotherapy, 21(2), August 1995, pp.167-182.
Publisher:
Routledge
This article attempts to draw attention to the difference between the states of mind and inner worlds of neurotic, borderline and psychopathic patients, with reference to different types of destructiveness: anger in the neurotic patient; desperate vengeful hatred in the borderline paranoid; and a cold addiction to violence in the psychopath. Although most patients refuse to stay put in the neat schematic categories outlined, they do seem to appreciate and to need the therapist's recognition of the specific quality of these vastly different states of mind.
This article attempts to draw attention to the difference between the states of mind and inner worlds of neurotic, borderline and psychopathic patients, with reference to different types of destructiveness: anger in the neurotic patient; desperate vengeful hatred in the borderline paranoid; and a cold addiction to violence in the psychopath. Although most patients refuse to stay put in the neat schematic categories outlined, they do seem to appreciate and to need the therapist's recognition of the specific quality of these vastly different states of mind.
Subject terms:
mental health problems, patients, psychotherapy, violence, children, diagnosis;
This report explores the needs and experiences of women living with and affected by HIV. It is based on a project to make women visible in the HIV response in the UK and was co-produced with women living with and affected by HIV which included a literature review, online surveys of women living with HIV and women concerned about HIV, and a mapping of services available. The report’s findings highlight significant unmet need, in both prevention services and support services that meet women’s needs across intersecting issues such as violence, mental health and immigration. The report calls for greater gender equity in research, funding, data, services and support. Specifically, it calls for researchers to develop a better understanding of the link between violence, gender and HIV in the UK and create better opportunities for women living with HIV to participate in local service design.
(Edited publisher abstract)
This report explores the needs and experiences of women living with and affected by HIV. It is based on a project to make women visible in the HIV response in the UK and was co-produced with women living with and affected by HIV which included a literature review, online surveys of women living with HIV and women concerned about HIV, and a mapping of services available. The report’s findings highlight significant unmet need, in both prevention services and support services that meet women’s needs across intersecting issues such as violence, mental health and immigration. The report calls for greater gender equity in research, funding, data, services and support. Specifically, it calls for researchers to develop a better understanding of the link between violence, gender and HIV in the UK and create better opportunities for women living with HIV to participate in local service design.
(Edited publisher abstract)
Subject terms:
HIV AIDS, women, needs, unmet need, access to services, user views, violence, prevention, mental health problems, diagnosis;
SHETTY Amrith, JAYAWICKRAMA Dilum, TAYLOR Pamela J.
Journal article citation:
Psychiatrist (The), 36(11), November 2012, pp.404-408.
Publisher:
Royal College of Psychiatrists
... in a UK specialist unit, and looked at the characteristics of these patients. In total, 38 of 42 study participants had prior contact with psychiatric services. Sixteen (about 40%) had had their diagnosis changed three or more times. All those who had major changes in their diagnosis had received a diagnosis of a psychotic illness at some point prior to the secure unit admission, but then had it withdrawn, only to be restored after prolonged assessment in the secure unit. Personality disorder and substance misuse comorbidity was common; however, non-psychotic diagnoses were seen as more important than psychotic diagnoses by general services. The authors conclude that changes in diagnosis between first presentation to psychiatric services and admission to a medium-security unit were more common
Some degree of diagnostic variability is routinely seen in clinical practice. There is evidence, from cases in England, that changing diagnoses may be an important factor preceding homicide. However there is little literature on diagnostic antecedents to admission to specialist secure units after violent behaviour. This study explored the frequency of a history of changing diagnoses in patients in a UK specialist unit, and looked at the characteristics of these patients. In total, 38 of 42 study participants had prior contact with psychiatric services. Sixteen (about 40%) had had their diagnosis changed three or more times. All those who had major changes in their diagnosis had received a diagnosis of a psychotic illness at some point prior to the secure unit admission, but then had it withdrawn, only to be restored after prolonged assessment in the secure unit. Personality disorder and substance misuse comorbidity was common; however, non-psychotic diagnoses were seen as more important than psychotic diagnoses by general services. The authors conclude that changes in diagnosis between first presentation to psychiatric services and admission to a medium-security unit were more common than would be expected from reports in the general literature. It is suggested that they demonstrate the difficulties experienced by service providers in delivering a consistent service.