As a result of COVID-19 related restrictions around the globe, individuals have experienced a stark shift in the way we socialize and connect. This has impacted many facets of people’s lives, one being sexual experience and expression. Although the fact that sex and sexuality were affected by the pandemic and the public health measures and restrictions is no surprise, the specific impacts are proving to be quite fascinating and unexpected. On the one hand, we may predict increased intimacy among partners due to closer proximity and more time together. However, a counter point could be that all that time together combined with the stress of the pandemic suffocated desire. And what about sexual interests? How and why might those be a casualty of pandemic life?
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Examination of the Structured Assessment of Protective Factors for Violence Risk – Youth Version (SAPROF-YV) in Canadian Adolescents
The Structured Assessment of Protective Factors for Violence Risk – Youth Version (SAPROF-YV) is a new measure of protective factors. It is used with a risk-focused tool, such as the Structured Assessment of Violence Risk in Youth (SAVRY), to provide a more balanced and comprehensive assessment of violence risk in adolescents. Our study investigated the relationship between the SAPROF-YV and aggression in a sample of 69 adolescents. Using a retrospective follow-up study design, we reviewed files at an inpatient treatment centre and a probation office. The SAPROF-YV showed good convergent and discriminant validity with the SAVRY. The SAPROF-YV was predictive of the absence of minor verbal aggression. While the SAPROF-YV added incremental predictive validity to SAVRY Protective factors for minor verbal aggression, it did not add incrementally to SAVRY Risk factors in the prediction of any type of aggression. We discuss implications for future research and clinical applications.
Read moreThe Impact of the Illusory Truth Effect and Location of Testimony in Juror Deliberations
The illusory truth effect (ITE) is the tendency to believe false information as being accurate after it has been presented repeatedly over time. ITE has been shown to hold true in many different contexts; however, there have been no studies that examine the influence of ITE in jurors’ deliberation. Given the importance of weighing legally relevant facts in the decision-making process, and the potential influence of ITE, this study examined whether the repetition of key evidence in testimony matters in this context. This study also examined whether critical information would be influenced by the location of ITE. In that context, jurors may process critical information differently when introducing ITE early (i.e., primacy effect) or later (i.e., recency effect) in the vignette of a murder case. To examine this effect, 100 participants were recruited and asked to read a vignette where pertinent evidence related to a murder was strategically repeated throughout the case narrative. Participants were assigned to one of four groups: control; ITE throughout vignette; ITE at the beginning of vignette; and ITE at the end of vignette. After reading the vignette, participants were asked to complete a short questionnaire and provide a final decision about various aspects of the case. Results revealed that repetition of pertinent evidence matters. The placement of evidence also has the potential to influence jurors’ perceptions of certain case relevant details. These findings suggest that within a sensitive legal context, such as jurors weighing evidence of an accused’s culpability, ITE could alter one’s perception of the facts.
Read moreReport on the Distribution of the Social Determinants of Health and Health Equity in a Forensic Psychiatry Program
The social determinants of health are important factors that shape a person’s well-being, life expectancy, and quality of life. The environments in which people live, work, and play are paramount in determining their overall health. As such, viewing health as an outcome, not only of individual choices and biomedical factors but also of socioenvironmental influences, can be an important lens to guide health-care practice. This report examined the social determinants of health of people admitted to inpatient units in a forensic psychiatry program in a major Canadian urban centre. Twenty health variables were collected from the Resident Assessment Instrument–Mental Health form. A deprivation scale was created to understand social and material inequality on a gradient. Findings showed that those surveyed had high rates of poor social determinant of health factors, such as low educational attainment, insecure housing, and lack of secure employment before their admission to the program. Chi-square tests showed associations between material deprivation, race, and comorbidity status. The findings may influence a multisectorial approach to mental illness prevention, management, and recovery practices.
Read moreForensic Psychiatry in Pakistan: An Update
Pakistan is a lower-middle income country in South Asia where forensic psychiatry is often not recognized as a distinct subspecialty of psychiatry. Although evolution toward this direction has begun, more development in this field is needed. Before Pakistan’s Mental Health Ordinance of 2001, much of the mental health legislation and institutional infrastructure pertaining to the mentally ill offender can be traced back to the Indian Lunacy Act of 1912. The past two decades have witnessed important legal developments in the role of psychiatry in Pakistan’s criminal justice system. This has been seen through the devolution of health-care provision and by an extension of psychiatric service provision from the federation (federal government) to the four provinces. Despite the sparse resources allocated to psychiatry, competent yet scarce psychiatry residents are graduating from Pakistan’s accredited residency programs with an interest in forensic psychiatry. The objective of this article is to reflect on the past, while examining the current state of existing forensic mental health in Pakistan. This article will also address the future trajectory of forensic psychiatry in Pakistan and supports the establishment of forensic psychiatry as a subspecialty in Pakistan.
Read moreEthics, Risk and Recovery—Challenges in Forensic Practice
The practice of recovery-oriented care with individuals who have been found unfit to stand trial or not criminally responsible, and who are subject to review board dispositions, presents a variety of ethical tensions. The assessment and management of risk in a rehabilitative context raises issues of autonomy, confidentiality, and conflicting roles. Awareness of and, where possible, resolution of these conflicts is necessary for the success of the recovery paradigm in this context.
Read moreA Cross-Sectional Survey of Patients and Staff on Inpatient Forensic Psychiatric Units in Canada During the COVID-19 Outbreak
Outbreaks of the coronavirus disease (COVID-19) on inpatient forensic psychiatry units present a unique challenge as early release is not possible and some facilities were not designed to achieve sustained social distancing. The enforcement of droplet and contact (D&C) precautions required by Public Health Ontario during an outbreak creates further confines and restrictions for patients that are typically subject to considerable constraints during their care. From December 2020 to January 2021, 30 clinicians and 12 patients on inpatient forensic psychiatry units under unit-wide D&C precautions during COVID-19 outbreaks completed a cross-sectional survey about their experience. We also conducted virtual focus groups to triangulate the qualitative feedback from clinicians. The survey and focus group discussions revealed similar themes of enablers, barriers, and desired changes to care provision during an outbreak. We discuss findings within the broader context of outbreak interventions and the provision of services to those living and working on forensic psychiatry inpatient units experiencing outbreaks requiring the unit-wide implementation of D&C precautions.
Read moreEmotional Content Analysis Among People With Psychopathy During Emotional Induction by the International Affective Picture System
The emotional processes within people with psychopathy have been thoroughly investigated. Although content analysis is an interesting area for evaluating emotional characteristics, few data exist concerning the speech content of people with psychopathy in response to affective and neutral images. Our study population included male forensic inpatients (n = 47) from Centre Régional de soins Psychiatrique, Les Marronniers, Tournai, Belgium. According to their total score, as measured by the Pscyhopathy Checklist—Revised (PCL-R), the inpatients were divided into three groups: Psychopath (n = 24, PCL-R score of ≥25), Intermediate (n = 12, PCL-R score from 15.0 to 24.9), and Nonpsychopath (n = 11, score of ≤14.9). Using Tropes analyses and EMOTAIX scenario tools, we examined each narrative’s emotional characteristics. We tested the hypothesis that people with psychopathy report fewer emotional words on all International Affective Picture System images, particularly on negative-valence images. Generally, our results do not support this hypothesis, that people with psychopathy report fewer emotional words on all images, but rather suggested a specific discordance in the verbal emotional treatment (exclusively PCL-R Interpersonal factor) but not in terms of the subjective evaluation. Moreover, this interpersonal factor was positively correlated with the self-referring pronouns (i.e., I and me) setting, whereas the PCL-R Social Deviance factor was positively correlated with action verbs. Speech outputs of people with psychopathy present specificities in terms of emotional content and verbal setting. The results are congruent with the notion that psychopathy combines both functionality and subtle impairment.
Read moreIntimate Partner Violence Among Pregnant Saudi Women: Prevalence, Risk Factors, and Attitudes
Intimate partner violence (IPV) during pregnancy has become a focus of attention in recent years, owing to its relatively high prevalence, its impact on maternal and fetal health, and its cumulative effects over time. This study aims to determine the magnitude and characteristics of IPV among pregnant Saudi Arabian women, to identify the factors that increase the risk, and to assess the willingness of abused women to report IPV. This is a cross-sectional, community-based survey of pregnant women in the Eastern Province of Saudi Arabia. A modified Abuse Assessment Score (AAS) questionnaire was used. Sociodemographic data were collected. Data related to willingness to report IPV, including reasons for declining to report IPV, were also collected. A total of 1,330 women completed the three parts of the survey. In total, 345 (25.9%) women reported emotional abuse during pregnancy, whereas 72 (5.4%) reported physical abuse and 180 (13.5%) reported sexual abuse. In emotional abuse, a significant association was found between having more children (p = .001), having a lower education (p = .05), having a lower income (p = .04), and being abused. In physical abuse during pregnancy, no significant associations were found between all variables and being abused. However, in reporting sexual abuse among women during pregnancy, a significant increase in the risk was found in those with four or more children (p = .01) and those who are employed (p = .01). More than two-thirds (71.2%) of abused pregnant women were unwilling to report the abusive acts to a medical authority. IPV is common among pregnant Saudi women. Emotional abuse is the commonest form of IPV, affecting one in four women. More than two-thirds of abused women were unwilling to report their partner’s abusive acts. Screening for IPV may encourage women to seek help and improve both maternal and fetal health.
Read moreThe Greats: Perspectives on Excellence in Forensic Psychiatry
For forensic psychiatry to thrive as a profession, practitioners need to be committed to intentional, continuous learning and development throughout their careers. However, carving their way through the challenges of practice and finding room to grow can be daunting. Research can help lessen this burden by examining the careers of experienced and skilled practitioners, identifying the factors that influenced their development, and the strategies they used to direct it. To date, little research of this kind has been conducted in forensic psychiatry. In this study, we used the deliberate practice model of elite performance as a heuristic to interpret the accounts of several experienced and distinguished practitioners, revealing and characterizing the influences and activities they identify as having been most important to their development. Semi-structured telephone interviews were conducted with six participants from across North America who started their forensic careers between 1965 and 1980. Transcripts were analyzed using directed content analysis. Participants cited little in the way of highly structured activities designed specifically to improve performance. They instead described using opportunities to learn from real casework and additional knowledge pursuits, as well as using deliberate career management to structure the conditions of their work-based learning. They also stressed the effect of entering forensic practice during a period of increasing interest, demand and investment, which yielded early opportunities to learn through practice. We discuss limitations in the deliberate practice model’s capacity to capture key learning strategies in forensic psychiatry, connections between work-based learning and the discipline’s general historical trajectory, and the role of career management in professional development strategies.
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