“Supporting me through emotional times,all different kinds of behaviour.” Forensic mental health service users understanding of positive behavioural support

This service evaluation project explored service users’ experiences of positive behavioural support (PBS) within a medium secure mental health service. Interpretative phenomenological analysis (IPA) was used to analyse interviews with ten service users. Four main themes emerged from the data: My plan; How I understand PBS; How PBS has helped me, the benefits; and Making the plan work. Overall, service users viewed their experience of having a PBS plan positively. They reflected that the plans offered staff greater understanding of their behaviours and needs, enabling them to receive appropriate support. Service users valued the experience of being involved in the process, offering important insights into their experiences. They also expressed frustrations about staff not following the plan and not understanding why they had a plan whilst others did not. Limitations of the study, clinical implications and ideas for future research have been discussed.     

Finding a voice – the feasibility and impact of setting up a community choir in a forensic secure setting

This study reports on the feasibility and impact of running a choir for forensic psychiatric inpatients, staff and members of the local community, within the confines of a medium secure psychiatric unit. The choir ran between October and December 2013. Eight weekly workshops and a final concert performance were evaluated through participant observation and focus groups held with the participants. Between 12 and 16 male and female patients attended each workshop and the final concert. All participating patients had received a diagnosis of schizophrenia, schizo-affective disorder or personality disorder, all had committed serious violent or sexual offences and all were legally detained and receiving treatment in a forensic medium or low secure ward, under the Mental Health Act (England and Wales). Considerable benefits were reported by patients, as well as by the participating community choir members and staff. Primary benefits reported by patients included the following: improved happiness and well-being; increased confidence and self-esteem; greater emotional connectedness and reduced sense of stigma. Participating staff also reported increased feelings of well-being and happiness, greater tolerance and more positive perceptions of the functioning and capabilities of forensic psychiatric patients. The longer term benefits of music participation on the mental health and social functioning of forensic psychiatric patients require further investigation.     

The Motivation Behind Serial Sexual Homicide: Is It Sex,Power, and Control,or Anger?*

Controversy exists in the literature and society regarding what motivates serial sexual killers to commit their crimes. Hypotheses range from the seeking of sexual gratification to the achievement of power and control to the expression of anger. The authors provide theoretical, empirical, evolutionary, and physiological support for the argument that serial sexual murderers above all commit their crimes in pursuit of sadistic pleasure. The seeking of power and control over victims is believed to serve the two secondary purposes of heightening sexual arousal and ensuring victim presence for the crime. Anger is not considered a key component of these offenders' motivation due to its inhibitory physiological effect on sexual functioning. On the contrary, criminal investigations into serial sexual killings consistently reveal erotically charged crimes, with sexual motivation expressed either overtly or symbolically. Although anger may be correlated with serial sexual homicide offenders, as it is with criminal offenders in general, it is not causative. The authors further believe serial sexual murderers should be considered sex offenders. A significant proportion of them appear to have paraphilic disorders within the spectrum of sexual sadism. "sexual sadism, homicidal type" is proposed as a diagnostic subtype of sexual sadism applicable to many of these offenders, and a suggested modification of DSM criteria is presented.     

BOLD—fMRI在肇事肇祸精神分裂症研究中综述

综述了肇事肇祸精神病患者脑功能异常区以及异常区之间的相互关系。主要采用事件相关的图片线索诱导一中性线索反应模式的fMRI扫描,对司法鉴定为精神病患者进行的探索实验性研究。结果表明,双侧大脑额叶、颞叶区域存在多个脑功能激活区。因此,脑功能成像（fMRI）可以作为肇事肇祸精神病司法鉴定的一个有效手段。     

受虐儿童及青少年法医学鉴定92例分析

本文对92例不满18周岁家庭暴力受虐儿童和青少年法医学鉴定案例进行回顾性研究。结果表明：虐待行为多发生于下午5时前后，受虐者以女性居多（63．04％），损伤部位以头面部最多见（36．98％）。损伤类型以软组织挫伤最常见（51．13％），损伤具有多部位、广泛性、新旧不一等特点；发生场所以家中及家居周围附近为多，受虐者家庭情感生活环境差等.同时，作者还对虐待行为产生的社会根源、受虐儿童及青少年法医学鉴定及法律保护等问题进行了探讨。     

Integrating DSM-IV Factors to Predict Violence in High-Risk Psychiatric Patients

Abstract:  This study incorporated Axis-II and Axis-IV factors in DSM-IV to test the relationship between predicted risk for violence assessed in the psychiatric emergency room and actual violence during hospitalization. Psychiatric nurses lack an objective instrument to use during the acute psychiatric assessment. The retrospective study comprised consecutive psychiatric admissions ( n  = 161) in one tertiary veterans' hospital. Statistical testing for the predictive power of risk factors, relationships between variables, and violent events included nonparametric tests, factor analysis, and logistic regression. Of the 32 patients who committed violence during hospitalization, 12 had committed violence in the psychiatric emergency room. Statistical significance was shown for violent incidents and dementia, court-ordered admission, mood disorder, and for three or more risk factors. The 13-item Risk of Violence Assessment (ROVA) scale suggests validity and sensitivity for rating DSM-IV factors and psychosocial stressors to predict risk for violence during hospitalization. Replication studies are recommended to strengthen validity of the ROVA scale.     

All in the Family? Family Environment Factors in Sibling Violence

Sibling violence is presumed to be the most common form of family violence and the least studied. Based on data from “Physical Violence in American Families, 1976,” this paper assesses the family environment factors associated with sibling physical violence. Of a range of potential family influences, measures of family disorganization were the most significant predictors of sibling violence, overriding the characteristics of children or particular family demands. What mattered most to the occurrence of sibling violence was a child’s actual experience of physical violence at the hands of a parent, maternal disciplinary practices and whether husbands lose their temper. These findings point to the deleterious effect of corporal punishment, and suggest sibling violence in families is associated with more ominous family and gender dynamics.

Childhood Abusive and Supportive Experiences, Inter-Parental Violence, and Parental Alcohol Use: Prediction of Young Adult Depressive Symptoms and Aggression

Issues in both the children of alcoholics and child abuse literatures were addressed in an attempt to disentangle the effects on young adults of growing up in alcoholic homes versus abusive homes. Using multiple regression, retrospective reports of parental abuse (emotional, physical, and sexual) and parental support (love/support, independence, and fairness), witnessing violence between parents, and parental alcohol use were used as predictor variables for outcomes noted by both literatures. When the effects of all other predictors were statistically controlled, parental alcohol use was not significantly related to depressive symptoms or aggression. Different abusive and supportive behaviors, depending on sex of parent and sex of participant, were significant predictors of both depression and aggression. Results underscore the importance of including and controlling for inter-parental violence and for different types of child abuse (especially emotional abuse) and parental supportive behaviors in investigations of outcomes related to abusive and alcoholic families. Implications for treatment of individuals from these families are discussed.     

The New Face of Terrorism in Turkey: Actor Unknown Political Murders

Abstract:  In this study, we have analyzed the temporal and spatial trends in actor unknown political murders in Turkey. A total of 1852 cases, defined as actor unknown political murders, occurred in Turkey between 1975 and 2006, with the peak years being 1980 and 1994. Three different time frames could be defined: 1975–1993, 1994–1999, and 2000–2006. During the first period, cases were common all over Turkey, but during the second and third periods, they were more frequent in metropolitan areas and in the southeast. Incidents occurring during the first period could be attributed to the struggle between right- and left-wing supporters, while most murders occurring during the second and third periods seem to have been related to Kurdish separatism. Although the most crucial factor in preventing actor unknown political murders is a politically stable atmosphere, forensics can also play an important role. Turkey needs to improve its forensic services to bring them in line with international standards, namely the Minnesota Protocol.