The impact of an intensive inpatient violent offender treatment programme on intermediary treatment targets, violence risk and aggressive behaviour in a sample of mentally disordered offenders

This study examined the impact of an intensive inpatient violent offender treatment programme, Life Minus Violence - Enhanced (LMV- E, Ireland, 2008), on intermediary treatment targets, risk for violence, and aggressive behaviour during treatment in a sample of male mentally disordered offenders. Using quasi-experimental design, offenders who completed LMV-E and a comparison group showed reduced problems with impulsivity and anger regulation and improvements in social problem solving. Aggregate risk for future violence lessened in both treatment and comparison groups, although by a significantly greater degree for the comparison group. The aggressive behaviour of both groups reduced. Completion of the LMV-E conferred additional improvements in some facets of social problem solving and anger regulation. Neither group showed improvements in empathic responses, coping skills or problematic interpersonal style. Overall, these results suggest anger regulation, impulsivity and social problem solving are most amenable to change, that reductions in certain facets of these dynamic risk factors transpires with nonspecific psychiatric inpatient treatment, but that the LMV-E, a cognitive behavioural violence specific psychological treatment, confers greater change in some facets of social problem solving and anger regulation

Re-examining the predictive validity and establishing risk levels for the dynamic appraisal of situational aggression : youth version

The Dynamic Appraisal of Situational Aggression: Youth Version (DASA:YV) is a brief instrument, most often used by nurses and was specifically designed to assess risk of imminent violence in youth settings. To date, it has been recommended that DASA:YV scores are interpreted in a linear manner, with high scores indicating a greater level of risk and therefore need more assertive and immediate intervention. This study re-analyses an existing data set using contemporary robust data analytic procedures to examine the predictive validity of the DASA:YV, and to determine appropriate risk bands. Mixed effect logistic regression models were used to determine whether the DASA:YV predicted aggression when the observations are correlated. Two approaches were employed to identify and test novel DASA:YV risk bands, where (1) three risk bands as previously generated for the adult DASA were used as a starting point to consider recategorising the DASA:YV into three risk bands, and (2) using a decision tree analysis method known as Chi-square automated interaction detection to produce risk bands. There was no statistically significant difference between a four and three category of risk band. AUC values were 0.85 for the four- and three-category options. A three-category approach is recommended for the DASA:YV. The new risk bands may assist nursing staff by providing more accurate categorisation of risk state. Identification of escalation in risk state may prompt early intervention, which may also prevent reliance on the use of restrictive practices when young people are at risk of acting aggressively. © 2024 The Author(s). International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd

Interviewing forensic mental health patients who have a history of aggression: considerations and suggestions

This paper discusses issues arising when interviewing men and women in forensic mental health services, noting that many patients in these settings have significant histories of aggression or violence. The differences between interviews conducted for assessment purposes and those that are conducted as part of treatment are noted. We identify some important considerations for interviewers. These relate to characteristics of the client, characteristics of the interviewer, and features of the mental health setting that might impact on the interview. Some practical recommendations are offered to assist forensic mental health practitioners who conduct both types of interview

Exploring the utility of the model for understanding inpatient aggression for general mental health settings

A comprehensive understanding of factors contributing to aggression within mental health inpatient units is necessary to generate timely preventative interventions. In practice however, the focus is dominated by consideration of factors that are intrinsic to patients. The Model for Understanding Inpatient Aggression (“the model”) was developed for use in a forensic mental health service to understand and help prevent aggression by exploring distal and proximal intrinsic patient-level ‘personal’ factors and extrinsic ‘contextual’ factors'- structural, organisational and interpersonal. The model also incorporates exploration of ‘near miss events’ when aggression does not occur, to learn about aggression and support early use of effective intervention strategies. This study explored whether the model is suitable for use in civil/general mental health inpatient settings. Fifteen people (n = 14 nurses, and n = 1 lived and living experience expert) participated in one of four focus groups. Data were analysed using thematic analysis. Three themes were constructed from the data: (1) Focus remains on intrinsic factors and post event exploration and not early intervention and prevention; (2) “Turning the mirror” on ourselves: The importance of considering and addressing contextual factors; and (3) ‘For us it might fill a gap’: Benefits of using the Model for Understanding Inpatient Aggression. Participants also suggested additions to the model so that it aligns with practice in general mental health inpatient units. In conclusion, understanding and preventing aggression remains a constant challenge. Intervention efforts may be broadened when a wide range of contributing factors is considered, beyond proximal intrinsic/personal patient characteristics. © 2025 The Author(s). International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd

Using the Dynamic Appraisal of Situational Aggression with mental health inpatients : a feasibility study

Purpose: This paper aims to explore the acceptability of Dynamic Appraisal of Situational Aggression (DASA) from the perspective of patients, its actual use by mental health nurses, and the predictive validity of the DASA instrument. Methods: A feasibility study design incorporating quantitative and qualitative components was used. The study was conducted in three mental health inpatient units at three hospitals in southern Finland. Quantitative data were used to explore demand (nurses' actual use of the DASA), limited efficacy (predictive validity), and acceptability (measured through patients' participation in the project). Qualitative data were collected to enhance the understanding of acceptability by describing patients' perceptions of the strengths and weaknesses of the DASA. Results: Nurses used the DASA for most patient assessments. The predictive validity of the DASA was outstanding or excellent, depending on the type of aggression predicted, although the patient recruitment ratio was low. Patients reported both strengths and weaknesses of the DASA, providing complementary information regarding the instrument's acceptability and clinical application. Conclusion: The DASA accurately predicts inpatient aggression. The patients' preferences and concerns regarding risk assessment have been noted. More patient involvement in risk assessment research and violence prevention efforts is required.Peer reviewe

The Impact of Gender on Conference Authorship in Audio Engineering : Analysis Using a New Data Collection Method

Contribution: This paper provides evidence of the lack of gender diversity at audio engineering conferences, using a novel and inclusive gender determination method to produce a new dataset of author gender. Background: Audio engineering has historically been male-dominated; whilst the number of non-male audio engineers has increased recently, the industry mindset has changed very little. Studies into the gender diversity of this field are required to force a shift in mindset and create a more inclusive environment. Research Questions: To what extent is there an imbalance in the representation of different genders at audio engineering conferences? Do conference topic, presentation type, or author position have an impact on the gender balance? Methodology: A novel method was designed to obtain pronouns of authors where possible, avoiding removal of data or potential false positives. The main limitation of this methodology is the time required for gender determination. Gender composition was analyzed across 20 conferences, with gender balance further analyzed within four key categories: conference topic, presentation type, position in the author byline, and the number of authors listed. Findings: This data-driven study demonstrates a clear lack of gender diversity in conference authorship in audio engineering. The results show low overall representation of non-male authors at audio engineering conferences, with significant differences across conference topics, and a notable lack of gender diversity within invited presentations. Index Terms— Audio Engineering, Conferences, Gender, Underrepresentation, Bias, Discrimination, STEM, Engineering Pipelin

Exploring the potential of virtual reality technology to investigate the health and well being benefits of group singing

There is a growing body of academic research aiming to quantify and understand the associated health and well being benefits of group singing. The social interaction is known to strongly contribute to perceived improvements to mental and physical health but there are also indications that singing together elicits better well being outcomes that other community activities. This paper introduces the Vocal Interaction in an Immersive Virtual Acoustic (VIIVA) system, which allows the user to take part in a group singing activity in 360 degree virtual reality, hearing themselves in the recorded venue alongside the other singers. The VIIVA is intended to make group singing accessible to those unable to attend real community choirs but also as a tool for experimental research into the health and well being benefits of group singing. This paper describes the system and presents a number of methodologies and applications which are discussed in relation to three ongoing research projects. Preliminary work indicates that the VIIVA system and the devised setups provide a promising tool with which to study the health and well being benefits of group singing, and in particular to control for the social interactions inherent in real group singing activities

Demographic, clinical, and service-use characteristics related to the clinician’s recommendation to transition from child to adult mental health services

Purpose: The service configuration with distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) may be a barrier to continuity of care. Because of a lack of transition policy, CAMHS clinicians have to decide whether and when a young person should transition to AMHS. This study describes which characteristics are associated with the clinicians’ advice to continue treatment at AMHS. Methods: Demographic, family, clinical, treatment, and service-use characteristics of the MILESTONE cohort of 763 young people from 39 CAMHS in Europe were assessed using multi-informant and standardized assessment tools. Logistic mixed models were fitted to assess the relationship between these characteristics and clinicians’ transition recommendations. Results: Young people with higher clinician-rated severity of psychopathology scores, with self- and parent-reported need for ongoing treatment, with lower everyday functional skills and without self-reported psychotic experiences were more likely to be recommended to continue treatment. Among those who had been recommended to continue treatment, young people who used psychotropic medication, who had been in CAMHS for more than a year, and for whom appropriate AMHS were available were more likely to be recommended to continue treatment at AMHS. Young people whose parents indicated a need for ongoing treatment were more likely to be recommended to stay in CAMHS. Conclusion: Although the decision regarding continuity of treatment was mostly determined by a small set of clinical characteristics, the recommendation to continue treatment at AMHS was mostly affected by service-use related characteristics, such as the availability of appropriate services