A Novel Experimental Approach to the Explication of Information Processing Differences Between High and Low Anxious Individuals.

The information processing perspective of cognition and emotion has been a fruitful area of research inquiry in recent years. As a result of this recent spate of interest, emotional processing biases in anxiety have been consistently demonstrated, indicating that anxious individuals possess a processing priority for threatening information. This study is an attempt to further examine the processing biases which characterize anxious and nonanxious individuals. Pilot work was conducted to investigate the utility of a novel approach, the affective categorization task, to examine the affective meaning of lexical stimuli. Pilot research using the affective categorization task with socially anxious individuals suggested that socially anxious participants exhibited a tendency to evaluate subliminally presented threatening information more accurately than nonanxious participants. Nonanxious individuals were more accurate in detecting the affective content of neutral and positive information. Furthermore, socially anxious participants took longer to make affective decisions to emotional information, regardless of valence, than did nonanxious individuals. Based on that preliminary data, a second and more complete experiment was conducted to replicate and extend those findings with generally anxious individuals. A secondary aim of the full study was to explore the relationship between affective categorizations and underlying associative network representations. Overall, results from the affective categorization task were quite similar to those obtained in pilot work. Anxious individuals evidenced an enhanced ability to correctly classify subliminally presented threatening information, whereas, nonanxious participants demonstrated an enhanced ability to correctly classify subliminally presented information that was neutral or positive in affective tone. Signal detection analyses, however, indicated that these results were primarily due to a response bias, or tendency for anxious participants to categorize all subliminally presented information as threatening. Such a bias in responding was not observed in nonanxious participants. There were no differences in decision time to emotionally valent information between anxious and nonanxious individuals. Additionally, contrary to expectations, no group differences were found in network representations using the Pathfinder (Schvaneveldt, 1990) methodology. Implications will be discussed in terms of information processing theories of emotion and cognition

Dynamic and static factors associated with discharge dispositions : the national trajectory project of individuals found not criminally responsible on account of mental disorder (NCRMD) in Canada

The majority of individuals found not criminally responsible on account of mental disorder (NCRMD) in Canada spend some time in hospital before they are conditionally or absolutely (no conditions) discharged to the community by a legally mandated review board. By law, the decision to conditionally discharge an individual found NCRMD should be guided by the need to protect the public, the mental condition of the accused, and the other needs of the accused, especially regarding his/her community reintegration. At the time of this study, Canadian legislation and case law required that the review board disposition should be the "least onerous and least restrictive" possible for the accused. This means that, if there is no evidence that the person poses a significant risk to public safety, he/she must be released. However, the Canadian Criminal Code does not specify the criteria that must be considered when making this risk assessment. This leads to two questions. (1) What predicts review board dispositions? (2) To what extent do disposition determinations reflect evidence-based practices? The present study examined dynamic and static predictors of detention in custody, conditional discharge (CD), and absolute discharge (AD) dispositions among persons found NCRMD across the three largest provinces in Canada. The National Trajectory Project (NTP) examined men and women found NCRMD in British Columbia (BC), Québec (QC), and Ontario (ON) between May 2000 and April 2005, followed until December 2008. For the purposes of this study, individuals who had at least one hearing with a review board were extracted from the NTP dataset (N = 1794: QC = 1089, ON = 483, BC = 222). Over the course of the study, 6743 review board hearings were examined (QC = 3505, ON = 2185, BC = 1053). Despite advances in the risk assessment field, presentation of a comprehensive structured risk assessment to the review board was not the norm. Yet our findings suggest that review boards were taking into account a combination of empirically validated static and dynamic risk factors, as represented by the items of the HCR-20 risk assessment scheme. Particular attention was being paid to the behavior of the patient between hearings (e.g., violent acts, compliance with conditions). Severity of index offense was associated with review board decisions; though index severity is not related to recidivism, it is an important consideration in terms of public perceptions of the justice system and can be related to better established risk factors (i.e., criminal history and prior violence). Historical factors had more influence on the decision to detain someone, while clinical factors were more influential on an AD decision. Disposition stability was the most common trajectory, meaning that a patient with a prior CD disposition was most likely to receive another CD disposition at the next hearing. Static and dynamic risk factors found in the HCR-20 influenced review board determinations, although presentation of a complete structured risk assessment is the exception, not the norm. Results suggest that clinicians recommending less restrictive dispositions are more likely to include a comprehensive risk assessment with their recommendation. An alternative explanation is that, when there is no comprehensive assessment of risk, the review board tends to be more cautious and apply more restrictive dispositions. The practice seems to be contrary to the legislation at the time of the study, given that there should be a presumption that the patient is not a significant threat

The use of telepsychiatry within forensic practice: a literature review on the use of videolink: a ten-year follow-up

In the last decade, telepsychiatry – the use of telecommunications technologies to deliver psychiatric services from a distance – has been increasingly utilised in many areas of mental health care. Since the review by Khalifa and colleagues in 2007 the body of literature relevant to the forensic applications of telepsychiatry has grown substantially, albeit not by much in the United Kingdom. In the current review, we aim to provide an update summary of the literature published since 2007 to determine the effectiveness and feasibility of increasing telepsychiatry utilisation in forensic practice. The literature reviewed provides some encouraging evidence that telepsychiatry is a reliable, effective and highly acceptable method for delivering mental health care in forensic settings. There are also a number of papers that indicate the use of telepsychiatry may be cost effective for health providers in the longer term. Further research is required to consider the potential legal and ethical implications of using telepsychiatry in forensic settings