How are you coping?:Stress, coping, burnout, and aggression in forensic mental healthcare workers

IntroductionPerceived stress at work has been linked to several adverse outcomes in workers, including increased risk of burnout and aggression (e.g., anger and irritability). However, much remains unknown about factors that might mitigate the negative influences of perceived stress on workers' well-being. This study focusses on coping as a possible protective factor against perceived stress and its consequences in forensic mental healthcare workers. We aimed to identify which higher-order coping factors were present in this worker sample and to investigate whether these coping factors modify the associations between perceived stress and burnout or aggression.MethodsFor this observational survey study, 116 forensic mental healthcare workers completed questionnaires assessing changes in work situation since the start of COVID-19, perceived stress, coping, burnout symptoms, and aggression.ResultsResults from principal component analysis indicated that four higher-order coping factors could be distinguished: social support and emotional coping, positive cognitive restructuring, problem-focused coping, and passive coping. Higher perceived stress levels were associated with higher levels of both burnout and aggression in workers. Problem-focused coping was associated with less burnout symptoms in workers. Furthermore, positive cognitive restructuring was associated with less aggression in workers.DiscussionIn conclusion, problem-focused coping and positive cognitive restructuring may protect workers against burnout symptoms and aggression and these results may inform future studies on preventive interventions aimed at promoting worker's well-being

Sensory processing and aggressive behavior in adults with autism spectrum disorder

Autism spectrum disorder (ASD) may be accompanied by aggressive behavior and is associated with sensory processing di

Sensory processing and psychopathology: a forensic perspective

Transcriptional regulation of genes involved in human appearanc

Monitoring & coaching of reactive intimate partner violence: A systematic development approach

Background: Monitoring and coaching technologies show much promise for the complex domain of forensic psychiatry, specifically for reactive intimate partner violence (rIPV). An important reason for this is that therapists are not present when violent outbursts occur, while technology is available 24/7. To predict violent outbursts and provide just-in-time feedback, multiple types of data should be used to provide reliable and valid information (e.g. conflict between partners, physiological arousal, or geographical location). In order to create a scientifically sound intervention, the choice for variables that will be monitored should be based on research. Consequently, in this development process of a monitoring and coaching technology, an important step is to determine which evidence-based determinants of rIPV can be monitored and provide valuable data for coaching purposes. Methods: This study aims to identify factors related to rIPV in three steps. First, mental models of expert-therapists are created via semi-structured interviews. Second, the resulting collection of variables will be validated and expanded by expert-scientists. Third, a literature study on all identified factors is conducted, after which a final collection of factors that contribute to rIPV is created. This serves as an evidence-based guideline to determine which variables should be monitored and coached in an eHealth intervention for perpetrators of rIPV and their partners. Findings: Preliminary findings of the mental models of experts will be presented in this poster. The used method and rationale behind it will be discussed. Discussion: Based on the results, suggestions for ways of monitoring important factors via technology are provided. Also, recommendations are made for further steps in the development process of eHealth interventions targeting rIPV, e.g. using methods and principles from multiple approaches such as participatory development and persuasive technology

FoReTech: eHealth technology development in forensic mental health

FoReTech: eHealth technology development in forensic mental health eHealth is the use of technology to improve health, healthcare and wellbeing. Research and practice have identified multiple advantages and possibilities of the use of these eHealth technologies, such as apps, web-based interventions, wearables and virtual reality, for forensic mental health. However, use in practice is lagging behind: uptake of these technologies is slow and often there is no good fit between the technology and the context in which it is used. In order to bridge the gap between eHealth’s potential and its actual use, proper design, implementation and evaluation is pivotal. This presentation addresses the issues described above. First of all, an overview of the current state of eHealth is provided. Examples of technologies that are being used in Dutch forensic mental health are used to illustrate the possibilities and limitations. Second, an explanation of the relevance of good eHealth development for increasing the fit between technology, people and the forensic mental health context is provided. Attention will be paid to the why and how of design, implementation and evaluation. This is based on recent insights, research findings and development models such as the CeHRes Roadmap. Third, a case from practice will be used to illustrate the development process of eHealth for forensic mental health. In this case, a VR application for treatments in Dutch forensic mental health is developed in close cooperation with patients. This development process is guided by the CeHRes Roadmap. FoReTech: Monitoring and coaching of precursors of violence via technology In the treatment of forensic psychiatric outpatients, a therapist is (often) not present when a violent outburst occurs, and can only discuss undesired behaviour before or after it has happened. Technology, however, can be present 24/7. It has the ability to provide just-in-time feedback to prevent undesired behaviour by intervening before escalations actually occur. In order to know when to intervene, a technology needs to monitor specific precursors (or predictors) of violence. Examples of these precursors are physiological arousal, conflict between partners, and geographical location. These precursors can be monitored via technology, e.g. a smartwatch that measures heartrate variability and skin conductance, experience sampling via a smartphone, or the GPS function of a phone. In a subproject of FoReTech, a monitoring and coaching technology for reactive intimate partner violence (IPV) is being developed. The development process starts by studying the biopsychosocial precursors of reactive IPV via mental models of experts combined with scientific literature. After the behaviour and its precursors have been analysed, an interdisciplinary team will determine how to monitor the most important precursors via technology. In close cooperation with patients, their partners and therapists, a technology that uses the monitoring data to coach patients and their partners in reducing IPV will be created. This development process will be guided by principles and methods from different approaches, such as participatory development, behaviour change theories and persuasive technology. This presentation will discuss the development process and provide insight into the possibilities and challenges of monitoring & coaching technologies in forensic mental health

Sensory processing and alcohol use in adults with autism spectrum disorder

The association between substance use and autism spectrum disorder (ASD) is complex. Although sensory processing difficulties are highly prevalent in individuals with ASD, data on the association between sensory processing and substance use in ASD are limited. This study aimed to investigate the association between sensory processing patterns and alcohol use in adults with ASD. Kruskal-Wallis tests were performed on questionnaire data (Adolescent/Adult Sensory Profile and Alcohol Use Disorders Identification Test - Consumption) of 101 adults with ASD. Sensory processing difficulties are associated with alcohol use in adults with ASD. Differences in sensory processing between alcohol-based subgroups vary per specific sensory processing pattern: drinkers reported 6.5 to 8 points higher levels of low registration [χ 2(2) = 12.408, p = .002, 99 % CI (.002.002)], non-hazardous drinkers reported 9 points higher levels of sensory sensitivity [χ 2(2) = 6.868, p = .031, 99 % CI (.031, .032)], and hazardous drinkers reported 7.5 points higher levels of sensory seeking [χ 2(2) = 6.698, p = .034, 99 % CI (.034, .035)], all in comparison with non-drinkers on scales ranging from 15 to 75. Our proof-of-concept study indicates that vulnerability in some individuals with ASD for substance use disorders might be explained by sensory processing difficulties. Whether alcohol is used as 'self-medication' or is associated with other neurobiological vulnerabilities needs further investigation in larger follow-up studies. </p

Screening for disruptive behavior in adolescents at risk using the strengths and difficulties questionnaire

Disruptive behavior in adolescents is burdensome and may continue into adulthood if left unidentified. The strengths and difficulties questionnaire (SDQ) can screen for disruptive behavior, but its psychometric properties in high-risk samples and ability to predict delinquency warrant further investigation. In 1022 adolescents, we investigated the predictive validity (on average 1.9 years after screening) of the self-reported SDQ on disruptive behavior disorders and delinquency, measured with multi-informant questionnaires and structured interviews. We compared three scoring methods: total, subscale, and dysregulation profile scoring. In this high-risk sample, SDQ subscale scores predicted disruptive behavior outcomes best. Predictive values for the specific types of delinquency were small. Concluding, the SDQ can be used in high-risk settings for early identification of youth with disruptive behavior

Sensory Processing, Perceived Stress and Burnout Symptoms in a Working Population during the COVID‐19 Crisis

Although previous research suggests an association between sensory processing and perceived stress in a broad spectrum of mental health conditions, it remains unclear whether this phenomenon occurs independently from psychopathology. The present study investigated the association between sensory processing patterns, perceived stress and occupational burnout as a stress‐related condition in a working population. We focused on different aspects of sensory processing and used the momentum of a particularly stressful period: during the first months of the global COVID‐19 crisis. A total of 116 workers at a mental healthcare institution in The Netherlands completed the Adolescent/Adult Sensory Profile (AASP), the Perceived Stress Scale (PSS‐10) and the Burnout Assessment Tool (BAT). Our results demonstrated that higher scores on sensory sensitivity and low registration were associated with higher scores on perceived stress and core burnout symptoms. Sensory hypersensitivity was also associated with more secondary burnout symptoms. Associations were not driven by underlying sensory‐related disorders (e.g., ASD or ADHD). In conclusion, sensory processing difficulties are relevant predictors of stress and occupational burnout, also in healthy employees. This phenomenon warrants further attention, as relatively simple adjustments in working environment may possess important preventive effects

Sensory processing difficulties in psychiatric disorders: A meta-analysis

In clinical practice, many individuals with psychiatric disorders report difficulties in sensory processing, including increased awareness or sensitivity to external stimuli. In this meta-analysis, we examined the sensory processing patterns of adolescent and adult individuals with a broad spectrum of different psychiatric conditions. A systematic search in various databases resulted in the inclusion of 33 studies (N=2008), all using the Adolescent/Adult Sensory Profile (AASP). By comparing diagnostic subgroups to the corresponding reference group of the AASP, we detected a general pattern of sensory processing, indicating elevated levels of low registration, sensory sensitivity and sensory avoiding and lowered sensory seeking behavior in patients with different types of psychiatric disorders. The majority of effect sizes were large to very large. In conclusion, sensory processing difficulties can be considered as a non-specific transdiagnostic phenotype associated with a broad spectrum of psychiatric conditions. Further research into the relevance and role of sensory processing difficulties in psychiatric disorders may improve long-term prognosis and treatment