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1.
Law Hum Behav ; 47(3): 448-461, 2023 06.
Article in English | MEDLINE | ID: mdl-37326550

ABSTRACT

OBJECTIVE: This study examined the degree to which polygraph results affected evaluators' decisions regarding patients committed as sexually violent persons (SVPs) in Wisconsin. Specifically, we examined evaluators' opinions on patients' significant progress in treatment (SPT), suitability for supervised release, and suitability for discharge. HYPOTHESES: We hypothesized that having failed a polygraph during the prior year would predict evaluators' opinions that patients did not meet criteria for SPT, supervised release, and discharge from civil commitment even after analyses controlled for other factors related to evaluators' decision making. Similarly, we hypothesized that patients taking and passing polygraphs in the year before the evaluations would predict positive recommendations for the aforementioned outcomes. METHOD: All patients civilly committed under Wisconsin's SVP statute who had a Treatment Progress Report (TPR) and a Chapter 980.07 evaluation completed by a state-employed forensic evaluator in 2017 were eligible for this study; we selected a random sample of 158 participants. TPR and 980.07 evaluation reports were coded to reflect evaluators' opinions regarding SPT, supervised release, and/or discharge. All polygraph types and outcomes completed within the review period were coded. RESULTS: Results indicated that taking and passing polygraphs significantly predicted favorable evaluator opinions regarding SPT after analyses controlled for other potentially relevant factors. Polygraphs were not significantly predictive of discharge or supervised release recommendations after analyses controlled for other factors. CONCLUSIONS: Some polygraph outcomes may affect specific evaluator opinions regarding treatment progress. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Subject(s)
Databases, Factual , Humans , Wisconsin
2.
Sex Abuse ; 35(5): 624-648, 2023 Aug.
Article in English | MEDLINE | ID: mdl-36377528

ABSTRACT

Undetected sexual offending creates challenges for risk assessment since estimated sexual recidivism rates are based on documented charges or convictions. Courts and other stakeholders may be primarily interested in the true risk for sexual reoffense and not simply risk for detected sexual offenses. Attempts to study and quantify the rate of undetected sexual offending have resulted in a wide variety of estimates. In this study, we explore whether sanctions imposed for detected sexual offenses increase the detection rate of subsequent offenses, and thereby suppress undetected sexual offending in an exceptionally high-risk sample who were ultimately committed as Sexually Violent Persons. Results indicate the detection rate of sexual offenses increased following an initial sanction, subsequently decreasing the proportion of undetected to detected offending. This effect only occurred after the first sanction. Overall, the sample had a high detection rate and spent little time in the community before subsequent arrests. These results differ from other reports that high rates of sexual offenses go undetected.


Subject(s)
Recidivism , Sex Offenses , Humans , Sexual Behavior , Risk Assessment
3.
Psychol Assess ; 34(6): 528-545, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35175077

ABSTRACT

The present study features the development of new risk categories and recidivism estimates for the Violence Risk Scale (VRS), a violence risk assessment and treatment planning tool. We employed a combined North American multisite sample (k = 6, N = 1,338) of adult mostly male offenders, many with violent criminal histories, from correctional or forensic mental health settings that had complete VRS scores from archival or field ratings and outcome data from police records (N = 1,100). There were two key objectives: (a) to identify the rates of violent recidivism associated with VRS scores and (b) to generate updated evidence-based VRS violence risk categories with external validation. To achieve the first objective, logistic regression was applied using VRS pretreatment and change scores on treated samples with a minimum 5-year follow-up (k = 5, N = 472) to model 2-, 3-, and 5-year violent and general recidivism estimates, with the resulting logistic regression algorithms retained to generate a VRS recidivism rates calculator. To achieve the second objective, the Council of State Governments' guidelines were applied to generate five risk levels using the common language framework using percentiles, risk ratios (from Cox regression), and absolute violent and general recidivism estimates (from logistic regression). Construct validity of the five risk levels was examined through group comparisons on measures of risk, need, protection, and psychopathy obtained from the constituent samples. VRS applications to enhance risk communication, treatment planning, and violence prevention in light of the updated recidivism estimates and risk categories are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
Criminals , Recidivism , Sex Offenses , Adult , Criminals/psychology , Female , Humans , Language , Male , Recidivism/prevention & control , Recidivism/psychology , Risk Assessment , Sex Offenses/psychology , Violence/prevention & control , Violence/psychology
4.
Behav Sci Law ; 40(3): 351-364, 2022 May.
Article in English | MEDLINE | ID: mdl-35083773

ABSTRACT

Civilly committed sexually violent persons (SVPs) are a select group of individuals designated as high risk for future sexual violence. Despite risk reduction in older age, SVP programs are seeing aging client populations, with many individuals remaining committed after age 60 (60+). Recent research found a sexual recidivism rate of 7.5% for 60+ individuals released from an SVP civil commitment program. The current paper follows up by examining reasons why individuals remain committed after age 60. It compares SVPs discharged after age 60 to those who are 60+ but remain civilly committed. Results of bivariate analyses reveal older SVPs who remain committed have significantly higher actuarial risk scores and are more likely to be of minority race. Multivariate logistic regression analyses found actuarial risk scores (Static-99R) predicted continued commitment, after controlling for other relevant variables. Barriers to community reintegration and suggestions for multi-disciplinary case management for older SVPs are discussed.


Subject(s)
Recidivism , Sex Offenses , Humans , Middle Aged , Patient Discharge , Risk Assessment , Risk Factors , Sexual Behavior
5.
Nutrients ; 13(10)2021 Oct 05.
Article in English | MEDLINE | ID: mdl-34684511

ABSTRACT

This study aimed to gain deeper knowledge about the relationship between vitamin D and physical activity in a sample of forensic inpatients. Sixty-seven male forensic inpatients participated. Participants were randomly assigned into an Intervention group (vitamin D) or a Control group (placebo). The Physical Activity-Rating (PA-R) questionnaire was used to measure physical activity from January to May. Vitamin D status was measured as 25-hydroxy vitamin D (25-OHD) pre- and post-intervention. The results revealed that vitamin D status at post-test was positively correlated with physical activity, but there was no effect of vitamin D supplementation looking at the two randomized groups. However, controlling for body mass index (BMI), the results showed an effect of BMI and a main effect of groups with a higher level of physical activity in the Intervention group. No interaction effects were found. Participants were also assigned into High and Low vitamin D groups based on the vitamin D status at post-test; i.e., the upper (75.1 nmol/L) and lower quartile (46.7 nmol/L). T-tests revealed that participants with a vitamin D status above 75 nmol/L showed significantly higher levels of physical activity than participants with a vitamin D status below 46.7 nmol/L. Thus, a vitamin D status above 75 nmol/L seems to be an optimal level.


Subject(s)
Dietary Supplements , Exercise/physiology , Nutritional Status/drug effects , Vitamin D/analogs & derivatives , Vitamin D/administration & dosage , Vitamins/administration & dosage , Adult , Body Mass Index , Double-Blind Method , Humans , Inpatients , Male , Middle Aged , Prisoners , Seasons , Treatment Outcome , Vitamin D/blood , Vitamin D Deficiency/blood , Vitamin D Deficiency/therapy
6.
Sex Abuse ; 33(1): 3-33, 2021 Feb.
Article in English | MEDLINE | ID: mdl-31478439

ABSTRACT

Although individuals with a history of sexual crime are often viewed as a lifelong risk, recent research has drawn attention to consistent declines in recidivism risk for those who remain offense free in the community. Because these declines are predictable, this article demonstrates how evaluators can use the amount of time individuals have remained offense free to (a) extrapolate to lifetime recidivism rates from rates observed for shorter time periods, (b) estimate the risk of sexual recidivism for individuals whose current offense is nonsexual but who have a history of sexual offending, and (c) calculate yearly reductions in risk for individuals who remain offense free in the community. In addition to their practical utility for case-specific decision making, these estimates also provide researchers an objective, empirical method of quantifying the extent to which individuals have desisted from sexual crime.


Subject(s)
Criminals/psychology , Criminals/statistics & numerical data , Recidivism/statistics & numerical data , Sex Offenses/statistics & numerical data , Criminal Psychology , Female , Humans , Male , Recidivism/psychology , Recurrence , Registries , Risk Factors , Sex Offenses/psychology , Violence/statistics & numerical data
7.
Nutrients ; 12(11)2020 Oct 24.
Article in English | MEDLINE | ID: mdl-33114392

ABSTRACT

Vitamin D status may be important for stress resilience. This study investigated the effects of vitamin D supplements during winter on biological markers of stress resilience such as psychophysiological activity, serotonin, and cortisol in a placebo-controlled, randomized clinical trial. Eighty-six participants were randomly assigned to the Intervention (vitamin D) or Control (placebo) groups. Before and after the intervention participants were exposed to an experimental stress procedure. Psychophysiological activity was measured during three main conditions: baseline, stress, and recovery. Fasting blood samples were taken in the morning and saliva samples were collected at seven different time points across 24 h. Prior to intervention both groups had normal/sufficient vitamin D levels. Both groups showed a normal pattern of psychophysiological responses to the experimental stress procedure (i.e., increased psychophysiological responses from resting baseline to stress-condition, and decreased psychophysiological responses from stress-condition to recovery; all p < 0.009). Post-intervention, the Intervention group showed increased vitamin D levels (p < 0.001) and normal psychophysiological responses to the experimental stress procedure (p < 0.001). Importantly, the Control group demonstrated a classic nadir in vitamin D status post-intervention (spring) (p < 0.001) and did not show normal psychophysiological responses. Thus, physiologically the Control group showed a sustained stress response. No significant effects of vitamin D were found on serotonin and cortisol.


Subject(s)
Dietary Supplements , Resilience, Psychological/drug effects , Stress, Physiological/drug effects , Vitamin D/administration & dosage , Vitamins/administration & dosage , Adult , Aged , Aged, 80 and over , Biomarkers/metabolism , Double-Blind Method , Fasting/blood , Female , Humans , Hydrocortisone/metabolism , Male , Middle Aged , Nutritional Status , Saliva/chemistry , Seasons , Serotonin/blood , Vitamin D/analogs & derivatives , Vitamin D/blood
8.
Alzheimers Dement ; 15(5): 615-624, 2019 05.
Article in English | MEDLINE | ID: mdl-30872114

ABSTRACT

INTRODUCTION: There is an unmet need for effective methods for conducting dementia prevention trials. METHODS: Home-based assessment study compared feasibility and efficiency, ability to capture change over time using in-home instruments, and ability to predict cognitive conversion using predefined triggers in a randomized clinical trial in (1) mail-in questionnaire/live telephone interviews, (2) automated telephone/interactive voice recognition, and (3) internet-based computer Kiosk technologies. Primary endpoint was defined as cognitive conversion. RESULTS: Analysis followed a modified intent-to-treat principle. Dropout rates were low and similar across technologies but participants in Kiosk were more likely to dropout earlier. Staff resources needed were higher in Kiosk. In-home instruments distinguished conversion and stable groups. Cognitively stable group showed improvement in cognitive measures. Triggering was associated with higher likelihood of conversion but statistically significant only in mail-in questionnaire/live telephone interviews. DISCUSSION: Relatively low efficiency of internet-based assessment compared with testing by live-assessors has implications for internet-based recruitment and assessment efforts currently proposed for diverse populations.


Subject(s)
Dementia/prevention & control , Geriatric Assessment , Healthy Volunteers/statistics & numerical data , Surveys and Questionnaires , Aged , Aged, 80 and over , Feasibility Studies , Female , Home Care Services , Humans , Male , Neuropsychological Tests/statistics & numerical data , Telephone
9.
Alzheimers Dement ; 14(11): 1397-1405, 2018 11.
Article in English | MEDLINE | ID: mdl-30297140

ABSTRACT

INTRODUCTION: Little is known about factors affecting motivation and satisfaction of participants in dementia prevention trials. METHODS: A Research Satisfaction Survey was administered to 422 nondemented older adults who participated in the Home-Based Assessment trial. RESULTS: Overall satisfaction was high, with means of all individual items near to above a value of 3 on a scale from 1 (worst) to 4 (best). Greater satisfaction was associated with staff-administered interviews versus automated technologies. The most liked aspects of research participation were volunteerism, opportunity to challenge and improve mental function, and positive interactions with staff. The least liked aspect was repetitiveness of the assessments. Participants requested more contact with staff and other older adults and more feedback on performance. DISCUSSION: Older adults' participation in research was primarily motivated by altruism. Methodologies that facilitate human contact, encourage feedback and novelty of tasks should be incorporated into future trial design.


Subject(s)
Biomedical Research , Dementia/prevention & control , Dementia/psychology , Aged, 80 and over , Altruism , Cohort Studies , Community Participation , Female , Humans , Male , Motivation , Neuropsychological Tests
10.
Psychol Assess ; 30(7): 941-955, 2018 07.
Article in English | MEDLINE | ID: mdl-29708372

ABSTRACT

The present study sought to develop updated risk categories and recidivism estimates for the Violence Risk Scale-Sexual Offense version (VRS-SO; Wong, Olver, Nicholaichuk, & Gordon, 2003-2017), a sexual offender risk assessment and treatment planning tool. The overarching purpose was to increase the clarity and accuracy of communicating risk assessment information that includes a systematic incorporation of new information (i.e., change) to modify risk estimates. Four treated samples of sexual offenders with VRS-SO pretreatment, posttreatment, and Static-99R ratings were combined with a minimum follow-up period of 10-years postrelease (N = 913). Logistic regression was used to model 5- and 10-year sexual and violent (including sexual) recidivism estimates across 6 different regression models employing specific risk and change score information from the VRS-SO and/or Static-99R. A rationale is presented for clinical applications of select models and the necessity of controlling for baseline risk when utilizing change information across repeated assessments. Information concerning relative risk (percentiles) and absolute risk (recidivism estimates) is integrated with common risk assessment language guidelines to generate new risk categories for the VRS-SO. Guidelines for model selection and forensic clinical application of the risk estimates are discussed. (PsycINFO Database Record


Subject(s)
Criminals/psychology , Psychiatric Status Rating Scales/statistics & numerical data , Recidivism/psychology , Sex Offenses/prevention & control , Sex Offenses/psychology , Adult , Canada , Criminals/statistics & numerical data , Follow-Up Studies , Humans , Male , New Zealand , Probability , Recidivism/statistics & numerical data , Reproducibility of Results , Risk Assessment , Sex Offenses/statistics & numerical data
11.
Innov Clin Neurosci ; 14(3-4): 17-23, 2017.
Article in English | MEDLINE | ID: mdl-28584693

ABSTRACT

Objectives: Our study objective was to compare the equivalence of a new version of the electronic Columbia-Suicide Severity Rating Scale that was administered on a tablet device with the existing interactive voice response version in order to support the prospective monitoring of suicidal ideation and behavior in clinical trials and clinical practice. Design: This was a randomized, crossover-equivalence study with no treatment intervention. Setting: The study setting was a psychiatric hospital. Participants: Fifty-eight recently admitted psychiatric inpatients and 28 employees of the hospital site were included in the study. Mean age was 41.0 years (standard deviation=12.5), and 59 percent were female. Measurements: Participants completed both tablet and interactive voice response versions in randomized order, with a 25-minute break between administrations. Finally, participants completed a second administration of the first administered version. Intraclass correlation coefficients (ICCs) and Kappa coefficients were used to evaluate agreement across modalities. Results: High levels of agreement were observed for most severe lifetime (ICC=0.88) and recent (ICC=0.79) ideation, occurrence of actual lifetime (Kappa=0.81) and recent (Kappa=0.73) suicide attempts, and occurrence of lifetime interrupted attempts (Kappa=0.78), aborted attempts (Kappa=0.54), and preparatory behaviors (Kappa=0.77), as well as non-suicidal self-injurious behavior (Kappa=0.73). Scores from both modes significantly differentiated psychiatric patients and hospital employee controls, and the test-retest reliability of both modes was excellent. Conclusions: These results support the validity and reliability of the new tablet-based electronic Columbia-Suicide Severity Rating Scale. This will allow the inclusion of the electronic Columbia-Suicide Severity Rating Scale in a wider range of clinical studies, particularly where a tablet is also being used to collect other study data.

12.
Int J Offender Ther Comp Criminol ; 61(14): 1593-1605, 2017 Oct.
Article in English | MEDLINE | ID: mdl-26758206

ABSTRACT

The Static-99R is an actuarial scale that is commonly used to assess the recidivism risk of male sex offenders. Hanson, Thornton, Helmus, and Babchishin recently revised the Static-99R norms based on revised analyses that excluded the large Bridgewater sample. As a result, the sample size of the high risk/high need (HR/HN) group was reduced substantially, which increased the confidence intervals around the predicted recidivism rates. This study provides alternative 5- and 10-year recidivism rates based on logistic regression analyses of the entire 2009 Static-99R HR/HN group that includes the Bridgewater sample. These rates fit the observed 2009 data well and have smaller confidence intervals. We propose that using alternative sexual recidivism rates from the 2009 HR/HN group is a viable option for assessing sexually violent person (SVP) and other high-risk offenders.


Subject(s)
Criminals , Recidivism , Risk Assessment , Sex Offenses , Follow-Up Studies , Humans , Logistic Models , Male
13.
Ann Gen Psychiatry ; 15: 2, 2016.
Article in English | MEDLINE | ID: mdl-26779277

ABSTRACT

[This corrects the article DOI: 10.1186/s12991-015-0077-8.].

14.
Ann Gen Psychiatry ; 14: 37, 2015.
Article in English | MEDLINE | ID: mdl-26535048

ABSTRACT

BACKGROUND: Rapid advances in information technology and telecommunications have resulted in a dramatic increase in the use of mobile devices and the internet to enhance and facilitate access to treatment. Cognitive behavior therapy (CBT) is an empirically based treatment that is well suited for enhancement by new technologies, particularly with youth. To facilitate the dissemination of this evidence-based treatment, we developed a technology-enhanced CBT intervention for the treatment of adolescent depression consisting of (1) online therapist training (2) in-session use of tablets for teaching clients CBT concepts and skills, and (3) text messaging for between session homework reminders and self-monitoring. METHODS: Eighteen licensed clinicians (social workers n = 7, psychologists n = 9) were randomized to have their patients receive either the intervention (CBT) or treatment as usual (TAU). Each clinician treated four adolescents for 12 weeks. Clinicians in the CBT arm completed an online tutorial on CBT treatment of adolescent depression, then received an iPad with access to patient education materials for teaching CBT concepts to patients during sessions. Individualized text messages were integrated into treatment for homework reminders, support, and outcomes measurement. Outcome measures included a 49-item multiple choice test for tutorial effectiveness; the system usability scale (SUS) for user satisfaction; quick inventory of depressive symptomatology-adolescent version (QIDS-A-Pat); and clinician and patient ratings on the therapeutic alliance scale for adolescents (TASA). RESULTS: A significant increase in knowledge of CBT concepts was found after completing the tutorial, t(8) = 7.02, p < 0.001. Clinician and patient ratings of user satisfaction were high for both the iPad teaching tools, and the text messaging. Ninety-five percent of teens said reviewing their text messages with their therapist was helpful, and all said they would use text messaging in treatment again. Ratings of the therapeutic alliance were higher in the CBT arm t(131) = 4.03, p = 0.001. A significant reduction in depression was found in both groups [t(34) = 8.453, p < 0.001 and t(29) = 6.67, p < 0.001 for CBT and TAU, respectively). Clinical ratings of improvement were greater on all outcome measures for the CBT arm; however, none reached statistical significance. Effect sizes (Cohen's d) ranged from small (QIDS-A) to large (TASA). CONCLUSIONS: Results support the feasibility of this technology-enhanced CBT intervention as a means of improving CBT treatment of adolescent depression and may help address the critical shortage of therapists trained on empirically based treatments.

15.
Int J Speech Lang Pathol ; 17(2): 115-20, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25020146

ABSTRACT

PURPOSE: To investigate the feasibility of adopting automated interactive voice response (IVR) technology for remotely capturing standardized speech samples from stuttering children. METHOD: Participants were 10 6-year-old stuttering children. Their parents called a toll-free number from their homes and were prompted to elicit speech from their children using a standard protocol involving conversation, picture description and games. The automated IVR system was implemented using an off-the-shelf telephony software program and delivered by a standard desktop computer. The software infrastructure utilizes voice over internet protocol. Speech samples were automatically recorded during the calls. Video recordings were simultaneously acquired in the home at the time of the call to evaluate the fidelity of the telephone collected samples. Key outcome measures included syllables spoken, percentage of syllables stuttered and an overall rating of stuttering severity using a 10-point scale. RESULT: Data revealed a high level of relative reliability in terms of intra-class correlation between the video and telephone acquired samples on all outcome measures during the conversation task. Findings were less consistent for speech samples during picture description and games. CONCLUSION: Results suggest that IVR technology can be used successfully to automate remote capture of child speech samples.


Subject(s)
Speech Production Measurement/methods , Speech Recognition Software , Stuttering , Child , Female , Humans , Male , Telephone
16.
Innov Clin Neurosci ; 11(9-10): 14-22, 2014 Sep.
Article in English | MEDLINE | ID: mdl-25520885

ABSTRACT

OBJECTIVE: To survey the current approaches of clinical trial sponsors in prospective suicidal ideation and behavior assessments and challenges encountered. DESIGN: An internet-based survey. SETTING: Inclusion of prospective assessments of suicidal ideation and behavior in industry-sponsored clinical studies were required following the release of the September 2010 United States Federal Drug Administration draft guidance. The International Society for CNS Clinical Trials and Methodology Suicidal Ideation and Behavior Assessment Workgroup conducted an online survey to understand industry practices and experiences in implementing suicidal ideation and behavior assessments in clinical trials. PARTICIPANTS: The survey was sent to 1,447 industry employees at 178 pharmaceutical companies. A total of 89 evaluable responses, representing 39 companies, were obtained. MEASUREMENTS: A 30-item internet survey was developed asking about potential challenges and issues in implementing prospective suicidal ideation and behavior assessments. RESULTS: Common factors in deciding whether to include suicidal ideation and behavior assessments in a clinical trial were psychiatric or neurologic drug product (95%); central nervous system activity (78%); disease (74%) and patient population (71%); and regulatory announcements and policies (74%). The most common challenges in implementing suicidal ideation and behavior assessments included cross-cultural differences in acceptance of SIB assessments (40%); obtaining adequate baseline history (36.8%); obtaining translations (35%); investigator/rater discomfort with asking about suicidal ideation and behavior (32%); and inadequate training of raters to administer suicidal ideation and behavior ratings (30%). CONCLUSION: Among sponsors surveyed, the implementation rate of suicidal ideation and behavior assessment in central nervous systems studies is very high. Most have used the Columbia-Suicide Severity Rating Scale. Challenges regarding standardization of retrospective assessment timeframes and differing approaches to summarizing and analyzing suicidal ideation and behavior-related study data were frequently reported. These results suggest that inconsistent reports of suicidal ideation and behavior within study datasets may occur and that integration of data across studies remains a concern.

17.
Innov Clin Neurosci ; 11(9-10): 23-31, 2014 Sep.
Article in English | MEDLINE | ID: mdl-25520886

ABSTRACT

OBJECTIVE: Examine the ability of baseline electronic Columbia-Suicide Severity Rating Scale lifetime suicidal ideation and behavior categories to predict prospective reports of suicidal behavior in psychiatric and non-psychiatric research participants. DESIGN: Meta-analysis of 74,406 eC-SSRS assessments completed between September 2009 and December 2012. SETTING: Thirty-three clinical research studies that used the electronic Columbia-Suicide Severity Rating Scale to assess suicidal ideation and behavior at baseline and prospectively during follow-up visits. PARTICIPANTS: Records from 6,760 patients with psychiatric disorders (opioid dependence, generalized anxiety, major depressive, and posttraumatic stress disorders) and 2,077 nonpsychiatric disorder patients (chronic obstructive pulmonary disease, epilepsy, fibromyalgia, human immunodeficiency virus, insomnia, multiple sclerosis, osteoarthritis, pain/back pain, Parkinson's disease, restless leg syndrome) were analyzed. MEASUREMENTS: Electronic Columbia-Suicide Severity Rating Scale assessment of lifetime suicidal ideation (5 severity levels) and suicidal behavior (4 types) at baseline and prospectively reported suicidal behavior during study participation. RESULTS: Increasingly more severe lifetime suicidal ideation at baseline was associated with a progressively greater likelihood of prospectively reported suicidal behavior during study participation. Intent to act on suicidal ideation was most predictive of reports of suicidal behavior. Reports of lifetime suicidal behaviors at baseline also predicted subsequent suicidal behavior, and multiple lifetime behaviors monotonically increased prospective risk of suicidal behavior. Baseline suicidal ideation and behavior predicted future suicidal behavior in both psychiatric and non-psychiatric trials. CONCLUSIONS: Lifetime reports of suicidal ideation and/or behavior at baseline significantly increased risk of prospectively reporting suicidal behavior during research trial participation in both psychiatric and nonpsychiatric patients. Lifetime prevalence of suicidal ideation and behavior is higher among psychiatric patients, but also presents a safety concern among nonpsychiatric patients when reported.

18.
J Clin Psychiatry ; 74(9): 887-93, 2013 Sep.
Article in English | MEDLINE | ID: mdl-24107762

ABSTRACT

OBJECTIVE: To evaluate whether lifetime suicidal ideation with intention to act and/or suicidal behaviors reported at baseline predict risk of prospectively reporting suicidal behavior during subsequent study participation. METHOD: Data from studies using the electronic Columbia-Suicide Severity Rating Scale (eC-SSRS) to prospectively monitor suicidal ideation and behaviors between September 2009 and May 2011 were analyzed. Studies included patients with major depressive disorder, insomnia, posttraumatic stress disorder, epilepsy, and fibromyalgia. Records for 35,224 eC-SSRS assessments were extracted. Incomplete assessments and eC-SSRS records from patients missing a baseline assessment or with no prospective follow-up assessments were excluded. Baseline lifetime eC-SSRS reports were categorized as negative (no lifetime ideation with intent to act or prior suicidal behavior) or positive (lifetime ideation with intent to act but no prior behavior, no ideation with intent to act but prior behavior, or both lifetime ideation with intent and prior behavior). RESULTS: 3,776 patients completed a baseline and 1 or more follow-up assessments. The mean follow-up period was 64 days. Of patients with negative lifetime reports, 2.4% subsequently reported suicidal behavior during study participation, compared to 12.0% of patients with lifetime ideation with intent only (OR = 5.55; 95% CI, 2.65-11.59), 9.6% of patients with lifetime behavior only (OR = 4.33; 95% CI, 2.94-6.39), and 18.3% of patients with both (OR = 9.13; 95% CI, 6.47-12.88). Sensitivity and specificity of positive reports for identifying suicidal behaviors were 0.67 and 0.76, respectively. CONCLUSIONS: Patients reporting lifetime suicidal ideation with intent to act and/or prior suicidal behavior at baseline are 4 to 9 times more likely to prospectively report suicidal behavior during study participation.


Subject(s)
Intention , Internet , Psychiatric Status Rating Scales/statistics & numerical data , Suicidal Ideation , Suicide, Attempted/psychology , Comorbidity , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/epidemiology , Depressive Disorder, Major/psychology , Epilepsy/diagnosis , Epilepsy/epidemiology , Epilepsy/psychology , Fibromyalgia/diagnosis , Fibromyalgia/epidemiology , Fibromyalgia/psychology , Follow-Up Studies , Humans , Psychometrics/statistics & numerical data , Reproducibility of Results , Risk Assessment , Risk Factors , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/psychology , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Suicide, Attempted/statistics & numerical data
19.
Alzheimer Dis Assoc Disord ; 27(4): 356-62, 2013.
Article in English | MEDLINE | ID: mdl-23151596

ABSTRACT

This report describes the baseline experience of the multicenter, Home-Based Assessment study, designed to develop methods for dementia prevention trials using novel technologies for test administration and data collection. Nondemented individuals of 75 years of age or more were recruited and evaluated in-person using established clinical trial outcomes of cognition and function, and randomized to one of 3 assessment methodologies: (1) mail-in questionnaire/live telephone interviews [mail-in/phone (MIP)]; (2) automated telephone with interactive voice recognition; and (3) internet-based computer Kiosk. Brief versions of cognitive and noncognitive outcomes were adapted to each methodology and administered at baseline and repeatedly over a 4-year period. "Efficiency" measures assessed the time from screening to baseline, and staff time required for each methodology. A total of 713 individuals signed consent and were screened; 640 met eligibility and were randomized to one of 3 assessment arms; and 581 completed baseline. Dropout, time from screening to baseline, and total staff time were highest among those assigned to internet-based computer Kiosk. However, efficiency measures were driven by nonrecurring start-up activities suggesting that differences may be mitigated over a long trial. Performance among Home-Based Assessment instruments collected through different technologies will be compared with established outcomes over this 4-year study.


Subject(s)
Dementia/prevention & control , Dementia/psychology , Geriatric Assessment/methods , House Calls , Research Report , Aged , Aged, 80 and over , Dementia/diagnosis , Female , Follow-Up Studies , Humans , Internet/standards , Longitudinal Studies , Male , Research Report/standards , Surveys and Questionnaires/standards , Telephone/standards
20.
J Nerv Ment Dis ; 200(8): 712-5, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22850307

ABSTRACT

This study aimed to investigate the psychometric properties of the Chinese translations of the Quick Inventory of Depressive Symptomatology (QIDS(16)), including the Clinician-Rated (QIDS-C(16)), Self-report (QIDS-SR(16)), and Interactive Voice Response (QIDS-SR-IVR(16)) formats. Thirty depressed Chinese Americans were assessed with Chinese translations of the QIDS-SR(16), QIDS-SR-IVR(16), and QIDS-C(16). Cronbach alpha estimates of internal scale consistency on the QIDS-SR(16), QIDS-SR-IVR(16), and QIDS-C(16) were 0.70, 0.74, and 0.79, respectively. Intercorrelations among the measures were QIDS-SR(16) and QIDS-SR-IVR(16), r = 0.79; QIDS-SR(16) and QIDS-C(16), r = 0.61; and QIDS-SR-IVR(16) and QIDS-C(16), r = 0.69 (all p values < 0.01). The areas under the curve for the receiver operating characteristics of the QIDS-SR(16) and QIDS-SR-IVR(16) were 0.78 (95% confidence interval, 0.61-0.95) and 0.81 (95% confidence interval, 0.65-0.96), respectively. The respective screening sensitivities/specificities were 0.73/0.74 and 0.86/0.58. The Chinese translations of the QIDS(16) have adequate psychometric properties and may be useful tools for depression screening.


Subject(s)
Asian/psychology , Depressive Disorder, Major/diagnosis , Psychiatric Status Rating Scales , Adult , Aged , Aged, 80 and over , Depressive Disorder, Major/psychology , Female , Humans , Male , Middle Aged , Psychometrics , Reproducibility of Results , Self Disclosure , Translating , Young Adult
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