Behavior Sequencing Violent Episodes in Forensic Youth Populations.

Every year, more children and youths are sent to Secure Children's Homes while moving through the criminal justice system. Aggressive and violent incidents in these settings are common, and staff are often required to intervene and restrain violent individuals. The research literature has many examples of aggression and violence questionnaires and measures; however, for staff in communal areas it is the observable behaviors that they react to most. The current research, therefore, analyzed observable behaviors leading-up to violent episodes, and used Behavior Sequence Analysis to highlight the typical chains of behaviors that tend toward violence. The outcomes of this research show pathways to violence that staff can use to highlight potential spirals of aggression and violence. The current results show the links between non-confrontational behaviors (e.g., talking) through to more confrontational (staring, approaching, and pushing others). Overall, the research forms the foundation for future investigation into these and similar settings and outlines a novel approach to understanding violence escalation in a way that can be interpreted and used by service staff.

A comparison of temporal pathways to self-harm in young people compared to adults: A pilot test of the Card Sort Task for Self-harm online using Indicator Wave Analysis.

Background: Self-harm is complex, multifaceted, and dynamic, typically starts in adolescence, and is prevalent in young people. A novel research tool (the Card Sort Task for Self-harm; CaTS) offers a systematic approach to understanding this complexity by charting the dynamic interplay between multidimensional factors in the build-up to self-harm. Sequential analysis of CaTS has revealed differences in key factors between the first and the most recent episode of self-harm in adolescence. Rates of self-harm typically decline post-adolescence, but self-harm can continue into adulthood. A comparison between factors linked to self-harm in young people vs. adults will inform an understanding of how risk unfolds over time and clarify age-specific points for intervention. A pilot online adaptation (CaTS-online) and a new method (Indicator Wave Analysis; IWA) were used to assess key factors in the build-up to self-harm. Methods: Community-based young people (n = 66; 18-25 years, M = 21.4; SD = 1.8) and adults (n = 43; 26-57 years, M = 35; SD = 8.8) completed CaTS-online, documenting thoughts, feelings, events, and behaviours over a 6-month timeline for the first ever and most recent self-harm. A notable interdependence between factors and time points was identified using IWA. Results: Positive emotion at and immediately after self-harm exceeded the threshold for both groups for both episodes. Feeling better following self-harm was more pronounced for the first-ever episodes. Impulsivity was an important immediate antecedent to self-harm for both groups at both episodes but most markedly for young people. Acquired capability was notable for adults' most recent episodes, suggesting this develops over time. Burdensomeness was only more notable for adults and occurred 1 week prior to a recent episode. Both groups revealed patterns of accessing support that were helpful and unhelpful. Conclusion: Commonalities and differences in the temporal organisation of factors leading to and following self-harm were identified in young people and adult pathways which shed light on age-specific factors and possible points of intervention. This has implications for clinical support and services around approaches to positive feelings after self-harm (especially for first-ever self-harm), feeling of burdensomeness, impulsivity, and acquired capability leading up to self-harm. Support is provided for card-sort approaches that enable the investigation of the complex and dynamic nature of pathways to self-harm.

Evaluation of benazepril in cats with heart disease in a prospective, randomized, blinded, placebo-controlled clinical trial.

BACKGROUND: Heart disease is an important cause of morbidity and mortality in cats, but there is limited evidence of the benefit of any medication. HYPOTHESIS: The angiotensin-converting enzyme inhibitor benazepril would delay the time to treatment failure in cats with heart disease of various etiologies. ANIMALS: One hundred fifty-one client-owned cats. METHODS: Cats with heart disease, confirmed by echocardiography, with or without clinical signs of congestive heart failure, were recruited between 2002 and 2005 and randomized to benazepril or placebo in a prospective, multicenter, parallel-group, blinded clinical trial. Benazepril (0.5-1.0 mg/kg) or placebo was administered PO once daily for up to 2 years. The primary endpoint was treatment failure. Analyses were conducted separately for all-cause treatment failure (main analysis) and heart disease-related treatment failure (supportive analysis). RESULTS: No benefit of benazepril versus placebo was detected for time to all-cause treatment failure (P = .42) or time to treatment failure related to heart disease (P = .21). Hazard ratios (95% confidence interval [CI]) from multivariate analysis for benazepril compared with placebo were 1.00 (0.57-1.74) for all-cause failure, and 0.99 (0.50-1.94) for forward selection and 0.93 (0.48-1.81) for bidirectional selection models for heart disease-related failure. There were no significant differences between groups over time after administration of the test articles in left atrium diameter, left ventricle wall thickness, quality of life scores, adverse events, or plasma biochemistry or hematology variables. CONCLUSIONS AND CLINICAL RELEVANCE: Benazepril was tolerated well in cats with heart disease, but no evidence of benefit was detected.

Unmaking a murderer: behaviour sequence analysis of false confessions.

The causes of false confessions are an important issue in legal studies and forensics. Recent advances in DNA testing have increased the number of proven false confessions; however, there are probably many cases without scientific evidence to refute the guilty verdict. The current research provides a novel approach to understand the structure and process of police interrogation techniques, in the United States behaviour sequence analysis. This method allows complex interactions in interrogations to be broken down and the progression of techniques analysed clearly. A case study is provided of an individual who confessed to a series of very serious crimes. The results show that several psychological techniques, such as leading statements, pressure, empathy, and inducements, are used, in increasing frequency, which resulted in the suspect's confession. This research provides support for behaviour sequence analysis as a new method to understand the structure of police interrogations and how psychological techniques may be used to gain false confessions.

A Behaviour Sequence Analysis of Nonverbal Communication and Deceit in Different Personality Clusters.

Despite difficulties in interpretation, nonverbal communication is especially important in forensic settings, such as police investigations. Three distinct clusters of personality disorders have been outlined as being associated with criminal behaviour. Understanding the similarities and differences between these personality clusters and nonverbal communication could help investigators look for key signs of psychological distress or deception. The current research proposes a novel approach to nonverbal communication: behaviour sequence analysis (BSA). An application of this approach is outlined to investigate whether criminals with different personality types are better at concealing emotions and nonverbal communication when being interrogated. The results indicate that while sequences are generally similar across clusters, individuals from different personality clusters exhibit unique patterns. This research provides an initial step towards a new area of nonverbal communication research and application, which could be used in future research to highlight increased possibility of deception or concealment of emotion.

Solving medical mysteries: hidden stresses and unexplained symptoms.

Medically unexplained symptoms and chronic functional syndromes are common but few healthcare professionals have had formal training about their connection to psychosocial issues. A systematic approach to diagnosis and treatment based on experience with over 7000 of these patients is described. Outcomes improve with assessment for and treatment of current life stresses, the prolonged impact of adversity in childhood and somatic presentations of depression, post-traumatic stress, and anxiety disorders.

Diagnosis and treatment of medically unexplained symptoms and chronic functional syndromes.

Medically unexplained symptoms and chronic functional syndromes are common but few health care professionals have had formal training about their connection to psychosocial issues. A systematic approach to diagnosis and treatment is described that is based on published evidence and detailed interviews with more than 7,000 of these patients. This approach is designed to meet the needs of primary care teams using techniques for assessing and treating current life stresses, the prolonged impact of adversity in childhood and somatic presentations of depression, posttraumatic stress, and anxiety disorders. (PsycINFO Database Record

The temporal rating of emergency non-technical skills (TRENT) index for self and others: psychometric properties and emotional responses.

BACKGROUND: To enhance the non-technical skills (NTS) assessment literature by developing a reliable and valid peer and self-assessment tool for NTS in a simulated ward setting to include emotional reactions: the Temporal Rating of Emergency Non-Technical skills (TRENT) Index. The paper aims to document (1) the psychometric properties of the TRENT index (e.g., reliability, idiosyncrasy biases) and (2) its validity in terms of performance-emotional associations in the high fidelity simulated ward environment. METHODS: Two samples of doctors (Ns =150 & 90) taking part in emergency simulations provided both self and peer-assessment of NTS, with the second sample also providing self-assessments of mood. The psychometric properties of the TRENT were explored for self- and peer-assessment, and pre- and post-simulation environment mood was used to assess validity. RESULTS: A psychometrically reliable and valid 5-factor assessment of NTS was developed. While there was evidence for both intra-rater and inter-rater reliability, inter-rater idiosyncrasy was also observed. Self-rated, but not peer-rated, negative performance was positively associated with post simulation negative mood. CONCLUSION: These are the first results that pertain to inter-, intra-rater reliability as well as idiosyncratic biases in NTS assessment and the first to show that simulator performance can influence mood after assessment. Potential clinical carry-over effects of mood are discussed.

Effects of pretesting implicit self-determined motivation on behavioral engagement: evidence for the mere measurement effect at the implicit level.

Research into individuals' intended behavior and performance has traditionally adopted explicitly measured, self-report constructs, and outcomes. More recently, research has shown that completing explicit self-report measures of constructs may effect subsequent behavior, termed the "mere measurement" effect. The aim of the present experiment was to investigate whether implicit measures of motivation showed a similar mere measurement effect on subsequent behavior. It may be the case that measuring the implicit systems affects subsequent implicit interventions (e.g., priming), observable on subsequent behavior. Priming manipulations were also given to participants in order to investigate the interaction between measurement and priming of motivation. Initially, a 2 [implicit association test (IAT: present vs. absent) ×2 (Prime: autonomous vs. absent) and a 2 (IAT: present vs. absent) × 2 (Prime: controlled vs. absent)] between participants designs were conducted, these were them combined into a 2 (IAT: present vs. absent) ×3 (Prime: autonomous vs. controlled vs. absent) between participants design, with attempts at a novel task taken as the outcome measure. Implicit measure completion significantly decreased behavioral engagement. Priming autonomous motivation significantly facilitated, and controlled motivation significantly inhibited performance. Finally, there was a significant implicit measurement × priming interaction, such that priming autonomous motivation only improved performance in the absence of the implicit measure. Overall, this research provides an insight into the effects of implicit measurement and priming of motivation and the combined effect of completing both tasks on behavior.

Investigating the predictive validity of implicit and explicit measures of motivation in problem-solving behavioural tasks.

Research into the effects of individuals'autonomous motivation on behaviour has traditionally adopted explicit measures and self-reported outcome assessment. Recently, there has been increased interest in the effects of implicit motivational processes underlying behaviour from a self-determination theory (SDT) perspective. The aim of the present research was to provide support for the predictive validity of an implicit measure of autonomous motivation on behavioural persistence on two objectively measurable tasks. SDT and a dual-systems model were adopted as frameworks to explain the unique effects offered by explicit and implicit autonomous motivational constructs on behavioural persistence. In both studies, implicit autonomous motivation significantly predicted unique variance in time spent on each task. Several explicit measures of autonomous motivation also significantly predicted persistence. Results provide support for the proposed model and the inclusion of implicit measures in research on motivated behaviour. In addition, implicit measures of autonomous motivation appear to be better suited to explaining variance in behaviours that are more spontaneous or unplanned. Future implications for research examining implicit motivation from dual-systems models and SDT approaches are outlined.

The predictive validity of implicit measures of self-determined motivation across health-related behaviours.

OBJECTIVE: Research on health-related behaviour has typically adopted deliberative models of motivation and explicit measures. However, growing support for implicit processes in motivation and health-related behaviour has caused a shift towards developing models that incorporate implicit and explicit processes. METHODS: The current research advances this area by comparing the predictive validity of a newly developed implicit measure of motivation from self-determination theory (SDT) with explicit measures of motivation for 20 health-related behaviours, in a sample of undergraduate students (N= 162). A dual systems model was developed to test whether implicit motivation provided unique prediction of behaviour. RESULTS: Structural equation models for each behaviour indicated some support for the role of implicit measures; explicit measures and intention provided more consistent, significant prediction across most behaviours. CONCLUSIONS: This study provides some support for dual systems models, and offers an important contribution to understanding why some behaviours may be better predicted by either implicit or explicit measures. Future implications for implicit processes and SDT are outlined. STATEMENT OF CONTRIBUTION: WHAT IS ALREADY KNOWN ON THIS SUBJECT? : Previous research has highlighted the unique effects of implicit processes on goal-directed behaviour. Several studies have supported the role of implicit processes in motivation. WHAT DOES THIS STUDY ADD? : The current study adds to the previous literature by investigating the role of implicit processes and self-determination theory. Furthermore, the current study uses a relatively novel implicit measure across a wide range of behaviours. Finally, the current study incorporates a dual-systems model to provide a conceptual understanding of the findings.

Investigating the predictive validity of implicit and explicit measures of motivation on condom use, physical activity and healthy eating.

The literature on health-related behaviours and motivation is replete with research involving explicit processes and their relations with intentions and behaviour. Recently, interest has been focused on the impact of implicit processes and measures on health-related behaviours. Dual-systems models have been proposed to provide a framework for understanding the effects of explicit or deliberative and implicit or impulsive processes on health behaviours. Informed by a dual-systems approach and self-determination theory, the aim of this study was to test the effects of implicit and explicit motivation on three health-related behaviours in a sample of undergraduate students (N = 162). Implicit motives were hypothesised to predict behaviour independent of intentions while explicit motives would be mediated by intentions. Regression analyses indicated that implicit motivation predicted physical activity behaviour only. Across all behaviours, intention mediated the effects of explicit motivational variables from self-determination theory. This study provides limited support for dual-systems models and the role of implicit motivation in the prediction of health-related behaviour. Suggestions for future research into the role of implicit processes in motivation are outlined.

Older drivers' road traffic crashes in the UK.

A sample of over 2000 crashes involving drivers aged 60 years or over was considered, from three UK midland police forces, from the years 1994-2007 inclusive. Each case was summarized on a database including the main objective features (such as time and place), a summary narrative, a sketch plan and a list of explanatory factors. The main findings were that older drivers have significant problems with intersection collisions and failing to give right of way; these formed the largest single class of crashes in the sample. Possible behavioural explanations for this will be discussed, along with other findings regarding older driver blameworthiness, fatigue and illness, time of day factors, and 'unintended accelerations'.

Killer crashes: fatal road traffic accidents in the UK.

Road traffic accidents are responsible for over 3000 deaths per year in the UK, according to Department for Transport (2004a) figures. Although progress is being made in a number of areas, vehicle occupant fatalities have not been falling in line with casualty reduction targets for the year 2010. A sample of 1185 fatal vehicle occupant cases was considered, from ten UK police forces, from the years 1994-2005 inclusive. The main findings were: (1) over 65% of the accidents examined involved driving at excessive speed, a driver in excess of the legal alcohol limit, or the failure to wear a seat belt by a fatality, or some combination of these. (2) Young drivers have the great majority of their accidents by losing control on bends or curves, typically at night in rural areas and/or while driving for 'leisure' purposes. These accidents show high levels of speeding, alcohol involvement and recklessness. (3) Older drivers had fewer accidents, but those fatalities they were involved in tended to involve misjudgement and perceptual errors in 'right of way' collisions, typically in the daytime on rural rather than urban roads. Blameworthy right of way errors were notably high for drivers aged over 65 years, as a proportion of total fatal accidents in that age group.

The treatment of patients with medically unexplained symptoms in primary care: a review of the literature.

Medically unexplained symptoms (MUS) are among the most common and frustrating in primary care. Our goal was to review published evidence to guide busy general practitioners working with a culturally diverse, challenging patient population coping with MUS. A search of PubMed and PsycINFO from 1985 to the present was conducted using MUS and related terms.The literature was then organised into subcategories based on its relevance to primary care. We conclude with a description of gaps in the literature based on the literature review and the clinical experience of the authors.

A prospective multi-centre clinical trial to compare buprenorphine and butorphanol for postoperative analgesia in cats.

One hundred and fifty-three cats undergoing surgery in seven veterinary practices in Great Britain were studied. They were randomly allocated to receive either 10-20 microg/kg buprenorphine or 0.4 mg/kg butorphanol with acepromazine before anaesthesia with propofol, Saffan or thiopentone and isoflurane or halothane. Routine monitoring was undertaken. Pain and sedation were assessed blind using a four point (0-3) simple descriptive scale (SDS) at 1, 2, 4, 8 and 24h. Pain and sedation data were compared using non-parametric statistical tests and continuous data using t tests or analysis of variance (ANOVA). Anaesthesia and surgery were uneventful, and cardiorespiratory data were within normal limits. After surgery, overall, more cats had pain score 0 after buprenorphine and more had pain score 3 after butorphanol (P=0.0465). At individual time points, more cats had lower pain scores after buprenorphine at 2 (P=0.040) and 24 (P=0.036)h. At 24h 83% after buprenorphine and 63% after butorphanol had pain score 0 (P<0.04). Buprenorphine provided better and longer lasting postoperative analgesia than butorphanol.

Work-related road traffic collisions in the UK.

Road traffic collisions while at work are the single largest cause of occupational fatality in the United Kingdom. Work-related road collisions do not comprise a homogenous group, but take many forms, encompassing the use of varying types of vehicle used for diverse purposes. A sample of over 2000 collision cases was considered, over 1000 in detail, from UK police forces, involving drivers/workers of all ages, and covering the years 1996-2004 inclusive. There were three key findings. (1) There were six main classes of collision-involved vehicles. These were company cars, vans/pickups, large goods vehicles (LGVs), buses (PCVs or 'passenger carrying vehicles'), taxis/minicabs, and emergency vehicles (police, fire/rescue and ambulance). (2) The drivers of company cars, vans/pickups, and large goods vehicles (LGVs) all appeared to have a high 'blameworthiness ratio' in their collision involvement. Company car drivers showed excess speed as a causal factor, whereas van drivers showed more observational failures, and LGV drivers showed more fatigue and vehicle defects as factors. (3) The drivers of buses (PCVs), taxis/minicabs, and emergency vehicles showed a low 'blameworthiness ratio' in their collision involvement. Their problems seemed to be primarily with the other drivers/parties with whom they share the road. While they made a variety of mistakes or errors, they were more likely to become the victim of another party's mistake or error.