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1.
Artículo en Inglés | MEDLINE | ID: mdl-38722568

RESUMEN

Previous cross-sectional studies suggest that birth weight (BW) is associated with aggression-, social- and attention problems differently in boys and girls. We sought to test if these differences could be confirmed in a longitudinal study. The 1989 Raine Study provided prospectively collected data on perinatal variables and repeated child behaviour checklist assessments from ages 5 to 17. Linear mixed effects models provided crude and adjusted relationships between BW and childhood behaviour at a conservative significance threshold using prenatal maternal covariables in adjusted models. Sensitivity analyses included an age10 teacher assessment. Data on behaviour, BW and sex, was available in 2269 participants. Male sex was associated with increased aggression problems at lower BW compared to females in the crude model (Interaction B: -0.436, 98.3%CI: [-0.844, -0.0253]), but not the adjusted model (Interaction B: -0.310, 98.3%CI: [-0.742, 0.140]). Male sex was associated with increased attention problems at lower BW compared to females in both the crude model (Interaction B: -0.334, 98.3%CI: [-0.530, -0.137]) and the adjusted model (Interaction B: -0.274, 98.3%CI: [-0.507, -0.0432]). Male sex was associated with increased social problems at lower BW compared to females in both the crude model (Interaction B: -0.164, 98.3%CI: [-0.283, -0.0441]) and the adjusted model (Interaction B: -0.148, 98.3%CI: [-0.285, -0.00734]). Using repeated measures from ages 5-17 we were able to show a crude and adjusted male vulnerability to lower BW in the development of attention problems and social problems. We did not find a BW x sex interaction for the development of aggressive behaviour.

2.
Psychiatry Res ; 337: 115952, 2024 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-38723408

RESUMEN

Our aim is to review and perform a meta-analysis on the role of impulsivity in fatal suicide behaviour. We included papers who used psychological autopsy methodology, assessed adult death by suicide, and included assessment of impulsivity. We excluded papers about assisted suicide, terrorist suicide, or other cause of death other than suicide or postmortem diagnosis made only from medical records or database. 97 articles were identified. 33 were included in the systematic review and nine in the meta-analysis. We found that people who die by suicide with high impulsivity are associated with younger age, substance abuse, and low intention to die, whereas those with low impulsivity were associated with older age, depression, schizophrenia, high intention to die and low social support. In the meta-analysis, suicide cases had higher impulsivity scores than living controls (Hedges' g = 0.59, 95 % CI [0.28, 0.89], p=.002). However, studies showed heterogeneity (Q = 90.86, p<.001, I2=89.0 %). Impulsivity-aggressiveness interaction was assessed through meta-regression (ß=0.447, p=.045). Individuals with high impulsivity would be exposed to a higher risk of fatal suicide behaviour, aggressiveness would play a mediating role. People who die by suicide with high and low impulsivity display distinct characteristics, which may reflect different endophenotypes leading to suicide by different pathways.

3.
Aggress Behav ; 50(3): e22148, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38747497

RESUMEN

Although there is a large research base on the psychological impacts of violent and prosocial visual media, there is little research addressing the impacts of violent and prosocial music, and which facets of the music have the greatest impact. Four experiments tested the impact of lyrics and/or musical tone on aggressive and prosocial behavior, and on underlying psychological processes, using purpose-built songs to avoid the effect of music-related confounds. In study one, where mildly aggressive, overtly aggressive and violent lyrics were compared to neutral lyrics, any level of lyrical aggression caused an increase in behavioral aggression, which plateaued for all three aggression conditions. Violent lyrics were better recalled than other lyrics one week later. In studies two-three no significant effects of lyrics, or of aggressive versus nonaggressive musical tone, were found on aggressive or prosocial behavior. In terms of internal states, violent lyrics increased hostility/hostile cognitions in all studies, and negatively impacted affective state in three studies. Prosocial lyrics decreased hostility/hostile cognitions in three studies, but always in tandem with another factor. Aggressive musical tone increased physiological arousal in two studies and increased negative affect in one. In study four those who listened to violent lyrics drove more aggressively on a simulated drive that included triggers for aggression. Overall, violent lyrics consistently elicited hostility/hostile cognitions and negative affect, but these did not always translate to aggressive behavior. Violent music seems more likely to elicit behavioral aggression when there are aggression triggers and a clear way to aggress. Implications are discussed.


Asunto(s)
Agresión , Música , Humanos , Música/psicología , Agresión/psicología , Masculino , Femenino , Adulto , Adulto Joven , Violencia/psicología , Hostilidad , Conducta Social , Adolescente , Emociones/fisiología , Pensamiento/fisiología
4.
Soc Dev ; 33(2)2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38736675

RESUMEN

Children's temperamental surgency is associated with later child behavioral problems. However, the underlying mechanisms linking child surgency and child aggression, such as negative parental control, are relatively understudied. Moreover, the potential protective effect of a close parent-child relationship on these associations remains untested, particularly among non-White families. Participants included 259 Chinese American preschoolers (Mage = 4.5 years, SD = 0.9 years, 50% girls) and their mothers (Mage = 37.9 years, SD = 4.7 years), the present study examined the moderating effects of parent-child relationship quality on the association between mother-rated child surgency and teacher-rated child aggression as mediated by maternal psychological control. Overall, results showed that child surgency was linked positively to maternal psychological control, which, in turn led to higher levels of child aggression six months later, but only when the parent-child relationship quality was less optimal. These findings indicate that psychological control is one underlying mechanism linking child temperament and child maladjustment, and that parent-child relationship quality is an important protective factor. Findings also expand an existing theoretical framework by explicating how these variables are applicable to an Asian American population, suggesting the critical buffering role that parent-child relationship quality plays. The study findings inform efforts to mitigate the potential negative effect of psychological control in reducing childhood aggression.

6.
Neuroimage ; 294: 120645, 2024 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-38734156

RESUMEN

Aggressive adolescents tend to exhibit abnormal fear acquisition and extinction, and reactive aggressive adolescents are often more anxious. However, the relationship between fear generalization and reactive aggression (RA) remains unknown. According to Reactive-Proactive Aggression Questionnaire (RPQ) scores, 61 adolescents were divided into two groups, namely, a high RA group (N = 30) and a low aggression (LA) group (N = 31). All participants underwent three consecutive phases of the Pavlovian conditioning paradigm (i.e., habituation, acquisition, and generalization), and neural activation of the medial prefrontal cortex (mPFC) was assessed by functional near-infrared spectroscopy (fNIRS). The stimuli were ten circles with varying sizes, including two conditioned stimuli (CSs) and eight generalization stimuli (GSs). A scream at 85 dB served as the auditory unconditioned stimulus (US). The US expectancy ratings of both CSs and GSs were higher in the RA group than in the LA group. The fNIRS results showed that CSs and GSs evoked lower mPFC activation in the RA group compared to the LA group during fear generalization. These findings suggest that abnormalities in fear acquisition and generalization are prototypical dysregulations in adolescents with RA. They provide neurocognitive evidence for dysregulated fear learning in the mechanisms underlying adolescents with RA, highlighting the need to develop emotional regulation interventions for these individuals.

7.
J Appl Behav Anal ; 2024 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-38767337

RESUMEN

Although decades of behavior-analytic studies have focused on decreasing the aggressive behavior of clients, relatively little research has been conducted on preventing injuries for the staff members who implement treatment plans. In this study, three direct-care staff members working with clients presenting with aggressive behavior were taught targeted blocking and distance management techniques designed to keep the clients safe while preventing injuries to the participants. Findings indicated that all staff members acquired the target skills in simulations, after which the skills for two participants generalized to the natural work environment.

8.
J Youth Adolesc ; 2024 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-38767792

RESUMEN

The daily reciprocal relations between parental psychological aggression and adolescent anxiety and the heterogeneity, i.e., whether these relations vary across different adolescents, remain unclear. This study examined this issue with a 15-day daily diary study among 326 Chinese adolescents (Mage = 14.53 years, SD = 0.60, 47.2% girls). Dynamic structural equation models revealed that parental psychological aggression co-fluctuated with adolescent anxiety within a day. For lagged associations, only father-driven effects were supported but not mother-driven effects, whereas child-driven effects were supported for both parents. These within-person associations were heterogeneous across adolescents. Moreover, adolescents with more parental psychological aggression reported higher anxiety. This study revealed the reciprocal relations between parental psychological aggression and adolescent anxiety at the micro timescale and also highlighted that the within-person associations were heterogeneous across different adolescents.

9.
Psychiatry Res ; 337: 115969, 2024 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-38772159

RESUMEN

Maternal history of suicidal thoughts and behaviors (STBs) has been identified as a robust risk factor for offspring emotional and behavioral problems, including risk for offspring STBs. The impact of maternal history of STBs has been well-documented in adolescent and young adult samples, with emerging research highlighting the need to examine early clinical correlates of risk in young children, prior to the emergence of STBs. In an extension of prior work, the current study examined associations between maternal history of STBs and previously identified emotional and behavioral correlates of STBs (negative affect, internalizing problems, attention problems, aggressive behavior) in young children. These associations were examined in a mother-preschooler sample (n = 158, mean preschooler age=41.52 months) with approximately half of mothers endorsing a history of STBs and 20 % of the sample scoring at the threshold that indicates suicide risk. In multivariate models, maternal history of STBs was significantly associated with preschooler aggressive behavior, assessed via mother- (ß=0.19) and teacher-report (ß=0.21), as well as mother-reported negative affect (ß=0.22). Results document a link between maternal history of STBs and increased risk for heightened negative affect and aggressive behavior at home and school during the sensitive preschool period. Findings are discussed within the context of enhancing models of intergenerational transmission suicide risk.

10.
J Affect Disord ; 2024 May 19.
Artículo en Inglés | MEDLINE | ID: mdl-38772506

RESUMEN

BACKGROUND: While many studies have established a positive correlation between adolescents' internet addiction and mental health problems, most of these studies have overlooked the internal heterogeneity of Internet addiction. This study aims to identify latent profiles among adolescents based on their Internet addiction and to examine the differences in aggression, depression, and anxiety across these profiles. METHODS: We conducted a survey involving 7422 adolescents and administered the Young's Internet Addiction Test, Aggression Behavior Questionnaire, Patient Health Questionnaire-9, and Generalized Anxiety Disorder Scale. Latent profile analysis was utilized to categorize Internet addiction profiles among adolescents. Associations between Internet addiction profiles and related factors were examined using the Bolck-Croon-Hagenaars method. RESULTS: Latent profile analysis suggested four profiles of Internet addiction, which were labeled: Regular, Risk, Low Internet addiction, and Internet addiction. The Internet addiction profile showed higher levels of aggression, depression, and anxiety than the Low Internet addiction profile. The Low Internet addiction profile had higher levels of aggression, depression, and anxiety than the Risk profile. The Risk profile demonstrated higher levels of aggression, depression, and anxiety when compared to the Regular profile. LIMITATIONS: Limitations include the cross-sectional design and the self-report measures. CONCLUSIONS: The identified Internet addiction profiles offer differential predictions for aggression, depression, and anxiety. These results underscore the significance of employing latent profile analysis when exploring the associations between Internet addiction and mental health issues.

11.
Heliyon ; 10(9): e30648, 2024 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-38765068

RESUMEN

Purpose: The present research was conducted to assess the effect of the Benson relaxation technique on sleep quality and aggression among patients with bipolar type I disorder. Methods: This study was conducted using a randomized clinical trial design with the participation of 60 patients with bipolar type I disorder (30 participants in each group) in Mashhad, Iran (IRCT20220108053659N1). The intervention group received the Benson relaxation technique for 21 days in a row, twice a day (in the morning and evening), under the supervision of an expert psychiatric nurse (On the first day, instruction was given on implementing BRT. In the subsequent days of the intervention, the nurse stayed by the patient's bedside for the entire relaxation process). Aggression and sleep quality were assessed using the Buss-Perry Aggression Questionnaire and Pittsburgh Sleep Quality Index, respectively, before and one week after the completion of the intervention. Data were analyzed using descriptive and inferential statistics (Chi-squared, Fisher's exact test, independent sample t-test, and analysis of covariance). Results: The participants in the present study were individuals of both genders aged 18 and above. Based on the results, both groups were homogeneous regarding demographic characteristics. Prior to the intervention, the two groups of control and intervention were not significantly different from each other in terms of sleep quality (p = 0.870) and aggression (p = 0.961). After the intervention, in an intergroup comparison, a significant difference was observed between the two groups in terms of the mean difference of aggression (p < 0.001) and sleep quality scores (p < 0.001). Conclusion: Despite the favorable effect of this intervention, it is necessary to conduct more studies considering the broader aspects of interventions and related variables before including these interventions in the care plan of patients with bipolar type I disorder.

12.
Front Nutr ; 11: 1356189, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38765817

RESUMEN

Introduction: Monosodium glutamate (MSG), an umami substance, stimulates the gut-brain axis communication via gut umami receptors and the subsequent vagus nerves. However, the brain mechanism underlying the effect of MSG ingestion during the developmental period on aggression has not yet been clarified. We first tried to establish new experimental conditions to be more appropriate for detailed analysis of the brain, and then investigated the effects of MSG ingestion on aggressive behavior during the developmental stage of an ADHD rat model. Methods: Long-Evans, WKY/Izm, SHR/Izm, and SHR-SP/Ezo were individually housed from postnatal day 25 for 5 weeks. Post-weaning social isolation (PWSI) was given to escalate aggressive behavior. The resident-intruder test, that is conducted during the subjective night, was used for a detailed analysis of aggression, including the frequency, duration, and latency of anogenital sniffing, aggressive grooming, and attack behavior. Immunohistochemistry of c-Fos expression was conducted in all strains to predict potential aggression-related brain areas. Finally, the most aggressive strain, SHR/Izm, a known model of attention-deficit hyperactivity disorder (ADHD), was used to investigate the effect of MSG ingestion (60 mM solution) on aggression, followed by c-Fos immunostaining in aggression-related areas. Bilateral subdiaphragmatic vagotomy was performed to verify the importance of gut-brain interactions in the effect of MSG. Results: The resident intruder test revealed that SHR/Izm rats were the most aggressive among the four strains for all aggression parameters tested. SHR/Izm rats also showed the highest number of c-Fos + cells in aggression-related brain areas, including the central amygdala (CeA). MSG ingestion significantly decreased the frequency and duration of aggressive grooming and attack behavior and increased the latency of attack behavior. Furthermore, MSG administration successfully increased c-Fos positive cell number in the intermediate nucleus of the solitary tract (iNTS), a terminal of the gastrointestinal sensory afferent fiber of the vagus nerve, and modulated c-Fos positive cells in the CeA. Interestingly, vagotomy diminished the MSG effects on aggression and c-Fos expression in the iNTS and CeA. Conclusion: MSG ingestion decreased PWSI-induced aggression in SHR/Izm, which was mediated by the vagus nerve related to the stimulation of iNTS and modulation of CeA activity.

13.
Int J Law Psychiatry ; 94: 101986, 2024 May 19.
Artículo en Inglés | MEDLINE | ID: mdl-38768526

RESUMEN

This study aimed to investigate the double mediation effect of entrapment and anger, as well as the moderated mediation effect of psychological flexibility and self-compassion on the relationship between the forensic psychiatric hospital ward climate and reactive aggression perceived by patients. A self-reporting method was used to measure ward climate, entrapment, anger, reactive aggression, psychological flexibility, and self-compassion in a sample of 246 participants being treated at the National Forensic Psychiatric Hospital. The relational model was verified according to the structural equation model analysis, and the double mediation effect of the conditional process model was verified using a Process macro. The results showed that both the simple mediation effect and the double mediation effect of entrapment and anger were statistically significant. Psychological flexibility significantly moderated the relationship between ward climate and entrapment, ward climate and anger-in, and significantly influenced the reduction of reactive aggression. When psychological flexibility was higher, ward climate did not cause entrapment, and the intensity of anger-in and reactive aggression was reduced. Self-compassion significantly reduced entrapment, and the higher the self-compassion, the lesser the entrapment. Finally, psychological flexibility and self-compassion moderated the indirect effect through entrapment and the indirect effect through anger-in on the relationship between the ward climate and reactive aggression. Hence, the moderated mediation effect by psychological flexibility and self-compassion was confirmed. To conclude our study, its limitations are outlined, and practical therapeutic intervention for preventing reactive aggression in forensic hospital patients is discussed.

14.
BMC Psychiatry ; 24(1): 378, 2024 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-38773533

RESUMEN

BACKGROUND: Challenging behaviors like aggression and self-injury are dangerous for clients and staff in residential care. These behaviors are not well understood and therefore often labeled as "complex". Yet it remains vague what this supposed complexity entails at the individual level. This case-study used a three-step mixed-methods analytical strategy, inspired by complex systems theory. First, we construed a holistic summary of relevant factors in her daily life. Second, we described her challenging behavioral trajectory by identifying stable phases. Third, instability and extraordinary events in her environment were evaluated as potential change-inducing mechanisms between different phases. CASE PRESENTATION: A woman, living at a residential facility, diagnosed with mild intellectual disability and borderline personality disorder, who shows a chronic pattern of aggressive and self-injurious incidents. She used ecological momentary assessments to self-rate challenging behaviors daily for 560 days. CONCLUSIONS: A qualitative summary of caretaker records revealed many internal and environmental factors relevant to her daily life. Her clinician narrowed these down to 11 staff hypothesized risk- and protective factors, such as reliving trauma, experiencing pain, receiving medical care or compliments. Coercive measures increased the chance of challenging behavior the day after and psychological therapy sessions decreased the chance of self-injury the day after. The majority of contemporaneous and lagged associations between these 11 factors and self-reported challenging behaviors were non-significant, indicating that challenging behaviors are not governed by mono-causal if-then relations, speaking to its complex nature. Despite this complexity there were patterns in the temporal ordering of incidents. Aggression and self-injury occurred on respectively 13% and 50% of the 560 days. On this timeline 11 distinct stable phases were identified that alternated between four unique states: high levels of aggression and self-injury, average aggression and self-injury, low aggression and self-injury, and low aggression with high self-injury. Eight out of ten transitions between phases were triggered by extraordinary events in her environment, or preceded by increased fluctuations in her self-ratings, or a combination of these two. Desirable patterns emerged more often and were less easily malleable, indicating that when she experiences bad times, keeping in mind that better times lie ahead is hopeful and realistic.


Asunto(s)
Agresión , Trastorno de Personalidad Limítrofe , Discapacidad Intelectual , Conducta Autodestructiva , Humanos , Trastorno de Personalidad Limítrofe/psicología , Femenino , Conducta Autodestructiva/psicología , Agresión/psicología , Discapacidad Intelectual/psicología , Adulto , Instituciones Residenciales
15.
BJPsych Open ; 10(3): e120, 2024 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-38773812

RESUMEN

BACKGROUND: Seclusion is a restrictive practice that many healthcare services are trying to reduce. Previous studies have sought to identify predictors of seclusion initiation, but few have investigated factors associated with adverse outcomes after seclusion termination. AIMS: To assess the factors that predict an adverse outcome within 24 h of seclusion termination. METHOD: In a cohort study of individuals secluded in psychiatric intensive care units, we investigated factors associated with any of the following outcomes: actual violence, attempted violence, or reinitiation of seclusion within 24 h of seclusion termination. Among the seclusion episodes that were initiated between 29 March 2018 and 4 March 2019, we investigated the exposures of medication cooperation, seclusion duration, termination out of working hours, involvement of medical staff in the final seclusion review, lack of insight, and agitation or irritability. In a mixed-effects logistic regression model, associations between each exposure and the outcome were calculated. Odds ratios were calculated unadjusted and adjusted for demographic and clinical variables. RESULTS: We identified 254 seclusion episodes from 122 individuals (40 female, 82 male), of which 106 (41.7%) had an adverse outcome within 24 h of seclusion termination. Agitation or irritability was associated with an adverse outcome, odds ratio 1.92 (95% CI 1.03 to 3.56, P = 0.04), but there was no statistically significant association with any of the other exposures, although confidence intervals were broad. CONCLUSIONS: Agitation or irritability in the hours preceding termination of seclusion may predict an adverse outcome. The study was not powered to detect other potentially clinically significant factors.

16.
Dev Psychopathol ; : 1-12, 2024 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-38774991

RESUMEN

The moral self-concept (MSC) describes how children view themselves as moral agents. Research suggests that the MSC may relate to moral behavior, yet little is known about how MSC relates to moral behavior in preschoolers. One hundred six low-income children (M age = 52.78 months, SD = 6.61 months) and their teachers participated in this study. In the fall, children completed a MSC puppet task measure. In the fall and spring, teachers reported via children's survey prosocial behavior and aggressive behavior. We used a person-centered approach to identify profiles of MSC, which revealed two profiles of behavior: comforting prosocials and helpful aggressors. Comforting prosocials showed a moderate preference for comforting, a slight preference for helping, and a slight preference for avoiding aggression. Helpful aggressors had a moderate aversion to comforting, a strong preference for helping, and a slight preference for aggressive behavior. Subsequent analysis of covariance analysis revealed that MSC profiles did not differ in concurrent behavior but did differ in behavior 6 months later. The comforting prosocial group participated in more aggression than the helpful aggressors. Additionally, analysis of covariance analysis of change in aggression scores over time showed that comforting prosocials aggression increased, while helpful aggressors aggression decreased. Both groups over time decreased in prosocial behavior, but to different degrees. Overall, findings reveal that the MSC in preschoolers may relate to future not concurrent moral behavior.

17.
Aggress Behav ; 50(3): e22157, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38770707

RESUMEN

This study examined the mediating role of anger rumination in the relationship between anger and reactive aggression and the potential of adaptive anger rumination in reducing reactive aggression. Study 1, a two-wave longitudinal survey of 177 Chinese adolescents, showed that anger rumination mediated the relationship between anger and reactive aggression. Study 2, an experimental study with 160 university students, showed that the self-distanced group had lower aggression than the self-immersed group, and anger rumination mediated the impact of anger on reactive aggression in only the self-immersed group. These findings clarify the role of anger rumination concerning the relationship between anger and reactive-aggression and highlight the importance of self-distanced anger rumination in preventing reactive aggression among adolescents and young adults.


Asunto(s)
Agresión , Ira , Rumiación Cognitiva , Humanos , Ira/fisiología , Agresión/psicología , Masculino , Femenino , Adolescente , Rumiación Cognitiva/fisiología , Adulto Joven , Estudios Longitudinales , Adulto , China , Estudiantes/psicología
18.
Front Psychol ; 15: 1381015, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38751766

RESUMEN

The aim of this study was to examine whether collective moral disengagement and authoritative teaching at the classroom level, and student-teacher relationship quality at the individual level, predicted individual moral disengagement among pre-adolescent students 1 year later. In this short-term longitudinal study, 1,373 students from 108 classrooms answered a web-based questionnaire on tablets during school, once in fifth grade (T1) and once in sixth grade (T2). The results showed, after controlling for T1 moral disengagement, gender, and immigrant background, that students with better student-teacher relationship quality at T1 were more inclined to score lower on moral disengagement at T2, whereas students in classrooms with higher levels of collective moral disengagement at T1 were more inclined to score higher on moral disengagement at T2. In addition, both collective moral disengagement and authoritative teaching were found to moderate the associations between student-teacher relationship quality at T1 and moral disengagement at T2. These findings underscore the importance of fostering positive relationships between students and teachers, as well as minimizing collective moral disengagement in classrooms. These measures may prevent the potential escalation of moral disengagement in a negative direction.

19.
Artículo en Inglés | MEDLINE | ID: mdl-38705578

RESUMEN

AIMS: Despite the public health impact of violence among young adults with psychosis, behavioural interventions to reduce the risk of engaging in violence remain rare. For young adults with early psychosis, cognitive behavioural therapy (CBT)-based psychotherapy has efficacy in reducing impairment and improving functioning. However, no CBT-based intervention to reduce violence has been formally adapted for young adults with early psychosis. This protocol outlines the first clinical trial of a behavioural intervention to reduce violence for young adults with early psychosis. This study is set in an early intervention services (EIS) setting and seeks to adapt and pilot Psychological Intervention for Complex PTSD and Schizophrenia-Spectrum Disorder (PICASSO), a CBT-based intervention, through an iterative process utilizing mixed-methods assessments. METHODS: All research will occur at OnTrackNY, the largest EIS program in the United States. This study will consist of an open pilot trial, with four EIS clinicians delivering the intervention to one to two EIS participants per round. In this mixed-methods study, both quantitative measures (acceptability, feasibility and hypothesized mediators of target outcome collected on a weekly basis) and qualitative interviews (with EIS clinicians at weeks 4, 8 and 12) will be conducted. Transcripts will be analyzed using thematic content analysis. Two to three rounds of iterative modifications are anticipated (n = 10-16 EIS participants total). RESULTS: Recruitment began in February 2024 and is expected to continue over a 9-12-month period. CONCLUSIONS: Because violent behaviour causes interpersonal disruptions such as incarceration and increased caregiver burden, an innovative intervention to reduce violence risk could have broader health impact for this vulnerable population. Adapting the PICASSO intervention to the EIS setting will optimize its acceptability and feasibility by the intended target population.

20.
Artículo en Inglés | MEDLINE | ID: mdl-38706140

RESUMEN

Safewards is a multi-intervention mental health nursing model of practice improvement aimed at preventing and reducing conflict and containment. The use of Safewards has now extended beyond mental health settings. Implementation of Safewards has been reported to be challenging and therefore requires an evidence-informed and structured approach. This review's objectives were to: (i) Comprehensively map approaches used to implement Safewards interventions; (ii) Characterise the outcomes measured in Safewards implementation studies; and (iii) Identify the facilitators and barriers to Safewards training and its implementation in practice. All quantitative, qualitative and mixed-methods publications of Safewards, the interventions, evaluations, barriers and facilitators from all healthcare services internationally were included. The Joanna Briggs Institute scoping review and Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews were used to guide methodology. Data were reported according to the 12 items of the TIDieR. Twenty-seven publications reported the implementation of Safewards. Descriptions were limited for reporting items such as intervention descriptions, materials, resources, specific procedures and processes, modifications made to interventions and delivery of interventions and training. No consistent theoretical implementation framework was reported. Collaboration, leadership, feedback and co-design were strong drivers for staff buy-in, engagement and success for implementation in mental health and acute settings. Transparency, replicability and generalisation require a detailed description of all elements of an intervention being implemented. Without adequate information, only assumptions can be drawn about the clinical governance and process of the implementation and training, and it is difficult to conclude when attempting to replicate the interventions.

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