[Lack of empathy in teenagers, a weakness in the therapeutic relationship]. / Le déficit d'empathie chez l'adolescent, une faille dans la relation thérapeutique.

The capacity to recognise others as being different from oneself is an essential element of empathy. Achille's treatment in a child psychiatry unit illustrates the clinical presentation of a teenager who lacks this social skill. The use of the Griffith Empathy Measure improves the screening and evaluation of this disorder, with the aim of being able to provide the young patient with adapted support.

Associations Between Father Temperament, Character, Rearing, Psychopathology and Child Temperament in Children Aged 3-6 Years.

Temperament refers to the totality of individual characteristics present from birth that determine a child's unique style of behavior. Maternal personality and attitudes, one of the factors affecting temperament traits in children, is a frequently investigated subject. However, paternal variables have remained insufficiently studied. The purpose of this study is to investigate the associations between the fathers' temperament, character, attitudes, psychopathology and temperament of the 3-6 years-old children. The parents of 36-60 months-old children in the preschool settings in Samsun were included in the study (n:200). Their mothers completed "Maternal Sociodemographic Form" prepared by the researcher, and the temperament of children "Children Behaviour Questionnare" were scored by the mothers. Their fathers completed "Paternal Sociodemographic Form", and to assess father psychopathology "Brief Symptom Inventory", to determine father temperament and character "Temperament and Character Inventory" and to determine attitudes "Parenting Attitudes Scale" were scored by the fathers. In this study, we found several significant associations between children's temperament and fathers temperament and character, attitudes styles and psychopathology. The scores of paternal harm avoidance increase and self directedness decrease were found to be significantly positivily correlated with negative temperamental charecteristics of the children. The democratic attitudes of fathers were significantly correlated with positive temperamental scores of the children. All domains of paternal psychopathology were found to be in significant association with negative temperamental characteristics of the children. Our findings showed the complex interplay between determinants of parenting. Specifically, this study is one of the first to investigate paternal personality, psychopathology and attitudes, alone and in interaction with preschool child temperament.

Comportamientos de riesgo relacionados con el consumo de sustancias psicoactivas en niños y jóvenes de Lisboa / Comportamentos de risco relacionado com o consumo de substâncias psicoativas em crianças e jovens da cidade de Lisboa / Risk behaviors to psychoactive substances use in children and young people in Lisbon

Objetivo: Caracterizar el comportamiento de riesgo de las sustancias psicoactivas en una población juvenil de Lisboa. Método: Estudio observacional, descriptivo y transversal. Los participantes fueron 113 niños y jóvenes quienes respondieron a la versión en portugués del Cuestionario de Riesgo y Comportamiento de la Salud - Youth Risk Behavior Survey. Resultados: Los participantes con respecto a la edad tenían entre 9-13, la mayoría de 5º grado de escolaridad, vivían con sus padres, tenían un buen rendimiento escolar, buena relación con los colegas aunque ¼ refería problemas. Cuando están preocupados, recurren a la madre, pero es significativa la atención de los padres. En cuanto a la prueba de sustancias psicoactivas se encontró: 9,7% de tabaco, 19,5% de alcohol, otras sustancias 5,3%. Conclusión: En relación con el comportamiento de riesgo destaca principalmente la ingesta de alcohol antes de tiempo. Surgieron como factores de protección: las relaciones familiares y la relación con el espacio escolar. Este grupo de edad puede constituir el momento ideal para la prevención (AU)

Objetivo: Caracterizar os comportamentos de risco face ao consumo de substâncias psicoativas numa população juvenil da cidade de Lisboa Método: Estudo observacional, descritivo, transversal. Os participantes foram 113 crianças e jovens que responderam à versão portuguesa do Questionário de Comportamento de Risco e Saúde - Youth Risk Behavior Survey. Resultados: Os participantes no que se refere à idade estavam entre os 9-13, a maioria frequentava o 5º ano de escolaridade, vivia com os pais, tinha bom aproveitamento escolar, boa relação com colegas embora ¼ referira problemas. Quando preocupados, recorrem à mãe, mas é significativa a atenção dos pares. Quanto à experimentação de substâncias psicoativas apurou-se: tabaco 9,7%, álcool 19,5%, outras substâncias 5,3%. Conclusão: No que se refere aos comportamentos de risco destaca-se principalmente a experimentação precoce de álcool. Emergiram como fatores protetores: relação familiar e relação com o espaço escola. Esta faixa etária pode constituir-se o momento ideal para a prevenção (AU)

Objective: To characterize the risk behavior of the psychoactive substances use in a youth population of Lisbon. Method: An observational, descriptive, cross-sectional study. Participants were 113 children and young people who responded to the Portuguese version of the Risk and Health Behavior questionnaire - Youth Risk Behavior Survey. Results: Participants with regard to age were between 9-13, most attending the 5th grade, living with parents, had good school performance, good relationship with colleagues while ¼ refer problems. When concerned, recourse to the mother, but it is significant the attention of peers. As for the trial of psychoactive substances was found: 9.7% tobacco, 19.5% alcohol, other substances 5.3%. Conclusion: With regard to risk behavior stands primarily to early alcohol testing. Emerged as protective factors: family relationship and relationship with the school space. This age group may constitute the ideal time for prevention (AU)

[Psychopathology of violence in prisons]. / Psychopathologie de la violence en prison.

The issue of violence in prisons concerns the people detained there, the conditions of the imprisonment and the relations which are established between the prisoners and the guards. The deprivation of liberty in prison, by suppressing desire, stirs up violence. Security contingency measures are not sufficient to control aggressive urges. Violence in prison stems from the internal regulations, the architecture of the building, the organisation of the surveillance and from the psychopathological dynamics of the deprivations resulting from being locked up.

[Prisoners in units for difficult patients]. / Les détenus en unités pour malades difficiles.

Prisoners, on remand or convicted, can be placed for a variable amount of time in a unit for difficult patients if their pathological mental state so requires. For the most part, their therapeutic care does not depend on their status as prisoner. The treatments provided are those indicated for their psychological pathologies and their potential or known dangerousness. However, some administrative measures make a distinction between their treatment and that of non-prisoner patients placed in these secure psychiatric units.

High-Quality Foster Care Mitigates Callous-Unemotional Traits Following Early Deprivation in Boys: A Randomized Controlled Trial.

OBJECTIVE: Callous-unemotional (CU) traits in childhood are a developmental precursor to psychopathy, yet the origins and etiology of CU traits are not known. We examined CU traits among 12-year-old children exposed to severe early deprivation and evaluated whether a high-quality foster care intervention mitigated the development of high levels of CU traits. METHOD: Participants were from the Bucharest Early Intervention Project, a randomized controlled trial of foster care for children in institutions. Children were recruited from institutions in Bucharest, Romania, along with age- and sex-matched children who were never institutionalized. Children raised in institutional settings were randomized (mean age = 22 months) to either a foster care group (n = 68) or a care-as-usual group (n = 68). CU traits were assessed at age 12.75 years in available participants from the randomized trial (n = 95) and children who were never institutionalized (n = 50). RESULTS: Children who experienced institutional rearing as young children had significantly higher levels of CU traits in early adolescence compared to children who were never institutionalized. Intent-to-treat analysis indicated that, among boys, CU traits were significantly lower among those who received the foster care intervention compared to those randomized to care as usual. Caregiver responsiveness to distress, but not caregiver warmth, mediated the intervention effect on CU traits in boys. CONCLUSION: These findings provide the first evidence to date that psychosocial intervention can prevent the onset of CU traits. Although severe early deprivation predicted higher levels of CU traits, high-quality foster care that emphasized responsive caregiving reduced the impact of deprivation on CU trait development for boys. CLINICAL TRIAL REGISTRATION INFORMATION: The Bucharest Early Intervention Project; http://clinicaltrials.gov; NCT00747396.

Crime is falling: how community practitioners can contribute to reducing crime and antisocial behaviour.

International research has provided so much evidence concerning risk factors for, and protective factors against, children becoming involved in offending that a way of making sense of the data for practitioners, particularly health professionals, is called for. One such way has already appeared as a matrix. This paper updates that matrix, retaining original entries that are still pertinent and identifying recent evidence of risk and protective influences upon the foetus, infant and child. It also indicates promising interventions available to practitioners.

Views on sex and sex education among gang-involved Latino youth in the United States.

Although gang-involved Latino youth in the United States are uniquely at risk of adverse consequences from sexual behavior, little research is available that can guide those who wish to develop interventions to reduce sexual risk among these youth. To facilitate the development of effective interventions, we identified cultural and contextual factors that influence sexual behavior and sex education among gang-involved Latino youth in one U.S. community. By analyzing transcripts from interviews and focus groups with three different groups of key stakeholders--gang-experienced Latino youth, the parents of gang-experienced Latino youth, and the personnel of a program providing comprehensive human services for gang-involved Latino youth--we identified three domains to be considered in developing sexual risk-reduction interventions for gang-involved U.S. Latino youth. The focus of our discussion is on the implications of these findings for future development or adaptation of interventions.

Decreased risk for violence in patients admitted to forensic care, measured with the HCR-20.

AIM: The aim of this study was to explore if patients admitted to forensic psychiatric care decreased their assessed risk for violence over time, to identify patients who decreased their assessed risk for violence exceptionally well (30% or more) on the clinical (C) and risk management (R) scales in the (HCR-20), and to compare them in terms of demographic data. METHODS: The HCR-20 risk assessment instrument was used to assess the risk for violence in 267 patients admitted to a Swedish forensic psychiatric clinic between 1997 and 2010. Their assessments at admission were compared with a second, and most recent, risk assessment. RESULTS: The risk for violence decreased over time. Demographic criteria had no impact on differences on decreased risk. Only two factors, namely gender and psychopathy showed a difference. Risk factors associated with stress and lack of personal support were the items that turned out to be the most difficult to reduce. CONCLUSION: The results show that risk prevention in forensic care does work and it is important to continue to work with risk management. The study highlights the importance of a careful analysis of the patient's risk for violence in order to work with the patient's specific risk factors to reduce the risk.

Girly mags and girly jobs: pornography and gendered inequality in forensic practice.

This article presents findings from a discourse analytic study into the constructive nature and textual variations of language in a high-security hospital. It explores how mental health nurses, and men convicted of sexual offences who also have a diagnosis of personality disorder, talked about pornography and sexual crime in the context of forensic provision. Access to sexually-explicit media, in relation to treatment environments for people convicted of sexual offences, has become a cause for professional and political concern in the UK. Data collection and analysis, undertaken concurrently, were informed by a discursive design. Semistructured interviews, as co-constructed accounts with nursing staff and detained patients, were audio-taped and transcribed. Data were coded to identify the discursive repertoires, or collective talk, of respondents. In contrast to empirical inquiry into pornography and sexual violence, methodology shifted attention from measurement to meaning, and situated research in a clinical domain. The findings focus on performative language use, where talk about pornography textured the treatment environment, contributed to an overtly masculine discourse, framed the ward as male space, and promoted gendered inequality. The discussion questions the legitimacy of the therapeutic enterprise.

[Difficult teenagers: the challenges of interdisciplinarity]. / Les adolescents difficiles enjeux de l'interdisciplinarité.

The adolescents in great distress, because of ruptures in the course of their lives and of their chaotic family environment, need educational and social actions. The consensual point of view is that responding to the needs of the so called "difficult adolescents" implies the involvement of educational, therapeutic and judicial services. Nevertheless, the usual tendency to categorize the users with the idea it will permit to guide them to the appropriate skill field and the transgressive characteristic of these adolescents' behaviours lead all these services to reject them and send them to the two other services.

Forensic and non-forensic psychiatric nursing skills and competencies for psychopathic and personality disordered patients.

AIM AND OBJECTIVE: To understand better the skills and competencies for forensic and non-forensic nursing of psychopathic and personality disordered patients. BACKGROUND: In the UK, there has been growing interest in service provision for this client group, but with little research to support the nursing skills required. DESIGN: A non-experimental design, using a postal survey to 990 forensic and 500 non-forensic nurses. METHOD: An information gathering schedule was used to generate data about the most desirable skills and competencies and least desirable weaknesses and nursing attributes to nurse this group. RESULTS: The results for the forensic nurses. Main strengths and skills: being firm, setting limits and defining boundaries. Main weaknesses: inability to engage, inability to resolve conflict and impatience. Main skills and competencies: being non-threatening, non-judgemental and able to expect anything. Least desirable qualities: over-reacting, being judgemental and over-confrontational. The results for the non-forensic nurses. Main strengths and skills: being non-judgemental, listening skills and good risk assessment. Main weaknesses: frustration with the system, a fear of aggression and no skills to engage. Main skills and competencies: being open-minded, non-judgemental and forming relationships. Least desirable qualities: a supercilious attitude, cynicism and being judgemental. CONCLUSION: The results highlight the importance of forming therapeutic relationships as the bedrock of both forensic and non-forensic nursing, and they also highlight the important differences with regard to the significance of therapeutic action and therapeutic verbal interaction. RELEVANCE TO CLINICAL PRACTICE: The provision of better care for this client group will rely on appropriate training for nurses. This research highlights the need for training that supports the development of engagement skills, communication skills and an ability to use reflection in action as a means of providing therapeutic care. It also highlights the different emphasis on the use of these skills by forensic and non-forensic nurses.

Increasing participation in prevention research: strategies for youths, parents, and schools.

TOPIC: Subject participation is a critical concern for clinicians and researchers involved in prevention programs, especially for intensive interventions that require randomized assignment and lengthy youth and parent involvement. PURPOSE: This article describes details of an integrated approach used to recruit and retain at-risk high school youths, their parents, and high schools to two different comprehensive, "indicated" prevention programs. SOURCES USED: Parent and youth recruitment and retention data for the two studies is provided in support of the approach described. A coordinated, multilevel approach, organized around cross-cutting issues, is described in detail as a response to the challenges of including vulnerable populations in intervention research. CONCLUSION: Methods are relevant to nurse clinicians who deliver prevention programs, and are important to clinical research that relies upon adequate participation in research programs.