A systematic scoping review exploring how people with lived experience have been involved in prison and forensic mental health research.

BACKGROUND: Introduction of guidance by the National Institute for Health Research has led to an increase in participation by people with 'lived experience' of mental health problems. However, some researchers have questioned the extent to which involvement has been meaningful, expressing concerns that involvement is impeded by the structure and culture of academia. A prior review of literature to 2016 provided little evidence of active engagement. AIMS: To find out from published literature how patient and public involvement in designing and or conducting research has been used in forensic mental health settings, prisons or probation since the last review period. METHODS: A systematic scoping review of research published in academic journals between 2016 and February 2023 was completed using terms for research activity, involvement of people with experience of receiving services and health or justice systems to search three databases: MEDLINE, EMBASE and PsycINFO. We used the Guidance for Reporting Patient and Public Involvement in Research Tool to support data extraction and to summarise our own service user involvement in this study. RESULTS: From 675 unique titles retrieved, 17 were eligible for inclusion, covering 16 unique studies. Most of the included research was by/with people who had prison experience. Only two studies had been conducted by/with people who had experience of secure hospital wards/forensic mental health services. Details of how people with lived experience had contributed to the research were scarce, but in 8 studies they had been involved throughout and included in the authorship group. CONCLUSION: Whilst this review identifies pockets of good practice, meaningful engagement in forensic mental health research seems to remain rare, at least as reported in papers published in academic journals. Further research is required into whether this reflects real limits on inclusion, as we suspect, or such full integration that such reporting is not regarded as necessary or desirable, which we doubt. We urge journal editors to routinely ask authors to include information about how people with lived experience have been involved in any published research and the nature and extent of the influence they had. This may help to develop the evidence base and guard against tokenistic involvement.

Evaluation of the lights4violence program: reduction in machismo and acceptance of violence among adolescents in Europe.

BACKGROUND: Machismo and acceptance of violence (AV) against women are part of the social construction of hegemonic masculinity and are related to the risk of dating violence. This study aims to analyze the effectiveness of the Lights4Violence program in reducing machismo and AV in secondary school students from different European cities. METHODS: Quasi-experimental longitudinal study using a convenience sample of 1,146 high school students from different European cities (12-17 years old) including 575 intervention group students (59.1% girls) and 571 control group students (62.7% girls). We performed linear regression models to identify the effect of the intervention, modelling the difference in means in machismo and AV (dependent variables) between wave-2 and wave-1. RESULTS: An interaction was identified between the group variable and the empathy variable. In wave-2, girls with high empathy at baseline in the intervention group obtained lower mean AV scores (ß: -0.131; p = 0.004). However, the boys in the intervention group (reference: control group) with low empathy at baseline registered a significant increase in the mean values of machismo (ß: 0.247; p < 0.001). CONCLUSION: The importance of empathy is shown in the effectiveness of interventions to reduce machismo and AV in adolescents. While the Lights4Violence program focuses on promoting healthy relationships, there were some controversial results. It is possible that some children, especially those with less empathy, may have felt "challenged" during the intervention and/or assessment. This suggests the need for the development of interventions that also consider psychological processes and integrate the promotion of positive expressions of masculinity.

Effect of the Lights4Violence intervention on the sexism of adolescents in European countries.

BACKGROUND: Sexism results in a number of attitudes and behaviors that contribute to gender inequalities in social structure and interpersonal relationships. The objective of this study was to evaluate the effectiveness of Lights4Violence, an intervention program based on promoting health assets to reduce sexist attitudes in young European people. METHODS: We carried out a quasi-experimental study in a non-probabilistic population of 1146 students, aged 12-17 years. The dependent variables were the difference in the wave 1 and wave 2 values in the subscales of the Ambivalent Sexism Inventory: benevolent sexism (BS) and hostile sexism (HS). The effect of the intervention was evaluated through linear regression analyses stratified by sex. The models were adjusted by baseline subscales scores, socio-demographic and psychological variables. RESULTS: In girls, we observed a decrease in BS in the intervention group compared to the control group (ß = - 0.101; p = 0.006). In the wave2,, BS decreased more in the intervention group compared to the control group in girls with mothers with a low level of education (ß = - 0.338; p = 0.001), with a high level of social support (ß = - 0.251; p < 0.001), with greater capacity for conflict resolution (ß = - 0.201; p < 0.001) and lower levels of aggressiveness (ß = - 0.232, p < 0.001). In boys, the mean levels of HS and BH decreased in wave 2 in both the control and intervention groups. The changes observed after the wave 2 were the same in the control group and in the intervention group. No significant differences were identified between both groups. CONCLUSIONS: The implementation of the Lights4Violence was associated with a significant reduction in BS in girls, which highlights the potential of interventions aimed at supporting the personal competencies and social support. It is necessary to reinforce the inclusion of educational contents that promote reflection among boys about the role of gender and the meaning of the attributes of masculinity. TRIAL REGISTRATION: Clinicaltrials.gov : NCT03411564 . Unique Protocol ID: 776905. Date registered: 26-01-2018.

Mental well-being and physical activity of young people experiencing homelessness before and during COVID-19 lockdown: A longitudinal study.

BACKGROUND: While lockdown restrictions in response to COVID-19 indisputably mitigated virus transmission, the aim of this longitudinal study was to establish indirect effects on vulnerable young people's mental well-being and physical activity (PA) levels. METHODS: Surveys conducted at time 1 (February 2020), and time 2 (April 2020) comprised of the short Warwick Edinburgh Mental Well-Being Scale, the Rosenberg Self-Esteem Scale, and self-reported moderate and vigorous PA levels. Repeated measures analyses established changes pre-post lockdown restrictions, and differences between sub-groups. Associations between changes in well-being, self-esteem and PA over time were explored through further regression analyses. RESULTS: 65 respondents completed the survey at time 1, and 50 respondent at time 2. Wellbeing increased significantly over time, yet remained significantly lower than the population average. Self-esteem increased significantly post-lockdown, however remained significantly lower for females, compared with males. Overall, PA levels increased-whereby 'inactive' participants at time 1 reported significant increases in moderate and total activity levels at time 2. Increased PA levels significantly predicted increased well-being: F(1, 48) = 4.15, p < .05; while participants who had become less active accounted for 69.2% with low self-esteem at time 2. CONCLUSIONS: Findings indicate that increased PA accounted for improved mental well-being, while decreased PA was associated with reduced levels of self-esteem. PA may represent a modifiable means of mitigating risk, and promoting resilience for vulnerable young people experiencing adverse conditions.

Psychometric Properties and Confirmatory Factor Analysis of the Spanish Version of the Maudsley Violence Questionnaire among Adolescent Students.

The Maudsley Violence Questionnaire (MVQ) is an instrument specifically developed to evaluate violent thinking through two subscales examining macho attitudes and the acceptance of violence. This study analyzed the psychometric properties and factor structure of the Spanish version of the MVQ questionnaire in a large sample of 1933 Spanish adolescents. An online questionnaire was used to collect variables, such as sociodemographic and sexism data. The factor structure showed good fit indices in Spanish adolescents, which were similar to the original scale. The exploratory analysis yielded a first factor that explained 11.3% of the total variance and a second factor that explained 10.8% of the total variance. The Goodness of Fit Index (GFI) (0.902), Adjusted Goodness of Fit Index (AGFI) (0.90), Normed Fit Index (NNFI) (0.85), and the Comparative Fit Index (CFI) (0.86) suggested that the model fit the data adequately (with values ≥ 0.90) and the Root Mean Square Error of Approximation (RMSEA) (≤0.10) values indicative of an adequate fit. This study contributes a Spanish-language validated tool to measure machismo and the acceptance of violence among adolescents.

Sexism and its associated factors among adolescents in Europe: Lights4Violence baseline results.

Despite the efforts of recent decades to reduce gender inequality, sexism is still prevalent among adolescents. The objective of this study was to identify the main socioeconomic characteristics, personal experiences, resources, and competencies associated with sexism in a sample of adolescents from different European countries. Baseline data from the Lights4Violence project included 1555 students ages 12-17 from secondary schools in six European countries (Spain, Italy, Romania, United Kingdom, Portugal, and Poland). Linear regression models were carried out, stratified by sex for benevolent (BS) and hostile (HS) dimensions of the Ambivalent Sexism Inventory. The average age of the sample was 14.3 years (SD = 1.5), 59.3% were girls. Boys scored higher on the measure of sexism (mean BS = 29.7; HS = 29.1) than girls (BS = 27.5, HS = 23.0; p < .001). Girls whose mothers had a university degree reported lower BS (ß = -0.113; p = .023) (reference: lower education). Girls who had experienced dating violence reported higher HS (ß = .080; p = .010) than those who had never been in an intimate relationship. For both sexes, high aggressiveness was associated with high levels of HS, and high aggressiveness was related to high levels of BS in boys. High assertiveness was associated with high levels of BS in both sexes and with high levels of HS in boys. A high level of problem-solving ability was associated with lower HS in both sexes. The study reinforces the need to invest in school programs aimed at preventing dating violence and promoting positive youth development.

The Role of Social Support in Machismo and Acceptance of Violence Among Adolescents in Europe: Lights4Violence Baseline Results.

PURPOSE: To analyze the potential association between social support, experiences of violence, and sociodemographic characteristics of adolescents and the likelihood of acceptance of violence and machismo in different European countries. METHODS: Cross-sectional design. We recruited 1,555 participants ages 13-16 from secondary schools in Alicante (Spain), Rome (Italy), Iasi (Romania), Matosinhos (Portugal), Poznan (Poland), and Cardiff (UK). We used linear regression models to identify how social support from teachers and parents, experiences of violence-dating violence, bullying, cyberbullying, abuse in childhood-and sociodemographic characteristics were associated with violent thinking, specifically: machismo and acceptance of violence. The analysis was stratified by sex. RESULTS: Acceptance of violence was higher for those who had lower perceived social support from parents (ßgirls = -154, p < .001; ßboys = -.114, p = .019) for both sexes. Perpetration of bullying and/or cyberbullying was associated with higher scores for machismo and acceptance of violence for both sexes (ßgirls = .067, p = .035; ßboys = .225, p < .001; (ßgirls = .118, p < .001; ßboys = .210, p < .001). Being the victim of dating violence, having suffered physical and/or sexual abuse in childhood, and lower perceived social support from teachers were associated with higher scores for both machismo and acceptance of violence. These associations differed between girls and boys. CONCLUSIONS: Machismo and acceptance of violence are widely present amongst adolescents in different European countries. Our results suggest the importance of providing educational/psycho-educational interventions with boys and girls to prevent these attitudes and, in turn, prevent interpersonal violence, including bullying and dating violence.

The Role of School Social Support and School Social Climate in Dating Violence Victimization Prevention among Adolescents in Europe.

The aim of the article is to show the role of school social support and school social climate in dating violence victimization prevention among adolescents in Europe. Study participants were students from secondary schools (age 13-16) in Spain, Italy, Romania, Portugal, Poland and UK. The analysis in this text concern student with dating experience (n = 993) (57.2% of girls and 66.5% of boys). School social support was measured by School Social Climate, Factor 1 Scale (CECSCE) and by Student Social Support Scale (CASSS), subscales teachers and classmates. The association between school social support and different types of dating victimization (physical and/or sexual dating violence, control dating violence and fear) was measured by calculating the prevalence ratios and their 95% confidence intervals, estimated by Poisson regression models with robust variance. All the models were adjusted by country and by sociodemographic variables. The results show that the average values of all types of social support are significantly lower in young people who have suffered any type of dating violence or were scared of their partner. The likelihood of suffering physical and/or sexual dating violence decreased when school social support increased [PR (CI 95%): 0.96 (0.92; 0.99)]. In the same way, the likelihood of fear decreased when school social climate increased [PR (CI 95%): 0.98 (0.96; 0.99)].There is an association between school social support and school social climate and experiences of being victim of dating violence among adolescents in Europe. Our results suggest that in the prevention of dating violence building a supportive climate at schools and building/using the support of peers and teachers is important.

Effectiveness of the Reasoning and Rehabilitation V2 Programme for Improving Personal and Social Skills in Spanish Adolescent Students.

Significant progress has been made in developing intervention programmes for adolescents at high risk of delinquency, school failure and emotional problems. The most effective programmes incorporate behavioural and skills training aimed at changing attitudes and promoting psychosocial and emotional skills in adolescents. This study examined the effectiveness of a school-based intervention programme based on the Reasoning and Rehabilitation V2 (R&R2). R&R2 is a cognitive behavioural programme developed using psychological theories about the aetiology of delinquency, as well as the cognitive, behavioural and socioemotional deficits in high-risk youth populations. A sample of 142 students (aged 13-17 years old) who were attending alternative education provision in Spain were randomly assigned to two experimental conditions (68 experimental group, 74 control group). The results showed that the R&R2 improved participants' self-esteem, social skills, empathy and rational problem-solving with a medium-large effect size (η2 = 0.08 to 0.26). The effects of the programme were significant after controlling for age and the pre-test scores in baseline. These findings confirm the effectiveness of the Reasoning and Rehabilitation V2 programme in Spanish adolescent students and offer additional evidence regarding the implementation of the R&R2 programme in both alternative educational and mainstream school settings.

Effects of combining physical activity with psychotherapy on mental health and well-being: A systematic review.

OBJECTIVE: Despite a vast evidence-base advocating the psychological benefits of physical activity, relatively little is understood about how combining physical activity with psychological therapies may influence these positive effects. The aim of this paper is to systematically analyse evidence from studies adopting a combined approach, and identify potential mechanisms of action on clinical outcomes. METHODS: The Embase, PsycINFO and Medline (PubMed and OVID) databases were searched for applicable trials published up to December 2018. Relevant data was extracted from eligible studies, and the Effective Public Health Practice Project (EPHPP) tool was utilised to objectively assess the quality of each study. RESULTS: Twenty-two studies met the inclusion criteria, seven of which were rated as methodologically `strong'. Combining physical activity with psychological therapy consistently engendered positive effects on outcomes compared with treatment as usual. Similar improvements in psychological outcomes were observed in most (7/8) groups receiving physical activity alone. Increased levels of physical activity were observed in psychologically-informed interventions, however this effect was unrelated to changes in psychological outcomes. LIMITATIONS: Clinical and methodological heterogeneity precluded meta-analyses of results, while risk of bias detected in the studies may compromise overall validity of the findings. CONCLUSIONS: Physical activity interventions may be a viable alternative to psychological therapies, provided psychological approaches are incorporated into the implementation design (i.e. behavioural activation). Improved psychological outcomes may be observed regardless of `dose' received, however further research is required to ascertain whether psychosocial mechanisms of change mediate positive effects.

The Role of Violent Thinking in Violent Behavior: It's More About Thinking Than Drinking.

This article aims to explore and report on violent thinking and alcohol misuse; how these factors may predict self-reported violence. The role of violent thinking in violent behavior is both well established in theoretical models, yet there are few measures that explain this role. One measure that has been identified is the Maudsley Violence Questionnaire (MVQ). This is the first study to explore the use of the MVQ with a general (nonoffender) adult sample, having already been shown to be valid with young people (under 18 years old), adult male offenders, and mentally disordered offenders. This study involved 808 adult participants-569 female and 239 male participants. As figures demonstrate that around half of all violent crime in the United Kingdom is alcohol related, we also explored the role of alcohol misuse. Regression was used to explore how these factors predicted violence. The results demonstrate the important role of violent thinking in violent behavior. The MVQ factor of "Machismo" was the primary factor in regression models for both male and female self-reported violence. The role of alcohol in the regression models differed slightly between the male and female participants, with alcohol misuse involved in male violence. The study supports theoretical models including the role of violent thinking and encourages those hoping to address violence, to consider "Machismo" as a treatment target. The study also provides further validation of the MVQ as a helpful tool for clinicians or researchers who may be interested in "measuring" violent thinking.

The evaluation of violent thinking in adult offenders and non-offenders using the Maudsley Violence Questionnaire.

BACKGROUND: The Maudsley Violence Questionnaire (MVQ) was designed to measure explicit rules and beliefs associated with violence. Previous studies with young people and offenders with mental disorder found the MVQ to be a valid and reliable measure of violent thinking. AIMS: This study explores the use of the MVQ with a 'normal' (non-offender) population and an offender population without mental illness in order to evaluate how the MVQ's subscales related to violence within these groups. METHOD: The MVQ was given to 78 adult male participants along with a measure of self-reported violence; demographic information and criminal history were also recorded. Thirty-five of the participants were convicted adult male offenders resident of an adult male closed prison in South Wales; 43 were volunteers from the staff group in the same prison. The MVQ factors were compared with self-reported violence and with officially recorded violent convictions. RESULTS: Although both subscales of the MVQ related to self-reported violence, 'Machismo' showed a stronger relationship to both self-reported and officially recorded violence. CONCLUSIONS: Violent thinking, specifically beliefs measured by the Machismo subscale of the MVQ, was robustly associated with self-reported and officially recorded violence in this study with offender and non-offender adults. IMPLICATIONS: The MVQ is a valid and feasible measure for use with adult populations. Violent thinking (specifically Machismo thinking styles) should be included in the assessments of violent offenders. Work on violent thinking and reducing 'macho' thinking could be a useful adjunct to anger management work with violent offenders.